1984, 03-18 Permit: 00001111 Cert of Exemption CE-50-84BAFPLiC' A IL ON
NO
SPOKANE COUNTY SHORT PLAT SUBDIVISION ORDINANCE �n
NOTICE OF ACTION ON CERTIFICATE OF EXEMPTION APPLICATION
Whereas, the Board of County Commissioners did, after public hearing on March 9, 1978, adopt
the Spokane County Short Plat Subdivision Ordinance, and
Whereas, the Board of County Commissioners,in adopting this Ordinance, did provide for certain
activities to be exempt from short platting activities, and
Whereas, the Board of County Commissioners did further provide for these certain activities
to receive a "Certificate of Exemption" from the Short Plat Administrator prior to the release
of a building permit, and
Whereas, the Short Plat Administrator has received a request for a "Certificate of Exemption"
for certain property located in the unincorporated territory of the County of Spokane, and
Whereas, the Short Plat Administrator has reviewed the evidence presented by the applicant and
all other information available, the Short Plat Administrator hereby takes the following action
on this "Certificate of Exemption" application, pursuant to the Spokane County Short Plat
Subdivision Ordinance.
APPROVAL
- Certificate of Exemption -
The Short Plat Administrator finds that a
"Certificate of Exemption" should be and here-
by is issued for said property, as described
on the reverse side, pursuant to Spokane
County Short Plat Subdivision Ordinance
Section
Approval of said "Certificate of Exemption"
and issuance of building permits, shall be
subject to the following conditions:
1. The applicant shall comply with all require
ments and regulations of the Spokane County
Zoning Ordinance.
2. The applicant shall comply with all require
ments of the Spokane County Health District
regarding the placement of on -site water
and /or sewa systems.
3 - G�%C..OaJ�cO
This "Certificate of Exemption" is and shall
run with the land and shall be applicable to
the applicant, owner, their heirs, successors,
or assigns.
DENIAL
\ - Certificate of Exemption - /
The Sh'drt Plat Administrator finds that!�a
"Certii,i,cate of Exemption" should not and here-
by is not issued for said property as �escribed
on the reverse side, pursuant to Spok'.ne County
Short Plat Subdivision Ordinance Section
for the following reasons:
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According to the Spokaq �._ounty Short Plat Sub-
division Ordinance, th vision of land that
you ro ose to develor`•defined as a Shor
Y P P P r ►� t
Plat and you will be r''`qu:4fed to comply with
the requirements of � id 6,1,dinance prior to
issuance of bui1dinq -* ermit•s.
dvy
APPROVED TH I SAY OF 19-/. IDENIED TH I S
W' kJwzf
t Plat Administrator
SPOKANE COUNTY
PLANNING DEPART-
MENT STAMP
C,THIS CERTI FICATE MUST ACCOMPANY
BUILDING PERMIT APPLICATIO
IIIIIIIIIIIIIII61A
Itt
DAY OF
/ Short Plat Adminis"trator
SPOKANE COUNTY
PLANNINP/"DEPART-
MENT SF ,MP
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APPLICATION FOR CERTIFICATE OF EXEMPTION a - S&*4116
APPLICATION FEE - $10.00 APPLICATION NO.--�-.Q�
'LEASE PRINT OR TYPE
1. Applicant's Nam� E �S R Phone Res4W4-7S 7/ ,3
Bus jljs /DSO
Address: /33 egg /'9//r/ City:S f _State: UM. _ZIP:
2. Legal Description of property for which this "Certifi ate of Exemption" is being applied
for: Section /_157 Township Range
0 ^ -� ' `o � tl 1 p /Y� y ? `I � f� e /
11� 11 /� o�cG�r
4 � rr f- Y� �� � '� •� o�i.i�d � p/� /t Yc Ca r o�c a/ i'// ✓n %l�/1'1 c �
_ /!
3. Parcel y �YNumber From Tax Statement or Assessor's Office: # �----
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4. Size of said property: Square Feet: rJ X Z 7J Z Or Acres:
5. Intended use of said property: r' i'
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6. Zoning of said property:
7. For which of the following reason(s) do you believe you qualify for a "Certificate of
Exemption " ?:
(For each box checked, please submit the listed documentation required to substantiate
your exemption. In addition, please submit an assessor's map and an ownership micro run
of your property, both obtainable from the Tax Assessor's Office, with your application T.
A. Division of land ten (10) acres or larger
DOCUMENTS NEEDED: (1) Assessor's map and ownership micro run as requested above.
B. Minor boundary or lot line adjustments
DOCUMENTS NEEDED: (1) Adjusted legal description; 2) Copy of sales /contract
agreement.
C. The reconveyance of old lots, tracts, or parcels of land which were separate and
distinct when purchased, although the purchase thereof makes the divisions
contiguous.
DOCUMENTS NEEDED: (1) Copy of tax statement; 2) Copy of deed or dated copy of
sales /contract agreement
iD Division of land created prior to March 13, 1978
E. Division of land for the purpose of housing public utilities facilities
The purchase of one separate and distinct parcel of land prior to March 13, 1978
DOCUMENTS NEEDED: (1) Copy of deed or dated copy of sales /contract agreement.
G. A division of land to a spouse, son or daughter
DOCUMENTS NEEDED: (1) Copy of deed /Quit Claim Deed or dated copy of sales /contract
agreement. 2) Notarized affidavit attesting to said
relationship
H. A division of land within properties zoned Residential Office, Local Business,
Commercial, Industrial, Manufacturing, or Freeway Commercial
DOCUMENTS NEEDED: (1) Copy of survey
8. Additional comments which may substantiate your qualification for an exemption:
I, the undersigned, swear under the penalty of perjury, that the above responses are made
truthfully and to the best of my knowledge. I also agree to furnish any further documenta-
tion that may be required by the Short Plat Administrator and I hereby agree to waive the
five (5) day approval period as specified in the Short Plat Ordinance if further information
is required. I also understand that, should there be any willful misrepresentation or
willful lack of full disclosure on my part, Spokane County may withdraw any approval that it
might issue in reliance of this appl;vca-�ion.
NOTARY SEAL -
SIGNM,
APPR, AS NOTED
MAR 191984
VALLEY FIRE DEPT.
DATE:��)
DATE:,_j
DATE RECEIVED:
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