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Annexation Certificate ~.j.:\'!ll.-: ... .....,'1'1 '''':<' .- v -;;;,....1- ~..;............,;. -.;v"ol' .........(:"-.V........r.rr-" .,'~-~~...... T ~..'.:rJ.r.........-..'...'.!.t-r- ... ..,,>f'(f'~-l- ... ~_....- .~ 1,..'1.:. ."- p t, i ~ 1 r I I l wt lJ '.F ' I , .. j j I 1 No Carbon Paper Needed - Do Not Separate Form . ANNEXATION CERTIFICATE STATE OF WASHINGTON '. OFFICE OF FINANCIAL MANAGEMENT * * See Attached Instructions * * i Y'e 1m Thurs t; on City or Town County , (If Applicable) Ordinance Number 5,2 9 I Amending Ordinance Number 1 1 -. 0 9 - 9 4 d Date Passed Date Passed Published 1 1 - 1 7 - 9 4 , Date Published Date Ordinance Effective Date 1 1 - 2 2 - 9 4 I Ordinance Effective Date Annexation Effective Date 1 3- - 2 2 - 9 4, I Annexation Effective Date J 5J\ 1 4 1 .2 0 I Statute( s) Authorizing Annexation 0 0 > - .....,.' Was a Boundary or Annexation Review Board Hearing Required? Yes No X - - If yes, date of hearing Annexation Area (in acres) 5 0 . .2 , Population and Housing Census: Housing Units 6 Occupied Housing Units 6 Population 1 '7 , I hereby certify that, to effect the above annexation, al/ legal requirements have been satisfied, and that the data set forth in this certificate, including the attached documents, are true and co"ect. I i " .. ()r. ;L-" ( I ' , - I - ~I/I> I I j , 1 /, I..: t .. , : , ,. ,f l .."j Attest: , / I t , '.. /f~. j , ,. (Mayor) (bate) (CiiYrrown Clerk) (Date) Form 170.1 (4/88) Forecastmg DiVIsion ';, , -----