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CUE-53-89 ♦r~ „ t_.,- ' . . , . ' . !I{J~ i. lb . _ • C~ • ' . ' ~ 1 7 ~ ZONING ADJUSTOR ` , ° • , ` • . ,t ,i;,',. ! SPOKANE COUNTY, WASHINGTON IN THE MATTER OF A CONDITIONAL ) USE PERMIT FOR A DEPENDENT ) FINDINGS OF FACT, RELATIVE ) CONCLUSIONS, [CUE-53-89] IVY LINDSLEY ) DECISION AND ORDER ADDRESS: E. 18212 SPRAGUE PARCEL NUMBER: 19551-0401 APPLICATION DESCRIPTION: The applicant requests a condirional use pernut to allow Paul Arthur Nichols to temporarily reside in a manufactured home on the property of Ivy Lindsley. Secrion 4.24.560 of the Spokane County Zoning Ordinance allows such a use in the Agricultural Zone upon issuance of a conditional use pernut PROJECT LOCATION: Generally located adjacent to and south of Sprague Avenue and approximately 1/8 mile west of Greenacres Road in the NE 1/4 of Section 19, Township 25N, Range 45EWM. OPPONENTS OF RECORD: NQNE PUBLIC HEARING: After consideraaon of all available informaaon on file, exhibits submitted and testimony received during the course of the public hearing held on October 25, 1989, the Zoning Adjustor rendered a written decision on November 3, 1989. FINDINGS OF FACT AND CONCLUSIONS 1. The proposal is described above. 2. The adopted Spokane County Comprehensive Plan designates the area of the proposal as Urban. The proposed uses are generally consistent with this category. 3. The site is zoned Agriculturdl, which allows the proposed use approval of this application. 4. The existing land uses in the area of the proposal include are primarily subdivided residential lots, all of which are compatible with t-he proposal. 5. The proposal is exempt from the provisions of the Washington State Envirnnmental . Protection Act, Chapter 43.21 C RCW pursuant to WAC 197-11-800 (1)(c). 6. The applicant has been made aware of the recommendations of various Counry agencies reviewing this project and has indicated those racommendations are acceptable. 7. No adverse testimony or written comments were received regarding the proposal during or prior to the hearing. ~ Y CASE NO.CUE-53-89 SFOKANE COUNTY ZONIIVG ADNSTOR PAGE 2 8. That the property being utilized is required to be occupied by the applicant or divided if two stiuctures are to be located on the property. 9. The proper legal requirements for advertising of the hearing before the Zoning Adjustor of Spokane County have been met DECISION . From the foregoing Findings and Conclusions, the Zoning Adjustor APPROVES the proposal, subject to compliance with the following CONDITIONS OF APPROVAL The following cond.itions shall apply to the applicant, owner and successors in interest and shall run with the land: 1. PLANNING DEPARTMENT 1. The Zoning Adjustor requires the applicant formally plat the property prior to January 1, 1991, to establish two or more lots on a permanent basis if she will not reside on the property. 2. 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) constructeri 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 ( fl the unit shall not be permanently affixed to the land, except for temporary connecrions to utilities. 3. The manufactured home shall be occupied by either the dependent relative(s) and family, or by thc family (of the dependent relative) providing care to the dependent relative owning and occupying the principal residence. 4. Upon the ternuination of the need for dependent relative care or the sale or lease of the property, the applicant shall remove the manufactured home from the site within forty-five (45) days. 5. A statement (Title Notice) shall be rocorded by the Planning Department in the County Auditor's Officc stating that the manufactured home is temporary and for thc usc of the named dependent relative(s) for which the Conditional Use Perntit is approved and that the manufactured home is not a permanent structure to be transferned with the property if it is sold or leased. CASE NO.CUE-53-89 SPOKANE COUNTY ZONING ADJUSTOR PAGE 3 6. The pemnit shall be granted for a period of one year and may be renewed administratively by the Zoning Adjustor or his/her designee upon the recer[ification: (a) by a licensed physician that the medical problem still exists; and (b) by the original applicant that the need srill exists. 7. The manufactured home shall be located in substantial conformance with the site plan on file in the Planning Department and any modification of proposed location shall only be authorized by the Zoning Adjustor prior to location and erection at the site. II. DEPARTMENT OF BUILDING & SAFETY 1. The issuance of a building pernut by the Department of Building and Safety is required. IV. HEALTH DISTRICT 1. Water service shall be by an existing public water supply when approved by the Regional Engineer Spokane, State Department of Social & Health Services. 2. Subject to specific application approval and issuance of pernuts by the health officer, the use of an individual on-site sewage disposal systems may be authorized. V. SPOKANE COUNTY ENGINEER'S OFFICE 1. An approach permit must be obtained from the County Engineer prior to the construction of any new driveway approaches. This must be done prior to the release of a building permit NOTICE: PENDING COMPLETTON OF ALL CONDITIONS OF APPROVAL WHICH NEED TO BE COMPLETED PRIOR TO PERMTT ISSUANCE, PERMITS CAN BE RELEASED PRIOR TO THE LAPSE OF THE TEN (10)-DAY APPEAL PERIOD. HOWEVER, THE COUN'1'Y HAS NO LIABILITY FOR EXPENSES AND INCONVENIENCE INCURRED BY THE APPLICANT IF THE PROJECT APPROVAL IS OVERTURNED OR ALTERED UPON APPEAL. DATED this 3rd day of November, 1989. . 4DI LAS S. ADAMS Zoning Adjustor Spokane County, Washington FILED: CASE NO.CUE-53-89 SPOK:ANE COUNTY ZONING ADNSTOR PAGE 4 1) Applicant 2) Spokane County Engineer's Office 3) Spokanc County Health I?istrict 4) Spokanc County Departmcnt of Building & Safety 5) Planning Dcpartment Cross-reference F'ile and/or Electronic File NOTE: ONLY TBE APPLICANT OR AN OPPOrfENT OF RECORD MAY FILE AN APPEAL WI'I'FHN TEN (10) CALENDAR DAYS OF THE ABOVE DATE OF SIGNIIVG. APPEAL MUST BE ACCOMPANIED BY A$100.00 FEE. APPEAIS MAY BE FII.ED AT THE SPOK:.ANE COUNTY PL.A[vNING DEPARTIViENT, BROADWAY CENTRE BUII.DING, NORTH 721 JEFFERSON STREET, SPOK;ANE, WA 99260 (Sections 4.25.090 and 4.25.100 of the Spokane County Zoning Ordinance). c a ~ .'~4 Q3" ~ ~ ' PLANNING DEPARTMENT . , ~ BROADWAY CENTRE BUILOING N. 721 JEFFERSON STREET PHONE 456-2205 Jp SPOKANE, WASHINGTQN 99260 , . . . . _ _...s~ . _ - - " $POKANC COUnTY COURT NOUSE ~ ~ f'-7- 6`~ OCT 0 4 1989 1, ~ ~O~ffC~ G~ 570MAME COu~rN~~r ZC~RHc~ ADJ~rS~D~ ; ~t t; U 6~~ FG~ DATE: October 25, 1989 TIME: 9:30 a.m. or as soon thereafter as possible PLACE: Spokane County Planning Department 2nd Floor Hearing Room, Broadway Centre Building North 721 Jefferson Street Spokane, WA 99260 AGENDA ITEM 3 Fi1e: CUE-53-89 CONDITIONAL USE PERMIT FOR A TEMPORARY RESID ENCE FOR A DEPENDENT - RELATIVE L O C A T I O N: Generally located adjacent to and south of Sprague Avenue and approximately 1/8 mile west of Greenacres Road in the NE 1/4 of Section 19, Township 25N, Range 45EWM. P R O P O S A L: The applicant requests a conditional use permit to allow Paul Arthur Nichols to temporarily reside in a manufaciured home on the property of Ivy Lindsley. Section 4.24.560 of the Spokane County Zoning Ordinance allows such a use in the Agricultural Zone upon issuance of a conditional use permit. FXISTING ZONINC: Agricultural COMPREHFNSIVE PLAN: Urban SITE SIZE: Approximately 1 acre APPLICANT: Ivy L. Lindsley E. 18212 Sprague Greenacres, WA, 99016 ITEMS CARRIED OVER FROM PREVIOUS HEARINGS MAY BE HEARD FIRST, POSSIBLY CAUSING DELAYS. LEGAL DESCRIPTIONS AND PROJECT DETAILS FOR THESE PROJECTS ARE AVAILABLE IN THE PLANNING DEPARTMENT FILES. APPEALS OF THE DECISION ON THE ABOVE LISTED CASE MAY ONLY BE FILED BY THE APPLICANT OR AN OPPONENT OF RECORD ACCOMPANIED BY A$100.00 FEE. (Sections 4.25.090 and 4.25.100 of the Spokane County Zoning Ordinance.) ~ c _53~89 CU ~ t ~ A" O , • ~ A V E. 4-STATE N IGNIKAY N° 90 AYL. 8 vE ~ ~ ~'.~,c• Rr'. . . ~ q ~ e + ( _ r r-j rl ; rr' . PO . 203 ' ) ; ---~Y ' ~ ~ . P..-c ` w^v r 'I ~ ~ ~ ~ ` ~ ~ 1 c T OFFI U Y N ~ Av i C~ `c AL CJ {10 ~ n e / ~ a,,► ~ - .';a~~,~ ~ a ~ 00~ 't^ ' • ~ ~ ' ' ~ ♦ ~ ~r OIA / 1 ~ ~ ~ ~ r t 2N0 ~ SE--OND AvE ' 2,04 A • Y ~ N ~ _ r ~ U T V ~ FOVRTN AVE 'E Q ~w N ~ ~ 1 E 1 GHTM AVE _ co <o 0 . = ♦ ~ ~ W . ~ ~ ~ Q ~ 1:1000 n ~ J ~ i SPOKANE COUNTY PLANNIIYG DEPARTMENT APPL-ICATIQNS BEFORF T'HE ZOIflN G D 1STMAOARD Q,F tD7L]STIviENT • I`~ ~ ~ L- 53 I CLrcificate of Exemption No.: Application Nd Nuine of Applicant: ✓ ~-`i ~t/~✓s L~~ Agent: Y ON Street Address: o? l a'Z ~r~y ~ 4c-Leq v Zip ~Phone - Homc. CiStatc:-k2c'1- Codo. Work. Ag nts No. ~ 'g:z% 04 \;unc of Propcrty Owntr(s): • ~ ~~L~ ~ Gl/ ~a ~~h~~'~' Strcet Address: ~'`~~,u . Zip Phone - Home: 2S s--993vl),- " Clty.Z-j tBtC. l~it r COdC. WOTk• l7p IiEQUESTED ACTION(S) (Circlc aPProPriatc action): V a r i a n c e( s) Conditional Use Permir ) Nonconforming LotlUse Waiver of Violation Temporary Use/Structure Otber: FOR AFF USE ONLY CODE: ORDINANCE n Cite Regulations Sectioo(s): ~ . ~ ''I • '5'b b Propert S e c t i on: Township:~-~ Range: u S Sizc: &~Eaifoolractcimoenn/t: Y N / Existing Zonc: ComP. Plan Dcs.: )-f-aL Crossovcr L.EGAL PSSA: (Y) N UTA: OY N ASA: o N FIRE DIST.' ~ CHECKED BY: Hcaring Date:_,,,lD Personnel TaYing in Application: Existing Use of Property: Qa-S i2 Dcscribc Inccnded Proposal in Terms of RE UES D A~"TIONS above: CA tit ~~p ~ p U J Strcct Address of Proporty: r - Lcbal Dcscription of Property (include eascmtnt, if applicable): 1 //J~--f Q-~ ,/1/. 3?9. T~ Q-P 4/-n 7`- l. 8L-v C,/c (f O ✓ b ~-v~ d s✓tL-.0 O (f~ e 2 &-t.~C-G~- Parcel h'o(s): 10 r Source of Legal: Total amount of adjoiniag land controlled by this owncr/sponsor: 1q,~~Q Whae interest do you hold in thc property? to Lla-ve ct--- 1-4;;.cP --~p e- t,t, 7b (t S Plcase l;st previous Planning Dcpartment actions involving ihis propert'y: ) no~.¢. 1 StiVEAR, UNDER PENALTY OF PE;RJURY, THAT: (1) I AM THE OWNER OF RECORD OR AUTHORIZED AGENT FOR THE PROFOSED SITE; (2) IF NOTTHE OWNER, WRITTEN PEuMlSStoN FROM SAID OwrrEx AuTHOFUZYNC3 MY ACTIONS ON HISIHER BEHALF ts ATTACHED; AND (3) ALL OF THE ABOYE RESppNSES AND THOSE ON SUPFORTING DOCUMEIv'T'S ARE MADE TR Y AND TO T EST~ K~.E E, S i g n e d: L!A►p 1 Address: 7 37S'o ~2 - d , ~ao..7~,, L~✓~~ ~.~A Phone No.:-,--,? ate: NOT Y ~ ~ - z ~ Notacy.• - : • ~ ,~7 ~ Date: ~ ~9 ' ~ ~ APR• X' • G ~ Page 3 o q'•..•••'~,~. Over ( ) Revised 3-4-88 zw rti,P~~ _ ( i l A • BURDEN ~ It is necossary for the applicant or his/hcr rcpresentativc to cstablish the reasons why tbc REQUESTED ACTION should bc approvcd and to litcrally put forth thc basic casc. Accordingly, you should havc bccn givcn a forai for your rcqucstcd action (variance, conditional usa, etc.) designed to help you ptesent your case ia a way . whicb addresses the critcria which the Zoning Adjustor tnust consider. Plcasc fill thc form out and return it wicb your application. If you did aot get a form. ask the Planning Departrrient personnel for advice on how to proceed. B. StrN-OFF BY COUNTY DEPARTMENTS AND OTHER ACENCIES 1. COUNTY HEALTH DISTRICT a) Proposed method of water supply: b) Proposed method of sewage disposal: A prclimin consultation has been held to discuss the proposal. The applicant ,gy hjbeen ' fo ed requi ements and` standards. < < (Sign ture) (Date) (Sign-off Waived) ~ C)2. COt1NTY ENCINEERIN[; DEPARTMENT A preliminary consultation has been held to discuss tho proposal. The applicant has een informed of requirements and standards. . 9- l~^e~ (Si aturc) (Date) (Sign•off Waived) ~ CQUNTY C1TIL.ITIES DFPARTMENT (Waivc if outsidc WMAB) A prcliminary consultation has beeD beld to discuss the proposal. The applicant has becn informcd of requirements a4d standards. ~~)/~,d? 9-- , 2--8y (Signaturc, , ) (Datc) (Sign-off Waived) The applicant is required to discuss the proposal with to becomc informcd of water system requirements and standards. The applicant is required to discuss the proposal with to bccome infomncd of sewage disposal requiremeats and standards. ~J. WAT ER j'LIRYEYORT (VV• 81Ye if outsids CWS S A ) a) The pro posal l o c a t e d w i t h i a t h e b o u n d a r y o f o u r f u t u r t service arca. b) The proposal located within the boundary of our current distr,ct. c) We ~re n= able to serve this site with adequate water. d Satisfac ry arrangemcnts havelhava not been made to serve this o , ( S i g n a t u re ) ( D ate) (Sign-off Waived) ' ~ SE1YERAGF P 1RV ,YORT , (If other than Spokane County) A prcliminary consulcation has been held to diseuss the proposal. The applicant has been informcd of requirements aad standards. (Signaturc) (Datc) (Sign-otf Waivcd) Page 4 of 4 ' •~~E ; CQNDITIONAL USE PERMIT APPLICATION x~~ . . - . e U~45(e V. GONDITIONAL USF.S Statc Law, Section 36.70.020(7), clarifies that the County Ordinaaccs must spccify the standards and criteria that shall be applied in the review by the Zoning Adjustor. . A: Assuming the proposal is listed as a"pcrmitted" conditional usc, do you believe the proposal mects all of the raquircd ostablished and applicablc criteria? B. What havc you donc or could you do to: 1. Makc the use compatible with other pcnnitted activitics in the same vicinity or zone? ' ~J - . - aud 2. Ensure against _iraposing excossive demands upon public utilities? , ~ . C Explain how or why the proposal will not bc dctrimoutal _ to: ~ ~P roc+' 1. Thc ComPrchensive Plan: ll ~ . : and , 2. surrounding propeny: 'f-e q,P dE. D. What reasonablo restrictions, conditions or safaguards will uphold the spirit and intent (hcalth, safety and gancral walfare) of 'the Zoning Ordinance A,N,D mitigate any adverse effect upon the neighboring properties including but not limited to: 1) time limits; 2) front, side or rear yard greater than minimum statcd; 3) suitablc laadscaping; 4) signing; S) off-straat parking; and 6) othe . . `r . . ~ AFFIDAYIT OF DEPENDEN? REI.ATIYE CIRCUMSTANCES , THIS STA7EMENT MUST BE NOTARIZED ysp%awt i.^6ftt• CC,.a/ w0~3[ STA7E OF WASHINGTON ~ ) COUNTY OF SPOKANE ~ ~V,~ L. . ;tl~ s<<~ , bei ng duly sworn on oath deposes and says : ~ Appllcant 1) I am th<owner).leasee or contract purchaser of the following property: Assessors Parcel v D/ , Lega1 Descri pti on : M ~ 7 9. 7 o , ~L a LA, 2 ~o C O~!o i t-t 'orf aL d- i-~i o G,s', ~ (continue separate sheet) 2) I seek to house /0"'L- ~~24 V~_ v C) Z_5 tuM name (-s) ot-d`ependent 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 Zontng Ordinance, Section 4.24.560. 3) The above named person(s) are related to me as follow: V~v c-, L-J l V 41W s t s 7<< ~ 4) The above named relatives are dependent upo-P* because of the following ci rcumstances : wt- y~~ s GL zs r Y i (xl'. G-4 l ~ IDe />rCSSCo/ U J ! 5) In your opinion, is (are) the above person(s) physically or mentally in- capable of taring for themselves andlor their property? 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. Vnt/lype A✓~s Name / gi gna ure SUBSCRIBED and sworn before me this /-:2- day of\, Oz~~ 19 v ' ` .i . t)Y L! ~ ;...s. ~ota ~ n an e ~e of sh gton, esid g at Spokane : 4 n • ,9 / SEAL : i'~ ' • ~ • ~ • . ~ ,y•. Fs.aFZ. ~ 1~~1 ? ~ ~ ~ ~G ! 0034z . . , . ' , ~ ~l;~ ':t~,,•~ . .t~. ~ . ' ~'.;:.i.• . : .ji • ' • ' ~ w1i 1:; 1• S?ATEMENT OF ATTENDING PHYSICIAH FOR OEPENOENT RELATIYE 1. . , , . • ' 'r4 I couMIY couRt «ousc To assi st i n meeti ng the requi rements of the Spokane County Zoni ng Ordinance, Section 4.24.560 b.2. and 4.03.020 19 G. concerning a 1lcensed physician's statement regarding the nature of the medical problem dnd the definiton of "Oependent", I submit the following information. 1) Ful l name of person(s) for which i nfonnation i s gi ven delow: PLez t, ( A - ~~LC.Ld'- 2) Describe the nature of the medical or health reldted circumstance(s), physical and/or medical whlch establish a"dependency" situation: / . 3) Is thi s a ci rcumstance of short or 1 ong term duratlon: 4•~`-Q~ ~~~~w V 4) The Spokane County Zoning Ordiaance defines a"dependent" relative as a relative Kho has been determined by a licensed physician to be physically or mentally incapable of caring for themselves dnd/or their property. Do you believe your patient 1s so qualifted at the present time? ~ Yes No G~ r ~ Mysf c i an' s Rame 1 9 2Y ~t,-o S (b usi~!s n dress) / ~ . J . gna ure ) ~ , J (-L I 1cs-- tbdte-) nnZ r, , • ~ C @ l~✓ G. ' ~ ; . F ~ • , . ~ ~i`' ~ J vV ~ ~ . 5 ~ u . U ~ ~ ~ , • j ~ ~ ~ e ~ i ~ - V ~T '1 . . . . . . . . ~ ~ 0~ ~ C- ~1 ~ r • ~ ~ V ~T v~ y, 1► ` ~ • . . ~ ~ ~ ~O ~ V ~ 1 . ~ . ~ . . ~ ~ ! . . . . ~ ~ I, . . . . . . . , , -1 ii/• j I .5~ ~ C n ~ 3 f 7 ~ SC L C_ cc-,-~,~► ,~d~,;:~~~, . ` I L' ~~r~.'~~ j•t S' . ~ ~ < ~ _ ~~Y ~ ~ ~ , • . , . ~ ~ ` ` ~ . `j- r` ~ Y ~ t . . r~ ~ ~ ' ' • ~ ~ ( . , % c' - ~ . : . ~ i , ► ~ ~ ~ ~ 5 0 L* 444 ! . . . ~ ~ a -t- - • J f ~ # ~ . , • sC, 'S,40" ' ~ ~ . • , . . • ` ~ , r{i . . ~ . j . ~ i ~ r • ; . , ~ , ~ . ~ ~ - ~ , . sc~~ ✓ ' ~c ~ Sv~ ~a //e } ~ ~ a 35 ; • . . CA J, ~ . ~ ' ti- ~ ; r ~ • ~ ~ , ~ "7 ~ ~ 7 0 ~ ~~tcTi G ' .F . I . ~ . ~ /y1 ~ ~ :y~ 3' ~ ~ . ~ , . . M. . ~ . V ~ , IY VACA~3T To , PRO-Lr..~- E i ~ I ~ j , . 1 ~ . i ~ ~ . . . , I ! , i . . OFFICE OF THE COUNTY ENGINEER SPOK:ANE COUNTY, WASHINGTON October 12, 1989 T0: SPOKANE COUNTY PLANNING DEPARTMENT (Current Planninq Administratar) FROM: SPOKANE COUNTY ENGINEER SUBJ: CUE 53-89 re: Variances The County Enqineering Department has reviewed the above referenced application. The followinq comments are offered for inclusion in the Findinqs and Order as "Conditions of Appraval" should the request be approved. 1. THE APPLICANT•SHOULD BE ADVISED THAT AN APPROACH PERMIT MUST BE OBTA I IVED FRt]M THE COUNTY ENG I NEER PR I OR TO THE CONSTRUCT ION OF ANY NEW DRIVEWAY APPROACHES. THIS MUST BE DONE PRIOR TO THE RELEASE OF A BUILDING PERMIT 1 SPOKANE COUNTY PL,ANNING DEPARTMENT PPPL[CATIONS BEF4RF THE ZOIVINC ADnISTOR/B4ELRD OF ADJUS'I'ME~T • Cercificate of Exemption No.: Application No.: OL- S3 Na,ne of Applicant:-2t ~ i~/~,~' L~+i Agent: Y CN) Street Address: ~~V-`7 c° c- L 2 ° CG`-„ ` s 7'c , l/ Zip ` Phone - Home: ' State:_,U.2CZ- Codc: Work: Ag nts No. ~ • ' ~ or ~ s' ,ti ame of Property Owner(s):-,~-,L'v A/d~ Strcet Address: 3,~oa 3r~• Zip Phonc - Home: CiL y:,41 tate: )-i~G~ ~ Code: Woric: ~ fZEQUESTED ACTION(S) (Circle appropriate actioa): V a r i a n c e( s) rConditional Use Permit ) . Nonconforming Lot/Use Waiver of Violation Temporary Use/Structure Other: FOR STAFF USE ONLY CODE: ORDINANCE Citc Regulations Sectioa(s): / Property Violation/ Section: Township:Range: Li S Size: Enforcement: Y N Existing Zone; Comp. Plan Des.: Crossover ' I.EGAL PSSA: Y N UTA: Y N ASA: Y N FTRE DIST.; CHECKED BY: licaring Date: Personnel Taking in Application: Existing Use of Property: Describe Intended Proposal in Terms of RE UEST D A~'I'IONS above: ~ts~c.'~o~czy 0p,X U J Strcet Address of Property: 19';2 /%2 < v ~ Lebal Description of Property (include easement, if applicable): ~4e , ,61~., 3~~~• ? r p ~ ~n 7~ l. ~L-v ~C ~ ~ O✓ b I~v1 ~~-L d cf~i ~4 L.O` ~ 2 ~i..a-G'-1- Parcel No(s): v y0~ Source of Legal: Total amount of adjoining land controlled by this owner/sponsor: What interest do you hold in the property? 740 LLQ- ve ~ l-~ce- '~fl , ~w 1:0 ~ ~ . G k_-e 6--"' ~p f S ~ob~,t e~-- ~ 5rs~v) Please list previous Planning Dcpartment actions involving this properiy: Q- 1 S WEAR, UNDER PENALTY OF PERNRY, THAT: (1) I AM THE OWNER OF RECORD OR AUTHORIZED AGENT FOR T'HE PROFOSED STTE; (2) IF NOT THE OWNER, WRITTEN . PERMISSION FROM SAID OWNER AUTHORIZING MY ACTIONS ON HIS/HER BEHALF IS ATTACHED; AND (3) ALL OF THE ABOVE RESPONSFS AND THOSE ON SUPPORTING DOCUNiENTS ARE MADE TRUTHFULLY AND'!'() THP, BFST OF NIY KNOWTrELGE. Signed: Address: - Phone No.: Date: NOTARY SEAL: Notary: Date: . Page 3 of 4 (Over) - Revised 3-4-88 ~ J • A. BU,RDEN QF, PR_Qn„F_ It is necessary for the applicaiit or his/her representative tv establish the reasous 'why the REQUESTED ACTION should ba approved and to literally put forth the basic case. Accordingly, you should have been glven a form for your requested action , (variance, conditional use, etc.) designed to help you present your case in a way . which addresses the criteria which the Zoning Adjustor must consider. . Please fill • the form out and return it with your application. If you did not get a form, ask the Planning Department personnel for advice on how to proceed. R. SICN-QFF BY CQUNTY DEPARTMENTS AND QTHER AGENCIES 1. COUNTY HEALTH DISTRIGT a) Proposed method of water supply: ' b) Proposed method of sewage disposal; A prelimin consultation has been held to discuss the proposal. The applicant ' h been ' fo ed requi ements and standards. . ~ 9-/y . Y ' SignAture) (Date) (Sign-off Waived) ~ 2. COtINTY ENCINEERINC DEPARTMENT A preliminary consultation has beea held to discuss the proposal. The applicant has een informed of requirements and standards. . c)- r;z^g~ . c) (Si aturc) (Date) (Sign-off Waived) 3. COUNTY UTILITIES DEPARTMEN't (Waive if outside WMAB) . , A preliminary consultation has been held to discuss the proposal. The applicant has beea informed of requirements and standards. (Signature) (Date) (Sign-off Waivcd) The applicant is required to discuss the proposal with to bccome informed of water system requirements and standards. The applicant is required to discuss the proposal with to become informed of sewage disposal requiremenis and standards. 4. WATER PURVEYnR: (Waive if outside CWSSA) a) The proposal Qis located within the boundary of our future service area. b) The proposal located within the boundary of our current ~ district. ~r rc) We able to serve this site with adequate water. d Satisfact ry arrangements have/ha,vP Q~ been made to serve this o . (Signature) (Date) (Sign-off Waived) SEWERACE PLIRVEYORT (If other than Spokane County) A preliminary consultation has been held to discuss the proposal. The applicant has been informed of requirements and standards. (Signature) (Date) (Sign-off Waived) Page 4 of 4 ~ o 4,12 / I . 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