Zupscan, Rochelle AUP_~r.
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CITY 0
ACCESSORY L]SE APPLICATION
1) Applicant's name and address: ~j~, ~S
y) Owner`s name and address: - r- A.~
3) Address of subject property:, ~ OZ `l,i..~,). I~ ~`.
r'~ - a-
r , do--~;~: i ~~ of :~ub.jer-t px nperty: ;~ 4--...s< :-.~cr; ~.
it lengthy) Si /l ~Cl C~ ~
5) Attach a copy of proof of ownership deed:
6) Size of parcel or lat : _ ~S ~ ?{ I DO ~
7) Present Wane of parcel o.r lot :,' Off' ~
8) P-riricipal permitted use : ~ ~ e ' a ~ ~
9) Use made of all abutting lots or parcels: _, '~~~~ ~C~,4~~;~
t` -S`r . -e ~.'~i
10) Accessory U4e requested and describe the use : _ ~- ~~~,~u,.~~Atr
~'_'
11) Ara there other accessory uses of a similar nature in the
area: If so state the lo~:ation and the accessory use r
C Ie1ar1~ ~'--1'~er~ ~• (11eCar~I~.~s
I Q X-~ ~ . uJ . ~ 3+h ~} .
l~e. S `1 "r ~ S "` 1.v Asa ~ Srr~-~+h
Cy r'1'~-1n. cam. Se1-, e r-+~ 1-
14G1~ ~.u:. ~a~h S~•,
-3S a ~r~ct~~ a_l C.~ .
Seoi+ ~+ Lis -; e. ~c~~~ ; ~ ~,
G~ I I I, avr~ ~ UE s~~ F i 5 ch
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Ste') Names and addre4s of owners of all abutting land owners : t If
lengthy attach a lot of owners and address*~)(Abutting land
include triable across the street an alley and kitty corner
including kitty corner wr,er•e a street or al1Ey is between
your property and the other property); ~-~
1:3) State any possible adverse impacts on adjacent property such
as ogles, tra*tic, a}:cess light, odor, etc. ~
14) Do you agree to pay increased sewer, water o-r~ trash fEes if
au4i, are required due to lncreaac•i1 ub~• :' ~
15i bias the tee at X80.00 been attached hereto:' l~~.
lE~i If tr,e accessary use includes const'ructior, of a building- an
the lot a-r parcel complete the fallowing:
a. Will all partW a# the accessory building bE located
within the lot ar parcel? aJLA _
b. Is the primary building already constructed'?
~~
c. IW the accessary building to be attached to the primary
building': ~
d. Will the accessory building be constructed in the rear
yard a# the primary building?
e. Will tree accessory building occupy less than 40% of the
required rear yard far the primary structure?
r. It the answNr to a above is nq, Will the accessory
Structure be connected to the primary structure and
will bath the primary and accessary structure then meet
,311 yard 31Yd . COUr t r equiramenta'?
g. UGes the heightr, of tt,e accessary building e.~ceed 15
feet ? ~li~r
~` w.
h. If the lot ar parcel is mooned cnmmereial~ is any
abutting px~aperty zoned residential and if so, will the
accessnry use occupy zany of the front yard?
17. If the accessory use is for a Family Child Care Home,
complete the following:
a. Is a State of Idaho basic day care license 'required fnr
tYiis type of facility? If so, attach a copy of your
license. UPS
b. .-a;::= you applied for ar ra,,;riycu ail Wc4upancy permit"
If so attach a copy of your application or permit.
~- Is one off street parking space per ernplnyee pravided`t
d. If the home is located on an arterial or collector
street is an off street child pick-up area provided?
e. Is screening of adjacent properties provided? ~~
f. Is the play area for the children fenced from streets
and neighbors'i If so what is the fence height and type
of construction? (Q~}
1.9. If the accessory use is far a home ur_cupatian, cnmplete the
following:
a. Are only family membexs residing ir, the principal
residence? ~
b. Is the use of the residence as a home occupation
incidental and subordinate to its use as a residence':
c. Will the home occupation use mere than ~5% of the floor
area of the dwelling..' 1Jb
d. Will any item be o;Efered for sale thaf_ is not produced
by the dwelling occupants of the premises':
rr:
e. Will electrical a-r mechanical equipment t,e installed
other than such as is cuetamarily incidental to
domestic use? p
f. How much traffic. will be generated b the hams
occupation " 3 r~. y r~s ~Yl - ~,,,,~ ~ ., .`
g. Will aff street parl.ing requirements be met'? ~
h. Will equipment ar• pr'acessing create anise, vibratinr,s,
glare, fumes, ada-r or electrical ir,terfe-rence
detectable to normal senses aff the lot or parcel?
. ,.-.
i. Will the dwelling be altered ar the occupation
~~onducted which would ~~au:~e the premises to differ from
its residential character? If sa, haw^
~ln
1y. Regardless of the type of a4cesac,ry use applied far'- pleasE
attach a drawing sr,nwir,g tree r,aundaries a# tree pr ope-r'ty,
structures located on tree praper'ty ar,d the prapased lacatiar,
of the use. In case of Family Child Care Home include
location • Ct+ka-C
G A T E G 'T H I5 DAY l7F _ ~. ~~-(,~,.~ ,., ., _ 19
'STATE -JF I17AH0 )
_ 3S.
9~171lNTY ~]F P.C1A 1
CJri this ~ ~ day. of
me, tr,e under~sgned, Na ar P_ub
personally appeared
known to be to be the person(s) whasE
withir~ instrument ar,d acknowledged
e:~cecuted tree same.
15 `~` ~, bef are
c ~ and far- said
~~ StatE,
narks 'a-re subscribed tG the
to me that (he, she, they) ,
IN WITNESS WNEFtEOF, I riave hereurita set my hand ar,d affi:~ceci
my afficXal seal the day ar,d year in tr,is certificate first aY,ave
written.
c SEAL) _ `~ ~ - ~
_ ~ -
__ - ~ _~' NC~~;~.~Y PUBLI Ci~- I 'AN
_ :~" - RY~Z~ING AT
[-IW-0387
STATE OF IDAHO
DEPARTMENT OF HEALTH AND WELFARE
TEMPORARY BASIC DAY CARE LICENSE
The holder of this temporary Basic Day Care License
$p[:AFT.LE M ZDPCSAN
Name of Facility/Applicant
19 DIAN ID. 83642
Address of Facility
has applied for a Basic Day Care License pursuant to the requirements of
Idaho Code 39-1101 through 39-1117 and the completion of a fire inspection
and health inspection establishing compliance with Idaho Code
Sections 39-1109 and 39-1110, and the requirements of Idaho Code
Section 39-1105 regarding criminal history checks are currently pending.
Your temporary Basic Day Care License authorizes you to provide day care
pending the completion of the fire and health inspections and criminal
history check, if one is required, up to one hundred twenty (120) days
unless otherwise extended by the Department of Health and Welfare.
You are temporarily licensed as a:
____._ Day Care Center
Group Day Care Facility
ggg Day Care Home
From JANIIARY 25, 199~o MAY 25, 1994
Effective Date Expiration Date
The issuance of a temporary Day Care License does not establish that a
facility is free of risk. Primary responsibility for evaluation and
selection of day care services rests with paten*_s and/or guardians. Idaho
Code Section 39-1101 and 39-1117.
Your temporary Basic Day Care License must be posted in a conspicuous place
at your facility, and a copy of Idaho Code Sections 39-1101 through 39-1117
shall be available on the premises at all times for staff and parents to
read upon request.
e on Director
D to
HW-0381
STATE OF IDAHO
DEPARTMENT OF HEALTH AND WELFARE
TEMPORARY DAY CARE PERMIT
APPLICANTS AND ANY OTHER OWNERS, OPERATORS, EMPLOYEES AND VOLUNTEERS AT A
DAY CARE FACILITY HAVING DIRECT CONTACT WITH CHILDREN WHO DO NOT MEET THE
RESIDENCY REQUIREMENT MUST HAVE A CRIMINAL HISTORY CHECK.
A criminal history pursuant to Idaho Code Section 39-1105 has been
initiated regarding the following individual:
ROCSELLL M. Z~,~
Name of Day Care Provider
This temporary Day Care Provider Permit authorizes the above-named
individual to provide day care services to childxen in an approved facility
meeting the requirements of a Basic Day Care License or Gertification
pending the completion of the individual's criminal history check and is
based an the individual's notarized Self Declaration of NOT having been
found guilty in this state's courts, in any other state's courts or in any
federal court of any offense involving neglect or physical injury to, or
other abuse of, a child pursuant to Idaho Code Section 39-1115. This
permit is issued fox a period not to exceed one hundred twenty (120)
calendar days, unless otherwise extended by the Department of Health and
Welfare.
From JANiIARY 26, 1990 1~fAY 2.5~_ 1994
Effective Date Expiration Date
DATED this 25TH day of JANIIARY 19 94.
Fami and Children's ervices Frogx'am Manager