1992, 10-07 App for Cert of ExemptionPAA/ C or4-y
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APPLICATION FOR
CERTIFICATE OF EXEMPTION
APPLICATION FEE - $18.00
_� APPLICATION NO. 66-7-6 ',V - 9 Z 0
COMPANION FILE NO.
Business Phone: Sart -0'7 et -2_
Applicant's Name: l.t !6E' --s Cf F4S-S'' c , :,7-a, C Home Phone: '92-6 — 07 7 7
Address: /0. C . /670>, / L( -7d-c/
City: (: /='/9-/-1,tz.. . State: L,4- Zip: 970.3
1.
SPOKANE COUNTY COURT HOUSE
2. LEGAL DESCRIPTION of property for which this "Certificate of Exemption" is being applied
NOTE: if the property is being divided or changed - - - provide the NEW LEGAL DESCRIPTION below.
Section (. Township Range y y within Spokane County, Washington.
/_ 2T / �r�� , /6V a? r,- /q)/,4-/ 7-
- 77 t \ r> , n„,v / 7- 77.4 Sbv Pti-c-la'-
7--
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3. Existing tax parcel number(s) 4$- : 63, -7 6e' 1
4. Total existing acreage tit./
1/ 4 ? S2}- FT. 5. New property size: (sq.ft. or acres) /0 7 6 7 f
U K'
6. Zoning: --J. 7. Comprehensive Plan Category:
8. Existing or intended use of property: iQ_c- S! 6 T7 -
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9 . Existing road frontage name:/3G t- vim= C'�% . Feet of Frontage PO �T /WA',
NOTE: Minimum Road Frontage must extend into or be adjacent to the property as required per ZONING. If access is
by Private Road, a copy of recorded Private Road Easement must be provided with this application and the AUDITOR
RECORDING NUMBER entered as "Existing road frontage name” above.
10. I, is / '-C S1/4 / (print name), swear under penalty of perjury that
the above responses are made truthfully and to the best of my knowledge. I also agree to
furnish any further documentation that may be required by the Planning Department. 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 on this application. I also have provided written permission from both property
owners, if this app ation is for a "minor lot line adjustment."
SIGNED:f�SL-
Applicant • Date
STAFF ONLY
THE PLANNING DEPARTMENT ISSUES THIS "CERTIFICATE OF EXEMPTION" AS INDICATED
BELOW FOR THE PROPERTY DESCRIBED ABOVE, PURSUANT TO SPOKANE COUNTY
SUBDIVISION ORDINANCE, SECTION 3 :S , c
THIS CERTIFICATE OF EXEMPTION SHALL BE SUBJECT TO THE FOLLOWING
CONDITIONS AND/OR FINDINGS:
1. The applicant shall comply with all requirements and regulations of the ZONING CODE of Spokane County.
2. The applicant shall comply with all requirements of the Spokane County Health District and/or Utilities
Division regarding wastewater disposal and on-site water or public water systems.
3. If above legal is new, the applicant shall file SEGREGATION APPLICATION with the County Assessor
immediately after this application is approved. Not required when denied.
4. The applicant shall comply with the following additional conditions:
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5. THIS CERTIFICATE OF EXEMPTION IS FOR AND SHALL RUN WITH THE LAND, AND SHALL
BE APPLICABLE TO THE APPLICANT, OWNER, HEIRS, SUCCESSORS OR ASSIGNS.
.'e/--r—='R( VED / THIS DAY OF CSG (04
RECEIPT NUMBER
,19 9'2---
Spokane County Planning Department
THIS CER I ThICATE OF EXEMPTION ISSUED BY SPOKANE COUNTY, WASHINGTON
SPOKANE COUNTY PLANNING DEPT., 721 N. JEFFERSON, SPOKANE, WA 99260 (509)456-2205
THIS CIERTIFICATE MUST ACCOMPANY YOUR BUILDING PERMIT APPLICATION