2004, 02-27 BLA Elimination App Sty6ka"ane . CITY OF SPOKANE VALLEY (For Staff Use Only)
► Community Development Department
. Valle' Current Planning Division DATE SUBMITTED: RECEIVED BY:
11707 East Sprague Avenue, Suite 106
Spokane Valley, WA 99206 FILE No. NAME:
Tel: (509) 9211000
Fax: (509) 921-1008
2.1.4nninq@SDokanevalley,orq CURRENT PLANNING FEE:
ENGINEERING FEE:
rnas _
BOUNDARY LINE ADJUSTMENT/ELIMINATION APPLICATION
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PART I - APPLICATION TYPE
(Check One)
0 Boundary Line Adjustment 0 Boundary Line Elimination
• PART II - APPLICATION INFORMATION
LOCATION OF PROPERTY(IES):
TALC PARCEL NQS.: 35133.1512
STREET ADDRESSES: _
ZONING DESIGNATION(S): � CT1uu
GENERAL PHYSICAL DESCRIPTION OF PROPERTY(IES)INCLUDING CURRENT USES 1 a 440
APPLICANT INFORMATION:
APPLICANT; TONY DANELO --
MAILING ADDRESS: 5710 N. Bannen Road
CITY: _ apnkaneSTATE: _WA - ZIP99216
PHONE:(HOME/WORK) 926-8907 (FAX) _(CELL)
Meese awe.
NOTE: IF APPLICANT IS NOT THE OWNER,INCLUDE WRITTEN OWNER AUTHORIZATION FROM THE LEGAL OWNER DELOW;
OWNER INFORMATION:
PROPERTY OWNER#1:
MAILINGADDRESS: 511(1 N, RannPn_Road
CITY: - okane STATE: WA _zip: 99216
PHONE: (HOME/WORK) 976—R.907 FAX)_ _ (CELL)
Please Clyde ^�
PROPERTY OWNER#2: TVA M. _DANELO __----- _
MAILING ADDRESS:.___(2.2 l 2 I'; V:i 11(syw{yAveCITY: Spokane .—_STATE: WA Zip: 99212
PHONE:(HOME/WORK) .54• 7€¶'I FAX)._,-----_—.-- (CELL) ---_—
Please GIrcle
Version 1:01/04 1
PLEASE NOTE: ALL SUBMITTAL REQUIREMENTS SPECIFIED IN THE SUBMITTAL
CHECKLIST FOR BOUNDARY LINE ADJUSTMENTS/ELIMINATIONS SHALT. BE
SUBMITTED BEFORE THE APPLICATION WILL BE PROCESSED.
PART III - LEGAL OWNER SIGNATURE
(Si hat re of legal owner or representative as authorized by legal owner)
I, /,',e'" �'� ! , (print name) SWEAR OR AFFIRM THAT THE
ABOVE RESPQfNSES ARE MADE TRUTHFULLY AND TO THE BEST OF MY KNOWLEDGE.
I FURTHER SWEAR OR AFFIRM THAT I AM THE OWNER OF RECORD OF THE AREA
PROPOSED FOR THE ABOVE IDENTIFIED LAND USE ACTION, OR, IF NOT THE OWNER,
ATTACHED HEREWITH IS WRITTEN PERMISSION FROM THE OWNER AUTHORIZING MY
ACTIONS ON HIS/HER BEHALF.
ADDRESS: 5110 N. Barmen Road PHONE: 926-8907
WA ZIP: 99216
(City) / /' (State)
.i0nature) (Date)
NOTARY
(For Part ill above)
STATE OF WASHINGTON ) ss:
COUNTY OF SPOKANE )
SUBSCRIBED AND SWORN to be`ore me this t
" day of 4 - 64,Ct4y , 20 'V
NOTARY SEAL /
6 • ARY SIGNATURE
atitstimmunnuttuttlittlrimittuttititfikary Public in an. for the State of Washin ton
✓r�. ~ � 1-' .ZIL Reading at:
v�
v f,C Y L. I`LO2ZS _ - •17. -
NOT/'Tr r!y,LIc STATE O7-WASHINGTON —
ccrE�r:if+t:r 5,21 appointment expires: s/OG
f�iSZf{�;:+Ila{CCi4!tC:iit:it4attt{tltiit4ttti4ttlilll!®
' PLEASE NOTE: THE SPOKANE COUNTY ASSESSOR'S OFFICE WILL REQUIRE EVIDENCE
THAT A BOUNDARY LINE ADJUSTMENT OR ELIMINATION HAS BEEN RECORDED WITH THE
SPOKANE COUNTY AUDITOR'S OFFICE IN ORDER TO UPDATE PROPERTY INFORMATION.
INFORMATION REGARDING THE SPOKANE COUNTY AUDITOR'S RECORDING
REQUIREMENTS IS ATTACHED TO THIS APPLICATION PACKET.
Version 1: 01/04 2
PLEASE NOTE: ALL SUBMITTAL REQUIREMENTS SPECIFIED TN THE SUBMITTAL
CHECKLIST FOR BOUNDARY LINE ADJUSTMENTS/ELIMINATIONS SHALL BE
SUBMITTED BEFORE THE APPLICATION WILL BE PROCESSED.
PART III LEGAL OWNER SIGNATURE
(Signature of legal owner or representative as authorized by legal owner)
I, TONY DANELO , (print name) SWEAR OR AFFIRM THAT THE
ABOVE RESPONSES ARE MADE TRUTHFULLY AND TO THE BEST OF MY KNOWLEDGE.
I FURTHER SWEAR OR AFFIRM THAT I AM THE OWNER OF RECORD OF THE AREA
PROPOSED FOR THE ABOVE IDENTIFIED LAND USE ACTION, OR, IF NOT THE OWNER,
ATTACHED HEREWITH IS WRITTEN PERMISSION FROM THE OWNER AUTHORIZING MY
ACTIONS ON HIS/HER BEHALF.
ADDRESS: __5J 1 n N __Bannon Read 926-8907
_ PHONE:
Spokane WA ZIP: 99216
(City) .��W. �- — �— (State)
(_/,
ter' L' " 2/27/04
/lirature) -- ----
(Date)
NOTARY
STATE OF WASHINGTON (For Part lit above)
COUNTY OF SPOKANE } ) ss:
SUBSCRIBED AND SWORN toe"ore me this
day Of6/Ac-e , 20��`i/
J
NOTARY SEAL 44-1 /
?ttrrittt:rrr: :t06t9tEErrt3:0fl;r,gt3'itt:ltt�tlllltll�, NOTA Y SIGNATURE
,�;t.zr ,� � Niitary Public in and for the State of Washington,
dr;OKY L. FLO�RES Ri_siding at: /
NOTARY runic STATE OF VIAS? INCT0N
coFE:1:'Jl::'•i1'5.2003 - _
�S:fl:�3:ueiii��$',:ar65�ir rC:;rrttiil�.�LriiitOrilri i 0� �---
My appointment expires:__ _N/0(o
PLEASE NOTE: THE SPOKANE COUNTY ASSESSOR'S OFFICE WILL REQUIRE EVIDENCE
THAT A BOUNDARY LINE
ADJUSTMENT OR ELIMINATION HAS BEEN RECORDED WITH THE
SPOKANE COUNTY AUDITOR'S OFFICE IN ORDER TO UPDATE PROPERTY INFORMATION.
INFORMATION REGARDING THE SPOKANE COUNTY AUDITOR'S RECORDING
REQUIREMENTS IS ATTACHED TO THIS APPLICATION PACKET,
Version 1: 01/04 2
>MilIev
COMMUIVITY DEP'1IEfVTDEPARTMENT
. .. i.... . i.« ..,_ a ^LTA •.
r BOUNDARY LINE
V ,Y.
f'4:"i- > C ADJUSTMENT/ELIMINATION
u",, SUBMITTAL CHECKLIST
❑ SUBMIT'TALCHE LIST
❑ APPLICATION FORM
Submit completed application on the attached form with ail required information specified and all
signature blocks completed.
iH CURRENT APPLICATION FEE
Cl ASSE$SOR'S SECTION MAPS
1:200 scale map of: 1/2; section ; township ; range
Submit one (1) copy cf the above Spokane County Assessor map(s), with your property (ies)
highlighted.
❑ EXISUNG CONDITIONS SITE PLAN: Provide a to-scale one (1) 8'/z inch x 11 inch plan
showing the following information:
1. The dimensions and square footage of the existing property/properties involved.
2. The location of any improvements (any structures, septic system, etc.).
3. The location and dimension of any access or utility easements.
4. The location, dimensions and names of public and/or private streets abutting the property
(ies).
❑ PROPOSED ADJUSTMENTJELIMINATION SIDE PLAN Provide a to-scale one (1) 81 inch x
11 inch plan showing the following information:
1. The proposed dimensions and square footage of the property/properties involved.
2. The location of any improvements (any structures, septic system, etc.) after the proposed
boundary line adjustment or elimination
3. The location and dimension of any access or utility easements after the proposed boundary
line adjustment or elimination.
4. The location, dimensions and names of public and/or private streets abutting the property
(ies) after the proposed boundary line adjustment or elimination.
Li Metes and bounds legal descriptions for the existing parcel(s) and proposed adjusted or
eliminated parcel(s) prepared by a professional surveyor licensed in the State of Washington
[] One (1) copy each of all involved property owners' recorded deeds, verifying current ownership.
0 Letter of intent explaining the purpose of the request including any special circumstances that
may be helpful in evaluating the request.
❑ Copy of boundary survey of existing lots,
❑ RECORD SURVEY OF PROPERTY; If you are proposing to decrease the distance between a
property line and any structure on the site, it is required that a record of survey of the property be
done to prove that no illegal building setbacks will result from the boundary line adjustment. The
survey must be done by a surveyor licensed by the State of Washington who must affix his or her
professional seal and signature to the survey. The survey must be recorded at the Spokane County
Auditor's Office and a copy of the recorded survey must be submitted with the application for
boundary line adjustment. •