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CUE-21-87 ~ ~ IIECEIVED ZONING ADJUSTOR JUL' 2 p 1981 SPOKANE COUNTY, WASHINGTON SPOttANF COUNTY ENGINEc. , IN THE MATTER OF A CONDITIONAL USE PERMIT TO) ALLOW TEMPORARY HOUSING OF A DEPENDENT ) FINDINGS, CONCLUSIONS RELATIYE. (CUE-21-87);) ANO DECISION JOANNE L. BARNSLEY ) SUiAMARY OF APPLICATION: The applicant proposes to house, in a manufactured home, a dependent relative, Alto Couture, on her property. Section 4.04.170 jj of the Spokane County Zoning Ordinance requires a conditional use permit for such a use in the Agricultural zone. Authority to consider and grant such a request exists pursuant to Sections 4.03.010 19G, 4.24.010 and 4.24.560 of the Spokane County Zoning Ordinance. LOCATION: Generally located east of Spokane, north of and adjacent to Boone Avenue, approximately 350 feet east of Flora Road in the NW 1/4 of Section 18, Township 25, Range 45. The Assessor's parcel number is 18552-1013. The address is E. 17203 Boone Avenue. DECISION OF THE ZONING ADJUSTOR: Based upon the evidence presented and circumstances associated with the project proposal, the Zoning Adjustor APPROVES the conditional use as conditioned and set forth below. PUBLIC HEARING: After examining all available information on file with the application, the Zoning Adjustor conducted a public hearing on July 8, 1987, rendered a verbal decision on July 8, 1987, and a written decision on July 17, 1981. FINDINGS OF FACT 1. The proposal is generally located east of Spokane, north of and adjacent to Boone Avenue, approximately 350 feet east of Flora Road in the NW 1/4 of Section 18, Township 25, Range 45 and is further described as Assessor's parcel number 18552-1013, being more completely described in Zoning Adjustor file #CUE-21-87. The address is E. 17203 Boone Avenue. 2. The proposal consists of locating a single-wide manufactured home on the property at E. 11203 Boone Avenue. The manufactured home would be intergrated into the site with landscaping, driveway and it's own septic tank/ drainfield set up. Water service would be provided by a line run from the primary residence, using the existing water meter. The unit is proposed to be located just west of a fence which divides the property in a north/south manner. East of the fence is an existing pasture for one horse. The application proposes to located the manufactured home approximateiy 13 feet of fence. The Zoning Adjustor notes that the Zoning Ordinance provides that a non-owner residence should be located at least 50 feet from a pasture. The fact that this is a close relative of the owner of the property, is temporary housing, and that the horse in the pasture predates this use need to be taken into account. The applicant stated in the hearing that there would be some intervening trees between the manufactured home and the fence. 3. The adopted Spokane County Future Land Use Plan designates the a rea of the proposal as Urban and the proposal is consistent with the County's entire Comprehensive Plan, including the Future Land Use Plan. ~ y FINDI«GS, CONCLUSIONS AND DECISION PAGE 2 CUE-21-81; Joanne L. Ba rnsl e,y 4. The site is zoned Agrucultural which would allow the proposed use upon approval of this application. 5. The existing land uses in the area of the proposal includes a mixture of scattered urban density housing and acreage tract housing. 6. The proposal is exempt from the provisions of Chapter 43.21C RCW pursuant to WAC 197-11-800 (1) (c) (i) and Spokane Environmental Ordinance 11.10.070 (1) (a). 1. The applicant has been made aware of the recommendations of various County/State agencies reviewing this project and has indicated she can comply with those recommendations. 8. The proposed site plan indicates Lhat setbacks, parking, height of the structure(s) will conform to the Spokane County Zoning Ordinance. The dwelling unit will be located approximately 12 feet from a pasture area owned by the sponsor. Since the dependent relative is closely associated with the applicant and knowlegable of the existing pasture area, it is concluded that this dwelling unit is going in next to a preexisting condition, and with full knowledge of that condition andis therefore not a violation of the spirit and intent of the Zoning Ordinance which normally asks for a 50 foot residential setback for the non-owner. 9. The applicant has indicated she understood: (a) the limitations imposed under the terms of Section 4.24.560 of the Spokane County Zoning Ordinance; (b) that if the temporary residence is desired for more than one year the application will have to be renewed; and (c) that a Title Notice will be filed by Spokane County with the Auditor's Office regarding temporary occupancy only by specific named parties. 10. The applicant has submitted the required form signed by a licensed physician regarding the need for dependent care and sufficient need is found to exist. 11. No one appeared to oppose the proposal nor were any written comments adverse to the proposal recei ved. 12. The proper legal requirements for advertising of the hearing before the Zoning Adjustor of Spokane County have been met. 13. Any conclusion hereinafter stated which may be deemed a finding he rein is hereby adopted as such. From the Findings, the Zoning Adjustor comes to these: CONCLUSIONS ~ 1. The proposal is listed in the Spokane County Zoning Ordinance as a conditional use allowed in the Agricultural zone and the proposal does meet the established and applicable criteria described for that conditional use. 2. Various performance standards and criteria are additionally needed to make the use compatible with other permitted activities in the same vicinity and zone and to ensure against imposing excessive demands upon public utilities and these shall be addressed as conditions of approval. 3. The proposal will not be detrimental to the Comprehensive Plan or the surrounding properties. 4. The Zoning Adjustor may require such conditions of approval as necessary and appropriate to make the project most compatible with the public i nterest and general wel fare. 5. Any finding hereinbefore stated which may be deemed a conclusion herein is adopted as such. ~ FINDINGS, CONCLUSIONS AND DECISION PAGE 3 CUE-21-87; Joanne L. Ba rnsley DECISION From the foregoing Findings and Conclusions, the Zoning Adjustor APPROUES the proposal. The following CONDITIONS OF APPROV AL ARE STIPULATED. CONDITIONS OF APPROVAL I. GENERAL 1. The following conditions shall apply to the applicant, owner and successors in interest. 2. Failure to comply with any of the conditions of approval contained in this decision, except as may be relieved by the Zoning Adjustor, sha11 constitute a violation of the Zoning Ordinance and be subject to such enforcement actions as are appropriate. 3, the Department of Building and Safety shall route the building permit application to all of the agencies and offices of county government below which are indicated as needing to give their autho rization prior to the rel ease of a bui 1 di ng permi t. Upon reviewi ng the various plans returned to the Department of Building and Safety by the other departments, the department will consult with the Planning Department if there are any changes resulting from review by the other departments when compared to the plans as approved by the Planning Department. Such review may necessarily result in a revision of the site plan for use by the Department of Building and Safety or possibly a with-holding of the building permit until any conflicts are resolved. II. PLANNING DEPARTMENT 1. The manufactured home shall be: (a) a minimum of thirty-five (35) feet or more in length and be at least eight (8) feet in width; (b) constructed in accordance with State of Washington or Federal manufactured home construction standards as evidenced by the attachment of an insignia; (c) designed for transportation after fabrication on public streets and highways on its own chassis and wheels; (d) skirted with a fire resistant material; (e) connected to electric power, water supply and sewage disposal facilities and other utilities as appropriate or necessary; and (f) the unit shall not be permanently affixed to the land, except for temporary connections to utilties. 2. The manufactured home shall be occupied by either the dependent relative and family, or by the relative with family providing care to the dependent relative owning and occupying the principal residence. 3. Upon termination of the need for dependent relative care or the sale or lease of the property, the applicant shall remove the manufactured home from the si te wi thi n forty-fi ve (45) days. 4. A statement (Title Notice) shall be recorded by the Planning Depa rtment in the County Auditor's Office stating that the manufactured home is temporary and for the use of the named dependent relative(s) for which the Conditional Use Permit is approved and that the manufactured home is not a permanent structure to be transferred with the property if it is sold or leased. 5. The temporary residence shall be "accessory" only to a pa rcel or tract of land under the ownership or lease by the applicant for the Conditional Use Permit. 6. Only one temporary residence may be permitted on a lot, parcel or tract of land under the ownership or lease by the applicant for the Conditional Use Permit. FINDINGS, CONCLUSIONS AND DECISION PAGE 4 CUE-21-37; Joanne L. Barnsley 1. The permit shall be granted for a period of one year and may be renewed administratively by the Zoning Adjustor or his/her designee upon the recertification: (a) by a licensed physician that the medical problem still exists; and (b) by the original applicant that the need still exists. 8. The renewal period shall be the first day of the month occurring after 12 entire months pass since the date of this decision (renewal August 1, 1938). 9. If the Zoning Adjustor believes there are extenuating circurnstances associated with the renewal of the pe rmit, he/she may cause there to be a public hearing and reconsideration of the permit; the expense shall be that of the county's if such reconsideration takes place. 10. Minimum lot size and frontage requirements for the zone in which the proposal is located shall apply to all applications. 11. The manufactured home shall be located in substantial conformance with the site plan on file in the Planning Department and any modifications of proposed location shall only be authorited by the toning Adjustor prior to the location and erection at the site. III. DEPARTMENT OF BUILDING & SAFETY None is appl icable other than a reference to the coordination set forth in 1, 3 above. Revision of the site plan caused by any agency review shall be reviewed/approved by the Planning Department. IY. UTILITIES DEPARTMENT None is applicable. V. HEALTH DISTRICT 1. Sewage disposal shall be as authorized by the Director of Utilities, Spokane County. 2. Water service shall be coordinated through the Director of Utilities, Spokane County. 3. Water service shall be by an existing public water supply when approved by the Regional Engineer (Spokane), State Department of Social and Health Services. 4. Subject to specific application approval and issuance of permits by the Nealth Officer, the use of an individual on-site sewage system may be authorized. VI. ENGINEERING DEPARTMENT l. The owner(s) or successor(s) in interest must obtain an 3pproach perm'lt from the County Engineer prior to the construction of any new access to the county road. fVOTICE: PENDING COMPLETION OF ALL CONOITIONS OF APPROVAL WHICN NEED TO BE COMPLETED PRIOR TO PERMIT ISSUANCE, PERMITS CAN BE RELEASED PRIOR TO TNE LAPSE OF THE (10) DAY APPEAL PERIOD. HOWEVER, THE COUNTY HAS NO LIABILITY FOR EXPENSES AND INCONVENIENCE INCURRED BY TNE APPLICANT IF THE PROJECT APPROYAL IS OVERTURNEO OR ALTERED UPON APPEAL. FINDINGS, CONCLUSIONS AND DECISION PAGE 5 CUE-21-87; Joanne L. Ba rnsley DATED THIS 17TH DAY OF JULY, 1937. ~ T omas G. Mosher ICP Zoning Adjustor, S okane County Washington FILED: 1) Appl icant 2) Parties of Recvrd .3) Spokane County Engineering Department 4) Spokane County Health District 5) Spokane County Utilities Dept. 5) Spokane County Dept. of Building & Safety 1) Planning Dept. Cross Reference File and/or Electronic File. NOTE: ONLY TNE APPLICANT OR AN OPPONENT OF RECORD MAY FILE AN APPEAL WITNIN TEN (10) CALENDAR DAYS OF THE ABOVE DATE OF SIGNING. APPEAL HUST BE ACCOMPANIED BY A $100.00 FEE. APPEALS MAY BE FILED AT THE SPOKANE COUNTY PLANNING DEPARTMENT, BROADWAY CENTRE BUILDING, N. 721 JEFFERSON ST., SPOKANE, WA 99260. (Sections 4.25.090 and 4.25.100 of the Spokane County Zoning Ordinance). 0019z/7-87 , a OFFICE OF COUNTY ENGINEER SPOKANE COUNTY, WASHINGTON . Date J4i1v 1 1987 Inter-office Communicotion Te Spokane County Zoning Adjustor from SpokaneM County Engineer Subject Aeenda Items SchedLled fer PLblir Hearing Jti1y_ 19R7 _ (1) VS-48-87 Sharp - The subject property is served by a private road. The attached conditions and stipulations are applicable to that private road and the easement to the property. (2) CUW-19-87 Moller - We have no comments to make concerning this applica- tion. (3) VE-24-87 Loehlein - The subject property is served by a private road. The attached conditions and stipulations are applicable to that private road and the easement to the property. (4) CUE-21-87 Barnsley - We have no comments concerning this application. _ . , ~ ~ . • ~ ~ • ~~!•0-- ~ K - - . _ - ~ . r~. . ; . , ~ T ~ ' ~ - ~•D - - - - - ~ . 1 ~ ~ . ~ 8 x I f'~ c2) X -p' . . . ~ ' - . . , ---}IV, o ~ ~ _ T. - ~ . _ ~r , . + ' ~ ~ r' • - - . ~ . . , ~ ~ . . , SPOKANE COUNTY ZONING ADJUSTOR - PUBLIC HEAR1NG A~`aENDA: ~~ly 8, 1987 TIME: As set fo rth belaw PLACE: 5pokane County Planning Rept., N. 721 Jefferson St.,2nd flnar hearing roam. 2) VE-24-87 VARIANCE FRQ'M FRaNTAGE REQUIREMENTS (This item wiZl be heard at 9:15 Generally located north of Lincaln Road a.m. or as soor~ thereafter as an the SE 1/4 of Sectian 20, Towns~rip 26, possible). ~ Range 44. PROPOS,4L: The appl icant requests a vari ance to al law a dwel1 i ng uni t to be bui 1t on a parce] of land havi ng 0feet of conti nuous publ i c road frantage, whereas 5ectian 4.04.040 af tFre Spokane County 2oning Ordi nance requi res 100 feet of continuous publ i~ road frantage. EXISTING ZONING: Agricu1tural SITE SIZE: Approximately 10 acres ,4PPLICANT: Kurt M. Loehloin 10101 E. Morgan Rd. Spokane, WA 99207 3} ~ CQNDITIONAL JSE PERMIT TO YEi•tPQRARILY HOUSE- (Tha s i tem wi 11 be heard at 9:45 A DEPE-NDEJVT RELATIVE a.m. or as soon thereafter as Generaliy east of Spakane, lacated north of ~os~ible). and ad.~aeent ta Boone Avenue, appraxirnately 350 feet east of Flora Road in the NW 1l4 of Sectior 18, Township 25, Ranae 45. The address is E. 17203 Baane Ave. PROPOSAL; The applicant requests a cond%tional use permit to allow the temparary location nf a manufactured home far Alta Couture, a dependent relative, on the subject property. Sections 4.04:170 jj and 4.24.560 of the Spokane County Zoiing Ordinance allow such a use upon issuance of a conditional use permit. EXTSTING fONING: Agricultur°al 5ITE SI2E. Approximately 82,000 sq. ft. APFLICANT: Joanne L. Barnsley E. 17203 Boane Ave. Greenacr es , WA 990.16 * 4) CUW-19-87 CONDITIDNAL JSE PERMIT FOR A MODEL (This item will be heard at 10:30 AIRPLANE FLYING FIELa a.m. ❑r as soon thereafter as Partially loeated south of Pine Bluff Road possible) zn tne SE 1l4 of Section 4, Township 25, Range 41, PROPOSAL : The appl icant requests a condi tivnal use permi t to alj ow a model ai rpl ane f] yi ng fi el dpark. Secti ori 4.24. 300 of the Spokane County 2oni ng Ord; nance all ows such a use as a pri vate non-prvfi t park upan issuance af a corrditi Dnal use perm~ t, EXISTING ZpNIhlG: Agrticultural . ~ SPOKANE COUNTY ZONING AQJUSTOR - PUBLIC HEARING AGENDA: July 8, 1987 TIME: As set forth below - PLACE: Spokane County Planning Dept., N" 721 Jefferson St., 2nd floor hearing room SITE SIZE: Approximately 33 acres APPLICANT: Eric N. Moller E. 2327 ye roy Ave. Spokane, WA 99207 * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ~ ~ ~ \ `~•Y~ ~ ~ . ~ - -i . ~ y,-- ~ C~ . ~ 8 7 ~ - • 7 .0 CU E,.- 21- 00~ - 01 - •-~x~ . . l N+ o ~T,_ n3 174 175 17b ~ 7e i . , - , . ~ _ O J a ~~~•LL r Boo►+ E ~ 90 TA ` 2.0 AVE i . ~ . ,....r INTER-STATE HIGN1KaY N ~v E. 13 v . 8 ADWAY - . - , • LK 1 V , . r J ( ~ • wl - ~ •Al..l►Lg, .n •J - ~ ~ - i - - --~Y ~ 7 T ,~.►.r I►V~ ~ l ~ ( • a 1:1000 m"Mpi 2 M,(► I N U - Y• L )'rn -x oeo( T ~ ~i~ . . t~ .F 1 SPOKANE COUNTY pLANNING DEPARTMENT APPLICATIONS BEFORE THE ZONING AOJUSTOR/BOARD OF ADJUSTMENT Ce rti fi cate of Exempti on Appl i cation NdfiE of Ao1 icant: Joanne L. Barnsley Street Address : E. 17203 Boone Ave. Home: 92G-09b9 City: Greenacres St3tC: Wa• Zip Code: 99016 Phone:WOrk: 922-5465 N ame o f P rope rty Owne r( s): Joanne L. Barnsley A9ent: , ~ _ REQUESTED aCT ION ( I-TC-ircle App rop ri ate Acti on0- Variance(s) nditional Use Permit ~.Non-Conforming Lot/Use Waiver of Vioiation Temporary %Structure Other: ~ ~ * FOR STAFF USE ONLY * * * * Ci te 0 rdi n an ce Secti on :~O /-A&V) Ol d Co de New Co de : .t * ~ *Sect~ or~ Towns hi p 2 5~ Range P rope rty Si ze ~~ocj t ~ *Existi nq Zoning: i F. L.U. P. Desj gnation: * *PSSA: Y N UTA: Y) N ASA: ~DN FIRE DIST. LEGAL CHECKFD BY: # * * *Hearing Date: Staff takirig in Application: t ****~~/*****~****x*xx:~~**** ExiSting US of Property: Residence , Describe Iritended Proposal: Make a space to put. my mothEr's mobilP hone. Street Address of Property• E. 17203 Boane Ave., Greenacres, Wa. 99016 Legal Description of Property (Include easemerit if applicable): sacoNS GREENACRES PT OF B10.4BEG AT A PT200FT N OF SE COR L10 TH NW4 TO A PT340FT N OF SW COR L10 iH S TO SWCOR TH E TO SECOR TH N TO BEG E16.5FT&EXC ST ---r- Parcel 18552-1013 Source of Legal,: j~} x -,)I Total amount of adjoiriing land controlled by this owrier/sponsor: Wh at i nte res t do you ho 1 d i n the p rope rty : Owner Please lis-t previous Planning Departmerit actions involving this property: None I SWEAR, UNOER THE PENALTY OF PERJURY, TNAT: (1) I AM THE OWNER OF RECORO OR AUTHORI- ZEO AGENT FOR THE PROPOSEO SITE; (2) IF NOT THE OWNER, WRITTEN PERMISSION FROM SAID OWNER AUTHORIZING h1Y ACTIONS ON HIS/HER BEHALF IS ATTACHED; AND (3) ALL OF TNE ABOVE RESPONSES A1i0 THq~n%4N,j~pORT iNG OOCUMENTS ARE riADE TRUTHFULLY AND TO THE BEST OF MY KNOWLEDGE. N G. M' 1T , ~ACOOa~ ~ Pe`~C~ Aj ~ • S i qn e d: , r; • 1"'U3 Boone, Greena~es, Wa., 99016 NOTARY ~ : = Pho esNo.. gZ6-0969 ~~Date: 04-21-87 = • -.c+,- • = *,~~/~~~~c'%^~~-CX-C NOTARY SEAk: Pt3BL1C Notary: ~tice_~ : ~'9~.•~'•q Y 15, ~99~'~ AzO Date : ••...o.e• Cj ~ •,~~~~F OF 11ASN\`,% ~ A. BURDEN OF PkO0F . It is necessary for the appl icant or fii s/her reprfsentativ; to establ i sh the reasons why the .-t n~,.--_ssted proposiil shoul d be app►•oved and to 1 i teral 1y put forth the basic case. Accordingly, you should have been given a►`orm for yaur requested action (variance, conditional use, etc.) designed to help you present your case i n a way whi ch addresses the c:ri teri a whi ch the Zoni ng Adjustor rrust cons i der. P1 easF- fi 11 the form out and r-etijrn i -L v►-i th your appl i cati on . I f you di dn' t get a form, ask the Planning Department personnel for advice on hew to proceed. B. SIGN-OFF BY COUNTY DEPARTMENTS 1. COUNTY HEALTH DISTRICT ~ a) Proposed method of water 4upply: . . , b) Proposed method of sewage di sposal : r~ _z .__Al . .i A preliminary consultation has been held to discuss the pr-oposal. The appli- cant has bje,en infq~rmed of requirements and s andards. ~ ~ (.Si gr~ature ( Si gn-o ff Wai ved ) 2. COUNTY ENGINEER'S DEPARTMENT A prel iminary consu'tation has becn hel d to cliscuss the proposal. The aapl i- cant as been infarmej of requirements and standards. , 1-21r7 ~ n ture~ Dat - ~ (Sign-off Waived) ~ 7, r_?J~,•~ v,l`T1_Y <<'S._1F'P4QIM:INT (W~t_•-E 14~ OI~t51 (lE' I•;M/~~3) j] A preliminar consultation has beF:n held to discuss the propos3l. The appli cant; be informed of requi rements and standards. ;Date) r 2_?~°Y~ ignature) 1•(Sign-off Waived) ~ The appl i cant i s requi red to di scuss the propo's'al wi th to become informed of sewage disposal requirements and standards. 9 The appl i carit i s requi red to Ci scuss the pro'osal wi th ~ to become informed of water system requi-rements and standards. 4. WATER PURVEYOR (Wai ve i f outsi de CWSSA) NAME ~•,5,7~- a) The proposal6?is not located within the boundary of our future service area, b} The posal Ois not located w:thin the boundary of our current district. c) We 4~?are not able to seV,~yeave his site with adequate water. 4Signature) isfactory arrangements not been made to serve this proposal. '1 A 7 -FDate) (Sign-off Waived) 5. SEWFRAGE PURVEYOR NAME: (If other than Spokane County) A prNliminary consultation has been held to discuss the pro osal. The appl-icant has been informed of requirements and stand sr; i I LSi gnature (.Da~e ) (.Si en- f ai ved ) t „ APPLICANT' S FORM NAME : - I FILE V. CONDITIONAL USES State Law, Section 36.70.020 (7), clarifies that the county ordinances must specify (the standards and criteria that shall be appl ied in the review by the Zoning Adjustor A. Assuming the proposal is listed as a"permitted" conditional use, do you bel i eve the propos al meets al l of the requi red establ ished and appl i cabl e cri teri a? Uc 5, `J B. What have you done or coul d you do to: 1) make the use compatl bl e wi th othe r pe rmitted acti vi ti es i n the s ame vi cinity and zone? . N • MO 2) ensure against imposing excessive demarids upon public utilities? /iC' 601 n S~P1'"L ~ C. Expl ai n how o r why the p ropos al wi 11 not be det wi mental to : 1) the Comp rehens i ve Pl an /11Z 6 fe ~L~~ .e cLa 0 ~ e c. t-~ba c fr- $ s'd ~ AND 2) s u r rou n d i n g p ro p e rty a c Irs a r e y►ti Ct-e L ~ 7 fc' f'S v . s D. Wh at reas on abl e res t ri cti ons , con di ti ons o r s afeguards wi 11 uphol d the s pi ri t and intent (health, safety and general welfare) of the Zoning Ordinance AND mi ti gate any adverse effect upon, the nei ghboring properties-- incl udinq but not 1 i mi ted to: (Oti me 1 i mi ts ;(2.) front, si de or rear yard greater than minimum stated; (3) suitable landscaping; ~A signing; (5) off-street parking; arid( 6) othe rs ? ~ ~ -f- -Q~~ ~ r-,r htit :J C~ J Sc,~ r, / -X-e hee5 -4 S ~ ¢v v ~ r v ~ _ . , . ~ • . 1 . • . 3 E. ' Noti fi ca-Zi on Requi rements ?he apRlicant is to provide notification as follows: More detailed instructions are provided when notification packet is picked up at the Planning Department. Step 1: All property owners and taxpayers within three hundred (300) feet of the property, all additional contiguous ownership and any easement providing access across other properties shall be notified by the proponent. Util-izing a list of property owners and taxpayers obtained from the Planning Oepartment or a Title Company and copies of the Agenda Notification prepared by the Planning Oepartment, the applicant shall accomplish notification by mailing the agenda notification by first class mail as directed by the Planning Oepartment staff. Step 2: 7he applicant shall provide the mailing list, Affidavit of Mailing and all returned mailings to the Planning Department at least two (2) days prior to the public hearing for inclusion in the file. , F. Publ i c Heari nq The applicant or representative must be present at the public hearing. If the owner is not at the meeting, the "representative" must have written authorization from all effected owner(s) to act on his/her/their behalf. t 1 . .q: y~lI _t •lSl ~ll~f` ~ •1•1.'~~.. 1~•~•• f ' r I " ) 5 ' '"i , . ` G 14 - + t STATEMEt1T QF . aTTENOING PNYSICIAN FOR DEPENDENT RELATIVE • 'I . . _ ; r • 41„' SPOMANC COUMTY GOURT NOUSC To assi st i n meeti ng the requi rements of ttie Spokane County Zoni ng Ordinance, Section 4.24.560 b.2, and 4.03.020 19 G, concerning a licensed physician's statement regarding the nature of the medical problem and the defi niton of "Dependent", I submi t the fol 1 owi ng i nformati on. 1) Ful 1 name of person ( s) for whi ch i nformati on i s gi ven bel ow: 414 lu,4e 2) Describe the nature of the medical or health related circumstance(s), pny si cai a nd/or medi cal whi ch establ i sh a"dependency" si tuation : . ~ 3) I s this a ci rcumstance of short or 1 ong term durati on : ~ 4) The Spokane County Zoning Ordinance defines a"dependent" relative as a re1 ati ve who has been determi ned by a 1 i censed physi ci an to be physical ly or mentally incapable of caring for themselves and/or their property. Do you believe your patient is so qualified at the present time? Yes - N43. F'CPE M.D. ~ ~""l`( Physi' ~i an' s Name ) ~ ` (Elusiness Address) 9nature ) 7 (Date) _ 0035z ~ ! . . y t~~• ' . ' - - . • • . AFFIDAVIT OF OEPENDENT RELATIYE CIRCUMSTANCES ( TNIS STATEMENT MUST BE NOTARIZED ) 59QKAtiC COVnTr COUAT hOUSC STATE OF WASHINGTON ) ) COUNTY OF SPOKANE ) Joanne L. Barnsley , being duly sworn on oath deposes and says: Applicant 1) I am the owner, leasee or contract purchaser of the following property: Assessors Parcel 18552-1013 Legal Description: BACONS GREENACRES PT OF B10<BEG AT A PT200FT N OF SE COR L10 TH NWLY TO A PT340FT N OF SW COR L10 TH S TO SWCOR TH E TO SECOR TH N TQ BEG EXC E16.5FT&EXC ST (continue separate Sheet) 2) I seek to house Alta M. Couture full name(s) of dependent relative(s) by addition of a separate manufactured home on the property in addition to the existing permanent residence, all under the provisions of the Spokane County Zoning Ordinance, Section 4.24.560. 3) The above named person(s) are related to me &s.follow: Mother 4) The above named relatives are dependent upon me because of the following circumstances: My mother has emphysema and requires oxygen. She is unsteady on her feet and has fallen several times. She is 70 years of age. nur fami]_v and her Dhvsician feel iC is in her best interest not to live alone. 5) In your opinion, is (are) the above person(s) physically or mentally in- capable of caring for themselves and/or their property? xx Yes No 6) I fully understand I am responsible for the removal of the manufactured home and related improvements at such time as the conditional use permit becomes invalid or the above named dependent relative(s) no longer need dependent care. Joanne L. Barnsley ' F Print/type Name ignature SUBSCRIBED and sworn before me thi s::1>/,o7'`day of ~ ' • ;,,`,~y111111//~~''' ~-'N G. A41 Cotary TPiubTic i n 4an or the State of Washi ngton, resi di ng at Spokane FtiOTARY ~ • . SEAL: = ' ' = . = • - ~ • • ~ a : ` ~ cp • a ~ ~ ' ~ /1 . ° : 4 I,' r:pOJLt6u \r~ 0034z . ~