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1985, 05-17 Permit: CE-181-85 Short Plan Ord '/` APPLICATION FOR CERTIF►.AT 0. ....MP APPLICATION FEE—S10.00 ) APPLICATION NO. (ce- 717/-7 PLEASE PRINT OR TYPE 1. Applicant's Name: I( A • /46 0,1016.1 PhoRe - Res: q&S-r) 5' us: 4d -3700 Address: C, /asa3 City: yune. State: W 4 . ZIP: 99 a 1 b 2. Legal Description of property for which this"Certificate of Exemption"Is being appligd fqr: Section / 'S Township ,S Range L�/ Lsti 4 - Ala 4 r !so- -f-t, - Tt/r E. /r Q-F A/P I-f- c'f -rd-e u -F-t• /)-1 tie- E r 6-0,. f)i ,tf R Lf gF pie. 1 1 L f f ocK j!'/ r) l f f�1/c't�117 L1 70 7J��i�C Liu Al j)/ iJeJr • e f fn,nthe I-falC c4 T . _ r , c • 0 e' • �' t ,/• r f.;'„' !w . G ,m X Q4 • . 4- • I -. 0.1 I ,.. 1 ro rt/ n ftKT,OA O f3. Parcel Number(From Tax Statement or As essor's Office): # if�4/,i —J9a / (And �S�fyj'^ /90,y4. Size of said property: Square Feet: Pi Z'CD Or Acres: _r 5. Intended use of said property: Iw3-vfAnrt- 1- 6. Zoning of said property: ,;,y6 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). A. Division of land ten(10)acres or larger DOCUMENTS NEEDED: (1)Assessor's map and ownership micro run a: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. D. Division of land created prior to March 13, 1978 DOCUMENTS NEEDED: (1) Copy of deed or dated copy of sales/contract agreement. E. OTHER: 8. Additional comments which may substantiate your qualification for an exemption: I,the undersigned,swear under the penalty of perjury,that theabove responses are made truthfully and to the best of my know- ledge. I also agree to furnish any further documentation that maybe required by the Short Plat Administrator. I also understand that, should there be any willful misrepresentation or willful lackoffu. di-closure on my part, Spokane County may withdraw any approvalthat it might issue in reliance of this application. H GNED: %\C, ARp • :/. �• SSI/..... ,,_ DATE: tr/ /7 / J SkON • NOTA• �.. \S E rp/„.1 • —� DATE: �/ J / NOTARY � PUBLIC ,� %�.`�FPr 1 10,E ted DATE RECEIVED: f- Off. WPIS `` . .✓ \.._ (APPLICATION NO. ' A -/Y7 .6 1 ) SPOKANE COUNTY SHORT PLAT SUBDIVISION ORDINANCE 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 Exemp- tion"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 Ii. q� DENIAL —Certificate of Exemption— —Certificate of Exemption— The Short Plat Administrator finds that a "Certificate The Short Plat Administrator finds that a "Certificate of Exemption" should be and hereby is issued for said of Exemption" should not and herby is not Issued for property, as described on the reverse side, pursuant said property as described on the reverse side, pur- to Spokane County ShortPt S bdivision Ordinance suant to Spokane County Short Plat Subdivision Ordin- Section - (7) ance Section Approval of said "Certificate of Exemption" and is- , for the following reasons: suance of building permits, shall be subject to the fol- lowing conditions: 1. t._(-1,2-1 " J The applicant shall comply with all requirements ' and regulations of the Spokane County Zoning — Ordinance. ' �2The applicant shall comply with all requirements of the Spokane County Health District regarding the placement of on-site water and/or sewage systems. \ ' 3. \ ,i \ \. According to the\Spokane County Short Plat Sub- division Ordinance\the division of land that you pro- pose to develop isfdefined as a Short Plat and you will be required to comply With the requirements of said Ordinance prior to issuance\of building permits. 1 This "Certificate of Exemption" is and shall run with 1 the land and shall be applicable to the applicant,owner, r their heirs, successors,or assigns. \ APPROVED THIS %!DAY /( ' 19>. DENIED THIS _DAY OF 19 . it ,i /;,, l> 7- _ r� /� • •rt Plat Ad nistrator Short Plat Adminis rator SPOKANE COUNTY SPOKANE COUNTY PLANNING DEPARTMENT PLANNING DEPARTMENT THIS CERTIFICATE MUST ACCOMPANY OUR BUILDING PERMIT APPLICATION