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HAVANA S 15 McDonald's Hamburgers i, ~ (THIS IS NOT A PERMiT) . BUiLD1NG PERMIT APPLICAT'ION WORKSHEET . . . . ~ PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOD UNDERSTANfl . COMPLETE IN INK ~ (Please return this original and your building plans to the Department of Building and Safety) SHADEp AREAS ARE FOR DEPARTMENTAL USE . ~ • ~ Project Ntxnber: . . . • . . Owner's Name I_qCT HST McDonald's Hamburaers F'roleCt Address (Street Namu ° tJumher) . - 7,~ South 15 Havana AppLcant ~ CitY State Z+p Phone ( ) 1 r3us~ntas Pr2on_ ( ) ContraCior/Ageni ~ .4ddre55 8aldwin Signs & Displays, Inc. North 3502 Market Street City State Zip Fhone Spokane 4Ja. 99207 ',489-►9191 Contact LicenSC rlumGer (h`equired) Business Phonc Dianna Linquist BA-LD-WS-D166D1 Arcnitect! Engineer Acldr;ss City StatQ ' ZiP Phone ; 1 ) Contact E3usiness Phone i . ~ ~ Lender Address atY Siate Zip Phone I I I j'►~~Wb~7~ Y1be•5lNk-~ A ?t`,:T` ~ • ~ ~ 1 . - . . • . . . , . Res. Comm. _ 6.5:~~ a-[' 1 A•T-T-~ N(1 P f,~F ~T C;N A(~F SttbdiyisionlP~.lat ~Jame/Short Plat Number ~ "°'~`Z``-~;:~ , !w''_ = . • • , .y . • 'i-ylr. Assessw Paroel Number.. . ~ Lot Block Plat Number ~ .s . --;2353=2';*-19-107-:.. ~ - Patinertt F71e Numbers _ , . . • . ~ Zone . Comp. Plan Census Tract ' ~ • - - . . _ ~~Pr~~l •Number QiDwellinp Unlts„a_,-- Numberof Buildings Lot Si2e (Sq. Ft./Acre) Depth Frontage ; •??','f;- . „ - Y =-34 . _.~l _ . . . - . ° . . ~ , ~ t Selbaclt~~~~.~►,;;~,"y~:: . Lett Setbaek_ r. _ - . Right Setback . Rear Setback..... R1W Width . ~ -Addi1iOf1dl IflfOfTT18tiOf1 , - . ';7 -i ' ' _ . . . . • Q-• _ . . _ Square Footage ,~•~r ~11~s ''~H'%ii ! _ . t~ . r=. I ` ~ r.a~~~5~_~a; ~ . ~ , t ~~'C r`.~~~ ( Hl.y`~ t1e~~,~y . _ ^L. ~ ~ . ' . • ' ~L~t`~^.,~ i~i~'~,-~~". 't~.:,~ w• s.~;~.. Y'wi, i r~ ?~Cr c' " y . y~• - . , _ , ~~*'y+.;~~~'~-~.~ .1~ :4 th:"i i q~ , : q , , ~ i Z Q INOgci~Yy~~'s~~Ff=~'-r, . \ ~ / o.. F„ . . „•'g • - t ~ ~:~~~'L'~E..~ ~ i :4'i 3."~ n~ j ~v`_i'° 1. ^ - ` ` ' • O . •~E, . v4~:^' ,'y,.~f ~ ! w, f... r'~ ~ ~~v-" i. ~ pw~ ~y - •ti~ h 3 i~ _ ~ ' Z . . , . ~ _ 'Y ' ' • . ` . . , ' a • ~ 1` i ~S'Y~:~ ±~~=w ' r . , ~ . . ~ 0 . J• ' . - i. .r}~ e i i~ ~ ~'~S°~i ~ r' ' ' ! ' • j ' ::fr !;F'~~?..~. .,-,~.J»irw~y,~. ' . . , % m N11lntw Ot B6d(OOT$ . 'ry~ n t a • : r. •.S _ . _ , - '.;:.9f'~" ` ° . - • ' ._..a.._ . . .,i~,'., •a ~ . . . =;b~'a~r--~"~'' - , ~ ,r• , :.1: , ' !:cl`S:.:y"l.3 ~i- .~„t..~ ..r ~:...c. ' QatO, _ - . , : - - _ Group • _ . TYPe ~ . _ _ .~3 ~ - . • - ~ e , . . ~ - ` DEPARTMENTAL REVIEW , Cond. Approvea Approval Hold Envlronmenlal Health Application M ❑ W. 1101 College Room 200 PlanninglZaning ❑ N. 721 Jefferson Englneers ❑ N. 811 Jefferson 4&4,rhed -5ite----ALbzqN Utilitles ❑ N. 811 Jefferson Plan ReviewlFire Preventlon ❑ N. 811 Jetterson Other (SEPA/Crli(cal MeterialJetc.) ❑ ~-T p - 1~/o;Cpp `Iv 't ~ , ~ W~►~0~ 4q0 OATt -7111Bb ~ A . ~ ~ . 1 a : . N . ~ h . ~OJN'S INb PI.~TE, ~ ~ ~ p46E b 0 . (2 . . . ~ ~ ~ 121 S s~ucE . W pA6E5 1 . . . ■ ~1 r H N 18'' a~~.~ 500►"~,~. o - ~ t.--- ~ SpLIC t y~ ~E a 28~ 4+( , F 24 P ~~E . , n~, r r I ~ ~ ~ ~ V-r . p - 4 - . . t: V . .T, ~ i'" • V Lt i , ! . . ~ C- f n: ~ , ~~,•~j, •TC ~ LK•y . ✓ ~ . ~ ~ - ~ , . ► rt ~ r ~ . . ~ . ~ ~ l1- 4 ~t ~j ~ A p c .Y ~,o R . s d - . , Q- . . m~ ~ t~ • ljl~ ; , L.L \r ~ 1 ~ ! . t ~ ~r~ 4 l• 1 - - ,:r - • . _ 7 7 _ . ~ ' ~ . L~.'.CIA'I E:'' ._~._I~_ ~ i 1~y/ 1 •i ~ ~ ~ ' - ~ • - ' ' . . : _ - - - - ~ ^ . .r. ..___--_EXt~TGy ~}.5• ~tPEvV-AI.K ~ ~ rr r C t ~ `t''. ~ ~ E ` • , / ~ •J • ~ ► , ~ x y7' MrNU InD I'r?n.N E-1 • F'A D ~ • ~...~..._...r~.._~....~.~.~.~-`. , "t""' . ~r ~ . ~ i ~ O1a P - - ' ~ - ~ ~{p~► ~ ;~~~~~rC -i:• _ E,~ ~ ' - ~ lN F! LTFtTIOts i-A 1 TJ F! E!_ r ~ i ~ ~ f r~ ~ ~ ~ • r ~ i ~ ~ y°" - ~ - ~.-,-,.w__._ . _ ,f..! ~ --~--+f -7•- e. n , i ~ rJ r E y ~i C 7g N ` - ~ ' . a . - ~ ~t 1 ~l R.. ' r"~ ~ r~ ~ ' f .FZ rs+lz.'ci ~ L-J \ , ~ • ~ ~ 4~ • ~ ` ~ ~ ~b. 4)1 10 tt l j , , r ~ ! i~.~ ~ V 3 A tEK M C TE EMPTY ~ ~ • , . ~ . ~ : ~ ►I , 4 ~ s . ~ , ~ ' , ~ ' 7';a! •.''~r i CIk:;~ 1 h~ • f <<FZ' f --A ~ ti ~ • , i~'~ ♦ ~ ~~I \ ~ 2tV r ~ ~ ~ ~ . . . ~ f 1C~' x I: ~ j~C ~A:~ I t' ~ T~''P=. ~'a►.'~'~-~~. ; . . ~3 . ~ . ~ ,ir~~ ` • ~ ~ ~ ~ . r'~ ~R ~ r • . ~ , . - . ` ~ ~ ~ r^~~~`•y 1'" 'y. -y t~ ...i i `f Y~~' ! • t~ t ~jr ' • ~ (ty ~ . f~ , t ~ ~ ~ i~ 1 ` ~ ! ~ • . .9~ ~ ~ ~ • V~ ' ~ ~ ~ ~ ~ 1 ` \ ~ - ~ ~ ~ ~ ~ ~ ~ ~ ~ J ro~ h~ 1 l , \ ~ • ~ M ~ i , ~ - y ~ ! ' { r-.. ♦ , ' ~ ' w .'"''"r.., , L ~ , ~ ~ G. ~ , i►~'~" ~ ~ ~ ' ~ ~ E ✓ ~J t~ • ~ , r, . ► 1 4.~1' ~ ~Y " ~ ~ c • _ , 1 T 2 p 1,.: " • 1 t ~ ~ ~ t .x 1 . ~ t-S ,t I-Al1 ~ ' ~ f . `r' A li ; , ~ ~ 1 tA_ ~ ~ , - ~ ~ ~ • ~ ~ . / } ~ ~ ~ p , ol ~ t ~ • a , , • , , S , • ~ ~ t? ~ ~ ~~ci . • G ~ i / . ...,q. - 8 . . 353 ~ A U N_ GQS13~ ~3~ RoaD raA~~ ~2 3 NO. 5 PARc~L No._? 3S"32 z lo 7 vCL.836 PAc- 762 NOTICE TO THE PUBLIC AC-IeM PURPOSE 3~C c 7- r KNOW ALL MEN BY THESE PRESENTS, Tha t McDonald' s Corporation, a Delaware Corporation ~ being the owners of the following described lands -in consideration uf mu6 ual benefits to be hereafter derived do for themselves, their heirs, grantee, and assigns, hereby agree to the following: To authorize the County to place their name(s) on a petition for the formation of a ULID by petition method pursuant to RCW 36.94 which the petition includes. ttie owners nroperty and further not to object by the signing of a protest petition against the formation of a ULID by resolution method pursuant to RCW Chapter 36.94, which includes the owner(s) property. PROVIDED, this condition shall not prohibit the owner(s) or successor(s) from objection to any assessment(s) on the T71"(1flOYrt7 ~?C ? rGC`:lt ~,if ;'mr,: -'Ltrem`.~r-o L ..SI 1 r,~.. .7 C ~ . • ~cr in cJCijuact'ior, wiC',l ll'ie formation of a ULID by either petition or resolution method under RCtiJ Chapter 36.94. This statement involves rhe following described property: That porCion of the NWJ of the N14i of the NWJ of Sec 23, Twp 25N, Range 43 E.W.M., in Spokane County, Washington, described as foll.ows: Beginning at the NW corner of the NWJ of said Sec; thence East 330 feet; thence South 236 feet;'thence West 330 feet; thence North 236 feet to the point of beginning; EXCEPT the North 30 feet thereof for Sprague Avenue; AND EXCEPT the South 6 feet of the N'orth 36 feet thereof for Sprague Avenue; AND ALSO EXCEPT beg at a point which lies 36 feet South of the North line of the Sec and SO feet East of the West line of the Sec; thence SWly to a point which lies 30 feet Ely of the West line of the Sec and SO feet Sly of the North line of the Sec; thence Nly and parallel to the West line of the Sec to a point 36 feet South of the North line of the Sec, to the point of beginning thereof for Sprague Avenue; AND ALSO EXCEPT the West 30 feet thereof for Havana Street. These requirements are and shall run with the land and shall be binding upon the owners, their heirs, successors or assigns. IN WITNESS WHEREOF, said corporation has caused this instrument to be executed by its proper officers and its corporate seal to be hereinto affixed this d a y o f '~c,~s?,wc~ 19 Frb . r~ ~ Pre ident ~ .:\C;~ y..,'•' . ~ ~ . - ~ ~.b Y e c: ~a r , Y . ; ~ • . ~ . STATE OF C►z..a- • . COUNTY OF r.yu, fa<?y-_ ) ss . On this day of 19Y6 , before me, the undersigned, a Notary Public in and for the gate of duly commissioned and sworn personally appeared ~,f.~~,,,,~,,~~,y~ to me known to be the &:tif..,-FRGJ1LLiVT and ~to me know to be thefv~'ECRETARY, resPectivelY, of hL,4 t he6o ' ~r'pM~fon t h a t e x e c u t e d the foregoing instrument, and ackr(owledged the said instrument to be the free and voluntary act and deed of said Carporation, for the uses and purposes therein mentioned, and on oath stated that ;;4w authorized to execute the said instrument. ~IN WITNESS WHEREOF) I have hereunto set my hand and affixed my official seal, the day and year first above written. ' . '~.,,~'~e~• ~ No~ary Publ In and foy' t~S(e 3tarC e . : .1 f i,• r e s i d i n g a t" . „ . = ~ • , - ~ t; • ( .M.'I ~ni► i if ~l i . --r A i . _ . . . . . ' • R a • . . . . . . . . ' . , • y ' - . • . 6864 ~°n E w~ . ~ . S E P 2 2 1986 0 ~ . O . o . J • ~ f Ral ph L. Gregory O~~ DE D~ 5540 Lake Washington Blvd. N.E. Kirkland, Washington 98033 RE: Sanitary Sewer Service to McDonald's Restaurant, South 15 Havana Street ~ i Dear Mr. Gregory: In regard to your request to build the above private pump station and connection force mai n, you are hereby granted- permi ssi on to construct sai d pri vate faci 1_:i ti es as shown on the following plan: , McDonald's Restaurant Site-Storm Water and Sanitary Sewer Force Main This permission reflects City's receipt of a signed letter of agreement betweenthe McDonald Corporation and Mr.Edward Unicume which allowsMcDonald's toutilize Mr. - Unicume's existing private sewer. This allowance is also predicated upon the _ understanding that City assumes no responsibility or liability for the operation, maintenance or repair of the entire pump system. Also, because there is no provision of a pressure manhole at the end of the force main allowing gravity flow into existing manhole, the same liability disclaimer applies to the existing private manhole in which force main empties. Manhole operation will be monitored initially to insure against (1) this possibility of force main velocities eroding i ntegri ty of manhol e structure and (Z) the possi bl e bui 1 d-up of grease i n outfl owto City sewer system. Approval is also subject to the following general conditions: ~ 1. No storm water, roof, or surface drai nage wi 11 be permi tted to enter the sewer. 2. Owners of the* property to be served by this private sewer must sign the ' enclosed form,waiving their right of protest and/or assessment for future City sewers designed to serve the property involved. This document must be signed by the Owners of record giving their legal status and bear the consent of any mortgagee, lessee or other person having a proprietary i nterest i n the property. Th i s wai ver form must be f i 1 ed for record wi th the Spokane County Auditor at your expense and will become an encumbrance on the property. It must be signed and accepted by the City before the necessary permitsare issued. For recording purposes,the County Auditor fees are: One Sheet Waiver - $5.00 Two Sheet Waiver - $6.00 Each additional sheet -$1.00 per sheet SEP 2 4 1986 PUBLIC WORKS DEPARTMENT SPOKA(~~E CQIJN`tY Frqcd;,,.e Brad W. Blcgen, P.E., Director - City Enginccr Larry J. Ncil, P.E., Supervisory Engineer - Design j Skytivalk Level Rlzuiicipal Brrilding / Spokafie, tiVashinoton 99201-3343 /(509) 456-4300 ~ ~ Ralph L. Gregory 6864 Page 2 3. You must provide the City with any required easements in connecting this private sewer. Additionally, a Private Sewer Maintenance Agreement must be filed with the Spokane County Auditor's Office at Owner(s) expense. This agreement by Owner(s) mutually covenants to maintain said sewer for the enjoyment of all such premises. Approval is contingent upon completion and recording by Owner(s) of the above easernent, and the enclosed Utility Local Improvement Covenant and Private Sewer Maintenance Agreement Forms, prior to the granting of a permit for connection to the City system. 4. The actual connection of this Private Sewer must be done by a contractor licensed to do business in the City of Spokane carrying the required perfarrrance bond ($10,000) and liability insurance ($500,000). 5. All work must be done under the supervision and inspection of the Wastewater Management Maintenance Division and in accordance with the 1984 Standard Specifications for Road, Bridge, and Municipal Construction, the Amendments thereto, the City of Spokane Supplemental Specifications thereto, and the Plans as approved. Permission to construct this Private Sewer is granted with the understanding that you will obtain all necessary permits, pay costs of engineering and inspection, replace any monuments disturbed, and any necessary changesin existing facilities, including the replacement of any road surfacing, curbing, sidewalks. Replacement will be to the City Standards in effect at the time your project is constructed. 6. You must negotiate with the Utilities Commercial Division for an appropriate sewer rate charge. 7. Your fees will consist of the following: A. Sewer Application Fee 1@$ 15.00 per each $ 15.00 B. Side Sewer Inspection Fee 1@ 50.00 per each 50.00 C. Special Connection Fee 437.50 D. Tap fee 100.00 E. Special Connection Charge 00.00 , Total $ 602.50 For properties not previously assessed a share of the City's sewerage systems. Because this is considered an interim type operation, this charge is waived. 8. Professionally engineered "As Built" drawings are required for this private sewer. A mylar reproducible incorporating the requested changes on your submitted workprints, is required by this department for future reference. Additionally, side sewer stubs constructed as part of this project must be inspected. Side sewer permits will not be issued until s i de sewer stubs have been accepted. Stubs not to be ut i 1 i zed at th i s t i me must be plugged and should be marked in accordance with acceptable construction practice to aid in their relocation for future use. SEP 2 1986 SPOKAN~ C,011P!7Y EfdGINEER . ~ Ralph L. Gregory 6864 Page 3 . 9. Thi s approval i s good through January l, 1987. At the end of that time, i f construction has not commenced, this approval is considered to be automatically cancelled and you must then submit a new request for project approval. 10. Upon presentation of this letter, payment of the above fees, and compliance withother stated conditions, theEngineering CounterService, Public Works Department, will issue the proper permits and furnish any further information necessary. The Engineering Counter Service is 1 ocated on the 3rd fl oor, Skywal k Level , of the Muni ci pal Bui 1 di ng, 456- 4300. 11. Upon issuance of permits, you must contact the Wastewater Management Maintenance Division, Field Office, North 1420 Normandie Street, 456- 4314, in order to arrange a mutually agreeable inspection schedule. If these facilitiesare constructed, theymustbe inspected by the Wastewater Management Maintenance Division. Facilities are to be uncovered at the time of inspection. Also, the area of construction is located outside corporate limits, therefore, you will be required to coordinate your efforts with the Spokane County Engineer's Office and to comply with the following conditions and whatever additional requirements may be necessary in order to proceed with construction. 1. Comply with traffic control measures imposed by Spokane County Engineer. 2. Obtain necessary Spokane County-right of way excavation permits for . construction. The repair and replacement of paving, curbing, etc., isto be effected in accordance with County standards. If you have any questions, please contact the Public Works Department at 456-4300. Sincerely, , Brad W. Blegen, P.E. Public Works Director - City Engineer JFS/lh Attachments: (1) Plans (2) Utility Connection Local Improvement District Covenant (3) Private Sewer Maintenance Agreement cc: See Attachment SEP 2 111986 SIPOKA~~c rnUNTY FPd(ilNLL', . • • y Ralph L. Gregory 6864 Attachment cc: Public Works file Larry Neil, Supervising Engineer - Design Services Joe Shine, Design Services Engineer Rich Davis, Permit Coordinator (Plan) Gale Olrich, Director, Wastewater Management John Snell, Supervisor, Wastewater Treatment Plant Gary Lindsey, Supervisor, Wastewater Management Maintenance Division Don Soehren, Supervisor, Commercial Accounts Dennis Kroll, Spokane County Health District Ron Hormann, Spokane County Operations Engineer Tom Yake, Spokane County Construction Engineer /r.erril Smale, Engineering Administrator, Spokane County Engineer's Office ary Kennally, Spokanej County Planning & Traffic Engineer Jim Legat, Utilities Engineer, Spokane County Utilities Department Ed Unicume C/0 Mr. Bob Spears Heritage Properties 10103 N. Division, Suite 101 Spokane, WA 99218 v La.r SEP 2,- 1986 bPOi1ltMI: rjqIJT~~ FPJGiNtUt" , McDonald s Corporation McDonald's Plaza j , McDonald's ~ ,Q Oak Brook, Illinois 60521 i Direct Oiel Number 31 2/887 37 56 AIRBORNE August 7, 1986 Mr. James Eads Right of Way Department Spokane County Engineer Spokane County Public Works North 811 Jeffersan Spokane, Washington 99260-0170 Re: SPOKANE, WASHINGTON L/C: 046-0169 Dear h1r. Eads : Enclosed is the fully executed Notice to the Public, per your request. Cordially yours, McDONALD'S CORPORATION ~ Gerald J. Pi zino Regional Attorney Real Estate/Legal Dept. eb cc: Patricia Tisdale, Seattle - #948 ACTIVE AIR FREIGHT P. O. Box 19234ZA irport Station AAF 3 4 0~ J Spokane, 99219 Airline B311 No. (509) 534-4610 Date 04 ipper Consignee Y i1 e ( U ~ T R 1i 4c F ~ZC~1~i"}Cir 61)t - Q Sh/pper's Street Add►ess Consignee's Street Address ~ IJ City State Zip Code City State Zip Code . ~ ~Or k~~ i) ND.OF ~ PIECES DESCRIPTION WEIGHT RATE CHARGE WEIGHT RA7E F~ 1 Vc CHARGE ~ ~ r PICK-UP , f CHARGE OELI vERY CHARGE ~ OTHER ~ TRANS. CHARGES ADV. ~r~vtIdmBy , t Date Time ~ , , , ~t~r ❑ PREPAID ❑ COLLECT TOTAL t1T IS MUTUALLY AGREED THE GOODS HEREIN DESCRIBEO ARE ACCEPTEO IN APPARENT GOOD OROER iEXCEPT AS NOTEDJ FOR TRANSPORTATiONAS SPECIFIED HEREIN, SUBJECT TO 90VERNING CLASSIFICATIONS ANO TARIFFS IN EFFECT AS OF THE'DATE HEREOF WMICH ARE FILED IN ACCORDANCE WITH LAW SAID CIASSIFICATIONS AND TAFIfFS, COPIES OF ~HIC!-1 ARE AVAtLABIE fOR INSPECTION BY THE PARTIES HERETO ARE HEREBY INCORPORATED WTO ANO MApE A PART OF THIS CONTRACT 1 ~ ~ A t A/ -7.1 C ~f troo~t . r #_&w1 tor Rwooi at Reqw* ol 830 15M ~~'~14z•)s rp T 1 c,or T i t 1t 1tsuranct ` 1006 Yts tern Ave. _ Statt lt. MA 98104-1032 Attn• J~ fr~edrlckson • r a~h~ngtan► 00 .f►• •f ~ • .-s ~ . ~ nn.E oRn" W. ~ . STATUTORY WAARANTY DEED THE (:RA%1l)R FRANCES S. LAREIDA, a widow dealing with her sole and awd iec.~m~allao~ Ten Dol lars ( $10.00 ) and other valuable cons iderat ion room."provements, eparate property, ~w+. ~,~+a Marr~u% t.~ M€DONALR ' S€ORPO~tATION Rak Brook I}Ainois, all V~rento~ s rig~t, ti le an in eres , inclu ing any bui ings, acjoining ~ublic roads and streets, in and to the Iu1WMUK ~fc+cnbrd rcal cwt~. utuatcd in t C.wnt% ol Spokane M a.hiRpon ~ That portion of the Northwest quarter of the Northwest quarter of Northwest quarter of Section 23, Township 25 North, Range 43 E.M.M., in Spokane County, Washington, described as follows: Beginning at the Northwest corner of the Northwest quarter of said Section, thence East 330 feet; thence south 236 feet; thence Mest 330 feet; thence North 236 feet to the point of beg.inning; EXCEPT the North 30 feet thereof for Sprague Avenue; and, EXCEPT the South 6 feet of the North 36 feet thereof for Sprague Avenue; and, EXCEPT beginning at a point which lies 36 feet South of the North line o the section and 50 feet Fast of the West line of the section; thence Southwesterly to a point which lies 30 feet Easterly of the west line of the section and 50 feet Southerly of the North line of the section; thence Northerly and parallel to the West line of the section to a point 36 feet South of the North line of the section; thence Easterly and parallel to the North line of the section, to the point of beginning thereof for Sprague Avenue; and, EXCEPT the West 30 feet thereof for Havana Street. Subject to: a) Concrete curb encroachment of 1.2 feet on East side of premises, anj b) Four-foot high chain link fence encroachment of .6 feet on East sid of premises, and c) Encroachment of 6" steel sign post on West side of premises. 1>atnl th►% da% (lf J_[ALI . 1906 , . , l -s47~•e...! . \J ~i..tiL..~..~~C Itiall 1 Sta11 ti 1A1 f(►f NASNI%(mIt►%. c~count% 4vr Spokane (►n thn Aa% pcn.mA11% appcrrccf hct,►rc mc FRANCES S. LARE I DA u) rrK ►nown til hc the irxdl%K1wl de..nFKd in and Mho c%nuteJ the Mithin srxl turcguing imtrumcnt. arxl &c►r►uv►lodVd thst Srle •iRncYf the .rmr a+ her frce rnd %oluntan a:t arxl deeY1, tur tIx u.t% and purpcne+ thc►rin mcntwt►cd 61% F\ undcr m% harxf iind 41I1i.W .cal thi. dA % ut . 1~86 ~ Excise Tax Pa+d on~ - ~~7~•)7 Icietl a`. 44-~ Sale An,~ Pd y~I(~. Yv ~'4,1ors !'uhl,o in an~l J,w rSyl~,~ t , . 5►KIP";CNILBERG • 0 E " Sp06ne C 'uMy T►wm ro.~a,hn~ J . ~ • . : ~ MY C~MMIJ~1o41 Nik,r / ~ as , F..., ~ ' . , - ~j'7:~ r ) l" 17 1; , . ~ - . . • t~:~7z i~~ ~1W r.:oEAUA , . K~. • • + .r.+ , . ~~molo• ~1'~~ '~'Q' SPOKAt~E • yASN1Nt'rtOM ` _ . Spr~gue an4 N&vsna 1MnS L/C; Q4(j-0169 , ' M' ►L' - ' z. O+c t~SM- tLLtMOts 60621 ~~,sr~a~c~~o~ , february ATI zsth casasrt d'` TDQ~t~~AltO W{E~~1S un~ ~RE ID~►NO1 V A~ t~o ~ . ~ 1956 fiAtES S • •~Sdiar"1 to conr''~' ~t° ~ ~ ~ ~ rrd jbW.Wdw e~M~~ ~ r 1 ~ on A ~ ~ ~ onoos. CAIP a (~1~~ D&JAMW ~ ~ ~ d~rc~b+d ~ a nesWictive Ca•w~ r" Shce~ ~~RE 10A. JR • oi ~ c°n~ s~'~s tl~ ~g~AB. °a~ °t ~ ~ ~ 0 5 P"Wty; ~ co~►wm~ aerd ~ ~ ~ ~ ~ RgF+O~E. ~~b9► ~~b~d oa gsh~t~t B. r u i nt h es r nt ~.a ~ THE tt~ct. ~~e PIO'~~ r or ~noT oi ts 9r ~ch Iriel- inc~u ~ within a der~vin roduc s• a~'►d f reU r ~t~ Serv1ce eStab ish~nt of a~Y.~ f or chic Q^ P res roast b~ ~ wean a ~r r round beef s " ~~t is ~~_gQx Da Ta ~ t~ sf h 20) 7~ ir°~a° tt,e ~ te e J ~ k. a o~ ~e ~e ~ ~°e of twe~tY ~ A ssd w s~r ~ ~ ~Q~ ~ a st ~~n~i b d ° ~a°t~' iot s Mi "Od t V44 o + r K " l rc~ tbest A,~ Art i c~ Purcha~ r°d Seder F g UpY~ Chi cke~ ~ b~t uP°~° ~ F~ Appt7I011A~1 tbF.CyAAATI4N O ISMIL-nv ~ P . 2 Of~ ~gRF,qF . sel~ b~':~c" °i i ~111'1N'' ~ .d~.~•G~~ . $F1.L.W r . 1 ~ „ `t _ --f'•_~~ . r - 3TA"1'E OF' COL'`'T'Y OF~ AFnDAYtT OF OW'''ERSHQ (ladi•idusll ~ and ststels) ~ on 06tt►. hcd and that be 1~) f~1+e'ti fust duly Swom ~n~ on Ezh ~nbed an E=hibtt a sttached- ^ r ~j ~e o,~nrtt~'1 ot the P ~ ot the P'r°pWt'~ ^ tM►Q 1 rl R111` ~ ~rttllltl a 1 the°u t h~(s) tlus no p~~ hsyel yet hu Ihrr! sl has t• ' • . I;v V~ 1T'~i►F~ ~'HEREOF . ~{~~,nu191L. - ' .19 / , • .r y L-1 0 Of ~wotn to brt°se ant thts , ~ ' _~t ' ' C_~_:Sir+.►+ Subrcnbed und - • - ~ O.T. kRy t►UBLiC . • . • ,ti; . 1 ~ i ~RE c~tESt' % y Coma+~n tsP EMEVT FOR 5'T~►TE wH 14LEASE A1'fACN QKOPEK ACK.tit3WLEDG . tECORDED) . McD-DRC-149181 ~ •~/G di -1-z TICOR lITLE ID1SU?2APyCE CON~PRNY ~R 2 ti ..West 521 First Avenue P. O. Box 2122 Spokane, WA 99204-0366 Spo-kar.e, WA 99210-2122 R 7PE D FIRST SUPPLEMENTAL TITLE REPORT 'JUL 7 1986 SPOKA~!" C~ui1i~~TY Ef~lGINEEP To: Ticor Title Patricia Tisdale ATTt1: Ann Rusbuldt McDonald's Corporation 1008 Western ave. 2700 Northup, Bellevue, Wa., Spokane, WA 98104 cc: Senske & Assoc. Our Order No. : C-174484 U-1 I (D cl ~Y Mortgagor/Purchaser: Laeida, Jr. / Sprague & Havanna, Spokane There has been no change in the title to the property covered by our prelininary repart since February 26, 1986, at 8 A.M. Except as set forth below: 1. Legal description is amended to be: That portion of the Northwest quarter of the Northwest quarter of Northwest qLarter oi Section 23, Township 25 North, Rar.ge 43 East W.M., in Spokane Coun*y, Washington, described as follows: Reginning at the Northwest corner of the Northwest quarter of sai.d Section, thence East 330 feet; thence South 236 feet; thence F;est 330 feet; thence North 236 feet to the point of beginning; EXCLPT the North 30 feet thereo-f for Sprague Avenue; and, Except tr.E South 6 feet of the North 36 fP_P,t thereof for Sprague Avenue; ann, Exccept beginning at a point which lies 36 feet South of the Nortll line of the section and 50 feet EaSt of thc West line of the section; thence Sout:lwester..lv to a point which lies 30 *feet Easterly of the West li-r.e of the section and SO feet Southerly of the North line of the section; thence Northerll anc', parallel to the t',lest line of the section to a point 36 feet South of the rlorth line of the section; thence Easterly and parallel to the North line of the section, to the point of beginning thereof for Sprague Avenue; and, Fx.cept the West 30 feet thereof for Havana Street. _ Dated as of the 26th day of February, 1986, 8 A.M. TICOR TITLE INSURANCE COMPANY Wash* gto State 'vis'on Ay ~ . CB91/jb ` o ' • SCHEDULE A Commitment Number: C-174484,'Unit 1 Effective Date of Commitment : February 26, 1986, at 8:00 A.M. RE : Laeida/ Prepared For: . PREPARED FOR: Ticor Title Insurance PATRICIA TISDALE ATTN: Ann Rusbuldt REAL ESTATE COORDINATOR 1008 Western Avenue McDONALD' S CORPORATION Seattle, WA 98104 2700 NORTHUP WAY BELLEVUE, WA 98004 REF: SPRAGUE AVE, SPOKANE Inquiries Should be Directed to: Ticor Title Insurance Company . West 521 First Avenue - Spokane, Washington, 99204 (509) 838-5281 1. Policy or Policies to be issued:, Liability Premium Tax Total Amount -ALTA Owner's Policy $1,258.00 $98.12 $1,356.12 $354,000.00 Form 1970 Proposed Insured: Request Names. 2. The estate or interest in the land described or referred to in this Commitment and covered herein is a Fee Simple. 3. Title to said estate or interest in said land is at the effec- tive date hereof vested in: The Heirs and Devisees of George Lareida, Jr., Deceased. MISC11/mca . .C-174484, Unit 1 - 2 - Preliminary Commitment 4. The.land referred to in this Commitment is located in the County of Spokane, State of Washington, and described as follows: That portion of the Northwest quarter of the Northwest quarter of Northwest quarter of Section 23, Township 25 North, Range 43 East W.ri., in Spokane County, Washington, described as follows: ~ Beginning at the Northwest corner of the Northwest quarter of J said Section, thence East 330 feet; thence South 236 feet; thence West 330 feet; thence North 236 feet to the point of beginning,t ~ ~ EXCEPT the North 36 feet thereof for Sprague Avenue, AND EXCEPT the West 30 feet thereof for Havana Street. , - - MISC11/mca - C-174484, Unit 1 - 3 - Preliminary Commitment SCHEDULE B Part I The followinq are the requirements to be complied with: 1. Instruments necessary to create the estate or interest to be insured must be properly executed, delivered and duly filed for record. . Part II Schedule B of the policy or policies to be issued will contain exceptions to the following matters unless the same are disposed of to the satisfaction of the Company: Defects, liens, encumbrances, adverse claims or other matters, if any, created, first appearing in the public records or attaching subsequent to the effective date hereof but prior to the date the proposed Insured acquires for value of record the estate or interest or mortgage thereon covered by this Commitment. _ Standard Exceptions: 1. Encroachments or questions of location, boundary and area, which an accurate survey may disclose. 2. Public or private ease*.nents, streets, roads, alleys or highways, unless disclosed c,f record by recorded plat or conveyance, or decree of a court of record. 3. Rights or clai.ms of persons in possession, not disclosed by the .public records. 4. Material or labor liens, or liens under the Workmen's Compen- sation Act not disclosed by the public records. ' S. Water rights or matters relating thereto. 6. Any service, installation or construction charges for sewer, water, electricity, or garbage removal. 7. Exceptions and reservations in United States Patents. 8. Right of use, control or regulation by the United States of America, in the exercise of powers over navigation. MISC11/mca r C-174484, Unit I _ 4 _ . Preliminary Commitment 9. Any prohibition or limitation on the use, occupancy or improve- ment of the land resulting from the'rights of the public or riparian owners to use any waters which may cover the land. 10. General taxes not now payable; matters relatinq to special assessments and special levies, if any, preceding the same becominq a lien. Special Exceptions: 11. General and weed taxes for 1986, in the sums of $2,609.71 and $.14, on land with an assessed value of $194,400.00, and im- ~ provements assessed at $3,500.00. (Assessor's Parcel No. 23532-9107, Code 043) , 12. Irrigation assessment of $132.61, by Carnhope Irrigation Dis- - ~ trict No. 7, for 1986. The first half will be delinquent April ~ 30th. The last half will be delinquent October 31st, if unpaid. 13. Inquiry for any charges for irrigation, domestic water, elec- tricity or other charges made by Carnhope Irrigation District- #7, should be made to said district at.East 4902 Second Avenue, or phone 534-2085. . . 14. Lien of real estate excise sales tax upon any sale of said premises, if unpaid. 15. A lease affecting the premises herein stated, executed by and between the parties herein named for the term and upon the terms, covenants and conditions therein provided. Dated : February 26, 1954 ~ Lessor : George L. Lareida, Jr., and Frances Lareida, ~`lv husband and wi f e ~ Lessee : Continental Oil Company, a Delaware corpo- ~ -ration, of Ponca City, Oklahoma Recorded : March 17, 1954 Auditor's No. : 228197B Terms : Twenty years, commencing at 12:00 o'clock noon on the lst day of January, 1954, and endin at 12:00 o'clock no n g o on the 1st day of January, 1974. Affects : That part of the Northwest-quarter of the Northwest quarter of the Northwest quarter of Section 23, Township 25 North, Range 43 East of the Willamette Meridian, in the County of , Spokane and State of Washington, described as follows: ~ MISC11/mca f • , ~ TYn].t 1 - ~ - PreZiI[C1I1ary CQmT13.tmEnt , Beginning at the Northwest corner of the Northwest quarter; thence Sauth 44 ~ods; • then4re Eas1r fiV iodti7; t#ieBLMxe LYVLth 4V i~dsj thence West 20 rvds to the paint of begin- ning, EXCEPTING THEREFROM the North 30 feet used as State Highway Na ~2 and EXCEPT the riest 30 feet used for Saounty roadi Said lease, amvng ather things~ ~~ovides for an vptian to renew for a period five years. Said lease, amvng other things, provides for an option to purchase. 16. Frobate proceedings are 1~eing had on the estate af the Decedent named her+ein. An Order of Solvency, including nonintervention powers rhas been entered. The Pe~sonal Representative narned herein is autharized to administer and settle Decedent's estate without intervention af the Court. Execution of any instr=ent shoul.d be as Persvnal Representative, Decedent : George Lareida, Jr. F3ate af Death ; November S. 1984 ~ County/Case No. : 84401415-8 - Personal Representative: Frances S. Lareida Attarney ; Richard A. 5taeheli 17. Any encroachment by or adverse claim with respect to any under- ground installation appurtenant tv said premises or other H praperty, the existence of vrhich is not disclosed by t,he pub].ic ' records. - . 18. Matters which rnay be disclased by an accisrate survey of the p~emises. Such survey should be submitted for our insgectivn and fil.e. NOTE: 1. In t~~ event this transactson fails tv clase f a cancellatian fee _ will be charged for services rendered in accordance with aur schec3ule, (End o f 5chedule B) MISC 1 l/mca . ~ . . MC- ~ 4 8 4, Un i t 1 ~ s~{'At! ~ rJ 2_ _iminary Commitment 4, The.,land referred to fn-this Commitment is located in the County of Spokane, State of Washington, and described as follows: That portion of the Northwest quarter of the Northwest quarter of Northwest quarter of Section 23, Township 25 North, Ranqe 43 East W,M., in Spokane County, Washington, described as follows: Beginning at the Northwest corner of the Northwest quarter of said Section, thence East 330 feet; thence South 236 feet; thence West 330 feet; thence North 236 feet to the point- of beqinning, EXCEPT the North 36 feet thereaf for Sprague Avenue, AND EXCEPT the West 30 feet thereof for Havana Street. , . MISCII/mca 711111J16 ~ Name- . \ Attached are the documents required for completion of your application. To avoid unnecessary delays, be sure each is signed properly by all parties shown on the document and that al1 signatures are_ properl_y, notarized. %flank you , ~ght of Way Department -Z q0 1'2 Ca &o ~ i DEPARTMENTAL REVIEW Cond. Apprnved Approval r old Envlronmentel Health Application M Q(-) 4~ ~ W. 1101 College Roorn 200 . . ' ~ Plennfng/Zoning •?I re' iA,~~- ~ . a, ~ N. 721 Jefferson • ~r ~ . o . r 0 7- ~ P-f v ~ Englneera l~l N. 811 Jefferson ~ Utllitles • N.811 Jefferson -,}%-M 3~,~"VuT ts Plen Review/Flre Prev tlon ~ N. 811 Jefferson Other (SEPA/Crlllcal Materlaf/etc.) ❑ . C3 Fast Track/Speclal Inspectlon Intormatlon • ProJsct Representative Phone Address I certify that I have examir,ed thfs appiication and state that the lnformation contained in it and submitted by me or my agent to complle sald application (s true and correct. A SI9nature 5aAALr e-,z6AA!-q Date 1 KOI" , _ . / (el-A \ . Spo AKE COUN'TY l.F1TER OF TRAhJSMITTAL /,tENGINEERS OFFICE OF 'TNF SPOKAtJE: COUt1TY EfJGIfIEER tJorz'rii 811 JEFFcRsori SPOKANE WASIi i NGTON 99260 ~09-456-3600 TO : DATE : ?o SUBJECT: . . --Re~LL~.~.~~~- -7'- ATTN GEtnLEMEN, wE aRE SEtdDiNG YOU; Q ATTA.CfIED ~ ENCLOSED ❑ UNDER SEPA(tATE COVER ❑ PR1NT~ ❑ CHANGE ORDER I10• ❑ PLArds COPY OF LETTER ❑ SPEC I F 1 CAT I O NS ~OTHE R COPIES DATE DESCRIPTION ~ ~ . . 1 I . i I - I l TNESE ARE TRANSP•11 TTED AS CMECKED: ~AS REOUESTED ❑ FOR REVIEW $ COMh1ENT n RETURPJED FOR CORRECTION P~ FOR YOUR USE F] FOR REVIEW & APrROVAL ❑ REPLY ❑ FOR REVIEW & USE ❑ FOR SIGNATURE 8 RETURN ❑ UTHER RFJMARKS : ~ 4tz&~oo ` v.. 79 ~ . CoPY T0; SIrNED: ~ 17 McDONALD'S CORPORATION LETTER OF TRANSMITTAL 2700 Northup Way _ Bellevue, Washington 98004 R EC EaVLD DATE JoeNO Phone: (206) 827-9700 9 -8 6 UUL 7 1986 ATTENTION rP01(A N'7 RE: A TO e"'ov.,] rr Aloen4 eLl . 1 i~c v<o- I 6~&---'A,a) r;,. ~ . 99 2l0 0 GENTLEMEN: WE ARE SENDING O Attached 0 Under separate cover via the following items: ❑ Shop drawings ffPrints 0 Plans ❑ Samples 0 Specifications * Copy of letter D Sepias ❑ COPIES ~ DATE ~ NO. ~ DESCRIPTION 1~j ~ THESE ARE TRANSMITTED as checked below: El For your approval O Approved as submitted ❑ Resubmit copies for approval r your use ❑ Approved as noted O Submit copies for distribution As requested O Returned for corrections 0 9eturn corrected prints ❑ For review and comment ❑ ❑ FOR BIDS DUE 19 O PRINTS RETURNED AFTER LOAN TO US REMARKS A--, ''so n $e COPY TO . SIGNED: ,i~'S~►_ .f?~ ..,c.. f ~ If enc/osures are not as noted, kind/y notify us at once. . Ille- - ~ ,p Contact Person Name ~vier_511 -~~eiT c~►! BuQiness I~~~~ey~~or~ _ pAd re s s 2 2 00 4~ ~~`,ftt~ P Gt~.~-y; 8,P ~lcuvc Add re ss _ Phone 7 -,9 9 Ekx>i't P h o n e Coun_y Contact Person eSPhone No. 456-3600 Date 4~ COMMERCZAL SUILDING PERMIT 'RI:VtCW This building permit review is 1.ntended ro appraise you of the improvements (roadway, side- walk, curb, stormwater, etc.) whi•ch must be constructEd in association with your building permit. This checklist will be filled out by t-he Engineer's stat-f and a copy wili be re-- turned to you at the time that the permit i.s initialed by the Engineering Department. A1l requirements,shall be completed prior to issuance or the building pecmit. All unchecked boxes require additional research or information Ga make a der.ermination. I. Stormwater llrainage Considerations A. Per gueeTines tor "Storcrwater rianagement 1981" both on and oFf site. 1. 208 Considerattons* . 4=24 Yes ~ No 2. Flood hazard zone considerations** ~ Yes No 3., Storm Drainage Plan . Yes ~ No . ~ II. Planning Action # ' • 1. Plat, short plat, rezone, Conditional Use or Variance ~ Yes a No on property. Planning Number 2. Are requirements of planning action incorporared a Yes ~ No into site plan ' III.. Ej~ht of Way - 1. Does permit necessitate R.O.W. dedication Li Yes No 2. Did zone change require R.O.W. dedication Li Yes ~ No 3. Radius at corner ~ Yes ~ No IV. County Road Improvements 1. Roads need to be improved. How wide ~ YPS ~ No 2. Curb Li Yes ~ No 3. CRP/RID agreement (Copy of deed, contract, or Ll Yes 9 No title report required.) • 4. -Plans 'f or improvements provided ~ Yes ~ No Yes No , 5. Sidewalk 'Bo ~ ~mCD ~ . V. Parking Plan & Approach Location 1. Review and -sign off by Traffic ~ Yes ~ No 2.• Approach Permit from Engineer's Office ~ Yes ~ No 3. ' State or City sign off ~ Yes ~ No 4. Is this road on 6 Year Plan ~ Yes ~ No VI. ULID Agreement: ~ i'es Li No VTI. Field Review: - Preliminary Comments IN, ~ L1l~ ~ 0~A n o ~ ~f V ~ I l/C ~ )r-6-=~Y l3~ t'---6- •-l'~ ~ / _ ' 7/ * All land•wittiin the Aquifer Sensitive Area; where deemrd £eiisible b}T the County Engi- neer, sha11 incorporate stormwater trcatment to miti.~ate the pot2ntia]. f.or gro~.~►~r.lwater degradation. (See Guidelines f or Stormwater Management 1981, Spokane Board of County Commissioner's Resolution No. 80-1592.-gs amenderi.) The purpose of flood hazard a.one review is to i-ilinimize ?osses due to flonding in spe- cific areas designated by Flood Hazard noundary maps an fite at the County EngineFr's Of f ice. (See Spokane Board of County Coin.missio:te r's ttc,sclue.ion No. 81--0726, as amended.) 8/22/85 ' . ` (THIS IS NOT A PF_RMIT) BUILDING f'ERM1T APPL1CAT'iON WORKSHEET PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOD UNDERSTAND COMPLE7E IN INK ~ (Please return this original and your building plans lo t1ie Department of Buildiny and Safety) SHADED ANEAS ARE FOR DEPARTMEN7AL USE ~ Project Number Owner's Name I.AST FIHST MI H c:..C6u&-0-S C62P4R~~/("i ProjeCt Addres9 (Street Name,.R Nurnber) 7ip . . S, l-~)4 v~ N~4- ~i P~~r`" . S Por~~' l~✓A Applicant l1Ndicss KE:r:,6ay- City Slate Zip Phone ~ 4Tu- r:--- vt,c E- ( ZDO 8~ ~ `~1700 SuSinesg F'hone ( ► i ,~i~E Contractor/Agent Addro,s L*. r~ ~r~ City Slate Zip Phone S 1 ContaCt licerise Number (Ftequired) , Ciusiness Phpnc 1 1 ArchiteCt/Engineer nddress City ~ State "Lip~ Nhone 827 - 2~00 Contatt Business f~hone K8~- ` Lender Address NoNE Cily Slate 'lip Phone l 1 b8 WOfk ' ~ z- ' • • . RBS. COnlm, _ _ ; t wt a.o ~i ~`G'~~ _ ~1v~' _ . ~ • . . - ~ ~y~ 1 ~ "s ,.y - 1 J "\\i = 1 v ~ Subdfvlslol /;Plat NamelShort Plat Number - , ~ r~R,; . ' ; . - • . •Assassor Paroel Number • ~ Lot • 81ock Plat Number ~:~~i'3.`: d ~i•~7 .L~ /,j ••y~ C~ ~ C ' -7 ~ •penlnent Ftle Numbess. ' , Zone Comp. Plan Census Tract ,r ~'Y, •t,' . . . ' • r"~ r I ~ g Unfts Number ot Bulldings Lot Size (Sq. Ft.lAcre) ~ Depth ,r Frontage ;Numbetof;Dwell'n ~~i~x;:~~• ' ~ . • ' ~ C' - n ~,~n ~f t Setback'~,r.t y+ left Selback ~ • Right Setback Rear $etbaclc . Ri W Wid1h `;~-~~i r 't : oM . . • - • • , ;Addltlonel,tnfotmatlan • ' ' ~ . . Square Footage ~ w, . , . ~ . • , ~ ~ •i . . • ~ ~ . . , ~,~~~'1.~st 3, ~ . . . ~ . ' • ~ ~~ry,_i t. ; ~ ~ ' ~ . . . ~ ~ r~ •i~~ , • ~ ~ ~:4-~'~~~ ~ ' ' ; ' • c~ n ~ O . ~r~i . ~~j;: ` • ~ .t C~~~ ' , • t.:. . . ~~'~+t°,~bi►'itr.fiv- e . . J a c CY ~':~±~jIF~~~.3::,`. } y~ F . ' , ~vs C .~•Y.+'^':~=!'~f.~`+~ f++<.~' ; ~ • ; ' : ' ' . • ~ o ~ ' ~ ~ »t t„it d O .qa''.cl ~y~~<~''r~`*~~Zj~;%.~~~tae''v ~ ~ . a . o . • . Z ~ %!!F ~ ~~~ti4.,. r_:. ' , . • ~ a , • . , . - Q ' „ ' ~ . • J ~ r +.•',~f~'~"'``,t' : . . ~ ~r~'`• z~~`•'"i~i~'`r~"~a,~ti'+,,,h'~~'''o''~~:~.~ , . , • • . . . . , . m Numberaf Bedrooms . ~ , •~~;~~~~1~'~,~ `w~.~i~.~Y.J , . 4% . ~ ~ . . . , _ ' - , aJ ~7'~~' ;'~~~17'~ia ti_ . . . ~ ~ • ,6i0IldtnpT _ nlClanL•~,<:,:F'' Date Group Type 'rR~R~~h~~+,r ~ ~ d l~'44 ,,ry~`.a~3 : t~ ~y ~~I • ~ ~ 1 r ~ •~y 1 ti ~ DEPARTMENTAL REVIEW Cond. Approved Approval Hold Envlronmental Healfh Appltcation # ~ W. 1101 College Room 200 ~ Planning/Zoning ~ M. 721 Jef ferson Engineera ` ~ N. 811 Jefferson Utilitles ~ N. 811 Je(ferson ~ LONT ~s REQ~%4 Y& or ~ ~ . . . . , ~ Plan Review/Flre Preventlon N. 811 Jefferson Other (SEPA/Crltlcel Material/etc.) ~ ~ Feat Track/Speclal Inapectlon Informatlon • ProJect Representative Phone Address I cenify that I have examined this application and state ihat the information contained in It and submitted by me or my agent to complle said applicatlon is true and correct. / sl9nature f)aAAA1 Date l l2 ' . ~ DEPARTMENTAL REVIEW Cond. Approved qpQrova4 Hold Environmenial Health Applfcation q 0 W. 1101 Cotiege Room 200 ~ Planning/Zoning N. 721 Jefferson ! d Englneera L~1 N. 811 Jef(erson ~ Utillties N.811 Jefferson ,,,5„~~•- ~ ~S ftdD%J1%twrz ~ . , . , Plan Revlew/Fire Preventlon ~ N. 811 Jefferson Other(SEPA/Critical Materlai/etc.) ❑ . , Faat TrMCk/Speclel inspection Intormation Pro)ect Representatlve Phone Address I certify that I have examined this app(Ication and state that the iniarmation contained in it and submitted by me or my agent to compile said application Is true and correct. Signature Date r ~ REQUtST h'UK Ut:51uN UF:4'lAI'lUN • KUAD NAME ~f~V[~lJ~ _ _Sl • ~ _ oA•rE ~~uNC _Ckk'/RiD/YLAT/Z.c. N~.-----------~--- FEuh.KM./sTATE PKOJEcT rrO. . PROJEI:'C T1'fLl•: - PKUJEC'I' LIMITS - --5~-!~----~~v~~- S~ _ - EXIS"TINC CC.)NDt`tIUNS: / PRDYOSEU IME'KOVEAIENT: ROAD WtDTH ROAD AVG. UAILY TKAFFiC Currtnt Design Year l'NUJECT DtSCtt [NT1UN sr.t/ - - / DESCR f YTIUN OE' ST'ANUAkD INVOLVEU 7c~-ria~-I G►~ c'~f,~~~ ~ D_ _ ~4~ Qt~ ~iQ~.x~c,~t UK. . ' !'ItOPO5EU Uh:SICN UEVIA"TION / JUSTIFICATION _ ~ - - _._G,' ~ :5 ~ . / Submitted By I`~ / tte ~ . 5TAFr' Kh.~.~~r~rtii•:~vu~~~t~ <<~~::; ` - ' - _L~_/?' l-S' ' - ~ • - ~~~~7...~/v L~~ _ _ . . ~~.~5 7f~~f •.T~'/-~.'_. ~i✓~j 1C App rovcJ Not Approved ~ - - - - - -17 Scc t iuii :n i nte z a ~ . b [ ~ _e - - - - _ - - - - - - - - - - ---~_J_~~-c-_-s-~-~~ ~ - - - - . - Appruve.i Not AI)r,r„vt-,i Tra ffic ~n- nctr Date - `~Zu~ ~ ~/_,Yl,•~~z~~- - - - - - _ _ _ _ Q'~- ~cG ~-C - , - - Approved Not Approved . - - - - ~~~i ~ - - - f ce Ent;ine er Da e Approved Not Approved Divisiun k:ngineer Date ^ Approved tio[ Approved - - y~- - + - 11 1 -~County Engineer --Qate REQur:sT FuR UE:S «u uEv lA'r tuN ROAD NAME _~jlf~'V~l~,e~ _ _S~ • 0A't'E GllfJc JZt 1 Y8~ -CKk'/RID/l'LAT'/Z.C. No.-L_e^_- FEUEKf\L/STATE E'KOJECT N0. PROJE(:'I' TITLL:~~~~~~~,~~- PRUJECT LIMITS Sy • _ - - - - - - EXIS`rING CONUITIUNS: ~ PROYOSEU IMPROVEMENT: ROAD WIDTH 50 ~J=Jo5 ROAD SUItFACr_' ___,~~~~-'7' • AVG. DAILY TRAFFIC Curreiit Design Year P P.O J E C T DES C k I t' T I O N _ _ - / DESCRI YTIUN OF STANDARU INVOLVEll PROPOSED DESIGN DEVIATION ~ ~ 1-87 ~ . 2~~ . . JUST1 FICATION / ~ ~ 5 i DE2crn_L.~v- 6vJ -TlGGr 5;l~ `5 P~6 u~ ,efr/ELUeQ') ~ - - - , . . ~ Submitted By _i~2i4•~ _ /~~atJa c~ /te ~ ~ STAFF KF.cOMMr.NuATtutiS V:~~:~~~Z%~ N~~~._----------_.~_--- AppravtLi Not Approved -1 - - - - • - - li S<~cti~~ .~;ineez Dat --J ~ - - ~-~~ti = - ~ - - -O - - - - - - - _ , ~ ,~j~ _ - - - • ^~r- _ r - - _ - _ _ _ ~ _ v Approved Nnt Apprt,vt-,il - rap - - ~t- ~ Traffineer Date Approved Not Approved Ll + Of f ce Engineer Da e r .s .400", Approved Not Approved ~ Diwiision Engineer ~ Dare _ _ - - - - - - - - - - - _ _ - .~.r_ , - Approved Not Approved _s ^ 'ounty Engineer ~ Da e ~ l_~