16th E 15211 Preschool 4 -
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pl AN NUMBER APPLICATION/PERMIT pLpMIT Nl1M141' R
SPOKANE COUNTY - BUILDING CODES DEPARTMENT ~,N ~
4 NORTH 811 JEFFER50N / SPOKANE, WASHINGTON 99280 / 16091 466 3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
oe Ao~ESS LEGAL DESCRIPTION - SEE ATTACHED k
PARCEL NUMBER/S / A
2 r`44 --(-7►1
2 r
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OWN£R PHONE
3 972~? ..6 z
ADpaE5S ZIP Actual Set Backs (n Foet M~~{~ll (q
Ivortn ISouth Eastry west
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CONTRACTOR PHONE Slte oi pa►cel 2ona Classlllwtion .
4 porlgLG
ADORfSS ZIP Type,nst Aec ncy SO►inklered
V ❑Yes ❑No ❑ Fieq'a
DESIQNEii PHONE Valuatlon Buflding Area fn Sq Ft
5 ADORESS 21P Maln Floo► Uooer Floors Garage Area Storoqe
CHANGE OF USE FROM TO Area oi Decks Finished Basement Un11n Basemant
6 J+AN"t1~~- Cogg' i 5cNcib L--
YYPE ❑ NEW ❑ALl` ❑ AD'N 0 aPL. ❑ MVE No Baths No Storles No Rooms No oi Dwellings
1 WORK ❑ ~LD ❑ PLMB ❑ MECH ❑ M.H ❑ PGOL ❑ OTHEf1 CERTIFICATE Req'tl Rec'd Not Req'd
of EXEMPTION
OESCRIBE WORK c.~v~►"~' e ~ Enum Olst Locatlon (Aroa)
~ G~r ~ JI~,c , fEESCOtLFCTEO
Ir4~?Sr
VALUATION SOUOFCE GAS ELE TRIC ;ATER S WER pWnership USE CODE
9 UTILITIES publlc ❑Privete
Single $
I hereby certify that I have read and examined this apphcation and have read the "NOTICE" provisions mcluded
an reverse side, and know dhe same to be true and correct All provisions of laws and ordmances govermng this Building
type of work wdl be compiied with whether specified herem or not The grantmg of a permit does not presume
to give authority to violate or cancel the provisions of any other state or (ocal taw regulating construction or the
performdnce of construction SEE REVERSE SIQE FOA REQUIRED INSPECTIONS Plumbing
DATE QF APPLICATION - 2-- 7- --8~- SIGNATURE OF APPLICA Mech
SPECIAL APPROVALS SpEC1AL CONDITIONS
NAME OATE H _ ,/Plen Check
E He -0
S ~I. ~P~• ~~6 ~ 1 SEPA
pta
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Fwt~ • ~~jw~"A~~ A+lobile Home
rn inear ~ lV~~' ~~lo
- e ~ Qther (Specify)~
~.'~i a~ ~ W ,oa
)iiteg ~ ~ ~ ~CtA~j ~J4"8~
.l TOTAL 8 ~
~ pEiM, E%amllter ~Q ~ /I V~,(t~~ Al / A A ~t rtd.
f~ " ~ ~ WHEN MACHINE VALIOATEQ IN THIS SP
ACE,
. SEPA Cnr~kliSt ~
Lo , ~ THIS BECQMES A PERMIT
.
~a~ng rac n~ P~MIT IS NONZRQN~RABLE N~`~.
PERMIT EXPIRES ONE YEAR FtiOM DATE OF ISSUANCE DA7E ISSUED ?ERMIT Nn Ti
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OfFICE OF TbE
SPOKANE COUNTY PLANN ! NG D E PARTMf NT
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Oh'FICr OF CUUNTY L►NG INtiEK
SPOKANE COUNTY, WASHINCTON ~
TO: SpukH~te Guutity YLanning Deparuaent t
>
tKOM: County Englncer'r; De-parLmen[ ~
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SUBJECT: Condi t i ons of Apprijvii1-Zone Change--Numbr r: - - fj3• E
Applicant's Name
Sectton 23 _ Townehip ,as N, Range~//~BW~ t
.
T'he Eollowing "cunditions of approval" foc the above-referenced zone change are euemitted tO
the Spokane County Hearing Examiner Committee for ioclueioa in the staff 8nalysie etLd
"fiadings and order" of thr hearing acheduled~TANwA1a I~ 19 8?r
prior To The Zoauaoce Of A Building Parmit
l. Applicant shall dedicate feet on
for right-of-wey prior to bny use of the properky.
2. Applicant shall dedicate feet on ,
for right-of-way and alope easemente as neceesary prioc to any uee of tbe propetty.
3. Applicant shall dedicate a foot radius oa
end piior to aay use of the property.
4. Applicant shall dedicate feet on and a foot cadius on
end for right-o€-way prior to aoy use of the property.
S~ Access permits For approaches to the County Road System shall be obteined itom the
Spokane Couaty Engineer. ;
6. Acceea permite and improvemente to_ muet be appsoved
by the Waehiagton Depdrtment of Transportation.
.
7. Accese permite and improvemente to muet be approved
by the City of
~ (a) Applicant shall tmprove SiXTEENT1j j4&ra _ in a manner coasi8tent with Spokene
County TYPICAL coddway aection No.1_ / minimum paviog width~~/~arie /~MI&iai's;/ ST'Q
(b) Applicant shall improve &~'tw:~,y17,_ 4Vi6 _in a mannec consistent with Spokane
County TYPICAL roadway eect ion No. a minimun paviag width--#u4rrAi Sr;q,;;~AMqW,6
(c) Applicant shall impruve ___in a menner consistent vith Spokane
- -
County TYPICAL roadvay sectioo No. _minimum paving wtdth
(d) Applicant shall impruves in a manner coneieCent with Spokane
County TYNICAL roadway Sec:ttun paving width
`
(e) ()thPC speciEic impcuv`•mc.•ritrs.- _
- --~~a_
-
9. Appl icant sha 11 5ubm i c for dppruva L by tlir SpakanN Co«n[y E;ngincer ruad, drainege, and
access piatib pc lor to t he i,,%udnre of a b„ i ld i ng prrmit un the prvperty. !
The appLiCan( hhdll titihmi[ toir irpruv.sl hy the Spuk,ine Cotiiirv F.ngineec and [he Spokaae ;
County Hrat[h Ui st r Ikt.i dt-t 4i Itci comb t ned on-sit~~ %Vw.1gU 5V.[Om rlaii anJ eticfece watec
dfdpos.il Pldn tur che, vnttr4 j,rt,ierL prior 01 tl~~~ 1-iticillit.• 01 iny builcitng pertatt on Che
property.
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1 A parkl.ng p1an and trdFl ic c i rc ulatton pl.,n siial l be- submi t tc•d dnd apNruved by ttte
Spokane County Enbinerr priur to thr itibuance of a butlding permil. un the property. The.
design, tocatiun. and Hrrdnbemrnt of parking bCalls shall be tn aecordancr vith 8tattdard
traffic eagineering practLees. Paving oc sucEacing as appruved by the County Engineeco
will be required for any portian of the pcoject Which is to be occupied oc tcavelled by
vehicles. 1~2 Thr wocd "applicant" shal t inc lude the owner oc dwners of the property, hie heice,
agsigne, and succeseors.
3 Ro conatcuct the road impruvements stated heceia, the applieant mety, with the approvsl of
the County Engineer, join Ln and be a willing participant in aay petition or resolution
which purpose is the formation of a Road Improvement Dietrict (RID) for eaid ianprovement
pureua4t to ltCW 36.88, as awended. Spokane Couoty Will not patticipate ia the coet of
these improvements.
~ Ae an alternxtive m+ethod of coastructing the road improvement stated hereia, the 8ppli-
cant may, with the approval of tbe County Engineer, accomplieh the coad impsoveme4ts
etated herela by joining and participating in a Couoty Boad Project (CRP) to the eattent
of the reauired road improvement. Spokaae County will oot petticipaCe ia the coet of
these impcovemeate.
15 The eoastruction of the road improvemeate etated hereia shall be accomplished es ap-
pYOVed by the Spokane Couuty Engiaeer.
~ All requiTed improvemeate shall conform to the current State Of Washington Staadard
Specifications for Road and Bridge Construction, aad other applicable county Btaad$sds
and or adopted cesolution8 pertaiaing to Road Standards aad Stosmvater IKanagement ia
effect at the date of coaettcuction, unleee othetwise approved by the Couoty Bomiaeer.
<
17. Applicaat shall file a petition far the vacatioo of prior to
aay uee of the property.
18 Applicaot shall conetruct a paved and deliaeated accees approacb(8) to meet the esistiaS
pavement oA 5i aClEmw1'6 I YE •
~ Accese to JJ9fre4Fiv7ls /4M &sed shall be prohibited until eucb tilae ae epecificaltq
•utborized by the Spokaae County Lngineer.
20 xoadway etaadarde, typical roadway sections and drainage plan requiremente are found in Spokane Board of County Commieaioners R+eeolution No. 60-1592 ae amended.
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fILE NO.: CUN-1-83
THRESHOLD DETERMINATION
PROPOSED/FINAL DECLARATION OF NON-SIGNIFICANCE
1) Proponent: Lynn Judd
Contact Person: Lynn Judd, 15812 E. 24th Veradale, WA 99037
2) County Action(s) Requested: Conditional Use Permit for a dance studio in
the Local Business Zone. Section 4.24.490
of the Spokane County Zoning 0 rdinance.
REVIEW AND COMMENT
If you wish to comunent in writinq as provided in WAC 197-10-340 (5), please
respond i n l i ght of the fol l awi ng i nfomation, noting particul arly the due
date fo r wri tten camments.
Proposed Decl arati on of Nonsi gni fi can ce Issued: 10/10/83
Written Response Accepted Until: 10/24/83
A Public Hearing is Scheduled for: 11/2/83
.
Contact: Spokane County Planning Department
- North 721 Jefferson Street
Spokane, WA 99260 (509) 456-2205
Attn: Douglas S. Adams
PROPOSED DECLARATION: FINAL DECLARATION:
w
Name: Richar-d K. Sc ivne~j D N ame: Douglas S. Adams/D.J. Hume
Si9 nature: ~Crze` Signature:
T, ~
~tle: Planner I Title: Zoning Adjustor/Board of
Qept.: Plan ing Adjustment, Chairman
Date: /G~~~ /K3 Dept. :
Date :
MAILING LIST
INTEROFFICE MAIL, Gary Nelson, Engr. Offi ce
INTEROFFICE MAIL, Jim Legat, Utilities Dept.
INTEROFFICE MAIL, Daryl Way, Health Dist.
INTEROFFICE MAIL, Spokane County Ai r Poll ution Control Authority
WA State Department of Ecoloqy, Spokane
WA State Department of Social an d Heal th Se rvi ces
Fire District #8
Water District, City of Spokane
RECEIVED~
OCT ~ J
~POKANE COUNTY Ff1sINEER
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EN'V I RC3 N['Vl ENTA L CHE C KL f S T
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3PeAAwt CauMn eauNT++pyXZ SEC/YWNIRNG:
Xntraduction: The 5tate Enviranmentai Palicy Act of 1971, Chapter 43.21G, RGW, requires all state and 1oca]
gov-ernmental agencies ta cansider environmentaT va2ues both far their own actions and when licensing private
praposais. The Act also requires that an Erivfranrnental Impact Statement be preRared for all major actions
significantly (and "adversely", as per WAG 197-10) affecting the qua~ity of the physical environment. The
purqpose of this checlclist is to he]p the agencies involved de#,ermine whether Qr nat a proposal is such a
maJor aGtian.
P1ease answer the follorving questlans as completely as yau can with the informatian presently available ta
you. Please answer questtons as "yes" ar "maybe" if, inyour apinion, even anly slight 3mpacts will result.
Tlte reviewers af the checklist will be aware af and concern themselves with the Legree af impact, asking you
for mcre informatfon, if rrecessary. Where exp7anations af yaur answers are reqUired, or where yau believe
an expZanatiQn would be helpful to goverrYment decisian-makers, incluae yaur exp3anatian in the space provided,
or use addit#onal a es, 3t necessary. You shauId include references tn any reparts or studies of which you
are aware and w c are re evant to the answers you provide. Complete answers ta these questions now will
heZp aiI agencies invalwed with your proposal to undertake the required envfronmental revfew wfthaut unnec-
essary delay.
The foliowing questions apply to your total proposal, not just to the license for which you are currently
applying or the proposal far whith apprava1 is sought. Your a.nswers shouid inciude the impacts which wiTl be
caused by yQUr proposal when i t i s comp1 eted, even Lhough compl eti on may not occur unti l sametime i n the
futrre. This wi11 a]low a11 af the agencies which wiZl be invvlved to complete their environmental review
now, without dup]icating paperwork in the future.
No application shall be processed until the checklist has been ComPleted arrd returned to the apprepriate
Ccunty department. State law muires exqlanatlons fvr eve "es" and "mavbe" answer on the checklist.
The persop campleting the fom may be required to providp explanation for "na" answers, and in same cases,
more detaiied information Lo aid in a threshald determination.
HOTE: 'Fh#s is a standard farna befng used by alI state and 1ocal agencies in the State of Washington far
var€ous types of praposais. Many of the auestions may noC apply to your praposai. If aquestion
does ttot appiy, just ar~swer it "no" and continue on to the next questian.
1
ENVIRONhIENTAL CH£CKLIS7 FDRM
I. BACiKGMUND
~ ~
1, Name of Prvportenx: S ~
Fhane Nunrber. .
2. Address af Propanent: l _DL_ c7t. c)_ 03 -7
k
3. Date Checkljst Submitted:
4. Agency Requi ring Chetkl i st; C ~~~►-nJ rut r* q
5. Name of Rr4posal, i f Appl ica51 e: CXNII~Z
6. Nature and srief Uescriptian of the Prapasai (inctuding bufi ~not timited ta fts sile, general design
e]eneryts, and ather factars that wi1l give an accurate understanding of its scape and nature):
~ l~ l ti t3 ~ ~ F~.,'r (.~►.3s...~~ ~ ~ v
4]
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7. Locatian of Proposal (descri be the physi cai setti ng of the Proposal, aa wel1 as the extent af the land
area affected by any environmental impacts, inc]udzng any ather informatian rigeded to give an acrurate
understanding af the enviranmental setting of the propasal ) i, L.a,_,_k 13X,_5;%.+~~S et r~,CL_
-,,i a 0- 6.e c"[-eQ eL-.--e_, `i:mA r--A~a
&10'.i s ' J'o cci rkA6___P
57,`^. e
8. Estimated Date fori Completion of Propasal. Kbti,.!
~
9. l.ist of ST i permi tS , l.icenses or rnme ~~p prov 1 s R~ ui d for~the opos~al fedez~al, state, ar~d
local -including rezonesy: r~ (n~.~ r ~ r1 .~Om ~ 04 ~'J'a 40 a~C.~.
~
10a. Do yau, cr the ownpr in the event you do nat own the subject land, have any plans far future additions,
expans#orc, or further activity re'[ated to ar cannected with this propasal? If yes, expiain,
t,) o
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1
August, 1981
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10b. Qo you owrr or Cnave options an land nearby or adjacent to thi$ propasal's ]ocatinn? If yes, explain:
11. Do you know of any plans by others i ncl udi rtg the owner whi ch may affect the property covered by ,your
proposal or tand adjacent or nearbyF If yes, expZ ai n:
~
12. Attach any other applicatian fvrm that has been cvmpleted regardirrg the propvsal, if nane has been
complefi.ed, but fs expected ta befiled at sonue future date, deseribe the nature of such app7ication
farm.
II. ENvIRQNMEN'I'AL DVACTS
(Explanatiorts of all "yes" and "may6ep answers are required)
,
1. Earth. WilZ the praposai resuit In; Yes Maybe Ho
(a) Unstable earth condztions or in changes in geoxogic substlruttures3, ✓
(b) Disruptians, displacements, compact3an ar overtovering of the s4il?. ~
(c) Change tn topagraphy or grostnd surface relief features? , , . . . , . . . .
(d) The destruct4an, covering cr modiffcatian of any unique geolagic ar ~
PhYstca3 featur'es?. . . . . . . . . . . . . w . . . , , . . . . , . , . . .
(e) Any increase fn wind or water erasion or soi'Os: either on or off the site?. v~
J
(f) Chanqes tri deposttlan of eFasion of beach sands, or changes in siltation,
depositfon ar erasion whichmay modify the chanrtel of a river or stream ~r
ar the bed of the ocean or any bay, inlet or lake? . . . . . . . . . . . . .
f3i k%
2. A9r. Wi11 tMe proposal result in: Yes M_aybe No
~
(a) Air emissfons or deteriaration of ambient afr qtraifty7. . . . . . . . . . . ,-2(.4~, ~
,
' (b) The creatfon of objectfona6ie pdors? , , . . . . . . . . . . . . . . , . . . ,
(c) Alteration of air movement, moisture or temperature, or any change in ~
cximate, either lacally or regiflnatly? . . . . . . . . . . . . . . . . . . . .
Effli$RStio11: ,.+1~+~/Y\ 1~"1.~~.1l~~l. il~
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3. Water. Wi11 the propasal resuit in: Yes ftbe Na
(a) Ctange in currents, or the course or directiQn of aater mavements,
in ei ther mari ne or fresh waters7 . . . . . . . . . . . . . . . . . . . . . .
(b) Changes in absorptton rates, drainage Ratternso ar the wate and
amount of surface water runaff? . . , . . . . . . . . . . . . . . . . . . . .
(c) Alterations to ttie course ar flow of flood waters7 . . . . . . . . . . . . . .
(d) Change in the amount of surface water in any water hody? . . . . . . . . . ~
(e ) Bi scha rge i nto surface water, or in any ai teratf on of surface water
quai i ty, i ncl udi ng but nat 1 imti ted to temperature, dissoX vecl axygen ~
or turbi di ty7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(f) Alteration of the directfan or rate of flow of ground waters?
(9) Change in the quantit,y of graund waters, either through direct
additiQns or wfthdrawals, ar through itrterr.eption of an
aquifer by cuts ar- excavations? . . . . . . . . . . . . . . . . . . . . . . . ~
(h) t?eteriaratiarr in ground water quality, either thrvugh dfrect
irjection, ar tYtrvugh the seepage of ieachate, phasphates,
detergents, waterborne virus ar bacteri a, ar other substances
inta the ground vraters7 . . . . . . . . . . . . . . . . . . . . . , . , . . , ~
0) RedUctian in the amount of water otherwise available for
pubi ic water supplies?. . , . . . . . . . . . . . . . . . . . . . . . . ✓
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4. Flora W11i the proposal result in: Yes Maybe No
(a) Change in the diyersfty of spec#es, or number of any species of
fTora (including trees, shrubs, grass, craps, microflora, and ~ 4OF
aquaticplants)?
(b) Reductivn of the nwnbers of any unique, rare ar endangeped
specfes of flara? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(c) Introductian of new species of fiora into an area, or in a ~
barr3er to the nornral replenis6timent of existing specias?. . . . . . . . . . . ~41-
(d) Reductivn in acreage of any agricultura] crop? . . . . . . . . . . . . . . . . ~
~1 anation: ~ ~
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5. Fauna. Wi 11 the proposal resul t 3 n: Yes Mavbe Na
(a) Changes in the diver$ity of species, or nunber of aay species
of fauna (birds, land anirnals fncluding reptiles, fish and ~
shetlfish, benthic organism$, #nsects ar microfauna)7 . . . . . . . . . . . . .
(6) Reductfon of the numbers of any aniquew rare, or endangered ~
species of fauna? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(C) Irttrvductfon of new species of fauna inta an area, ar result
in a barrier to the rnigratfan or moaement of fauna? . . . . . . . . . . . . .
{d} Qeteriaratian of exfst9ng fish or wildlife habitat?. . . . . . . . . . . , . ✓
Expl anati ori:
i
6. Noise. Yes MaYbe No
(a) Will the proposal fncrease exfsting naise 1evels? . . . . . . . . . . . . . .~g 60
' ¢ c~
Excl anati an : nc
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7. l.iqht and G1are. , Yes MU,be Na
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4ay bfil'l the propasal praduce new light or glare? . . . . . . . . . . . . .
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8. Land 1Jse. Yes Maybe Na
(a) Wili the propasal resu1 t i n the aI terati an of the present or
planned land use of an area? . . . . . . . . . . . . . . . . . . . . . . . . . ~
Exvianatian:
9, Natural Resaurces, Wijl the prapasal result tn• Yes Maybe Na
(a) Increase in the rate of use of any natural resaurces? . . . . . . . . . .
(b) Depletion of any nonrenewable natural resource? . . . . . . . . . . . . . ~
' • ExD lanatian: "
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10. Risk of URset. Oces the proposal involve a rfsk of an exp1o$ion or the ltes Maybe- IVa
reIease of hazardous substantes (1nCllldihg, but 1iGt 11j[lited CQs 0ils •
pesticides, chernicals, or radiatfon} in the e+vent of an accident or ~
tipS@t CI}Rd1tiGAS? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Exp 1 anatf an:
11. Lopulatian. W111 the proposal altet` the location, d1StT'ibLItiOns density, Yes Maybe Na
or growth rate of the hwnan population of an area?. . . . . . . . . . . . . . . . ~
ExDt anati an :
7 2. NauS Y n . Wi 1 Tthe proposal a#fect exis ti ng haus i ng, ar create adernand for Yes tN_ aybe No
additional f1GU5iRg? • . r . . . . . . . . . . . . • • • • , . . . . . . . . . .
. ~
ExDlanativn:
13. TransvortationlCirculation. Wi 11 the proposal resul t f n: Yes EMbe No
(a) Generation vf additional vehicular movement? . . . . . . . . . . . . . . . . 40
(b) Effects on exi sti ng parki ng faci 1 i ti es, ar demand for -new parking? .....xko Ad
(c) Impact upon existfng transportation systems?. . . . . . . . . . . . . . . . ~ rIr
(d) Alterations ta present patterns of circu3ation or morrement ~
vf peopte aad/ar gaods? . . . . . . . . . . . . . . . . . . . . . . . . . . .
(e) Alterations to waterborne, ra17 cr air traffic3. . , , . . . . ~ . . . . . . ~
(f) Increase in traffic hezards to mator vehicles.
S f
biqCllsts, or pedestrians? . . . . . . . . . . . . . . . . . . . . . . . . . ~
~I an$y fri on:__bw d' G • ~~fti.~ ' 1e- ~0:-
♦ 4 ;r
. , Oe
14. Public Services, Witl the proposal hdve an effect upon, or tesult Y'es Ma,ybe No
In a need fior new or altered governuuental servXtes in any of the
fol7Mng areas:
(a) Fire protectiart?. j . . . . . . . . . . . . . . . . . . . . . . . . . . . . . gp
~
,
(b) Police prot.ectian? . . . . . . . . . . . . . . . . . . , . . , . . . . . . .
y .
. (c) Sctlools?................................... v
° (d) Parks or other re+creatianal faci1 i ti esY . . . . . . . . . . . . . . . . . . . ~
(e) Maintenance of public fact3ities, including reads? . . . . . . . . . . . . . . ✓
(f) Other goverrrmentat services7 . , . . . . . , . . . . . . . . . , . . . . .
ExDl ana tf on; 5744L.Q4 r +9e__
"+r
Q 0 4 e
-
15. Enerql. Wi11 the proposal resul t 1 n: Yes M~Xbe, No
L~ R
fi (a) Use of substantlaI amounts af fuel or energy? . . . . . . . . . . . . . . . . >#Qm ew
NL
(b) Demand upan ex#sting saurces of energy, or require ~
t-he development o€ nev soutces of energy7 . . . . . . . . . . . . . . . . . . ~
, ExpZanation:
•r4 f '
4
I
}
~
41
. *
,
76. -Utilities. Wi11 the proposal result in a need for new systems. Yes M,~e No
. ar aiteratians to the foliawing util#ties:
(a) Fower or naUral gas? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C~
(b) Camnunir.atfan systans? . . . . . . . . . . . . , . . . . . , . . . . . . . . .
(c) Water? . ................E.........* ...7C.~~~j ~
(d) Sewer or septt c tanks? . . . . . . . . . . . . . . , . , . . . . . . . . . . . .
(e) 5torm water drainage? . . . . . . . . . . . . . . . . . . . . . . . . . . .
(f ) 501 id waste and di sposat ? . . . . . . . . . . . . . . . . . . . . . . . . . . .
Explanation: *VOL, Z At7L4.~4 vact
o ~ ra 444
Yes hayb4z, No
17. Numan Heatth, 41i11 the proposal resuit in the creatian of any health hazards
or potentiaj heaith hazard iincluding mental healthy? . . . . . . . . . . . . . . . .
Exalanation:
Yes Maybe No
1$. Aesthetics. Wi11 t-he proposal result in the obst,ructian of any scenic vfst,a or
vtsw open to the pubZic, vr wi11 the proposal resu2t in the creatian of ari
eesthetica1ly offensive site open to pub]fc view? . . . . . . . . . . . . . . . . . .
Exfll anati on:
Yes ~A_ aybe No
19. Recreatfon: Will the proposal result in an impact upan the qua1ity or ~
quantity of existing recreationai apportunities? . . . . . . . . . . . . . . . . . .
Lxyla11ation: ,:c~^ 4 f c-c''e m~se_~ i A% o;
'r' kt+~. 1 ek
YeS Maybe No
20, Archeotoqical ~listorical. Vill the proposal result in an alteration of a
sigRificant arc eoiogfcal or hfstarical site, structure, ohject or 6uildfng?
Exp 1 anati on:
,
Y I I . 5 IMTURF ~ -
I. the undersiOned, swear under the penalty af perjury that the abvve responses are made
•truthfully and tv the best of my knvwiedget. I also understand that, shou3d there be any wj31-
ful m#srepre5entati on ar wil l fui lack af f u1 l di sc1 asure on wW part, Spokane County may wi th-
draw any decl arattan of nansignif9 cance that i t might i ssue In re1 i ance upon thi s checkli st.
Date: Proponent=_
(Please Print or TyQe)
,
Propoaent: ~9. Address: ~ ~~-1 -a- Lr. dl~
Phane:
Rer~son campi eti ng farm: Phone: ~~r~ q r Date:~ 3--.~
~
AMIM~
FOR STAFf USE ONLY
Staff Member(s) Revjewing Checklist:
Based on this staff review of the envirommta1 checklist arid other pertiment informati the staff:
~ ACancludes that there are no potentially Significant adverse impacts ao<reconmend Jissues
7• -1 a propased declaratian of nonsignificance.
~
B. Co ncludes that pctentialiy signif#cant adverse fmpacts do exist and recomends/issues a fi na'i decl aratf on of si gni ficance. 4,31 ~f
G. Cflncludes that there are no pa#.entiaily significant adverse impacts and. because af the
;
ratur'e of the proaosal, reu3rnmends/issUes a finai declaratiart af nonsignificance.
~
Revised: August, 1981 ~
`
L
, 3l04, 4
SPOKANE COUNTY P1.ANNING DEPARTMENT .
APPLICATION FOR CONOITIONAL USE PERMIT/VARIANCE/WAIVER OF VIOLATIO(d
Date : Appl i cati on No :
Name of Appl i cant : Ji c.ti J~..
~
rStreet Address of Appl i cant : e a y
Ci ty: State : ~ Zip Code : ~9o37Tele. ~So• .
' J
'Name of Property Oame~( s ) : 6, p ,v- ue 'T
,
aequested Action (Cite Ordinance Section) : Y, ,ael. 4&0
~
Lo c,~ / &45iiVeSs
Existing Zoning Classification:
Exisutin Use of Pro ertY 7~-fi' : G~r~ s G~s S oiv Ike., 9 P ft ~ f S ~rAu'Q
~ Proposed Use of Property : ,.~~ce S~ cFi p
. ,
Legal Description of Property (Include legal description of easenent if applicable)
. . & *,-JL~
a
s t Sb Fl-- oF 9~jn oz 6 L& E s,6
. •
Gomprehen s i ve P1 an Des i gn at i on : ~ A v- loi4 q%)
Secti on : ~ Toromshi p : Range :
Q??-~ ' ♦
.
9 ~ Source of Legal : ~vN
,;,Asses'sor' s Paroel- No. (see tax statement ) a 14 4/ 3a - 30 0(o '
Propewty Si ze : (v I~~IV lFrontage : sP&L,,a f Feet• on :
'7 Tota] amountr of adjn n9 land cont oll d bY this owner or sponsor: - b- a ,
Street Address of the Property : /yo 7 5- 7
` / L
~ on , what is
If yoy do not hold titl e~to the\property affected by ~this /appl• ~cat•
, your interest in it? - /e-4see-, +
Please` list previous Planning Department actions involvinq this property:
l
.
_ o .
.
I SddEAR THa? I AM THE OWNER OF RECORD OF THE PRQPOSED SITE, IF NOT THE OWNER,
ATTACHED N@RE Rr FROM SAID OWNER AUTHORIZIIdG MY ACTIONS
ON k1IS QR HER BEHALF.
( (Si gne
(Addre ~ G. phone: ~J,~'.o,f
Q~0
•
• ~ ~ Zip•
ow
NOTAR Date: /-.251~3
: ~
NOl`~~~,jEAL: ~s ~ ~ •
` 1 S
SIGNATURE OF APPLYCA1dT OR AGENT
♦
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~ }/o1Date • / r~ ~ + ` ~ ✓
7f ~ ~ i 7~ ~ ~ ~ 7~ -7F ~ 777~ 77ii 77f 7i~ 7~ 7~ af is 7i 'I7i f ~ 7f
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FQR OLAWNING OEP7MEP1T U§ qN4X Fees Receipt #
~ Hear~ Oate: M J..2 Le al Checked by: ,
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