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��6 STA7 o� <br /> y'�1889�0 <br /> State of Washington <br /> Office of Financial Management,Forecasting Division,General Administration Building,PO Box 43124,Olympia,WA 98504-3124 <br /> ANNEXATION AND MUNICIPAL BOUNDARY CHANGE CERTIFICATE <br /> For all Annexations and Boundary Line Adjustments—Including Street Right-of-Way Adjustments <br /> IMPORTANT: The following documents must be attached with this certificate(RCW 35.13.260,35A.14.700,43.62.040): <br /> 1. Three copies of the final ordinance containing the legal description of the boundary change area; <br /> 2. Three copies of a map clearly showing the boundary change area and existing city limits on an 81/2"x11"or 81/2"x14"size paper. <br /> Outline the boundary changes in red;outline former city limits in green. Maps should conform to acceptable engineering standards <br /> (i.e.,directional arrow,scale,street names,rivers,and other physical characteristics). The Office of Financial Management(OFM)may be <br /> able to help with maps; <br /> 3. The original Field Enumeration sheets used to enumerate the population and housing of the boundary change area and all summary <br /> tabulation sheets. Copies are not needed. Census procedures and definitions must follow OFM's Enumerator's Manual. Please contact <br /> OFM at(360)902-0597 or(360)902-0599 or see http://www.ofin.wa.gov/pop/annex/default.asp for census manuals and forms;and, <br /> 4. If this is a mutual boundary change between governments,include a copy of the other government's(city/town or county)agreement to <br /> the change. If this is a boundary change between municipal governments,each municipality needs to submit this certificate to OFM with <br /> supporting documentation. <br /> City/Town 'C,+ County JYiINt3 Vt. <br /> Name of the Annexation(if any) SiNk. i .4 `�. IS\ \.k) <br /> Original Ordinance Number ?ter Q Amending Ordinance Number(if applicable) IV/ <br /> Date Passed '1 i Date Passed <br /> Date Published �� Date Published <br /> Ordinance Effective Date to- 'T ' . 1 Ordinance Effective Date <br /> Boundary Change Effective Date 6 - '" \ ii Boundary Change Effective Date <br /> Authorizing Statute(s)RCW . '� . a i�) GIL 4 iT S il\E) kO'V\ t\ t) .') <br /> Was a Boundary Review Board hearing required? Yes ❑ No`yl If yes, date of hearing <br /> Has this annexation been filed with the county? Yes ❑ No Date filed with county <br /> Has the city/town attorney reviewed the legal requirements associated with this annexation? Yes ].No ❑ <br /> Annexation Area(in acres) S 'T,e t = Census: Housing Units �E <br /> Occupied Housing Units tl 0 p <br /> Population t <br /> CERTIFICATION: I hereby certify that,to effect the above annexation,all legal re' ' ements have been satisfied,and that the data set <br /> forth in this certificate,including the attached documen ' and correct. <br /> Mayor Date <br /> [CITY SEAL] Attest:City/Town Clerk '/ ,/ p Date 6 - 2 , <br /> OFFICE OF FINANCIAL MANAGEMENT ONLY diJ^a <br /> The requirements of RCW 35.13.260 or 35A.14.700 and 43.62.040 have been Date Received <br /> met. I recognize this annexation as a part of the city for the purpose of Date Approved <br /> developing official population estimates(RCW 43.62.020). This certification <br /> is for the limited purpose referenced above. OFM File Number <br /> State Certifying Official Provisional Approval Yes 0 <br /> Date Provisional Status Cleared <br /> (White) Office of Financial Management No Carbon Paper Needed <br /> Office of the City Attorney <br /> Do not Separate Form <br /> (Canary) Department of Transportation y <br /> (Pink) Return to City/Town APPROVED AS TO FORM Return all Three Copies <br /> David C.Hall,City Attorney <br />