1993, 06-08 App for Cert of ExemptionAPPLICATION FOR
CERTIFICATE OF EXEMPTION
APPLICATION NO. CE -.2176-473
COMPANION FILE NO.
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1. Applicant's Name: ?A+4K /Y7dieaye, Home Phone: af3-299z
Address: rSox - Zz_q
City: da1;E,4.s(rcet State: OA, Zip: q,7016 -C-4 5/"
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 - 1 -3 Township 2S Range Y V within Spokane County, Washington.
1/e ✓L k P -t FL w t/3 o f N %x._ 6F s V a .L M t o Y
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3. Existing tax parcel number(s) Y S 13 N•
4. Total existing acreage R 3 A c 5. New property size: (sq.ft. or acres)
6. Zoning: _� IA 7. Comprehensive Plan Category: _
8. Existing or intended use of property:
. wMdaued m back
9. Existing road frontage name: 1; L o 2 A Feet of Frontage lo,
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 XtrmToR
RECORDING NUMBER entered as "Existing road frontage name" above.
10. I, T1aa,✓11 l?'119 �'ZFA�s(print nane),swear under penalty ofperjury 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 application is for a "minor lot line adjustment."
SIGNED:
Applit 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.
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 and/or County Engineering Division regarding wastewater disposal, on-site water or public water
systems and access and roads, respectively.
3. 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.
5. The applicant shall comply with the following additional conditions:.
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6. THIS CERTIFICATE OF BXFMD?ION IS FOR AN— SI'_TT iri
R ,v 9 iAF. LAND, AND SHALL
BE APP LE TO THE APPLIC OWNER, HEMS, SUC SSORS OR ASSIGNS.
APPROVED/ NIED THIS DAY OF _---i{ 19 93
THIS CERTIFICATE OF EXEMPTION ISSUED BY SPOKANE COUNTY, WASHINGTON
SPOKANE COUNTY PLANNING DEPT., 721 N. JEFFERSON, SPOKANE, WA 99260 (509)456-2205
THIS CIERTIECATIE MUST ACCOWANY YOUR BUILDING pRU4 T APpLICATZON
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