2005, 03-24 Permit App TUDR-01-05 Temp MHsPane..
,0FUalley
CITY OF SPOKANE VALLEY
Community Development Department
Planning Division
11707 East Sprague Avenue, Suite 106
Spokane Valley, WA 99206
Tel: (509) 688-0179
Fax: (509) 921-1008
planninc sookanevallev.orci
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DATE SUBMITTED: n RECEIVED BjY:
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FILE NO./NAME: : 6-co
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CURRENT PLANNING FEE:�1S�SD in`)
MANUFACTURED (MOBILE) HOME
FOR A DEPENDENT RELATIVE
TEMPORARY USE PERMIT APPLICATION
PART I — APPLICANT INFORMATION
APPLICANT INFORMATION: M�
APPLICANT: ' (J ,(, �44t 1 V 1 Al2�J+cy,
MAILING ADDRESS: I'15O H a 3'1 Co, 1-Ci. Ua frivc
CITY: Spa '1.a.its4 (.UcJ STATE: (./34
PHONE: (HOME/WORK) n7b`1) ca -s111- (FAX) (WO (3.741 S a
Please Grde
ZIP: cA0 (
(CELL)
NOTE: IF APPLICANT IS NOT THE OWNER, INCLUDE WRITTEN OWNER AUTHORIZATION FROM THE LEGAL OWNER BELOW:
OWNER INFORMATION:
LEGAL OWNER: S k"1 lu
MAILING ADDRESS: I r% S
CITY: :SO OYGl.iris? VOA 1e 1
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PHONE (HOM cfl ORK) ("SZA)Q �-a�t�'
STATE: I-O A
ZIP: lq-C O I (D
FAX) n-tcOga-7-Sl2'Sl (CELL)
PART II — PROPERTY INFORMATION
APPLICATION RENEWAL (YE'' NO) FILE REFERENCE NO.
Please •"-- J /
PROPERTY SIZE (SQUARE FEET): `_I del 3 O,G.L e . n
NUMBER OF EXISTING DWELLINGS: {i Y\te S %c i.!xx netr y
LEGAL DESCRIPTION: PROPERTY PARCEL NO: S `5 18 a, 1
PROPERTY STREET ADDRESS:I / �S R C(it -( � (ado W kit
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ZONING: (-)1-34
EXISTING USE OF PROPERTY:
PROVIDED DETAIL REGARDING PROPOSED TEMPORARY USE OF PROPERTY (INCLUDE INFORMATION REGARDING
ACCOMODATION FOR SEWAGE DISPOSAL, WATER HOOKUP, TYPE OF MANUFACTURED HOME, AND SIZE OF STRUCTURE):
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Version 2: 7/28/2004
Page 1 of 4
PART III - LEGAL OWNER SIGNATURE
(Signature of legal owner or representative as authorized by legal owner)
I, SMactS in (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: I'7 5-O5 Ea3 t CGS"ict(c(o A v'e" PHONE: CSt) R as -211a
5,9okov1P U0.1IP, CZIP: ciC30I Co
(City) (State)
STATE OF WASHINGTON
COUNTY OF SPOKANE )
(Signature)
NOTARY
(For Part III above)
) ss:
SUBSCRIBED AND SWORN to before me this
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NOZ1irP�.
9 4!`gstoN;•. ).
■ NOTARY i', s
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PUBL'iC Notary Public in and for the State of Washington
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(Date)
day of vQ r200 5—
NOTARY SIGNATURE
My appointment expires:
Version 2: 7/28/2004 Page 2 of 4
3-23-05
Shelley Monson
Judy Kneis
17505 East Cataldo Avenue
Spokane Valley, WA 99016
To Whom It May Concern:
My partner and I have been caring for my Mother Clara Kneis since her
stroke in November 2003 at age 71. We have purchased a Home based
business and relocated to Spokane Valley. We need to have a modular
home for her to have some independence and easier access with her walker.
The house we bought with the new business is a older home with no
bedrooms on the main floor and there is also only one small bathroom.
Clara is not able to go up or down stairs without assistance. The bathroom
in our house would have to be remodeled to accommodate her elevated
toilet chair and shower chair. The modular home will have a walk in shower
. We understand that the modular home would not be permanent. The
modular home is the least expensive option that we have due to the age of
our house. If you have any questions please feel free to contact me Judy
Kneis or my partner Shelley Monson at (509) 922-8118.
Sincerely,
`l cdy /%,lua)
Judy Kneis
3-23-05
I, Judy Kneis, am also the owner of record for the area proposed
for the above identified land use. I give my permission for the
modular home to be placed on the property.
Shelley Monson is also the owner on record and has had her
signature notarized.
Please contact me immediately at (509) 922-8118 if my signature
also needs to notarized.
Thanks you!
Sincerely,
Judy An&
Judy Kneis
m▪ ®0 03/21/2005 16:53 4156644352
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(509) 927-9199
PAGE 01
P.
Sfieliane
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11707 East Sprague Avenue, Suite 106
Spokane valley, WA 99206
Tel: (509) 921-1000
Fax: (509) 921-1008
STATEMENT OF ATTENDING PHYSICIAN
FOR DEPENDENT RELATIVES
FILE NO:
To assist in meeting the requirements of the Zoning Codc of the City of Spokane Valley concerning a licensed
physician's statement regarding the nature of the medical problem, I submit the following information.
1. Full name and address of person(s) for which information is given below:
V-vtei,5
2. The Zoning Code of the City of Spokane Valley defines a "dependent" person as a person who has been
determined by a licensed physician to be physically or mentally incapable o . caring for themselves
and/or their property.
Do you believe your patient is so qualified at the present time? Yes No
3. Describe the nature of the medical or health -related circurestance(s), physical and/or medical,
which establish a "dependency" situation:
4. Is this circumstance of short or long term duration?
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PS,YSICXS-N'S CERTIFICATION:
Physician's Name (Please Print):
Business Address:
DAVID Q. SEGARS, M.D.
380.West Portal Avenue,a#C
San Francisco, CA 94127
(415)664r3323:Fax: (415) 664-4352
CA L4G55445 Tqr ID 94-3214721
Phone Number:
Signature
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RE-GL 7'V C
MAR 2 5 2D05
SPOKANE VALLEY
DEPARTMENT OF
COMMUNITY DEVELOPMENT
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FOR STAl''N USE ONLY:
File No:
TUP
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- UtD-
Spokane County Fire District No. 1
APPRO ENIES
(CIRCLE ONE)
Cdt�I
ignatur /T e e
Spokane C ntv e i al Health Dis 'ct
PROVES
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U ENIES
(CRC ONE)
Conditions
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ignaturein
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Spoka ntv Air Pollution Control ority APPROVES/DE
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Co
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Signature/Title
Date
City of Spokane Valley Division of
APPROVES/D NIESn�(cuts NE)
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City of Spokane Valley Development Engineering Divisio ` APPROVE
NIES (CIRCLE ONE)
Conditions:
kai, 14-A IY--
gnature/Title
Su / Date
Name:
APPROVES/DENIES (CIRCLE ONE)
Conditions:
Signature/Title Date
Version 2: 7/28/2004
Page 3 of 4
The City of Spokane Valley Planning Division approves / denies this "dependent relative temporary use
permit" for the property described above, pursuant to the City of Spokane Valley Interim Zoning Code,
Chapter 14.510, and subject to the following applicable staff and agencies approval.
This temporary use permit is subject to the following conditions and/or stipulations pursuant to the
City of Spokane Valley Division of Planning:
1) The applicant and property owner shall comply with all requirements and regulations
Code.
2) The applicant and property owner shall comply with all City of Spokane Valley
regulations, such as but not limited to water, sewage, stormwater, building permits,
areas, access, approach permits and others.
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3) The temporary use shall discontinue operation on (12nonthsfo.dateofde�ision):4
development
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of
grading,
the Zoning
critical
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The applicant
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property owner shall comply with the
be attach -d :
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RESULT IN IMMEDIATE REVOCATION OF THIS
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i ' 'on of P arming Signature Date
Version 2: 7/28/2004 Page 4 of 4
Page 1 of 1
Karen Kendall
From: Sandra Raskell
Sent: Thursday, April 14, 2005 12:08 PM
To: Karen Kendall
Subject: TUDR-01-05
Karen,
The Public Works Department Development Section has no issues with the above mentioned project.
Thanks,
Sandra Raskell, P.E.
Assistant Development Engineer
City of Spokane Valley
11707 East Sprague Avenue
Spokane Valley, WA 99206
Phone: (509) 688-0174
Fax: (509) 921-1008
4/14/2005
10319 EAST SPRAGUE AVE.
Date: March 29, 2005
SPOKANE VALLEY FIRE DEPARTMENT
Spokane County Fire District 7
SPOKANE VALLEY, WA 99206-3676 • (509) 928-1700 ` •I FAX (509) 892-4125
Mike Thompson REGENED
ED
Chief
WAR 3 0 2005
SPOKANE VALI-EY
DEPARTMEN O.
CoMMuwtT,Y DEJ::LUv'N,,_i
To: Karen Kendall, Assistant Planner
11717 East Sprague Ave., Suite 106
Spokane Valley, WA 99206
From: Bill Clifford, Fire Inspector
10319 E. Sprague Ave.
Spokane Valley, WA 99206
SUBJECT: Temporary use dependent relative File #: TUDR-01-05
The only requirements would be that the manufactured home has its own
address and the address is visible from the fronting road and the driveway
accessible.
Sincerely,
Bill Clifford
Fire Inspector
(509)928-1700
cliffordb@spokanevalleyfire.com
Page 1 of 1
Karen Kendall
From: Anderson, Patti [PAnderson@spokanecounty.org]
Sent: Thursday, April 14, 2005 9:43 AM
To: Karen Kendall
Subject: TUDR-1-05
4/14/2005
SPOKANE REGIONAL HEALTH DISTRICT
ENVIRONMENTAL HEALTH DIVISION
INTEROFFICE MEMO
DATE: April 11, 2005
TO: Karen Kendall, Assistant Planner, City of Spokane Valley Department of
Community Development
FROM: Donald Copley - EHSII, SRHD
SUBJECT: TUDR-1-05 Monson
The Spokane Regional Health District has reviewed the above mentioned action. The
following conditions apply:
1. Applicant must submit a signed and dated plot plan along with dependent
relative building application for review and signature.
2. After review of the proposal, a determination will be made as to whether an
application and permit will be required.
Page 1 of 1
Karen Kendall
From: Dawn Dompier
Sent: Monday, April 18, 2005 9:33 AM
To: Karen Kendall
Subject: 17505 E Cataldo
Karen,
The placement of double wide manufactured home has the building department approval.
Building permits are required prior to placement of manufactured home.
Manufactured home will require a separate address.
Dawn Dompier
Permit Specialist
Building Division
11707 East Sprague Ave.
Spokane, WA 99206
(509) 688-0036 (Direct)
(509) 688-0037 (Fax)
4/18/2005