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f � � i <br /> � :� Kroll PeRe �_ <br /> CIIT OP EVGE2T <br /> cariricenon or wr st rus � /3•�/ <br /> osre <br /> A lut whlch quellffee ee e aubetenderd lot, es provlded Ey Subaectfon 78.OBO.A.1 of <br /> [he Everet[ 2on1nR Cade, muet be cer[lffed es a nonconfoning lot prlor to [he <br /> leeuence of e 6uflding penit. in otder to be �erClfled ea e legel lot for buflding <br /> purpoeee, the epplfcant ehell provlde eufflcfent lnformetfon to verlfq thet the lat <br /> vae leqelly creeted and chet ell eppllceble Ctty Zoning Code requfrenente 1n effect <br /> at the tlme the lot we� ere�ted were met, or thet the lot vas crested prlor to <br /> ennexe[lon to the C1ty end eet [he minlauo 2oning Code requlremente of Snohoslah <br /> Countv at the tlme the lot ves ee[ebllehed. <br /> TO BE FILLED OI1T BY APPLICANTt <br /> Owner: �p ///�/' t.ytt,tr� Phone� 1�`'I«� <br /> Addreeet //,f/� 9�� d <br /> �� 91lfOs- / n <br /> Addrees of lot Defng certlHeds 7•CY7 G'�!/Co�G+.�c� �[�• <br /> � Avneor'e Accounc 40. S��l�' ��- ��R' �•��� — <br /> LeRel Deecrlptlons lpf" z/ /�/� i�� �7�7����/� ���� <br /> Date of Annexe[lont <br /> � Documenc Date Audltor'e Ffle No. <br /> (coDY co e�Atcached) <br /> Mor[gage <br /> Glerranty Deed � �A91/� <br /> Oultelslm �eed <br /> Deed of irue[ <br /> Reel Eetate Contrnct <br /> nther <br /> I heteby cerN[y [het the ebove InformsUon la [rue end rorrect [o the 6eet of my <br /> knavledse. <br /> ,lpp ean <br /> The following In to be determined by Plenning Deperteent: <br /> The tot Aoee� meet Zonlnq Code/Subdlvtefon requfrmente In effeet at [hr <br /> U me che ebove trenesetton(e) wne(were) recorded in che Councy 4udltor'e OfH ce. <br /> I herehy flnd [het che n6ove pxrcel ln/�e a leqel lot [or buflding purpoeea <br /> under che C1ty 2on1nR 3nd Su6dfvfefon Codee. Thie cettl H eatlon le eubiect co <br /> revocecfan If Ic Is found [ha[ the informetlon �pon vhich 1t fa beeed fe erroneoue. <br /> \uthatlzed Siqna[ure <br /> 9At! <br /> _. 'ull�l!:i4 Deonrcaent - �or iddrese if'.e <br /> '�mer�Purcnaser <br /> 1151 1 <br />