CE-453-93SPONANC COUNTY COURTHOUSE
1. Applicant's Name:
Address: /f2 3 S • 15..-/7/S .
APPLICATION FOR
CERTIFICATE OF EXEMPTION
APPLICATION NO. C5 — Jc ?i -
COMPANION FILE NO.
Business Phone: -5W- JJB - //nT
Home Phone: Sdf- 92-7- Seo/$
City: a- end." ((JAC" - State: Zip: 7,26 6
2. LEGAL DESCitTPl'ION of property for which this "Certificate of Exemption" is being applied:
NOTE: if the property is being divided or than ed - - - provide the NEW LEGAL DESCRIPTION below.
Section 25 Township - .Range within Spokane County�', AWashington.
LcT s /L - / 3 4he. c `e 4' 7/ rn�2 4,//s VD-C.
. continued on back
3. Existing tax parcel number(s) Si., L 9 /. 03 / Z 03/3
4. Total exist* acreage 5. New property s .ft. or acres) -Sat
6. Zoning: /l L 3 .1 7.. Comprehensive Plan Category: //IM 2/8. Existing or intended use of property: ....5- f- .' .t 5�/1"+ t 4y/I,en- . / 0 e j
6N /.O r /3 / continued m back
9. Existing road frontage name: FA /7S E , Feet of Frontage fvo' t To7A /
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
MBER e ered 'tingg woad frontage name" above.
10. I, \ /,{'' �/ . L/.4'4(.C— (print name), swear under penalty of perjury that
the above res onses 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 r om both property
owners, if this a lication is fpr a ',minor lot line adjustment."
SIGNED:
Applicant
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 3 di
THIS CERTIFICATE OF EXEMPTION SHALL BE SUBJECT TO THE FOLLOWING
CONDITIONS AND/OR FINDINGS:
(
The 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 warn 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.
5. The applicant shall comply with the following additional conditions:
.eonenuci on b:=
6. THIS CERTIFICATE OF EXEMPTION IS FOR AND SHALL RUN WITH THE LAND, AND SHALL
BE APPLICABLE TO THE APPLICANT, OWNER, HEIRS, SUCCESSORS
SUCCESSORS OR ASSIGNS. /�
THIS / ! �DAY OF (n,l�l l- 19 t3
APPROVED'/
RECEIPT NUMBER
SpookanffilLa
e Cour' Tanning Department
THIS CERTIFICATE OF EXEMPTION ISSUED BY SPOKANE COUNTY, WASHINGTON
SPOKANE COUNTY PLANNING DEPT., 721 N. JEFFERSON, SPOKANE, WA 99260 (509)456-2205
THIS ChSt IthEATE MUST ACCOMPANY YOUR I:.UILDINTG PERMIT APPLICATION
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