1994, 08-02 Certificate of Exemption.n lie
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1. Applicant� r t's Name: ae , o .P �„� Home Phone A q S �/ /
City: vv w Q ro
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.
Scc� tt t_ l8 Town hip 2 5 Range 4fs
• g within Spokane County, Washington.
APPLICATION FOR
CERTIFICATE OF EXEMPTION
APPLICATION NO. < SS8 - 9gf
COMPANION FILE NO.
Business Phone:
Address: / 7 A/. hip re p /!
State: iij : 9qo/ 6
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3. Existing tax .rce umber(s)
4. Total existing acreage r
6. Zoning: R � 3/4 5 New property size: (sq.ft. or acres) I 3 A ce.t=
property:
8. Existing or intended use of n_7•, Comprehensive Plan Category: i eai c A
9. Existing road frontage name.
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NOTE: Minimum Road Frontage must extend int or be adjacent to the property asequirdp ONINGacc isFert of eeinf
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.
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swear under
enalty of pry
the above responses are made truthfully and pto the best of my knowledge. I ally agrreetto
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 application is for a "minor lot line adjustment."
SIGNED:
Applicant
Date
STAFF
THE PLANNING DEPARTMENT ISSUES THIS "CERTIFICATE OF EXEMPTION" AS INDICATED
SUBDIVISION ORDINANCE, SECTION
BELOW FOR THE PROPERTY DESCRIBEp AB VE, PURSUANT TO SPOKANE COUNTY
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THIS CERTIFICATE OF EXEMPTION SHALL BE SUBJECT TO THE FOLLOWING
CONDITIONS AND/OR FINDINGS:
6The applicant shall comply with all requirements and regulations of the ZONING CODE of Spokane County.
. The applicant shall comply with all requirements of the Spokane County Health District and/or Utilities
Division and/or County Engineering Division regarding wastewater disposal, on -site water or public water
systems and access and roads, respectively.
If above legal is new, the applicant shall file SEGREGATION APPLICATION with the County Assessor as
soon as possible after this application is approved. Not required when denied.
4 • If private road is used, no building permit can be issued until the standards Chapter 3.05.050 of the County
Code have been complied with for the location and construction of the private road.
The applicant shall comply with the following additional conditions:
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THIS CERTIFICATE OF.cmtinuci on back
BE APPLICABLE TO THE APPLICANT,�IS �R HEIRS SUALL CCESSORS S OR ASSIGNS.LAND, AND SHALL
APPROVED DENIED THIS DAY OF 4t/4[%< T
,19aZ__
RECEIPT NUMBER - S oka'Coun :Tannin De artment
THIS CERTIFICATE OF EXEMPTION ISSUED BY SPOKANE COUNTY, WASHINGTON
SPOKANE COUNTY PLANNING DEPT., 721 N. JEFFERSON, SPOKANE, WA 99260 , (509)456-2205
THIS CE2TI1FICATIE MUST ACCOMPANY YOUR ]E
r,.o,o:Apptkat;,,,ro,,,.:caArrmrnunc.r,c.u9z :.. .. BUILDING' PERMIT APPLICATION