CE-558-941.
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Sro`•'•C COvsr• COURT NOUSC
Address:
City:
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3. Existing tax rc
4. Total existing acreage _3/4 /4e.2E
6. Zoning: S.
8. Existing or intended use of property: 7.
APPLICATION FOR
CERTIFICATE OF EXEMPTION
s•
APPLICATION NO. Ss--8 - 99-
COMPANION FILE NO.
Applicant's NamBusiness Phone:
e:
''' `� " �� �' Home Phone:
LEGAL DESCRIPTION of property for which this "Certificate of Exemption" is being aZip:pp ied:9 9 0
NOTE: if the property is being divided or changed - -
p g provide the NEW LEGAL DESCRIPTION below.
Sc $ o • Town hip 2 Range 5 !1�
���i___ _
,on,„
within Spokane County, Washington.
7-111-
" C number(s) :AIWA_ • continued on back
• .� .r •
New property size: (sq.ft• or acraP
es)
3 ActzE
Comprehensive Plan Category: won, cl roc , ,4r
9. Existing road frontage name: • continued m back
NOTE: Minimum Road Frontage must extend in or be adjacent to the property as r ed per ZONINGnIf access is
Ft of 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.
10. I, A T c.i - c)'4) Lc--
swear under
the above responses are made truthfully and to the beet of my knowledge. I also of grethat
e 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."
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.
tie The applicant shall comply with the following additional conditions:
n) co �' — Pc.E7 ES
So t' o
CyTHIS CERTIFICATE OF continued on back
BE EXEMPTION IS FOR AND SHALL RUN WITH THE LAND, AND SHALL
PPLICABLE TO THE APPLICANT, OWNER, HEIRS, SUCCESSORS OR ASSIGNS.
APPROVED DENIED THIS
2- DAY OF 19
State: t_v
SIGNED:
A licant
Date
STAFF ONLY
THE PLANNING DEPARTMENT ISSUES THIS "CERTIFICATE OF EXEMPTION" AS INDICATED
SUBDIVISION ORDINANCE, SECTION
BELOW FOR THE PROPERTY DESCRIB ABQ VE, PURSUANT TO SPOKANE COUNTY
ci
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
The applicant shall comply with all requirements of the Spokane County Health Districtand/or Utilit esnty
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.
RECEIPT NUMBER
THIS CERTIFICATE OF EXEMPTION ISSUED BY SPOKANE CO Tannin aGTO
SPOKANE COUNTY PLANNING DEPT., 721 N. JEFFERSON,' WASHINTON
TES CERTIFICATE MUST ACCOMPANY YOUR BUIL�D�ANE��, ��•W 1 R99\2I A60 PPLICATION
J.Cnu:ADplkatiauForma:CEAPI'1ltSTRtnc.):,avt/93 BUILDING PERMIT AlPIP1L�tCATd®�
r ID
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