CE-807-94AAPPLICATION FOR
CERTIFICATE OF EXEMPTION•
APPLICATION NO.
COMPANION FILE NO.
SGO✓.A."C COV"iv CO V Ri "OVSC
Applicant's Name:0 /4, Q ARCk.A.f ceeSR)
Address: P o. Oant l?71i
1
qyk1-(/
-653-t
Business Phone: `)9 y-3S7z
Home Phone: 91G �-SzZ9
City: S'po .v State: € 4-- _ Zip: '2 t 3
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 2 Township 254/ Range V4 eg- within ., Spokane County,t'Washington.
—�.X , '�ip.R-.er �jI' arvo__ 4.,. ,Sp7d' R4/-4 erg
. continued on back
3. Existing tax parcel number(s) C) 7 54' St- 2 i'fl/
4. Total existing acreage 5. New property size: (sq.ft. or acres) 34, 750
6. Zoning: C!A' - S 7. Comprehensive Plan Category: LIA5 i-y
8 . Existing or intended use of property:
. wnonued on bo ,�
9. Existing road frontage name: �FS� �[tr<.v • Feet of Frontage / G.' y(2•2 sA
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 as "Existing road frontage name" above.
10. I, /,U.esi e y C (%/egos G:1DZ.rc (print name), swear under penalty of perjury that
the above/ responses e 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 inor lot line adjustment."
SIGNED:
plic
ate
STAFF ONLY
THE PLANNING DEPARTMENT ISSUES THIS "CERTIFICATE OF EXEMPTION" AS INDICATED
BELOWISION ORDINANCEFOR THE ROPERTCY TION CRIBED A$QV�i1 RSUANT TO SPOKANE COUNTY
THIS CERTIFICATE OF EXEMPTION SHALL``55 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 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 hall co pl ,I ith the fol
IS FOR AND SHALL R WITH THE LAND, AND SHALL
BE APPLICABLE TO THE APPLICANT OWNER, HEIRS, S CE SO SSl OR ASSIGNS.
ciPPROVEDSD THIS DAY OF /Y_4 199--
)3 oC/�D< ge�r�
RECEIPT NUMBER Spokane Coun[yPlanni g epar[ment
THIS CERTIFICATE OF EXEMPTION ISSUED BY SPOKANE COUNTY, W SHINGTON
SPOKANE COUNTY PLANNING DEPT., 721 N. JEFFERSON, SPOKANE, WA 99260 (509)456-2205
MIS CERTIFICATE MUST ACCOMPANY YOUR r.,UIILDENG PIER -MIT APPLICATION
Ft.0 r: AppRctiass/Faras: (c APP MS1R(ncw): rev 493