MONTGOMERY E 11115 OFFICE & WAREHOUSE , -
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BLDG. PLRiMIT f~ ~ -
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Date ta Review
Date Received o~
Pro'ect ~`:~.me ~.c~ts Nn. Acres -
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PARCEL#
s~~ ~DREss
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Fbone #
Sponsor's Name
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Address
~ork , Date carrditions ailed _
Contact persan Phone #
FLODL] ZONE Yes ~ No ~
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Engineer ! Surveyor's l Architect's Narne _
Wate~ Address - Sewer
Schoo1
Plannxng Cantact Persan Phone #
Date Submitted Descriptian II11t1a15
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t EW1NG M. MICKEN - ARCHITECT
~ . .
• N. 6116 G. STREET • SPOKANE. WASHINGTON 99208 ~ 509•328-7628
DATE: 12 JUL 91
. ,
T0: SPOKANE COUNTY DEPARTMENT OF BUILDING & Sf1FETY ~~~~~A@ ~1!/~~ .
W. 1303 Broadway ~
Spokane, Wa 99260
~ JUL 1 21991
k
RE : A-A Bl1IL D1NG f~ sPOp(ANE COUNTY ENG{NEER .
E 11115 Montg omery - - -y -`y ~ -
SUBJECT : CHANGE ORDER / CLARIFICATION #2
This Change Order is applicable-to the items affected and all parties to
construction are held responsible for the.contents herein. Its purpose is
to add, or delete items, to clarify information given in Plans or Specifi-
cations, and/or to include information ommited from either or both. This
memo hereby becomes a part of the Drawings or Specifications to the same
extent as though it had been written into the original Drarvings and Specifications...
ITEP9#1 - See attached supplementary Dtl. 3A/A:0 & partial Sht A:1 (revised)
1 . UI11ENSION - SEE SITE PL/1N ~
5' -4"
TYPE 3 METAL GRATE
° GRASS LAWN - TURF TYPC TYPE B PRE-CAST CONCRET DRY WELL
-f= ( UNLESS NOTED OTHERW SE N -5 - - - ' .
• 112 SLOPE 11
\ ^ / \ 2 ASPH.PAVING (TYP) ON
00 %10 \ 2" GRAVEL LEVEL COURSE
N N~
DRY WE__ /~A
NO SCALE
cc Bob Turnery SCD of Eng'g
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3 +
' JUL 091991
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:
TYPE OF CONFERENCE
J
SPOKANE COUNFt ENGINEER ~
Pre-Application Pre-Construciion Other.
TI M E:
DOCUMENTS CIRCULATED
~ DATED REVISED
APPLICATION
SITE PLAN
DRAINAGE PLAN . ~
LANDSCAPE PLAN ~
Other: I
Other: ~
ADDITIONAL INFORMATION
ll'C~'Al~
l'
(
CIRCULATED TO CIRCULATED BY
SCAPCA-M. Caine Utilities
Engineering Fire District # ~
Health District ~ Liberty Lake Sewer Questions? Contact Jeff Forry or:
Planningi Other:
't A 1
I
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Spokane County
DIVISION OF BUILDINGS
West 1303 Broadway Spokane, WA 99260
(509) 456-3675 (office) or (509) 456-4703 (fax)
. f ~
SPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE, WASHINGTON 99260
(509) 456-3675 '
I cenify that I have examined this permit/epplicetion, state that the iniormation contained in it and submitted by me or my agent tacompile said permlt/application is true
end correct, and authorize Spokene County to proceed with processing. In additlon, I have read and understand the INSPECTIOIV REQUIREMEN7SINOTICE
provisiona included hereln and agroe to comply wlth seme. All proviaions of laws and ordinancea governing this type of work w111 be complied wlth whether specitied
hereln or not. t understand that the issuance o1 this permit/application and any subsequent fnapectlon epprovals or Certificates of Occupancy 8hall not be construed to
glve authorlty to violate or cancel the provisions oi any state or local law regulating construction, or as a warranty oi conformance with the provisions of any state or local
laws regulating construction. ~
SIGNATURE OF APPLICAT{ON
OWNER OR AGENT DATF
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PUBLIC WORKS DEPARTMENT
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' _ ' OFFICE OF
COUNTY ENGINEER
RONALD C. HORMANN, P.E.
,~'il~~.t,.~r1,1'. .'!•~j ~1,~1'~~.y;.~'.~,~,~,~'..,~~ii''~; COUNTY ENGINEER
' SPOKANE, WASHINGTON 99260-0170
. _ .
AGREEMENT TO PAY FEES
A9r eement Number I /oc) q
- -
This agreement between Spokane County and 49,<4
,
whose interest in the project is OF`/Ge-
WA- is entered into
this day of iY,IA~' , 19 ql . This agreement is
applicabl to t~ e project know` as:
~e r~► !/N-u. ~ 6'Ks„~ ~ss ~~2K- .
i
That the individuals and parties named herein as having an
interest in the above described property or project agree to the
following:
1. Reimburse Spokane County for project review and inspection
fees as specified in Board of County Commissioner's
Resolution 80-1592 attachment C, as amended. The fees will
be based on actual salary costs incurred by Spokane County
for project reviews and / or inspections plus a ten percent
. . administrative charge, and will be billed monthly as
accrued.
2. The undersigned agrees that these fees aze due and payable
upon receipt of the billing as specified above. The
monthly billing should be sent to the attention of:
~LL ~ f'VSON
~?o . r3dx ~y/7or
SDo,C ~4~vc=~ w r9Z i~
I understand that failure to pay these fees may result in
delay in completion or approval of the pro7ect or other possible
sanctions.
~
By \ S~
Public Works Building / North 811 Jefferson Street / Spokane, Washington 99260-0170 (509) 456-3600
CIVED
NOT CE OF TRANSM TTAL.
~ FEB 2 11991
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TYPE OF CONFERENCE '
~
✓ Pre-Appiication Pre-Construction Other: DATE:
f '
TI M E: Q" ~
DOCUMENTS CIRCULATED
DATED REVISED
APPLICATION I
SITE PLAN ~
~
DRAINAGE PLAN I ~
LANDSCAPE PLAN I ~ .
Other: A11
Other: I ~
ADDITIONAL INFORMATION
~
;IRCULATED TO CIRCULATED BY
DATE
Air Pollution Utilities
Engineering,/ Fire District # ~
Health District-/ Liberty Lake Sewer Questions? Contact Jeff Forry or:
Planning ✓ Other: ✓
P~PsdkC.j~
~
Spokane County ~
DEPARTMENT OF BUILDING AND SAFETY •
West 1303 Broadway Spokane, WA 99260 ~
~
(509) 456-3675 (office) or (509) 456-4703 (fax)
9: 04:3": F~il ~~{~Iti~ BEi~:~1~ETT&c~:E~d3?P r,11R T~~ Ir S F01
Err & ASHENBRENER, P.S.
JACK BENNETT ATiORlVEYS AT tA1N
CNR!`"n7F'MER R, ASHENBRENER EAST 941$ TRENT AVENUE TELEPIIONE
L.ARRV M. Wa'S4N SPOKANE. M.94INfa°1ON 99206-4289 (S09) 9288076
FA?C (549) 928-9286
EMTRAN5MML CaVERSHEET
DATE: 5/22191 FAX 956-4715
COM PANY NAM E: CcUN~ ENcINEER
AT't'ENTION: lgag TL1abw
REFERENCE: Bi LL LnwsoN UEVELQPMEN'1' / A&A PROPERTIES
FROM: CHRIS ASNENBRENER
NUMBER oF PAGES INCLUD)NG COVER: ~
AtJR FAX NUMBER (509) 92&-9288
NOTES:
F1PagP rPView this PagPment as to form and contact me if it is
inaploror)riate since I intend ta obtain siqnatures and record as
gnnn a~-- p ncz s i hl P_ (pj,P wi ll nrovitie? yoii wit.h a S;QAV of the site
iplan at a l.ater dc-ite.
rphank „I
1F YOU DO NOT RECElvE Al.L. PAGES, OR HAVE ANY PROgLEM
WITW RECE{V1NG THlS FAX, PL.EASE CALL THE NUM6ER ASOVE.
YHANK YaU}
-!j 1 0 1; F'P~ ~ ~ ~)iU1 ~ ~I'JI~ S:~ 3'~j~ R: ~~JEF~ 1 1_~'` I 1 I 'T' `t ~ F ~ ~ ~
. . F 0 ~
STORM DRAINAGE EASEMENT
FOR GOOD AND VALUA.BLE CONSIDER.ATYON and for the mutual
benefits to be derived therefrom, the undersigned parties create
and grant this Easement and make the following recitala and
covenants:
1. pARTIE3:
GRANTOR: WILLYAM J. LAWSON and CAROL LAWSON, hueband and
wi.fe.
GR.ANTEE: NORTH VALLEY BUSYNESS PARK, a Wa$hington
general partnership.
2. OWNERSHIP OF REAY, PROPSRTY:
Grantar owns and ha$ some right, title and intereet, both
legal and equitable, in the fallowing deacribed property:
Parcel A:
That portian of the South half of the Northwest Quarter
of Section 9, Township 25 Noxth, Range 44 E.W.M. Spokane
County, Waghingtan, described as follows:
8egin at the centerline intersection vf Bowdish Roac3 and
Jackson Avenue, thenee South 89 32'30"West, alang the
centerline of Jackson Avenue, a distance of 560.00 feet;
thenee South 00 08'I0" East parallel with the East line
of said Northwest Quarter, a distance af 30.00 f eet to
the Sauth right of way line vf Jackson Avenue; thence
cantinuinq Soutb 00 QS' 10" East a distance of 60.00 feet
to the True Point of Beginninq; thence Sauth 89 32'30"
West a diatance of 64.17 feet; thenae South 50 53•26"
West a distanee of 249.71 teet to the Northeasterly right
EASEMENT - 1
%-`al 114F'~4~ t~~~lU~ ~~:rJI'dF 'T.?,& A ~~~y~~i~L~iE~'
'~I~I'T°` r~r
of way line of Montgomery Drive, gaid point ie on a curve
cancave to the Sauthwest having a radiua ef 1030.00 teet,
a radial line through said point bears Narth 41 41'13"
East; thence Sautheasterl.y, through a central angle of 9
12' X3", an arc distance of 165.45 feet to end of curve;
thence South 39 06134" East a digtance of 50.26 feet;
thence North 50 53' 26" East a distance of 145 . 05 feet to
a point 580.00 feet West of the centerl.ine of Bowdieh
Road, measured along a line parallel with the centerline
of Jackson Avenue; thence North 00 08'10" West parallel
with the centerline of Bowdieh Road, a diatance of 225.00
feet to the True Point of Beqinning;
EXCEPT those portiana canveyed to Spokane Gounty as
degcribed in Right of Way Deeds recarded under Auditor' a
Fi1e Nos. 7308210258; 7308210259 and 7308210263;
Grantee owns and has some right, title and interest, both
legal and equitable, in the following described propertys
Parcel C:
That porti.on of the South half of the South half of the
Northwest Quarter of Section 9, Township 25 North, Range
44 E.W.M., described as fallows:
Begin at the centerline intersection of Bowdish Road and
JacksQn Avenue; thence South 89 32'3011W, dlong the
centerline of Jackson Avenue, a distance of 580.00 f eet;
thence South 00 08'10"E, parallel with the East line of
said Northwest Quarter, a distance of 30.00 feet ta the
Sauth right of way line of Jackson Avenue and the ~rue
Point of Beginning; thence continuing South 00 48110"E a
distance of 295.00 feet; tbence North 89 32'3011E,
parallel with said Jackson Avenue, a distance of 425.00
feet; thence North 00 08' 10"W, parallel with said Ea$t
line „ 295.00 feet to the South line of said Jackson
Avenue; thence Soutb 89 32' 30"W a distance of 425.00 feet
ta the True Point of Beginning.
3. PURPOSE: The purpdge of creatirig and granting thia
easement is to permit an easement for the benefit of North Va11ey
Businesa Park and their successors and assigns far storm drainage
runotf from real property owned by them and set foxth abave as
ParGe1 C.
4. DURATIQN: The easement created and granted herei.n shall
EASEMENT - 2
r- e I A - + i~~} ~ ~ ~ nR~ r•NF~; fi;l 71, t; ~Pr
.:c . , .3^ PP4~( _ t:f'.~I 3~ ''.~I~1~~~~~~~;~~.Fr~~i. _ _ -~~~r ~ `a Pp~
be perpetual in duration.
5. CREATION AND DESCRZPTION OF EASEMENT: Grantor hereby
creates and grants an eagement for gtarm drainage runoff far the
benef it of Grantee far the purpose of disposing of atorm drainage
runoff flowing from Grantee's property as abov►e eet forth and
referred to as Parcel C. The exact location of the eagement upon
which Grantee's Btarm drainage may flow i$ that particular 11208
Drainaqe Swale" lacated in the Northeastern corner af Grantor'e
property, the exact locati,on of which ig set farth on Grantor' a
site plan, a capy of which is attached hereto and by thie reference
made a part hereof and desigriated ae Exhibit "A".
6. BENEFICIAL INTERESTS: The easement herein created ie for
the non-exclusive benefit of the owners, successors and aeBigns of
Grantee's property, the legal description of which ie above eet
forth.
7. SERVIENT ; BINDING AFFECT AND RUNNING WITH THE LAND : The
easement created and granted herein shall be binding upon the
owners and successors arid assigns of Grantor's real property the
legal desGription of which is get forth above, and sai.d easement
ghall run with the land.
8. MAINTENANCE OBI.,IGATYON : Grantor hereby gcknawled+ges the
obli.gation of creating and maintaining a drainage swale pn the
lacation established an the attached Exhibit "A" with a permnnent
live cover af lawn turf and with optianal shrubbery and/ar treee
which do not abstruct the flow and percolation of storm drainage
water in the drainage swale as received from Grantee's abave
EASEMENT - 3
: - 22- 9 1 0 4 . 4 U PII F _R 0 H B JNi~ E T T & A : H -7 T1; L N=, ij 11 i I TY SF O ' ~J 1
the aaid instrument.
OIVEN under my hand and official seal this day of May, 1991.
Notazy PubYic in antl for the State
of Washington, residing at Spakane.
My cammission expirea:
$TATE OF WASHINGTON )
) gg.
GOUNTY QF SpOKANE )
On this day personally appeared before me wILLIAM J. LAWSON and
CAROL LAWSON, to me known to be the individuals described in and
who executed the within and foregoing instruinent, and acknowledged
that they signed the same as tbeir tree and voluntary act and deed,
for the uees and purposes therein mentioned.
aIVEN under my hand and off icial eeal this day of Irtay, 1991.
Notary Fublic in and for the State
of Washington, residing at Spokane.
My commission expires:
EASEMENT - 5
referenced property.
DATED this 25th day of March, 1991.
GRANTdR:
WILLIAM J. LAWSON
CAROL LAWSON
dRANTEL :
NaRTH VALLEY BUSTNES3 PARK
a Washington general partriexship
Bx~
MEAUOW HILLS CORPORATION
Robext A. BonuGCelli, President
By:
NORTHWOOD PROPERTIES, INC.
Theodore G. Gunni.ng, President
STATE OF WASHINGTON )
) sg.
C4U1+tTY OF SPOI{ANE )
On thig day personally appeared before me ROBERT A. BaNUCCELLI,
President of Meadow Hills Gorporation, and THEQDORE G. GuNNING,
President of Northwood Properties, to me knawn to be the General
Partners of NORTH VALLE'Y BUSINESS PARK the Waehington General
Partnership that executed the faregoing instrument, and
acknowledged the said instrument to be the free and voluntary act
and deed af said partnership, for the u$es and purposes therein
mentioned, and on oath stated that they are authorized ta execute
EASEMFNT - 4
~
I
Page 1
OFFICE OF TNE COUNTY ENGINEER
SPOKANE COUNTY, WASNINGTON
Project: office - warehouse Date 2-27-91
Address: E. 11115 Montgomery
Parcel No: 09545-9060 Ref No. B91009
The County Engineering Department has completed a review of
the above referenced project. The following information must be
provided in order for us to proceed with our review. A) A drainage plan for the site which has been prepared in
compliance with Spokane County "Guidelines for Stormwater
Management". At a minimum the plan must contain:
1. Drainage calculations for stormwater volumes
generated on site.
2. Calculations for total impervious surfaces
contained within the site.
3. Finished grade elevations for structures to be
constructed on site.
4. Finished grade elevations at the top and bottom of
the 208 swale.
5. A typical cross section of the 208 swale.
6. Calculations to 7ustify the number and type of
drywells proposed.
7. Elevation of drywell inlets where applicable.
B) The subject property is affected by the "Findings and
Order" and the "Conditions of Approval" for the following
land use action:
1. Spokane County Zone Change No. ZE-50-72
C) The following improvements within adjacent Right of Way
are required prior to the release of a building permit:
lo You must submit road and drainage plans for street
improvements. These must be prepared by an
engineer. Plans must be prepared for the following
streets:
a. Montgomery Drive
b. Jackson Avenue
All required construction (sidewalk/curbing/pavement) within
the Public Road Right of Way is to be completed prior to the
release of a building permit or a financial guaranty in an amount
estimated by the County Engineer to cover the cost of
construction or improvements shall be filed with the County
Engineer. Required plans are to be submitted prior to estimating
the amount of the financial guaranty or permit release.
Page 2
2. Approach Permits must be obtained from the County
Engineering Department for driveway approaches to
the following streets:
a. Montgomery Drive
b. Jackson Avenue
~D) Insufficient information was submitted with the proposal.
. We are unable to proceed with our review. We will need
the following before we can proceed:
l. Site Plan.
2. Drainage plan as specified.
3. Other information:
a. Improvement of the Montgomery and Jackson
intersection as directed by the Spokane County
Traffic Engineer.
b. Construction of connecting road between
Mon'tgomery and Jackson, including any right of
way dedication if necessary.
E) Utility Condition: Permittee is responsible for arranging
for all necessary utility adjustments or relocation as
required for completion of the improvement.
F) The owner of the property or the authorized
representative must complete and sign Spokane County
Engineers "Agreement to Pay Fees". This document must be
returned to the County Engineers Office. Plan review will
not be completed until this document is executed. This
. document is attached to these comments. Please return
the completed Agreement to your contact person at the
Engineers Department.
Only after all the information and requirements listed above
are supplied or completed and the necessary review has been
accomplished will your building permit be released.
Your contact person at the County Engineering Department may
be contacted at 456-3600. Your contact person is Robert Turner.
.
Page 1
OFFICE OF THE COUNTY ENGINEER
SPOKANE COUNTY, WASHINGTON
Project: office - warehouse Date 5-8-91
Address: E. 11115 Montgomery
Parcel No: 09545-9060? Ref No. B91009
The County Engineering Department has completed a review of
the above referenced project. The following information must be
provided in order for us to proceed with our review.
A) A drainage plan for the site which has been prepared in
compliance with Spokane County "Guidelines for Storrriwater
Manaqement". At a minimum the plan must contaiii:
1. Drainage calcu3ations for stormwater volumes
generated on site, ancl any off-site drainage that
will be disposed of on the property in question.
2. Calculations for total impervious surfaces
contained within the site.
3. Finished grade elevati(Dns for structures to bta
constructed on site.
9. Finishsd grade elevations at the top and bottom of
the 208 swale.
5. A typical cross section of the 208 swale.
6. Calculat ions to just i fy thP number and type of
drywel ls proposed.
7. Elevation of drywell inlets wher-e applicable.
B) The subject property is aftected by the "Findings and
Order" and the "Conditions of Approval" for the following
land use actiori:
1. Spokane County Zone Change No. ZE-50-72;ZE-104-83
C} Tt-ie following ii-nprr_.vements withiti adjacent Rig}zt of Way
are required prior to the r_elease of a building permit:
1. You must submit road and drainage plans for street
improvements. These must be prepared by an
engineer. Plans must be prepared for tht followiiZg
streets:
a. MQr.tgomery Drive
All required construction (sidewalk/curbing/pavernent) within
the Public Road Right of Way is to be completed prior to the
release of a building permit or a financial guaranty in an amount
estimated by t}ie County Enginee-r to cover the cost of
construction or improvements shall be filed with the County
Engineer. Required plans are to be submitted prior to estimating
the arriount of the financial guaranty or permit release.
' .
Page 2
2. Approach permits must be obtained from the County
Engineering Department for driveway approaches to
the following streets:
a. Montgomery Drive
D) Insufficient information was submitted with the proposal.
We are unable to proceed with our review. We will need
the following before we can proceed:
1. Site Plan.
2. Drainage plan as specified.
E) Utility Condition: Permittee is responsible for arranging
for aIl necessary utility adjustrnerlts or relocatiotl as
required for c-ornpletion of the impzoverr►ent.
F) Tt-ie owner of ttle propezty or t}ie authori2ed
representative rraust completF and sign Spokane County
Engineers "Agreement to Pay Fees". This document must be
returned to the County Engineers Office. Plan reviPw will
not be completed UIltll this document is executed. This
doeument is attachEd to these comments. Please return
ttle completed Agreement to your CoI1tdC.t person at the
Engineers Uepartrnent.
Only aftzr all the information and requirernetlts listed above
are supplied or corripleted and the riecessar-y Ycview has been
accumpl ? shed wi 11 your bui l.d ing pe-Lmit be r eleased .
Xour contact person at the Couizty Engi.neering Pepartment may
be contacted at 456-3600 . Your curitact per jon is RobF•rt Turnez.
~ t . .
Z
Page 1
OFFICE OF THE COUNTY ENGINEER
SPOKANE COUNTY, WASHINGTON
Project: office - warehouse Date 5-8-91
Address: E. 11115 Montgomery
Parcel No: 09545-9060? Ref No. B9I009
The County Engineering Department has completed a review of
the above referenced pro7ect. The following information must be
provided in order for us to proceed with our review.
A) A drainage plan for the site which has been prepared i.n
compliance with Spokane County "Guidelines for Stormwater
Management". At a minimum the plan must contairl:
1. Drainage calr_ulations for stormh=ater volumps
genexated on site, and any off-site drainage that
will be disposed of on tr►e property in question.
2. Calculations for total imnervious surfaces
contained within the site.
3. Finished grade elevations for structures to be
constructed on site.
4. Fini.shed grade elevations at the top and bottom of
the 208 Uwale.
5. A typical cross sectiun of the 208 swale.
6. Calci.ilations to justify the number and type of
drywell5 propostid.
7. Elevat i on of drywell inZ?ts w}ier e appl icable .
B) Tt7e subject property is affected by the "Findings and
Order" and the "Conditions of Approval" for the following
land use action:
1. Spokane County Zone CYtange No. ZE-50-72;ZE-109-83
C) The following irnprovements withi.ii adjacent Right of Way
are required prior to the r_elease of a building permit:
1. You must submit road and drainage plans fur street
improvements. These must be prepared by an
enyinzer. Plans must be prepared for the following
streets:
a. Mortgomery Drive
All requircd c.onstruction (sidewalk/curbing/pavement) within
the Public Road Right of Way is to 1De completed prior to the
release of a building permit or a financial guaranty in an amount
estimatPd by the County Engineer to cover the cost of
constrUCtion or i.mpravemznts shalZ be filed with the County
Engineer. Required plans are ta be subm~Itted Prior to estimating
the amount of the financial quaranty or permit release.
I ~ • •
Page 2
2. Approach permits must be obtained from the County
Engineering Department for driveway approaches to
the following streets:
a. Montgomery Drive
D) Insufficient information was submitted with the proposal.
We are unable to proceed with our review. We will need
the following before we can proceed:
l. Site Plan.
2. Drainage plan as specified.
E) UtiJ.ity Conditian: Permittee is responsible for arranying
. for aIl necessary utility ac.-~justrnents or relocation as
required for completion of the improvement.
F) The owner vf the property or the authorized
representative must complete and s?gn Spokane CoUiity
Engineers "Agreement to Pay Fees". This document must be
returned to the County Engineers Office. Plan reviPw will
not be completed uritil this document is executed. This
ducument i5 attachEd to thcse comments. Please return
the completEd Agreement to your coiltact person at the
zngineers Uepartrnent.
Only after all the inforrnation and r_equirenlents listed above
are supplied or carii~,aleted and the necessary review has becn
accompli-shed will your building peLrnii: be released.
Xour contact persan at the Cvunty Engineering Departrrtent may
be coritacted at 456-3600. Your cotitact person is Robert Turner.
. ? , . ~
. ~
~ Page :i°--
~
~ OFFICE OF THE COUNTY -ENGINEER
~ SPOKANE COUNTY, WASHINGTON
ll va3
Project: office - warehouse Date 2-27-91
Address: E. 11115 Montgomery G
Parcel No: 09545-9060 Ref No. B91009
The County Engineering Department has completed a review of
the above referenced project. The following information must be provided in order for us.to proceed with our review.
A) A drainage plan for the site which has been prepared in
compliance with Spokane County "Guidelines for Stormwater
Management". At a rninimum the plan must contain:
1. Drainage calculations for stormwater volumes
generated on site.
2. Calculations for total impervious surfaces
contained within the site.
3. Finished grade elevations for structures to be
constructed on site.
4. Finished grade elevations at the top and bottom of
the 208 swale.
5. A typical cross section of the 208 swale.
6. Calculations to justify the number and type of
drywells proposed.
7. Elevation of drywell inlets where apPlicable.
B) The subject property is affected by the "Findings and
Order" and the "Conditions of Approval" for the following
land use action:
1. Spokane County Zone Change No. ZE-50-72
C) The following improvements within ad7acent Right of Way
are required prior to the release of a building permit:
1. You must submit road and drainage plans for street
improvements. These must be prepared by an
engineer. Plans must be prepared for the following
streets:
a. Montgomery Drive
b. Jackson Avenue
Al1 required construction (sidewalk/curbing/pavement) within
the Public Road Right of Way is to be completed prior to the
release of a building permit or a financial guaranty in an amount
estimated by the County Engineer to cover the cost of
construction or improvements shall be filed with the County
Engineer. Required plans are to be submitted prior to estimating
the amount of the financial guaranty or permit release.
~ V •
Page 2
2. Approach permits must be obtained from the County
Engineering Department for driveway approaches to
the following streets:
a. Montgomery Drive
b. Jackson Avenue
~•D) Insufficient information was submitted with the proposal.
We are unable to proceed with our review. We will need
the following before we can proceed:
l. Site Plan.
2. Drainage plan as specified.
3. Other information:
a. Improvement of the Montgomery and Jackson
intersection as directed by the Spokane County
Traffic Engineer.
b. Construction of connecting road between
Montgomery and Jackson, including any right of
way dedication if necessary.
E) Utility Condition: Permittee is responsible for arranging
for all necessary utility adjustments or relocation as
required for completion of the improvement.
F) The owner of the property or the authorized
representative must complete and sign Spokane County
Engineers "Agreement to Pay Fees". This document must be
returned to the County Engineers Office. Plan review will
not be completed until this document is executed. This
document is attached to these comments. Please return
the completed Agreement to your contact person at the
Engineers Department.
Only after all the information and requirements listed above
are supplied or completed and the necessary review has been
accomplished will your building permit be released.
Your contact person at the County Engineering Department may
be contacted at 456-3600. Your contact person is Robert Turner.
<
a- •
i
I
S P O K A N E;, C O U N T Y
DE['ARTMEiVT OF BUILUINGS • A DIV[SION OF THE PUBLIC WORKS DEPARTMENT
-
JAMES L. MANSOf~, C.t3.0., DIRECTOR DENNIS M. SCOTT, P.E Y
-s[RE---~-~'- R
f .
MAY 1 0 19el1 ;a
~
+ ~I~~IL~aOtl~ ii~l1JAC~ d t~E~~~fbYs~~ 1
TO: Paul Chase, Fire District No. 1
Lorne Lakshas, Planning Department
Paul Jensen, Planning Department
Bob Turner, Division of Engineering & Roads
Daryl Way, Health District
FROM: Tom Postlewait, Plans Examiner er
Division of Buildings
DATE: May 8, 1991
RE: May 8, 1991 Pre-Construction Conference
East 11115 Montgomery Avenue
Enclosed is your copy of the minutes to the referenced meeting.
Should you have any questions or need additional information, please
feel free to contact me.
TLP:rmd
cc: Mr. Bill Lawson, Owner
Mr. Ewing Micken, Architect
Ms. Mabel Caine, Air Pollution Control Authority
Mr. Dennis Scott, Public Works Department
I
I
CODE ENFORCEMENT DNIS[ON
WEST 1303 BROADVYAY 0 SPOKANE, WASHINGTO,! 99260-0550 * (509) 456-3675
FAX (509) 956-4703
,
f MINUTES . '
PRE-CONSTRIICTION CONFERENCE
EAST 11115 MONTGOMERY DRIVE
OFFICE & WAREHOIISE
MAY 8, 1991
CALL TO ORDER: The meeting was called to order at approximately
10:00 a.m. by the Division of Buildings Plans Examiner, Tom
Postlewait, with the following in attendance.
PERMIT REVIEW PARTICIPANTS:
Paul Chase, Fire District No. 1
Robin Domitrovich, Division of Buildings
Lorne Lakshas, Planning Department
Paul Jensen, Planning Department
Bob Turner, Division of Engineering & Roads
Daryl, Way, Health District
APPLICANTS:
Bill Lawson, Owner, P.O. Box 141701
Spokane, WA 99214 (509) 927-8613
Ewing Micken, Architect, N. 61116 G St
Spokane, WA 99205 (509) 328-7628
SCOPE/PROJECT DESCRIPTION:
I. General Overview - The owner A& A Construction & Development
Inc. is proposing the construction of a 15,475 square foot off ice
and warehouse. Access to the property will be through an
ingress/egress easement. The proposed was subject of a
Pre-Application Conference held February 27, 1991.
SUMMARY OF DEPARTMENTAL REOUIREMENTS:
I. Planning Department (456-2205)
A. Discussion/Requirements
1. A 10 foot strip of Type III landscaping is required -
along Montgomery Drive. The applicant stated that five
feet of the required landscaping is existing and asked if
the 208 drainage swale would be adequate for the remaining
5 feet of required landscaping. Lorne Lakshas stated that
the 208 area could be used for landscaping as long as the
landscaping does not effect the integrity of the 208 swale
(sod only is not considered landscaping). A six inch
protective curbing or wheelstops are required to be
installed around all landscaping.
- 1 -
2. A minimum of 10% of the parking lot located in the
rear of the property is required to be landscaped. All
parking spaces are to be within 60 feet of a landscape
feature consisting of 32 square feet in area.
3. A certificate of exemption has been obtained for the
subject property. Please contact the County Assessor's
Office to obtain the correct parcel number and submit the
parcel number to the Planning Department for their
records.
4. As per the requirements of Zone Change ZE-104-83 an
exterior liqhting plan for the subject parcel shall be
submitted.
5. Please submit a revised site plan illustrating
detailed landscaping, the required six inch protective
curbing around all landscaping, and indicate the specific
uses and square footage of the proposed.
6. The applicant stated that the proposed will be one
story. If a second story is proposed at a future date
please contact the Planning Department for further
requirements.
B. Permit Release Requirements
1. An estimate from a nursery including size, type, and
quantity of landscaping, itemized cost of the irrigation
system, and the cost of labor along with a promissory
letter form the owner stating the landscaping will be
installed shall be submitted.
2. Please submit a revised site plan as described above
for review and approval.
3. Please submit the correct parcel number for the
subject parcel.
II. Division of Engineering & Roads (456-3600)
A. Discussion/Requirement
1. Comments were given to the applicant and the Division
of Buildings by Bob Turner.
2. Please submit a drainage plan for the site that is in
compliance with Spokane County Guidelines for Stormwater
Management. Bob Turner informed the applicant that there
- 2 -
ti
J is a problem with off site drainage at the proposed site.
The applicant will either need to take care of the
stormwater through 208 drainage swales or by constructing
a wall to keep the stormwater from draining onto the
proposed site. If the off site drainage is taken care of
through a 208 drainage swale a copy of an easement
agreement for the off site drainage shall be submitted to
the Division of Engineering & Roads.
3. Please submit' road and drainage plans prepared by an
engineer for road improvements to Montgomery Drive. All
required construction within the county right of way must
be completed prior to the issuance of the building permit
or a bond in an amount estimated by the County Engineer to
cover the cost of construction shall be submitted to the
Division of Engineering & Roads.
4. An Agreement to Pay Fees was given to the applicant
during the meeting. The agreement is to be signed by the
owner and returned to the Division of Engineering & Roads.
Plan review will not be completed until this document is
executed.
B. Permit Release Requirements
1. Please submit a drainage plan for the site as
described above for review and approval.
2. Please inform the Division of Engineering & Roads of
how the off-site drainage problem will be taken care of.
If the off-site drainage is taken care of through a 208
drainage swale, an easement agreement shall be submitted
to the Division of Engineering & Roads.
3. Please submit road and drainage plans prepared by an
engineer for road improvements to Montgomery Drive.
4. Please submit a copy of the Agreement to Pay Fees
signed by the owner.
III. Health District (456-6040)
A. Discussion/Requirements
1. The proposed will be served by an on site sewage
disposal system. The applicant stated that the subject
property is not large enough to accommodate an on site
system, therefore an easement will need to be granted by
the adjacent property owner to install the system on the
- 3 -
r
• ,
adjacent property. Daryl Way advised the applicant that
since the proposed office/warehouse is speculative to make
sure that the easement is large enough to accommodate the
worse case scenario for sewage disposal. Please submit
anticipated sewage disposal flow calculations for review.
2. Please submit critical material lists for each space
once it has been occupied. If it is determined that the
proposed is a critical materials user the owner will be
required to sign a Sampling Agreement. The agreement
allows the Health District to sample the eff luent of the
septic tank on an annual basis. Al1 cost for sample
retrieval and analysis shall be paid by the owner.
3. Please verify how the stormwater drainage from the
loading dock areas will be disposed of. Final loading
dock drawings shall be submitted to the Division of
Engineering & Roads and the Health District for review.
4. Because the proposed is speculative, no floor drains
will be allowed unless they are connected to the public
sewer system.
5. Al1 construction debris is to be taken to a licensed
landfill.
B. Permit Release Requirements
1. Apply for a permit to install the proposed on site
sewage disposal system and submit plans of the proposed
septic system for review.
2. Submit a copy of the easement for the on site sewage
disposal system.
IV. Fire District No. 1(928-2462)
A. Discussion/Requirements
1. Fire f low for the proposed is 3,500 g.p.m. Paul Chase stated that there is only a maximum of 3,000 g.p.m.
available to the site. The applicant requested that
another fire flow test be performed on the hydrants.
2. Additional fire flow calculations and relocation
and/or additional four-hour fire-resistive area separation
wall with 30 inch parapet may be required to maintain a
maximum 3,000 g.p.m. fire -flow. Automatic sprinkler
system may also be an alternative. The existing hydrants
- 4 -
.
•
are adequate based on a maximum fire flow of 3,00 g.p.m.
unless fire flow test of existing hydrant indicate
otherwise.
3. A lock (Knox) box entry system for fire department
personnel access is required to be installed.
4. Future requirements for revisions of existing hydrants
were discussed for Lot B.
5. Access on Jackson Avenue shall be maintained.
V. Division of Buildings (456-3675)
A. Discussion/Requirements
1. Plan review has been completed on preliminary plans
and a letter was sent to the applicant by Jun Mascardo.
2. A SEPA Checklist has been filed for the proposed. The
review period ends on May 17, 1991, no permits can be
issued until after the 17th. The owner was instructed to
post at the job site, the SEPA public notice given to him
prior to the meetinq.
3. Each tenant space must apply for an interior
completion permit and shall submit a critical materials
list for review.
4. A one-hour fire-resistive wall must be provided on the
northwest and southwest side of the building.
5. Draftstops must be installed so that the area between
draftstops does not exceed 3,000 square feet and the
greatest horizontal dimension does not exceed 60 feet.
6. Please submit shop drawings for the truss diagrams for
review and approval.
7. A four-hour area-separation wall shall be constructed
to meet the minimum fire flow of 3,500 g.p.m. The wall
must extend a minimum of 30 inches above the roof.
8. Please specify if special inspections will be required
on concrete and welding.
9. If the occupant load of the future second floor is 30
or more, handicap access to the second floor will be
required. Plans shall be submitted for review.
- 5 -
9. Each unit should have a drinking fountain or water
station.
B. Permit Release Requirements
1. Two complete revised sets of plans addressing the
items discussed during and after the meeting and other
items from the plan review letter needs to be submitted
for review and approval.
APPLICANT'8 COMMENTSIACRNOWLEDGEMENT:
The applicant acknowledged that all comments/requirements were
understood and had no further questions at this time regarding
permit requirements.
CORRECTIONS:
To miautes or changes from what appears in the minutes, we should be
notified within one day of your receipt of these minutes.
To site plans as required by any or all of the above-listed
departments shall be submitted to the Division of Buildings who will
then distribute accordingly to those departments.
ADJOIIRNMENT: There being no further business, Tom Postlewait
thanked the applicant and the departments for their participation
and reminded all that he should be contacted if there are any
unforeseen problems which may arise.
The meeting was adjourned at approximately 11:10 a.m.
Copies of Minutes to: Al1 participants
File - East 11115 Montgomery Drive
Office & Warehouse
NOTE TO APPLZCANT: Some time ago the County recognized the need to
streamline the building permit system and accordingly initiated
these Pre-Construction Conferences. Comments so far would indicate
these conferences are successful and do enhance the permit system.
As a recent participant, we would appreciate any comments you might
have to further improve the process or, should you have any
questions or concerns regardinq your conference, please contact
either Jim Manson, Division of Buildings Director, at 456-3675 or
Dennis Scott, Public Works Director, at 456-3600.
Sincerely,
James L. Manson, Director
- 6 -
. r ~
S P O K A N E O U N T Y
DEPARTMENT OF BUILD[NGS • A DIVISION OF THE PUBLIC WORKS DEPARTMENT
JAMES L. MANSON, C.B.O., DIRECTOR DENNIS M. SCOTT, P.E., D[RECTOR
TO: Paul Chase, Fire District No. 1
Lorne Lakshas, Planning Department
Jun Mascardo, Division of Buildings
Bob Turner, Division of Engineering & Roads
. Daryl Way, Health District -
~ `
FROM. Tom Davis, Code Compliance Coordinator
Division of Buildings
DATE: February 28, 1991
RE: February 28, 1991 Pre-Application Conference
East 11115 Montgomery Avenue .
Enclosed is your copy of the minutes to the referenced meeting.
' ' . . ' • . - . , . ' + • - - . ,
• • • . , , r-~ ~,,~:J~ t' ' ' • • , . . . _
Should you have any questions .or need additional information, please feel free to contact me. - _ .
TLD:rmd .
.
, . .
cc: Mr. Ewing'Micken, Arch'itect
y.,~ e , .l a .
. a
Ms. Mabel Caine, Air Pollution Control Authority
Mr. Dennis Scott, Public Works Department
CODE ENEORCEMENT DIVISION
WEST 1303 BROADWAY 0 SPOKANE, WASHINGTON 99260-0550 * (509) 456-3675
FAX (509) 456-4703 _
. .
MINIITES ' PRE-APPLICATION CONFERENCE
EAST 11115 MONTGOMERY AVENIIE
OFFICE/WAREHOIISE
FEBRIIARY 27, 1991
CALL TO ORDER: The meeting was called to order at approximately
11:00 a.m. by the Division of Buildings Code Compliance Coordinator
Tom Davis, with the following in attendance.
PERMIT REVIEW PARTICIPANTB:
Paul Chase, Fire District No. 1
Robin Domitrovich, Division of Buildings
Ken Jeffrey, Division of Buildings
Bob Turner, Division of Engineering & Roads
Daryl Way, Health District
APPLICANTB:
Ewing Micken, Architect, N. 6116 "G" St
Spokane, WA 99205 (509) 328-7628
SCOPE/PROJECT DESCRIPTION:
I. General Overview - Proposed is the construction of a 15,475
square foot speculative office/warehouse. Approximately 10,000
square feet will be warehouse and the remaining 5,475 square feet
will be office.area. The proposed will be Type V-N Construction.
Tenants for the proposed have not been determined at this time.
An Environmental Checklist requiring a 15 day public comment period
and a$75.00 fee is required for_the proposed building.
SDMMARY OF DEPARTMTsNTAI, REQIIIREMENTS:
I. Planning Department (456-2205)
.A. Discussion/Requirements
1. The proposed is located in an I-2 Zone. The subject
property is effected by Zone Changes 50-72C and 104-83C,
conditions of the,zone changes must be met.
2. Property boundaries have yet to be determined. A
minor lot line adjustment through a certif icate of -
exemption or short plat will be required once the
boundaries have been determined. The applicant stated
that Simpson Engineering is in the process of surveying
the property and the applicant will inform the appropriate
departYaents once boundaries have been determined.
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~
3. A minimum of 20 parking stalls will be required for
the proposed. The parking lot is required to be paved.
4. Type III landscaping is required to be installed along
road frontage. Also a minimum of 10% of the parking lot
is required to be landscaped. All parking stalls are to
be within 60 feet of a landscape feature consisting of 32
square feet in area. Landscaping can be placed in the 208
drainage swale areas as long as the landscaping does not
effect the inteqrity of the swale.
5. A copy of sign standards and landscaping requirements
were given to the applicant during the meeting.
6. Please indicate on the site plan that the proposed
structure is one story.
B. Permit Release Requirements 1. An estimate from a nursery including size, type, and
quantity along with a promissory letter from the owner
stating the, landscaping will be installed shall be
submitted.
2. Establishment of a legal building lot as described
above shall be completed. -
II. Division of Engineering & Roads (456-3600)
A. Discussion/Requirement 1. Comments were given to the applicant and the Division
of Buildings by Bob Turner. 2. Please submit a drainage plan for the proposed that is .
in compliance with Spokane County Guidelines for Stormwater Management for review and approval.
3. The proposed will have a metal roof therefore, roof
drainage may go directly into drywells.
4. The proposed shall comply with the conditions of Zone
Changes 50-72C and 104-83C.
5. Approach permits are required for new driveway
approaches.
6. There is no legal access to the subject property,
please submit a copy of the ingress, egress easement as
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well as a copy of the utility easement for Division of
Engineering & Roads records.
7. Please submit road and drainage plans prepared by an
engineer for Montgomery Drive and possibly Jackson Avenue.
Al1 required construction within the county right of way
must be completed prior to the issuance of the building
permit or a bond in the amount estimated by the County
Engineer to cover the cost of construction shall be
submitted to the Division of Engineering & Roads. Once
property boundaries have been determined the Division of
Engineering & Roads will determine if road improvements
will be required on Jackson Avenue.
8. An Agreement to Pay Fees was given to the owner during
the meetinq. The agreement is to be signed by the owner
and returned to the Division of Engineering & Roads. Plan
review will not be completed until this document is
executed.
B. Permit Release Requirements
1. Please submit a drainage plan as described above for
review and approval.
2. Please submit a copy of the ingress, egress easement
as well as a copy of the utility easement.
3. Please submit road and drainage plans for Montgomery
Drive and possibly Jackson Avenue for review and approval.
2. Please submit a copy of the Agreement to Pay Fees -
signed by the owner.
III. Health District (456-6040)
A. Discussion/Requirements 1. In 1985 there were plans to install a sewage disposal
system for the entire industrial park. The Health
District has no record of the system and therefore is
doubtful that the system was installed.
2. The applicant stated that a condition of sale of the
property was that the sewer lines are to be extended. The
applicant was advised to contact Jim Legat of the County
Utilities Department (456-3604) to verify if there is a
public sewer line in Montgomery Avenue.
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s- .
3. If the proposed is connected to public sewer there
will be no problem, but if an on site system is installed
there will be a problem with the location. The subject
property does not have room for an on site sewage disposal
system.
4. Please submit critical materials lists for each
speculative space once a tenant has been determined.
5. Please verify how the stormwater drainage from the
loading dock area will be disposed of.
6. Submit copies of the easements for ingress and egress
and the utility easement.
B. Permit Release Requirements
1. Please verify if the proposed will be serviced by the
public sewer system or by an on site sewage disposal
system.
IV. Fire District No. 1(928-2462)
A. Discussion/Requirements
1. A lock (Knox) box entry system for fire department
personnel access is required to be installed. A lock box
for each speculative space may be required, contact Clyde
Wisenor, Fire District No. 1 for a determination.
2. Fire ow for e proposed is 5,000 g.p.m. Fire f low
available to e site is only 3,000 g.p.m. Area
separation waY s will be required to be constructed to
.
keep the fire~flow at or below 3,000 g.p.m.
3. The re hydra locations are adequate.
4. All two port hydrants are to be changed to three port hydrants.
5. Access to all fire hydrants shall be maintained.
V. Division of Buildings (456-3675)
A. Discussion/Requirements
1. The proposed will be Type V-N Construction. A two
hour area separation wall will be required to be
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A
1 fni I~ E
S P O K A N E; • C O U N T Y
DEPARTMENT OF BU[I.DINGS • A DIVISION OF THE PUBLIC WORKS DEP.4RTMENT
JAMES L. MANSON, C.B.O., DIRECTOR DENNIS M. SCOTT, P.E., DIRECTOR
11 . _ - - .
~ R E12CEIVED ,
TO : Paul Chase, Fire District No. 1 ~
Lorne Lakshas, Planning Department ~ MAR 041991
~
Jun Mascardo, Department of Buildings .
Bob Turner, Engineering Department ' gppKc;NE CpUNTY ENGII~EER
Daryl Way, Health District
FROM: Robin Domitrovich, Secr ar ~
Division of Buildings
DATE: March 1, 1990
RE : Amendment to 02/27/91 Pr =Application Conference Minutes
East 11115 Montgomery Avenue - Office/Warehouse
With regards to the above referenced minutes, Fire District No. 1
Discussion/Requirements item Number 2 shall be changed to read as
follows:
2. Fire flow for the proposed is ~jpp¢ 5 500 g.p.m. Fire flow
available to the site s only 3,000 g.p.m. Area separation walls
will be required to be constructed to keep the fire flow at or below
3,000 g.p.m.
Please add these comments to the Pre-Application Conference minutes
dated February 27, 1991.
Should you have any questions or need additional information, please
feel free to contact me.
rmd
cc: Mr. Ewing Micken
Ms. Mabel Caine, Air Pollution Control Authority
Mr. Dennis Scott, Public Works Director
CODE ENFORCEMENT DIVISION
WEST 1303 BROADINAY 0 SI'OKANE, WASHINGTON 99260-0550 0 (509) 456-3675
FAX (509) 456-4703
'Z
.
constructed. One hour fire resistant walls are required
on the east and west side of the building.
2. Critical materials lists are required for each
speculative space once tenants have been determined.
Complete sets of plans must be submitted for each space
for plan review (i.e. building, mechanical, plumbing).
3. Specify if special inspections are required for the
proposed project. Please indicate the name of the testing
laboratory and submit copies of the inspection reports to
the Division of Buildings for review.
4. Please submit a lighting layout and a lighting budget
for the proposed.
B. Permit Release Requirements
1. Two complete revised sets of plans addressing the
items discussed during and after the meeting needs to be
submitted for review and approval.
2. Completion of the environmental review process as
described in the project description.
APPLICANT'8 COMMENTS/ACKNOALEDGEMENT:
The applicant acknowledged that all coniments/requirements were
understood and had no further questions.rat this time regarding
permit requirements.
CORRECTIONB:
To minutes or changes from what appears in the minutes, we should be
notified within one day of your receipt of these minutes.
To site plans as required by any or all of the above-listed
departments shall be submitted to the Division of Buildings who will
then distribute accordingly to those departments.
ADJOIIRNMENT: There being no further business, Tom Davis thanked the
applicant and the departments for their participation and reminded
all that he should be contacted if there are any unforeseen problems
which may arise. . _ _ . .
The meeting was adjourned at approximately 11:50 a.m.
Copies of Minutes to: All participants
File - East 11115 Montgomery Avenue
Office/Warehouse
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NOTE TO APPLICANT: Some time ago the County recognized the need to
streamline the building permit system and accordingly initiated
these Pre-Construction Conferences. Comments so far would indicate
these conferences are successful and do enhance the permit system.
As a recent participant, we would appreciate any comments you might
have to further improve the process or, should you have any
questions or concerns regarding your conference, please contact
either Jim Manson, Division of Buildings Director, at 456-3675 or
Dennis Scott, Public Works Director, at 456-3600.
Sincerely,
James L. Manson, Director
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, . .
S?OKAIJE ENVIRONMENTAL ORDINANCE
DETERMINATION OF NONSIGNIFICANCE
File No. 91002186
. _ . _ .o.-----
t F- Iv n -1
Description of proposal: To construct a 15,475 square foot buitding for warehouse and speculative offic,es
~
i l~Y 0 2 1991
~
Proponent: A& A Construction 8 Oevelopment Inc. ~
Locatian of proposal: East 11115 Montgomery Avenue ~ 5~~~~~ ~~NTY ENGfNEER ~
Spokane County, the tead egency for this proposal has determined that it cioes not have e probable significant adverse irtpact on
the ernironrient. An Envirarniental Impact Stetement (EIS) is not required under RCW 43.21C.030(2)(c). This decision was made
efter review of e compteted ernrironnental checklist end other information on file with the lead agency. The information is
available to the public on request.
There is no coim►ent period for this DNS.
[X] This DNS is issued under 197-11-340(2); the lead agency will not act on this proposal for the required 15 day review period
camiencing on May 3, 1991. Cormients pertainire to this checklist/determination must be sttxnitted/received no later than 4:00
p.m., May 17, 1991.
_Responsible Official: James L. Manson, Director
c/o Thomas L. Oavis, Code Cortpliance Coordinator
Spokene Canty Department of Building and Safety
West 1303 Broadaay Avenue
Spolcane, Washington 99260 (509)456-3675
Date May 1, 1991 Signature ,
You may appeal this determination within 10 calendar days after it becomes final: •
The Board of County Cortmissioners 41est 1116 Broadway Avenue
Spokane, 4lashington 99260
The appeal must be sutmitted in writing no later than 4:00 p.m., May 27, 1991. You should be prepared to make specific factual
objections.
Contact above responsible officiat to read or ask about the procedures for SEPA appeals.
*****•****************************************************~*t*#*
A copy of the Determination of Nonsignificance was mailed to:'
Spokane County Air Poltution Control Authority Spokane County Health District - Envirormental Health
Mr. Fred Gray Mr. Demis Kroll
Spokane County Engineer's Office Uashington State Department Of Social & Health Services
Mr. Gary Nelson Mr. Tom Justus
Spokane County Plaming Department Uashington State Departinent Of Ecology
Mr. Tom Mosher Envirorniental Review Section - Ms. Barbara Ritchie
Spokane County Utilities Oepartment Fire District No. 1
Mr. Bill Dobratz Clyde uisenor
.
.
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: . ~ -
SPOKANE ENVIRONMENTAL ORDINANCE
-
SECTION 11.10.230 -1-
~ SPOXANE ENYIROfWENTAL OROIKIUiGE •
~ .
. (YAC 197-11-960) Section 11.10.230(1)
Envlronxntal Checklist
Ftle No. ~~~7C0 (r~ .
Purpose of CAecklist: .
The State Environmental Fo11cy Act (SEPA) chapter 43.21C RGw. requires ail governmental agencles to conslder the envfromiental iiapacts of a prcposal
before aaking Aecisions. An Envlronmental Impact Statebent (EIS) aust be preqared for all proqosalz v1th probable signlticant adverse icapacts on
tlte Quallty of tAe envfrons+ent. The purpose of this checklist is to provlde lnforsaation to help you and the agency fdeniify impacts froo rour
proposal (and to reduce cr avotd iapacts from the proposal. 1f 1t tan be done) and to help the agency declde whether an EIS is reQutred.
instructSons for 1lpplicants:
This environsental checklist asks you to Cescribe soae basic inforcaation about your proposal. Governwental agencies use this checklist to determtne
Mhether the environaentel fapacts of your proposai are siqnificant, reQulring preparetion cf an EIS. Ans.rer the questions briefly. vith the a+ost
precise informatS4n knarn. or give tAe best Eescriptlon you can.
7ou wust answer each Question accurately and tarefully, to the best of your knowledge. In inost cesey. ia should be able to artsuer the puestlons
froa your own observations or proSect plans vtithout the netd to hire ezperts. If you really do not know the aru wer. or it a Questlon does not apply
to your proposal, vrite 'Ea not know' or •Coes not apply.• Casplete ansMers to cfie questtons nar aay avoid unnecessary delays later.
Soeae questlons ask about governaental requlatlons, such as zoning, shorellne, ana landmark designations. Answer these.questtons tf you can. If you
hare probleas, the govenaental agenctes can assfst you.
The checklist Questions apply to all parts of your proposal, even if you plan to do them over a perloE of tirne or on dffferent parcels of lanE.
Attach any additfonal inforwation that will descrl0e Yaur proposal or 1ts rnvlronnental effects. Thc egency to vhlch you submit this checklist asay
ask you to explatn your ansvers or provide addittonal lnformation reesonably related to deteraining 1t there aay be slgntficant aAverse lmaact.
Use of checklist for nonproject qroposals:
Caap{ete thls checklist for nonproject proposals, even though questlons ray be answered "does not •pply'. .
IN JIDOITION. caeplete the SUPPIEKElITIIL SKEET FOR MO!IpR4JECT 1lCTIONS(Part D).
for nonproSect actfons, the references 1n Lhe checklist to the words 'project.' 'applltant.' end 'property or site' sbould be reaA as 'proposal.'
'provoser.• anE •affected geographlc area.• respectively.
A. BACKGROUMO ~ I~ l c7
1. 'taae of proposed projett. 1f applitable: A~~14~' ✓nmp6e~~ rPPG
f
,~/exr ro Nop-m
~
2. 4a.e of npplieant: I.F/LL
3. Adsress and phone nunber of app 1 icant or contatt pPrsan: f2 79 C,/ 3 ~
/JD• ~3oX /yiTo/
S,oo ~r w ~ ysz ~4!
4. Oate check l tst preparcd:
S. Ayency rcQuezting checklist: /7~~~' ~0~+ ~~D~~''~~ u~~~~
6. Proposed tiwing or schedule ( fncluEing phasing. 1f applicable): fi' •s -S~~J~ #-T 'e%eow
I's"SeeCO
7. a. Oo you heve Any pians for future additions. t~cpansion, or further activity related to or comected vrith thls proposal? If yes. e~lafn.
/f ,;o9
b. Oo you ovr+ or have options on land nearby or adjacent to thls proposat? If yes, explatn.
8. list eny enriroaaental lntonoation you knor about thet has ban prtpared, or vill be prtpared. dlrectly related to this proposal.
~OrY~
Rev.211/88 ~
, . ` 9POUVtC LliQIAOtilSHrAI. ORDItiAriCE
(vAC 197-11-960) Seetion 11.10.230(1)
A. EAC7CGROQLm (contimud)
9. Oo 7ou lmov vhether •ppliu tiona ate pending for goveromental approval• oE other proro u 1s directly affecting the propercy covercd by pouc
prnposal2 If Tes, erplain.
/Yd
10. Lisc any govecnmenc approvale or permits that vil] be needed tor your propoeal, if Imovn.
/ L. t~ i~~ t...i • c'-T Y.1 1~7 l• / ~t(' G
JX24-1 W 1LV • jc~ _ .
J ovP
~J Ll.c~(a e. ~
11. Give a Drief, caoplete deacription of your proposal, incluGing the proposed wes and the ol:e oi the projecc and slte. 'ture are several
Qvestioas Lter in this cAecklist that aak 7ou io deserlbe certsin upects oi your proposal. You do not need to re9ut thoae anawera on thls
PdBe• ~
S.e c o*ac „
~L. .
co-o c avt-z~
1:. locatloo of the proposal. Give sufficient informattoa for a persoo to understand the ptttlse loution of 7our proposed pro}ect, including a
scnet addresa. if an7, and seecion. tovnahip and raage. !f kno+rn. Ii a proposal vould oeeur over a range.of area, provtde the range or
bocmdaries of the site(@). Provide a legal QaacrlpcLon. s1[e pLn. Kelniq asp. aad topoarapltlc sap. if reasoasElr aveiLEle. Lfiile you
•hwld subait any pLos reQutred by the agenc7r. you are not teQuired to dupliute eaps or decailed pLns autaicted vitfi any permit application
relatcd to this elrecklisc.
s-
~~•eC~CL r -rGG- '/f"-fT"~Ac-cO /J7OP~00)
I nu,ll 9nl,~o
~
13. Does the proposed actioe lle vithie the Aqulfer Seasitlve Aru (/lSA Ceneral Sever Service Area Prlorltq Sever Service Area? :he
City of Spokznel (See: Spok.ane Couacy's AS OverLy Zosu AtLs fot boundarie• . „
•
,00~w " I~l~r.dlc. m.~ ~'.i~w~✓ Li~L D.~F 1~~ I/.o-~~
jS /.~Gd1NG ,0/'AW.401 ,Vou> G/r lPp,orod.r~ , 17 T~~ dWN/•-J
-o ae cM01-r cn at APri.z c.Arrr Oi✓ f fi~ Qa~ ~/Lp~ i S~Qo'Ooo/OS u>
E. T1t9IROR`~R'.AL IS.L?~t2'S
Evaluatlon For
Agency Use Only
1. EAR--51
a. General deserlpcion oE the siCe (circlr-vae): flet, rolling, hilly, steep slopes, souataieous,
ochez: -L.. GIF7-
/
b. •lhac is the aceepcst slope oo the slte (approsiaate percent sloqe)?
c. vhac aeneral type• oi •oils are found oo the •ite (for euaaple, clay. uod. 6tavel. peat. w+ct)!
lf 7ou kaov the clastifiution of agrieulcucal soila, specif7 thes ac►d note aa7r prlme faralaad.
d. Ate there surface lodicatioes or history of unsCable sotla 1a the imaeEiace viciaiCr? Ii •o.
descrlAe.
2
SPQKANE EI{VIROtQM1EfiTAI. 'OROINANGE
(WAC 197-11-960) Section 11.10.230(1)
B. ENYIROKMEtfTAL ELEHENTS(contieued)
Eraluatlon For
Agency Use Only
e. Describe the purpose, type, and apyroxtmate quantlties af any tilltng or gredlrtg proposed.
IndScate source of ftii.
e'e-C- 8!-.)
.4
f. Could erosion o a ur as a result of clearing, construction, or use? If so. qeneralty describe.
q. About what percent of the slte will De covered wlth impervlous surfaces after project cortstruc-
tton (for exar.ple. asphalt or DuS{dings)?
l~
h. Proposed weasures to reduce cr control eroston. or other ta~pacts to the earth. Sf any:
~e SS
2. aia
a. lthat type of ewissions Lo the aSr would resulL from the proposal (1.e.. dust, automa011e. odors
Industrlal, wood smoke) durSng constructfon and when the prosect is tompleteE? If any,
generally describe and 9ive approxiwate quantites If known.
/llOr~~
b. Are there any off-site sources af emissions or oAor that may affect your proposal? 1f so.
generally describe.
~U
c. ProposeE a+easures to reduce or control esaissio or other impacts to a1r. if any:
~~~/L ~u~~ •ClI7~T~I-~~"
/ •
3. MATER
a. Surface: -
(1) Is there any surface water body on or 1n the immedlate vicintty of the site includlnq year-
round and seasonal streans. salt,rater, lakes, ponds, wetlandsl? If yes, deuribe type ar+d
provl4e names. It approprlate. state ahat stream or river 1t flows 1nto.
/v v
(2) Nill the project requtre any work over. in, or ad3attnt tu lwtthln 200 feetl the descriDed '
waters? If yes, ptease descrlbe end attach avallable plans.
3
. ~ SPOIUitE LttFIRORlMtTAL ORDIHAIiCE
• (57AC 197-11-960) Scccion 11.10.230(1)
E. HHVIttOt7KENrAL ELI.lM'S (continued)
Evaluatlon Foc
Agency Use On1y
(3) Estimate the aaount of fill and dredge matertal tltit wuld be placed in or remowed froa the
eurface vater or vet L nde and lndicate the area of the •ite that vould De affected. Iadieate
the source of fill mnterial.
~
/
(6) Vill the proposal require surfaee uater vlthdravals ot diverslona.' Give • geaeral dtscrip-
tion, puspose. and aQpcoximate' Quancl[Ses. !f lcaov~j~
N
~
(S) Doee the propooal lie vithia a 100-rear flood plaln? It so, eote locatlon on the •!te plan.
/Ov~
(5) Does the proposal lnvolve any diseharges of vasce eaterial• co surface vaters? It 60,
describe the cype oE vaste and anticlpaced volume of dischrrgt.
/r/a
b. Cround:
, (1) uill groundvater be vithdravn. or v111 vacer be dlecharged to groundvater2 Ciae general
descrlption. purpose, •nd epproximate Qusncltie,. !f Imorn.
(2) Describe vaste material Chac vill be distharged into the ground itom septic taaki of other
sanltary vaste treacment faeilit7. Descrl6e the general slze of the ryatem, ct+e aamber of
houses to be served (Ii aqplltaDle) ot t!K number of perao w the qstea(s) are espeeced to
s e rve .
(J) Deacrlbe any •yeteas, ocher thsa those designcd for the E1sposal of saaitar7 vu te,
inatalled for the purpose of disclu rging fluids Delow the ground •urface (lncludt• syscea• such
aa thooe for the dieposal of tcorn vater o[ draiaage frm floas draies). Describe the cype ot
syateo. the aoounc of saterial [o be disposed of through the •7lstm aad the tppe• of Materiale
llkely co be disposcd of (including saterials vhich aay eater the systca iwdvertencly through
epllle or a• a result of flrefighting activltles).
(4) qill aor cheaicals (especiallr orgsnic wlvents or petroleum fuels) be scorcd in above-
ground or underground storage taoks? If so, vpat t7rpe• aod Quaatlties of fateclaL vill be
acoced? -
~O ~RC 2n~V~~~t~ ~l eci
G-LG 'S, X1 c.e-
"~`~~~4 n`ES ~krcJc ~P~y tlr~ftr~ruvxL~
L~
a
. Sroxext r.xvtsoHPMerrei. OxDUZANcx ~
, (vAC ]97-11-960) Section 11.10.230(1)
E. CNVIROEdSENTAL E1.BffiJ:S (continued)
Evsluation For
Agency ll~e Only
(S) VM t protcetive oeasures vill be takea to insure [Rat lealu or sp111s of anp ched cals stored or used oe slCe vill not be alloved co percolate to grouedvscer (thi• loclude• eee wres
co keep themicals w t of dispoaal syeteme descriEed ia 3b(2) aad 3b(3)? _
~ew,-C- ~ ~/Izr
c. Veter Ruaoff (including eco m veter):
(I) Qe x ribe the •ource of runoff (lncluding storm veter) and attltod of eollection and dispo wl
if anp (inelude Quancities, it knovn). tthere vill thl• r+ecer tlov? Vill CRis water flov into
other vaters? If so, de scribe.
eG c,>
_f
(2) :Jfll any chemictle be scoted, hartdled or used oa the site la a lou[loo vhere a spill or
leak vill dtain to •urface or grovndwster or to astorm water disposal srs[eo discAarging to
surface or groundvacer?
~v
(3) Could vasce material• enter ground or surfice vaters? If •o. senerally describe.
/ v
d. Yroposed eusures to reduce or control surfaee. ground. and rvnoif water lapacts. tf •ay (if
c the proposed •ctloa 11e• vlthin the Aqulfer Sensitive Acea Ee especia117 elear on esplaaacions
r relatlng co fecllltlea tooterning Sectian• 3b(4). 3b(5). •nd 3c(2) of chis checklllit): CtJti? Nw
< f Yl
4piJ ~Ct bt./ ~GC ~ }
T n/
a C P 14v h ✓~°~u,r'~c-~` /
C-{
d
r.~`Trheck or ciccle type of regeiation found oa tfie site: J Y v C ~O~
~~deciduous tree: alder. naple. &opea. other.
evergteen tree: fir, cedar, pine. other.
shruba.
grase. "
paacuce. '
ctop or grain. •
vet eoil plaocs, cactail. butcercup, bullrush. •Icuak u bbage. other.
water nlAk,p(s: water llllr. eelgrass, silfoll. ochec.
other type• of veqetati . . :b. Vhat klad and saount of veae[acion vill be rmoved or alteTed2
c. Lisc thr ntencd or eodangered speeies kaovn to 0o rr~ ae chesite.
. .
,/V ( /NC:
d. Proposed laadscaplag, we of oacive pL4ts. or other seuuras to presern oc entuoce regeutian ar~1Lf~Kc 71),e uy
on the •it . if aar:
G~j~~ e! I V~~,,~►«'S
OUG C!Z - ~ GQ0
,
•S !/1 ~ !I ~ r~'✓"
SP09CANE ENVIROKMEt(TJU. aROIt(AlICE ~
(WAL 191-11-960) Section 11.10.230(1)
8. ENVIROTd1ENTAL ELQiEttTS (contlnued)
Evaluatlon For
Agenty Use Only
S. ANIHALS
A. C1rcle any b1rds an4 animats wfiicfi have been oDserved on or near the site or are knwn to be on
or near the s1te:
~
birds: ha.rk. fieron. eagle, songbirds. other: A
nacemals: deer, bear. elk. Deaver, other: ~/D/~ ~
fish: bass, salrnon. trouL. herring. sbellfSsh. other: ~C/
i
ocher:
b. List any threatened or enEangered species known to be on or near the site.
fV~ / /
-
,
c. Is the site part of a mSgratfon route? lf so, expia/n. ,
d. Proposed aeasures to preserve or enfiance wildlife. tf any:
5. ENERGY ANO NATURAL RESOURCES
a. What kinds of energy (electrfc. natural gas. wooA stove. solnr) will be used to aket tRe -
tfie tompleted project's energy needs? Descrlbe whether 1t w111 be useE for heatfny, manufac-
turing. ett,
~
b. Would your project affect the potential use of solar energy by adjacent propertlez? 1f so, '
generally describe.
C. 11het kSnGs of enerqy conservatton features are included 1n tfie plans of this praposal? Lizt
other proyosed measures to reduce or control energy tepacts. 1f eny: ,
'Z- / (~~'t'!~ ji•~SKl~~!-~~"i (~N'1.Cl.f,tG~ ~ l:~L~p~ ~t~
, ' ~~f C~'o~-~ee- c,(ec~v~r'Ctf+~►t ~
- 3 ~ c ~ , ~j ,
C71
~
1. ENYIRONHENtAL HEALTN
a. Are there any environoentai health hazards, irtcluding e,cposure to toxic theraicals. risk of fire
and explos{on. spill, or hazardous waste. that ould occur as a result of this proposal? lf so.
describe.
(1) Oescribe special emergency servSce~t mig!ie required.
a'
6
SPOXANY LHVZRO!$W'fAl. OBDINAI7CE •
' (L•AC 197-11-960) Seetion 11.10.274(1)
B. L!PVIRONMEPTAL LLEKENTS (contiaued)
Evaluatioo For
Agency Use O~ly
E1~VIROtCEtT:AL REAL:Fi (continued)
(2) Proposed meesures to reduee or contro Lrovmental health tsazarde, if •ny:
~
b. Noise:
(1) L►hat tqpea of aoise eziat in the ares vhicfi mey affecc 7ouc project (for euaple: tr►fLic,
equlpment, operetion, other? .
~vp~vE
(2) tThat cypea and levelc of ooise vculE pe cru ted by or assotiatcd vith tlx proyect on a
ahort-tecm or s long-term baeis (for eumple: traffic. cooatruetion. operation, ocher)i Iodicate
vtuc hourc noise vould eose frnm the .ite. ~
1140
(3) Ytoposed meanure co reducc or control noise/mpacce. lf any: ~
!
8. L\'1D ARD SHOP.II.It1E USE
a. What is tfit curtent uae of the site and adjacent pr pertlea'
Of~'~~~~f2tv .
.
b. iiea che site Deen used for agriculcure' If so, deacribe.
c. Deocribe any atructuie• o'rf tlse •ice.
d. v111 any eCructuree I>e demoliahedi If •o, vhlch2 / v v
e. V:sac is the eurrent zoning classificacion of che slte1 ~
f. Whac i• [hc eurient cmpredeasive plan desigoaClon of the •ite!
9. If appliu Dle. vtu t i• the eurrent ahoreline aaster prograa de gnation of the •itet
.
, /
/t/
l
h. fiae anr part of the site been clauif ied as an 'anHroasencallT sonaltive' •rut Lf so,
, speclfy. N~l
1. Approzlaacelq hov oany people vould reside o vorlc the taopleted projecct
~ -
7
, ` - SPORANL LR9III+O1II'0=AL LRDINAN(E •
. ~ (VAC~197-11-960) Seccion 11.10.230(1)
II. ENVIRONKEli7dL CLL`eNZ'S (eontlnuad) •
Lvaluation For
Agency Use 0 nly
J. Approxioately hov aany people vould the eonpleted project dltp Lte!
k. Fropoeed neasures co avoid or reduce disp Le ment inpacts, if any: /
C
1. Proposed measurce to ensure the propoaal is eompetlEle vitd e:isting and projeeted L rtd use~ and
plens, if an7:
9. HOUSING
a. Approxiascely hov saay unita vould be J rovided. !f any7 Iodlcate vt~ether high-. ■iddlr , or
loriacoeoe howiag. /
fAl/ #4"-
b. Appcoxioately hov oaa7 uniCS. if aoy. wou1E bc elialaatedl Iodfu [e vhetl+er hlgh-, aiddle-, or
lov-incooe Aousing.
c. Proposed veasures to redute or con[rol housirtg impacts. !f aay:
I
,
10. A£STIiETICS '
a. uhat 10 [he tallest tuigA[ of aay ptoposed scructure(e), not iacluding aaCetufu ? Ytut i• che
prlnclpal ezterioz Duilding m terlal(e) proposed?
D. uhst vlew in the laaediate vicinl70 rould oe altcred or obstcutteQT
e-
c. Proposed meaeures to redute or control aesthetie iapaccs. it s%:
1,/a,v ✓ s ~ ~~L~ - cc ► r. .~C
~ S.
11. LICfi'• A.W C1.ARE
A. :Ituc type of lighc or g L re vill the proposal product? tlhat clse of da7 vou1C ic naial7 occur!
b. Could lighc or alate fron tbe fiaiahed project be a "fecp ds:ard or incerfere wich vie wt
~Q •
c. What eslsting off-site sources o( lighc oc gL re Rar •ffeet yous proposall
it/p~✓~'
d. PTOposed asaoures co nduce or control light aad Ylaie Smpacts. !f aay: !
arif~ o•v~ ~frl r
~
e
= sraru" r.xvtgoMExrei.•oantxnxcz ~
. (WAC 197-11-960) Section 11.10.230(1)
D. T.NVIROtQMTAL ELEMeNiS (continued)
Evaluatlon For
Agency Use Onlq
12. RECREA?IOtJ
What dcaignated and inEon+al recreatiooal opportaaitie• are in the imacdiate vitini[yT
b. Would the proposed project displace any exis[lag reeru cional wea? If so, descrlbe.
/ VO
c. Proposed w-ssuree to nduce or control lapacts on recrnatioe. lacludiag recYaational opportuei-
ciee co be proviEed by the pcoyeet or aqpliuat. if aa7:
N/A .
~
11. 8I5'ORIC AND CULTURAL PRFSERVA:ION
S. Are chece anq places or object• listed on or proposed for national. •cate or loul preserva-
cion registers krwvn to be on or ne:t to the •iteT If so. geaerally describe.
1410
b. Ceeera117 describe aay laadmarlu or evideote of hlstoric irclueologlcal. scientifle or culcural
inportance lmovn to De oa or next to the •1te.
c. Proposed eeaeure• to reduce or tontrol i=pacts. iir any:
l
14, :1',AJlSPOR'ATIO?7
a. Ideatify public stree u and highvar• •erving the site and deacrlbe proposed accesa co the
exieting street s7stm. Shovron slte plaas. 1E any. ' - ,
D.t/ AG *.V5 rm eo-c~
D. I• nite currentlr •erved by publlc traasitT If noc, vhat 1• the approzfa.ate distaace co the
nearesc craaslc •top? /
~!G c
c. 8ov eua7 parking apaces vo the eoopleted proSect have? Hov waay vould the pro}ecL eliad oa[e?
16
d. Vill :eQulre ao7l aev roads or •treets. or improvements to exiscina ruds ot streec•
aoc inclv,ding dtivevaysT If •o. geoerally descri0e (indi u te vlmther public or private).
✓ufi /~t`l/1 oti~~!lQ~7S , S'i . G~~--
o~✓ C. Vill the yco}ecc uae (or occut io the Saaediate yicioicy of) water. rail. or air traosporeation?
If so. geoerally destsibe.
9
~ . ' .
, . . SPOICANE LNVIROMMNfAL ORAIAA?iCC
(LiAC 197-11-960) Sectlan 11.10.230(1)
E. P.NVIR02IISETi"'J1L CI.EKD1TS (continued)
E.alustion For
Ageaq Oae Only
f. Rov aeny vehicular tripe per day vould be gerteraced by the coopleted projeet? If kaova,
lndicace vhen peak vould occur.
? d~~ / !~J ff•~S~
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g. Proposed measuree to reduce or contcol transportaclon imyects, if •nq:
~O Ar ~
15. PUBLIC SERVICES
a. Would the project result 1n an increased need for pu!)lic secvice• (for ezanple. fire procection.
policc pcocection, health care. •chools, other)' If •o, 6enerally das^.ribe.
/ V
b. Proposed meaouree to ceduce or concrol direcc iflp" on public rervices, if •ny:
./1~'0~✓~
16. U'ILI'•IES r-
a. Circle ucili[1es evrrently ava1 L ble at [h •~ectricl~.,:4~'s ter ~usc ~
•ervlce. e ephone. sanltary •ever. • cic -y-tem other.
b. Desczibe the utilltie• [hat are propoeed for the project, the utility providiag the secvice and '
the beneral corte[tvctlon actlvitie• oa the site or in the looedLte viclnity vhich atghc be
needed. ,
' GsIGV~~-
.47'a
G44e•r~~
~
C. SICtiATQRE
I, the undersigncd. wear uader the penalty of perjury that the aDove respoares ate eade tivthtully and to the Dest o[ ay knovledge. I also1
undecstand tha[. should tl+ere Ee any villful misrepreseatation or villful Lck of full disclo.ure on my parc, the aRency w y vi[hdrav .ny
decernlnatlon o nonalgnllicaace tMt it aight 1 u ue ln rellaace upon cAla cNetkllsC.
Propoaeni
Da ce :
(Pleu e Print or Sype)
Proponenc: Addreas: ~a• ~x /qr 7 U~
(Signaturc)
Phone: s O~p 92- 7 44-~ Lc ~'T -~t Cr Z/ l
Yerson conpletio,g fotv: Date:
- Phooe:
roa srere use oNLY
Scaff aeaEec(s) revieving cf+ecklisc:
Baaed on chis staff revlev of the envlroameatal checklist 'and other perciueot lafocma[loo. the •taff: ,
A. Concludes thac chete •re no probaale signlflcaac advecse Sapact• and recamaeod• • detersioatloo of aonalgnificaace.
B. Coaclude• that probable slgnlficaac adverse envlronaental lapacts do esist for the curreat proposal aed reconneads a miclgaced deter-
oimtion of noniignificaace wich coodicions.
C. Conclude s ttut chere are proEable •lgniflcant •dverse eavirooaeetal impacts aod retoamead• a detecnlnatlon of signlfiu nce.
TILINC YLE - :75.00
10
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