HomeMy WebLinkAboutLaTulippe, Janine AUP 11-005E IDIAN~--
IDAMO
Planning Department
ADMINISTRATIVE REVIEW APPLICATION
Type of Review Requested (check all that appty)
~~_~~_~
D Accessory Use
^ Alternarive Compliance
[~ Certificate of Zoning Compliance
^ Certificate of Zoning Compliance Verification ~'
^ Conditional Use Permit Minor Modification
^ Design Review
^ Private Street
^ Property Boundary Adjustment
^ Time Extension (Director)
^ Vacation
^ Other
ST1~~U$,~ ONLY:
File nu~nber(s}: ~ lI ~' ~~
Projcd tmme• ~TGL~,,..
-.-~-
Date fi~od' ~~ .~/,~ Date • T Zd ~ZS!
Assignexl Planner: ~'l ! _,
Related files:
Applicant Information
.~
Applicant name: canine LaTulinne Phone: 541-619-1772
Applicant address: 418 W Indian Rocks St Zip; 83646
Applicant's interest in property: Q Own ^ Rent ^ Optioned ^ Other
Owner name: Janine LaTuliyoe and Britton LaTulitive Phone: 208-914-4363
Owner address: 418 W Indian Rocks St Zip: 83646
Agent name (e.g., architect, engineer, developer, representative):
Firm name: Phone:
Address:
Zip:
Primary contact is: ^ Applicant Q Owner Q Agent ^ Other
Contact name: Janine LaTulinue Phone: ~4 ~ 619-1772
E-mail: ia~inen~uven7(a hotmail.com Fax:
Subjeet Property Information
Location/street address: 418 W Indian Rocks St
Assessor's parcel number(s): R147i900290
Township, range, section: 3N 1 WO 1 Total acreage: 0.19?
Current land use• Residential Current zoning district: R-4
33 E. Broadway Avenue, Suite 210 • Meridian, Idaho 83642
Phone: (208) 884-SS33 • Facsimile: (208) 888-6854 • Website: www.meridiancity.org
1 (Rev. 11/4/08)
Project Description
~,_,~~
Project/subdivision name: Clearbrook Estates .Subdivision
General description of proposed project/request: Family Daycare
Proposed zoning district(s):
Acres of each zone proposed:
Type of use proposed (check all that apply):
~ Residential ^ Commercial ^ Office ^ Industrial Q Other Family Daycare
Amenities provided with this development (if applicable):
Who will own & maintain the pressurized irrigation system in this development?
Which irrigation district does this property lie within?
Primary irrigation source: Secondary:
Square footage of landscaped areas to be irrigated (if primary or secondary point of connection is city water):
ltesidentia}Project Summary (if app}icabk)
r
Number of residential units: Number of building lots:
Number of common and/or other lots:
Proposed number of dwelling units (for multi-family developments only):
i Bedroom: 2 or more Bedrooms:
Minimum square footage of structures) (excl. garage): Proposed building height:
Minimum property size (s.f): Average property size (s.f.):
Gross density (DU/acre-total land): Net density (DU~aare-excluding roads & aNeys):
Percentage of open space provided: Acreage of open space:
Percentage of useable open space: (See Chapter 3, Article G, for qualified open space)
Type of open space provided in acres (i.e., landscaping, public, common, etc):
Type of dwelling(s) proposed: ^Smgle-family ^ Townhomes ^ Duplexes ^Muiti-family
Noe-res~entia} Project Sammary (if applicabk)
i i~~~ r~~ ~~ ~+~
Number of building lots: SOtl~c lots:
• i-
Gross floor area proposed: ~_ Existing (if applicable):
Hours of operation (days and hours): Mondav-Friday ?am-6pm Building height:
Percentage of siteJproject devoted to the following:
Landscaping: Building: Paving:
Total number of employees: 0 Maximum number of employees at any one time: 0
Number and ages of students/children (if applicable): 2-6 years old Seating capacity;
Total number of parking spaces provided:,~,_~_ Number of compact spaces provided: -8'
Authorization
Print applicant name: T 2.
Applicant signature: Date: ~'l/ f
33 E. Broa y Avenue, Suite 210 • Meridian, Idaho 83642 ~
Phone: (208) 884-5533 • Facsimile: (208) 888-6854 • Website: www.meridiancity.org
2
(~irE IDIZ IAN*--
IDAHO
May 6 2011
Janine LaTulippe
418 W. Indian Rocks Street
Meridian, Idaho 83646
RE: LaTulippe, Janine (AUP-11-005)
Dear Ms. LaTulippe:
Mayor Tammy de Weerd
City Council Members:
Keith Bird
Brad Hoaglun
Charles Rountree
David Zaremba
This letter is to confirm that the Director approved the accessory use permit application for a
family daycare for six (6) or fewer children out of your home located at 418 W. Indian Rocks
Street.
Your approval of the subject application is conditioned upon compliance with the standards for
daycare facilities listed in Unified Development Code (UDC) 11-4-3-9, including but not limited
to, the following ongoing conditions:
1. The maximum number of allowable children cared for during the day is six (6), excluding
the applicant's own children. The total number of clients cared for during the day, and
not the number of clients at the facility at one time, is the determining factor.
2. The applicant shall maintain the approved on-site vehicle pickup, parking and turnaround
areas. The applicant shall also maintain the approved design of the outdoor play area(s).
3. The operafion of the daycare shall be limited to the hours between 6:00 a.m. and 11:00
p.m. This standard may be modified through approval of a conditional use permit.
4. In no way shall the family day care cause the premises to differ from its residential
character in appearance, lighting, signs, or in the emission of noise, fumes, odor,
vibrations, or electrical interference.
5. All outdoor play areas shall be .completely enclosed by minimum six-foot (6') non-
scalable fence to secure against exit/entry by small children and to screen abutting
properties. The fencing material shall meet the swimming pool fence requirements of the
Building Code in accord with Title 10 of the Meridian City Municipal Code.
6. Outdoor play equipment over six feet (6') high shall not be located in a front yard or
within any required yard. Per UDC 11-IA-1, a required yard is an area that extends
along a property line to a depth or width specif ed in the setback regulations for the
zoning district in which the property is located. Dimensional standards for residential
Planning Department . 33 E. Broadway Avenue, Meridian, ID 83642
Phone 208-884-5533 Fax 208-888-6854 www.meridiancity.org
Page 2
districts are located in UDC I1-2A and may be obtained through the following link.
http://www.sterlingcodifiers.com/codebook/index.php?book id=306.
7. Outdoor play azeas in residential districts adjacent to an existing residence shall not be
used after dusk.
If you fail to maintain compliance with the above standazds or limitations your approval may be
revoked or modified by City Council in accord with UDC 11-1-11D.
The applicant, director, or a parry of record may request City Council review of a decision of the
Director. All requests for review shall be filed in writing with the Planning Department on or
before May 23, 2011, within fifteen (15) days after the written decision is issued, and contain the
information listed in UDC 11-SA-6B.
If City Council review of the decision is not requested, the action of the Director represents a
final decision on a land use application. You have the right to request. a regulatory taking
analysis under Idaho Code 67-8003.
Thank you for contributing to the success of Meridian. Please help us serve you better in the
future. Visit our web-site at www.meridianci , .org departments/planning/comment card to fill
out a customer survey and give us feedback on how we aze doing.
Sincerely,
V^~A~
Pe riedman, AICP
Deputy Director
PF:kv
,.
CITY OF MERIDIAN PLANNING DEPARTMENT ACCESSORY USE STAFF REPORT
fencing material shall meet the swimming pool fence requirements of the Building Code in
accord with Title 10 of the Meridian City Municipal Code.
6. Outdoor play equipment over six feet (6') high shall not be located in a front yard or within any
required yard.
7. Outdoor play areas in residential districts adjacent to an existing residence shall not be used
after dusk.
8. In no way shall the family day care cause the premises to differ from its residential character in
appearance, lighting, signs, or in the emission of noise, fumes, odor, vibrations, or electrical
interference.
9. Off-street parking shall be provided as set forth in Section 11-3C-6 of this Title, in addition to
the required off-street parking for the dwelling.
AUP-11-005 LaTulippe, Janine PAGE 2
MayorTammy de Weerd
City Council Members:
E IDIAN~-_, Keith Bird
1 ~' Brad Hoaglun
Charles Rountree
A ~"~ ~ David Zaremba
May 6, 2011
RE: Notice of approval for the operation of a Family Daycare for six or fewer children located
at 418 W. Indian Rocks Street.
The Meridian Planning Department has reviewed an application to operate an in-home family
day care located at 418 W. Indian Rocks Street. Based on the review and inspection conducted
May 2, 2011, we find that the application complies with the Unified Development Code (UDC)
Title 11, Chapter 4, Section 3-9. UDC 11-4-3-9 is available for review at:
http://www.sterling.webiness.com/codebook/index php~book id=306.
The applicant, Director, or a party of record may appeal this decision or a condition of approval
by requesting City Council review of this decision within fifteen days after the. written decision
is issued. All requests shall be filed in writing with the Planning Department no later than May
23, 2011 and shall comply with the provisions of UDC 11-SA-6B. The application for City
Council Review is available on our website at www.merdiancitY.org, or upon request from this
office. For additional information about this decision or about your right to appeal, please contact
this Kristy Vigil at 884-5533.
Sincerely,
to Freedman, AICP
Deputy Director
PF:kv
Enc.
Planning Department . 33 E. Broadway Avenue, Meridian, ID 83642
Phone 208-884-5533 . Fax 208-888-6854 . www.meridiancity.org
y~a6~
Neighborhood Meeting Sign-In Sheet
Name Phone Oate Time-In
2 JAI I ~-E~c___~ ~' --cwt, L ZU~ ~0 2°l. $ 5 d 1 ~t ~ 2~0 ~ f I
3
4
5
6
7
8
9
10
11
12
13
14
15
CITY OF MERIDIAN PLANNING DEPARTMENT ACCESSORY USE STAFF REPORT
DATE: May 6, 2011
TO: Anna Canning, Planning Director E IDIAN~--
IDAHO
FROM: Kristy Vigil, Assistant City Planner
CC: Janine LaTulippe
Party of Record
SUBJECT: AUP-11-005
Family Day Care Facility for six or Fewer Children
STAFF RECOMMENDATION
Staff recommends approval of the accessory use permit for a family day care facility for six or fewer
children located at 418 W. Indian Rocks Street for Janine LaTulippe, subject to the conditions outlined
below:
APPLICATION SiIMMARY
The applicant, Janine LaTulippe, has requested approval to operate a family day care facility for six or
fewer children out of her home located at 418 W. Indian Rocks Street Meridian, Idaho.
LOCATION
The property is located at 418 W. Indian Rocks Street, in the NE'/4 of T. 3N., R. 1W., Section 1.
APPLICABLE CODE
The property is zoned R-4, which allows for a family day caze facility with written approval from the
Planning Director.
Section 11-4-3.9 of the Unified Development Code (IJDC) for the City of Meridian lists specific criteria
for day care facilities that serve children:
1. In determining the type of day caze facility, the total number of clients cared for during the day
and not the number of clients at the facility at one time, is the determining factor. In the case of
a child day caze, the operator's children are excluded from the number.
2. On-site vehicle pickup, pazking and turnaround areas shall be provided to ensure safe discharge
and pickup of clients.
3. The decision-making body shall specify the maximum number of allowable clients and hours of
operation as conditions of approval.
4. In residential districts or uses adjoining an adjacent residence, the hours of operation shall be
between 6:00 a.m. to 11:00 p.m. This standazd may be modified through approval of a
Conditional Use Permit.
5. All outdoor play azeas shall be completely enclosed by minimum six-foot (6') non-scalable
fence to secure against exit/entry by small children and to screen abutting properties. The
AUP-11-005 LaTulippe, Janine PAGE 1
o Z~F z`a...~~,
~w my~m,~ n~ D v D t~1 ~ zro yr ~ pzrom~3 ~
~ t~ 3 i? ~ ~ Z ~m {t! y~z~D N
6~ -+
N r O
< ~ c ~' ~ ~ m m 3 ~ m m r
~ ~ .« ~ ,.,
Narrative
My family daycare will operate out of my home located at 418 W Indian Rocks St in Meridian,
Monday through Friday from 6:30am to 6pm. Only the first level of my home wilt be used, which is
approximately 850 sq. ft. I will be watching 5 or fewer children between the ages of 2-5-years-old. I will
provide the children with breakfast, lunch, and an afternoon snack. 1 am CPR certified and have a
college degree. I will teach a preschool curriculum that covers reading, writing, arithmetic, history,
geography, science, health, and manners. ._
~L
STANDARDS FOR DAY CARE FACII.ITIES
STATEMENT OF COMPLIANCE
UDC 11-4-3.9: Day Care Facility
A. General standards for all child day care and adult care uses, including the classifications of day care center;
day care, family; and day care, group:
1. In determining the type of day care facility, the total number of children cared for during the day and not
the number of children at the facility at one time, is the determining factor. The operator's children aze
excluded from the number.
2. On-site vehicle pickup, parking and turnaround areas shall be provided to ensure safe dischazge and
pickup of clients.
3. The decision-making body shall specify the maximum number of allowable clients and hours of
operation as conditions of approval.
4. In residential districts or uses adjoining an adjacent residence, the hours of operation shall be between
6:00 a.m. to 11:00 p.m This standard may be modified through approval of a Conditional Use Permit.
B. Additional standards for day care facilities that serve children:
1. All outdoor play areas shall be completely enclosed by minimum .six-foot (6') non-scalable fence to
secure against exitlentry by small children and to screen abutting properties. The fencing material shall
meet the swimming pool fence requirements of the Building Code in accord with Title 10 of the
Meridian City Municipal Code.
2. Outdoor play equipment over six feet (6') high shall not be located in a front yard or within any required
yard.
3. Outdoor play areas in residential districts adjacent to an existing residence shall not be used after dusk.
C. Additional standards for family daycare facilities conducted as home occupations:
1. In no way shall the family daycare cause the premises to differ from its residential character in
appearance, lighting, signs, or in the emission of noise, fumes, odor, vibrations, or electrical interference.
2. Off street pazking shall be provided as set forth in section 11$C-6 of this title, in addition to the required
off street parking for the dwelling.
CertiHcatioa:
1 have read and understand the above standards for operation of a day care facility and certify that I will conduct
my business in accordance with these standards. If I cannot meet these standards, 1 am not allowed this accessory
use.
/,/
Applicant's Signature: Date• 1 ~ ~ ~ ~
d
1--1
C
1
1
1
1
1
1 1
1
1
1
1
/
i
1
1
1
1
1
1
1
1
1
1
I
I
1
1
1
1
1
I
1
1
1
1 1
1
1
1
1
/
/
~ 1
1
I
1
,
1
1
1 1
1
1
1
1
1
1
I
1 ~ 1
1
1 1
1
3 I
, I
1
,., ~ i c -o
i ~ ~ 1 L 1 LL
~ ° ~
~
~
1 ~ ~
1 tL ~"'
I
1
1
1
1
1
1
1
1
1
1
1
1 /
1
1
i
1
1
1
1
1
1
1
1
1
, ,
;
,
,
,
,
,
,
,
,
, 1
1
1
1
I
I
I
I
1
1
1 ,
/
1
1
1
1
1
1
1
1
•,
t--------------
1
1
1
1
1
1
1 ~
1 crf
1
1
1
/
t~ 1
1
S 1
O~
~-
1
1
1
1
1
I
~
~ 1
1
Oo m
I
~ 1
~ Q 1
I j 3+
~
I
,
1 a I 1
'
1 I
• 1
1
i
1
~.._.._.._.._
.._.._.._.I 1
1
I
1
1
1
1
1
Y
V
~ I
I
1
1 ~
1
1
1
1
1
~
} 1
,
1
1
1
I
I
1
1
1
1
1
1
1 1
I
1
I
1
1
n~~ r~~=.' ~i ~~~ ~~~~_~ -;t~~~~rer ~. #~~ch ~,l~intJNT 10.00 1
_ _ _ R = _~ ~ - ~1, II~~ II!III[I IIIIIII IIII! IIII Illl lllllllfli VIII IIII IIII
''~ ' ~` - -- - = - - 111013256
~~ g,~xr~rr~~ ~~ -_ __ __._x ,~ --v ...
~ ~ ~ ~ :d s
corpt?~stion orga€t extista:~ ~ ....e~ _.,. ,_ - _. _ ~..~e a .~, ~~k: __ ...,... .: ~ _:
Washington Tat tCrranzcr} to p
Arittan IzTu;ippe and Iani~ts ~aTulippe, Husband and Wife (Grancec;
whose current address is dl8 W. Indian Rocks Sk, tvferidian, ID, 8364b, and to the Grantu's heirs and assigns:
~. '--='u.:.,.~~;-~, L*:G,:,aa~ ~enb,- ~-;~, ;:ru,ses. 3?ers ~~ aruve~n treic+ ~ntc^ ,,~.,.t ?e G~:tee's :~cirs a.~d
--- _~~;. ~ _u,c:~z .c _s-~~, ~e.,~,.,:_._._ ~r s:~*-s :.; ex~~ as e~,r°x.4a ~ i~a,z-.., f,. urs;w:'s ~:;-:'.,
;r.. ~ s_ w _ --........ _- ~~ _. la~~ ~:^sste:; .ra ;?:e ~c~:: L~ ~~:. ~- ~wa?:e,_ c~,a.-~°d
. " - .. _~ ~ :~~ ,.-,.~~.a~.k e~.2:r ... _ - .,R. ~s ~ ,., Nei d~ fk.~tY is. ~ :'3 cf Mats at
. -- ca 1~~t"s7,:eeostisiff~.':~ ,._._,
The Crtanttar, for itself and for its successors dots t~vecwat an zs~rea, az and with Grantee, Grar3tee's heirs and
assigns, that Grantor has not done ar suffered fo be dote; a~yzl:ntr, xbereby the Fzettiisa& hereby granted :are, or ~5'
be, in arty mamter encumbered or charged, except. as herein Tecitrd: and that Grantor wilt warranty and forevar
defsatd tttie to zlte Premises, against ali persons taw#hlIy 6Eaming'or who may claim the same, by; through or under
Crtanfor but not otherwise.
Grantor is exempt from alt mxation irapasu! by any state, couttry, raunicipatity, or local taxing authority, except
for. real prop®rty taxes. Thus,. Gratttor is axetnpt any and slt trdQtsfcr tastes. Sec. 12 TISC I')23a fc) {2~•
Thiazd~ `'
F t N t Mo tion
~~.
w~A iE OF : t.X `siu. ~",6LL4N t3f ~1~3..~tSS, sr.
On this day of February, in rite year of 20} t, before me the undersigned, a no
hsry public, personalty
appeared ~~ t~''1~-~s s ~g~ known. or identifted to me to bt the
of the corporation that executed zhe
instrument or the pe~sotdpersons who an behalf of said corporation, and acknowledged
tome that such corporation executed the same.
r
2V P ~4
P•,,,,,~GB'~UQV(Q ~, R~tX~~lJEZ % s
%p ° ~ ~ ~~ Notary t'ubiic. s Alotary Public of Texas
h
t ~'~~rj~. ~~°~t`-a` Stake of Texas t Restd~ at: ;
»~„~a`' Contm. Exp. 09-2 (-14 = Commission axpu~es:
~IQ~~~N~ -~4a
{
8"2 5 E:agie Road
t~#erid4an. Tdacc t?_~42
.--::;
'~isvNir: -__ - _a
RBC~ Nix: L i 3~AL~
Tlta _ ~ _
LYec~ ti tom U=~~i. .m,~as~. _ - .. __ _ - __~ -
corrora~on crgarez~., ~~ ex~??-,r€s ~.rad~- ~ _ - -~ z_ _ _ -. - ._
Washington I3G tvrantor} to
Britton LaTulippr and Janine LaTulipoe, Husirand and j3'a.ie tGra~.te.)
whose current address is 418 A~. Indian Rocks St., Meridian, ID, S364b, and to the Grantee's heirs and assigns:
~~.. n«~ Yti~. yes. G _~.o~ ..v ~~_L . _ ..e:'. '-n _ -.crt~P,a .~.,:~ =:r.4.:~ce t., .>, ~..__ a :za.~~ 2~~
TheGrartcr,. frri iCc.lf and :ter irs .. ~ . _, ~. _,. „ ._ ~~.. ~., era .._. ~. _..._...::~e _ s_:'s --
assigns,!that Grantor ham; nordo~ or serffere... _ _ _ ~r~~ .,.. ~~~ .,_~ ...,r ~. ~ntPa : _. ors r _
bo, in env manner encumbered or chars: s cx: e.t sir.: resit€;:: and`tl-fat Cnartor +.i!. w~ai~t-atity and fore~~er
defend title to £ne Premises, agaimt ail persons lar~rfu:-_. claiming cr «o may c{air.. mz saute, by, titrough or under
Grantorbut not otherwise.
Grantor is exetnpt frotn s}I taxation imposed by any state. scanty, municipality; or local taxing atti;hprity, except
for real property taxes. Thus; Grantor is exempt~om any and all transfer taxes. Sec. t2 USC 1723a (c) {2).
~,kt.
Feral N al lvto ration
~_`^ -..,_... ASST V~~"
On This r ~ day of February-, in Yne year of 2411, before me ilte undersiEned; a notary pubSic, personally
aPP~ted ~~k~c°, ~- known or identified m me m be the
of the corporation that executed the.
instrument or the person/persons who a on behalf of said corporation, and acknowledged
to me that such corporation executed dte sate.
' P ~f
.+` ~,/ /
^~.O'4ww4490w\\w'~\1a.+~i~saY~.t~.iww ~ 6 d i ~i•`,
tip'°.,e,"'s ~DAVIa J. ~ODRIGUEZ s 4 -
o ~ ~_ g ;Notary Public of Texas ~ ~ ,.
%_<:- ~`= _ P~Jatary Public,
="a ~,~ ~ Residing at: : !
y YT ns~ ~.~ State of Texas :,~`
Ss ~ os;,~,,.. Comm. Fxp. 49-2 (- p 4 ~ Commission expires:
itwwwew~wwww.+wwwwwwwwe4.wwwwwwti
8~~~~ ~~3
~ o °
_....
2 0 ~
~7
8 H
~ ~ ~ m
8a~ ,
~
- Q _
a fig'
8~
r
lV Mr~S~ ~lt}~k ~~1CEJ
_ _
~, ~
,,
_ - _
~~~~ ~~~~
f
+ ~ ~
~ /~y
`
~_~ o~~~ i~
- ~ ,t
r
~~~g g
~ ~
~ ~-
~
~ ~ ~
~
~
~~ ~
~ Nl1ALl
~8
m i
z ~~
_
.
r - - -
--
-._ a
~ ~ _.- ~'
}_ ~
~ ~_ i ~ ~" -
F ..
~ - ~~ ~ -/:
- ~ ...... ,~Q ~ t
- ifx~' ~ , `-~
- ~,
. _ ~ ~,, ,_
P
._ ..
~ ! p ~
,~ - < `' " S
- i - Y ~~
J.. ~~ _.
- "~
~ _ ~
c
-
~~
' ... ~
~l T
~"~
T
~
y /
~~
p` a ~,
~/ ~,
''~'
i f
_ / V
r ~ / ~
.__
~ .-
., 0 ~
'. .
~ ..._
~ ~ ~ ~
!~
~ ~ i
i
_..
~ .....
i i ~ ~ ,
"_
_
_ - - ~_. ~ {_.
~''rd-MERfE31A~A1 dZ'~ -!-__ ,r_-
~ ?-
--
d
N '1~y Ti::
~~
~ -~
~~ ~
~ - i
~~
~
,-~ ~
~ -.
_.,.~_
i-
~ I A
~- .p,- ',
nT Rlt]G~B~L1~tY! ~
r ,~-
~,
' . -
-
-, ~ ~
_~ i
i ~j 7
~ I r
_ ~ n ~ r ~.
p ~'~ ~
i / -/ ~
~
~
%
'~, __
, _,, a~
~~ ~ ~__
~-
~
s
:
;
,
,;
_ =.
~-
~
I - ~ ~_
a ,
y
,.. ,,_
._
...1
~ ~ ..
_.
im _~~
Sri J
- 4~ _ ~
.
-- ~ -
~ I~ b--
.... ~ r'.:: : ~ ~'__
i
\i i, __
~. _._. ,
J
---
'
~
~
~
p
__
~ ~
_ . Y . ,
~U ~RLD St
~ N
'~
'; i ~
~ i
i ~
~.
...,I .........., ~ _,
r-- , ~ ~ - - I ,~ m
~
--F '( ~~~~
~ I F~~ ~ I j 7 J
' ; ice.
/'
~_ ~ ~
v;/~
~ ~~
,.
_
'
~
~ i
x
;~ ~ ~
~ ,
~ ~
'
~~
_ ~
.
t ~
~ ~ ~,i
`
I I
~
:~< ~ ~ ~. ~~( -T 1 -
~ f~~~ ~
~
~
-- ,
¢.
~ ~ r ~..
-
a ~
~
\~
~ '
~
' /~
N u~~
te N~~,vIE,.,
(/
\ IT IXN~Tbl~l-/
_ .,
_,~ .
_ -
i
- -r.
i ..__~ ,--.y .
..__.: j.._._f
,~~, -
~' _ R'
a
~__,
-- ` ~ ,
"o _'
~,
C~i~Y!- E IDIAN~--
IDAHO
33 E. Broadway Ave. • Meridian, Idaho 83642
208!888-4433
Date "~~~~~`~
Applicant
Address 1- i ~ "
' ~ hone
CHECK # NAME ON CHECK IF D ERENT THAN APPLICANT
~ ~~
- I
i
I
I
i
I
TAX I
TOTAL I
N
TANCE OF APPLICA O
P
TE CCE
PAYMENT DOES NOT INDIC
A
-
///
~ ~ n ~ (~ Received ~ 1 c / p/// '~J /'' / ~~ }-~ ~
,'
r lL (,/`~+'" ; J'
~' ~ o ~~ E w~ ~ ~~~~
ry ~
~ ~ ,
~
~
~
°
~, N
o
~y .
~~
I - ~ a , ~,
s{ as
~ n
~'
~.
e
0
~
.~
,,.
~~
a
Q ~
~
]
~1- V~ V i~
f`~.
]
f ~
h
x+1 4 vV
'! _
~ ~
O ~ a
~
,
_.'
~ -s
~,
p ~
~
~ ~ ~ ~
~
~
T F
e. ~f.
L i V i v gy pl~• ~v -~ 1i v /..~.r'..~.~~/J
55747 v//~~t~'~G/7/ ~~~'~/