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VE-141-84 . SPOKAPdE COUNTY PlANN1NG OEPARTMENT NPPLICATIONS BEFORE THE ZOriING AQJUSTOR/BOARD OF AOJUSTMENT " a Certificate of Exernption No.: ApplTCation Na.: V~- V41 'V4- " Name of App1 i cant: t" Street Address: /0ti_ . ' _ City: _.,~wC. State: Zip Code: Tele. No.: N ame o f P rope rty Own e r( s): Requested Action(5) (Circle Approp riate Actipn): . CVariancels) Condttional Use Permit Admfnistrative Appeal . 7emporary .ermit Waiver of Uiolation _ Other: • Ze ro Lot Line Nan-Conforming Lat/Use * * * * * * * * ~ * ~ * * * * t * * * * * * * * * * * * * * * * * * * * * * * * * * * FOR STAFF USE ONLY . * q* . * Cite Ordinance Section . ~ * Section' 11 Township' ag Range Property Size: * E'xisting ZoniR.q: Compreherrsive Plan Designation: * . • ~ lagai CheGked by: Nearing Date: Receipt * « . . * ~t . ; ' * * dr. * '1t it ~Ir * # * " # ~r w ~t 1t ie * k . * k tlr Ir . * # * ~t * ir 1r * * ,k * * t ic ic Fr 1r ir * ~c ir . • . . . E xi s t i n g lfs e n f P rppe rty • ~.Pr^opasitd Use of Property:• c-►-~.~,~ Street Address of Property: /v 1) j /Vh~ - ~ LeQal Des cri pti on oP P rrope rty ( i ncl ude easement i f appi i cabl e) . . , Parcel -7: / 7T~/2- JDf Source of Legal: Tota] amount of adjoining land controlled by this owner/sponsor: What interTst do you hold fn ttte proper°ty: c4~1s~•-n_~; ~ Il~t Fit'E_'V1oCi$ P1df1(11f1Cf D2(}c31"t(iIE'.flt dCtTOlIS if1V0lVll'T~'? tf1iS pt17aE't't'/: 1 SWEAR THAT I AM THE UWNER OF RECORD OR AUTHORIZED AGENT FOR THE PROPOSED SI1'. . IF N07 TNE OWNER, WRITTEN'PERMISSION FROM SAID OWNER AUTHORIZING Mr ACTIONS ON HEi; BEHALF IS ATTACHED. , i Signed: rc Uate: , Address: Phone ldo. : ~ NOTARY : DATE : , r'" ~ ~ ~ ~ VARIAP~CES 1. In view of the above information, what special circun~stances (beyond your control or actions) deprive you of the sarne..gener.al right~ and privi.leges ' of other property owners within the same zone and vicinity? , . ~ .l . • ~ , r'' ~ ' • ~ : ~ . 2. If the variance were granted, how would it affect neighboring properties or ir~roverr~ents? ~Le--~,c-- , B. CUIdDITIOiVAL~► USES, ~EkO LOT LINE, IV01~-CONFORMI~JG USE, TEMPORARY PERMITS, ETC. 1. Please g a concise explanation of the proposal including size, hours of . . aperation, pected traffi c and other features , etc. ~ . , , , c. WAIVER DF VI~l.1~TION 1. How or why was the structure e dbiished outside the provisions of the ~ Spokane County Zoning Ordinance. , - , ~ 0: SIGi~t-OFF BY COUNTY DEPARTMEI~TS ~ ~ ~ ~ 1~.~ C~UNTY HEALTH DISTRICT ~ A preliminary consultation has been held to discuss the proposal. The appl i cant has been inforn~ed of r~c~ui r~en►~nts and standards. ~5ignature) (Date) (Sign-orf Waivtd by PTanning ~tafr; ~ COUNTY ENGIi~EER'S DEPARTMENT A preliminary consuTtation has been i~e1c1 to discuss ti~e proposal. The ~p~lican~ a been informed of requi rements and standards. ~ i~%'l ~ 7~~?, ~ {'tgnatu ) ` ~Aate ' (~i,~r;-off Wcsiveq by Planning Starf? ( 3. J COUf~TY UT It iT IES DEPRRTMEIVT ~ `,r..... A prelirninary cons ltation ~as been heid to discuss the prbposa~. appl icant has b~e 'nf rmed of requi rements and standards.. ~ , -23 ~ , j gnature ' ~ ~ Date) ~Sign-off Waived f~,~ P~,~nr~irtg Staff) ~ATER PURVEYOR ( i f appl i cabi e j Nan~e: _ _ a) The proposa~ is/is not located vrithin the boundary of our service area. b} We are/are not able to serve this site with adequate water. c) Satisfactor•y arrangements have/f~ave not been made to serve this proposal. ~S~qnat~,-rE~)--- - ~Date) (Si~~r~-off~Waived by Plannii~g 5taff)