CE-283-96AAPPLICATION FOR
CERTIFICATE OF EXEMPTION
APPLICATION NO. et- ZSS
COMPANION FILE No.
l \• ,\\ Business Phone:
1. Applicant's Name: 1.VI LLOSc Lt dAerLwlf+ Home Phone: % -(77n.SR
Address: E. 1/nR2.Q
City: Re evlQCr eS State: . Zip: Q 61 G)
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 �a Township J SA/ Range LYV— g within Spokane County, Washington.
sce I4-1-Iraeked
A-
. continued an back
3. Existing tax parcel number(s) 1jS% oZ I%. /) l I 4" •1)/33 t04-1„..
4. Total existing acreage . 9,22. D Acre 5. New property size: (sq.ft. or acres) I. 3 `) U Akre S
6. Zoning: 7. Comprehensive Plan Category: ��.��n
8. Existing or intended use of property: ` AJ --tro Flo)) nut" C t,t.¢a. t7^f\-- 7�g
. continued�t^ back
9. Existing road frontage name: What &tea Feet of Frontage � n
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 assn"Existing
,�road frontage name" above.
10. I, wl—.4-tlrc� M/ UP. W r7Ioa(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 application is for a "minor lot line adjustment."
SIGNED: iJJ /ge
Gll e OP Gv%4!
Applicant
Date
STAFF ONLY
THE PLANNING DEPARTMENT ISSUES THIS "CERTIFICATE OF EXEMPTION" AS INDICATED
BELOW FOR THE PROPERTY DESCRIBED ABOVE, PUIUr.1T TO SPOKANE COUNTY
SUBDIVISION ORDINANCE, SECTION GGI�'
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 Spolcane 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.
��✓.I%•rtir5. Th applicant shall comply with the dadditional^ adi c„G_
tyvTa
OW ' •' • 0- , 0/ 3/� a' .emtinncd on back
6. THIS CERTIFICATE OF EXEMPTION IS FOR AND SHALL RUN WITH THE LAND, AND SHALL
BE APPLICABLE TO THE APPLICANT, OWNER, HEIRS, SUC/J(��/r�''SSORS OR ASSIGNS.
THIS 42 DAY OF I A' °�'.� 19
RECEIPT NUMBER - DATE Spokane County my Planning Department
THIS CERIIMCATE OF EXEMPTION ISSUED BY SPOKANE COUNTY, WASHINGTON
SPOKANE COUNTY PLANNING , 1026 W. BROADWAY, SPOKANE, WA 99260 (509)456-2205
THIS CER1wICATE MUST ACCOMPANY YOUR WILDING PERMIT APPLICATION