DICKEY N 1720 INSTALLATION OF POLE SIGN
~ 1 • • -
rERMtT APPLICATION WORKSHEET
rLtASE PRINi AND COMPLETE ONLY THOSE PARTS OF THE FORM YOD UNDERSTAND
COMPLETE IN INK
(Please return this original and your buitding pians to the Department ot Buitding and Safety)
SHAOED AREAS ARE FOR DEPARTMENTAL USE project Number Owner's Name LAST FIRST N+! ~
~
bURLIN^vTON hORTHcRh: RAILROFiD ~
Project Adoress (Stre-si Name R Numbsr) Z;p E
1720 R'Oi? TF; J 1 CKE Y ~
~
Appiicant ' Address ~
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1
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City Siate Zip Phone
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Business PhOne
{ 1
ContractorlAgent Address
(ilOR7H 3502 t•JARKE7 3TREE i ~
. DALDv.' ~ ' It~! jlGl:~> L. ..l_.~AYS~ 1R.C. ~
's
City State Zip Phone ~
SPOKNhE irjASH ItvGTnN 99207 ! ) 439
:
CoMatt ' License Number (Required) 8usiness Prione :
DttiwNA I INoU isY uj~;-LD-Wa-01603RU t 43C) -G' c ;
Architect 6 Engineet qddress ~
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~ Staie Zic Pnone ~
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Cantacl . 8usiness PhOne, ;
Lender Address 3
9
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C+ty • State 2ip . Phons ~
C3escrtoe Work . , Res. Comm. '
j NSTALLAT ION 0F POLE S IGN
Subdiv;sionlPtat Na►ne/Short Piat Number -
Assessor Parcel Number Lot 81ock Plat Numbsr
12533-1204 12 13
Pertirrent File Numbers Zone Comp. Plan • Census Tract
RI '
Number of Dwelling Unics Number of Buildings _ Lot Size (Sq. Ft.lAcre) Oeptn Frontage
Ftont Setbsck Lett Setback RiAhl Setback . Rear Setback R! W Width -
Additional tnformation Square Footage .
Z
O
Q
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O
LLZ .
, 0
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C
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' • m t3untbe► Of BedroomS
Buildinfl TechNcian Qate - - ' ' Group Type ; , '
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DEPARTMENTAL REVIEW
Cond.
Approved Approval Hold -
Environmental Nealth Appiication •
~ W. 1101 Co{iege
Room 200
Pianning/Zoning
~ N. 721 Jefferson
. ~
'.Engineers N. 811 Jefferson
6
. s
e
.r
Utiiities
~ N. 811 Jefferson ,
. , . . . . :4
f
~l
.
Plan Review/ Fire Preventlon
~ N. 811 Jefferson
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ar
.
Other(SEPA/Critical Mate►ial/etc.) tFf
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~4.
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~ Faaf Treck/Speclal Inapectlon Informetlon
Project Representatlve PhonP
. t~
Address
•
I certify ihat I have examined this application and state that the information contained in it and submitted
by me or my agen:to compile said application i rue and correct.
Signature~ Date IC5
. ~~z;
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LEGAL DESCR7PTION
That portion of Orchard Park Addition according to the plat _
reoorded in Yalu.me B of Plats, Page 76 of Spoke,ne County, Wa.
deecribed ae folloeas . Beginning at the intersection of the east R/W line
o i' D i cke y Ro ed and the oa n te r line of Balydw in A ve nue ; N Q R A
" thenoe southerly along said- easterly R/W line of -Di6bey
Ro ad a d i s tan ce o f 493 . 37 f t, to Lhe nor the rly R/W 11 ne
of the N.F. Ry.;' thenoe N. 73°0l138" E. along eaid
~ nort,herly R/W line a distance of 31,3.85 ft. to. a point
on the lrot line between Lots 6& 7, Bloak 13, eaid
Orcherd Park Ad.dition; thence N. 00°Ol1l+2" W. along the
l,ot lines between ivta 6& 7, Block 13, Lot,B 113 & 19,
and Lots 6& 7, Hlock 12, eaid Orchard Park Addition,
~ e d ie tan ce . of 398.45 f t, to e po int in the ce n te r line
o f B aldw in A ve nue ; the nce No. 89 °22 110" W.- alo ng e a id ,
centerline a distance of 300.00 ft. to the point of
beg1nning.
S,W.1/4, SEC.12,
Z, 2 5 N.) R,43 EWM. S POKA N E CO, WA•
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