1990, 09-04 Receipt of App to Provide Child CareTO:
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SERVICES
FROM:
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'James C. Marison, Director,' Building Codes, Spokane'County .'`<-1rJNi
N.811, Jefferson,,Spokane, WA.,99201
Roy R. Harrington, Regional Administrator,DCFS Region 1``
TAF C-38, B32-21, Spokane, WA 99220,
SUBJECT: RECEIPT OF APPLICATION to PROVIDE CHILD •CARE , t,
This is. to inform your office that we have received from:
Gwen Melcher
NAME
East 14123 Cataldo
STREET OR BOX NO. '
Spokane,. WA
CITY
an application to establish a
VALLEY MONTESSORI SCHOOL
TYPE OF FACILITY
at Fact 13900 Mission
STREET
Spokane, WA
CITY
We will be acting on this application within 90. days of receipt.
99216
ZIP CODE
for 49 children •
99216
ZIP CODE
While this department does not assume any responsibility for the enforcement of local ordinances, including those pertaining to
zoning, land use permits, etc., we have advised the applicant to contact your agency regarding your requirements.
If your office is not responsible for zoning, land use permits, building code, etc., please forward this notice to the appropriate
agency. -
See Instructions on Reverse
0SH5 15-165 (Rev. 3165) OX A-90
2
1-•t,
Instructions for Originator
1. This form is to be used upon receipt of an application for a day care center, mini -day care center, or group care facility for
children. ---
2-; It,isunnecessary to use this form for relicensing unless there is also a change of address for the facility.
3. One copy of the completed form shall be forwarded to the appropriate local planning/zoning agency, one to the applicant,
and one copy shall be placed in the licensing file.
4. For day care centers a copy shall also be forwarded to:
DSHS 15165 (Rev. 3/85) Back ox A.90
r
Chief Boiler Inspector` ' r
Department of Labor and Industries
300 West Harrison, Room 506
Seattle, Washington 98119 •
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