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Proposed Elementary School Portable ClassroomCERTIFICATE OF ZONING COMPLIANCE REPORT DATE_ : June 24, 2010 El TO: Greg Greg Bush, Hutchison Smith Architects 1 D A H 0 FROM: Sonya Watters, Associate City Planner SUBJECT: CZC-10-038 — Prospect Elementary School Portable Classroom OWNER: Meridian Joint School District No. 2 DESCRIPTION OF APPLICANT'S REQUEST The applicant, Meridian Joint School District No. 2, requests certificate of zoning compliance (CZC) approval of a 28' x 64' 1,792 square foot portable classroom facility for Prospect Elementary School. The applicant also requests design review (DES) approval of the proposed structure. The site is located at 4300 N. Red Horse Way. DECISION The applicant's request for CZC is approved with the conditions listed in this report. The applicant's request for DES approval will not be evaluated until such time as a pending amendment to the UDC in regard to portable structures is acted upon by City Council. Note: This is not a building permit Prior to any construction, you should contact Building Services at (208)887-2217—to verify if any additional permits and/or inspections will be required Process Conditions of Approval 1. The applicant shall complete all improvements related to public life, safety, and health as set forth in UDC 11 -5C -3B. A surety agreement may be accepted for other improvements in accord with UDC 11 -5C -3C. 2. The site plan prepared by Hutchison Smith Architects on 6/21/2010, labeled Sheet A1.0, is approved (stamped "approved" on 6/24/10 by the City of Meridian Planning Department) with no changes. 3. The landscape plan prepared by Hutchison Smith Architects, labeled Sheets L-5.1 & L-5.2, depicts the existing landscaping on the site; no new landscaping is proposed or required with the CZC application. 4. The approved site plan, landscape plan and/or elevations may not be altered without prior written approval of the City of Meridian Planning Department. 5. The elevations prepared by Hutchison Smith Architects on 6/21/2010 labeled Sheet A3.0, are approved (stamped "approved" on 6/24/10 by the City of Meridian Planning Department) with no changes. 6. The applicant shall pay any applicable impact fees prior to the issuance of a building permit. 7. If any changes must be made to the site plan to accommodate ACHD requirements, the applicant shall submit a new site plan to the City of Meridian Planning Department for approval prior to issuance of the building permit. 8. The applicant shall complete all required improvements prior to issuance of a Certificate of Occupancy. It is unlawful to use or occupy any building or structure until the Building Official has issued a Certificate of Occupancy. Conditions Document 1 Prospect Elementary School Portable Classroom CZC DES Ongoing Conditions of Approval 1. The applicant and/or assigns shall have the continuing obligation to provide irrigation that meets the standards as set forth in UDC 11-3B-6 and to install and maintain all landscaping as set forth in UDC 11-3B-5, UDC 11-3B-13 and UDC 11-3B-14. 2. The project is subject to all current City of Meridian ordinances and previous conditions of approval associated with this site (AZ -02-022, PP -02-019, CUP -02-028, FP -03-069, and CZC- 05-094). 3. The issuance of this CZC does not release the applicant from any previous requirements of the other permits issued for the site. 4. The applicant has a continuing obligation to comply with the outdoor lighting provisions as set forth in UDC 11-3A-11. Exhibits A. Vicinity Map B. Site Plan (dated: 6/21/10) C. Existing Landscape Plan D. Building Elevations (dated: 6/21/10) Conditions Document 2 Prospect Elementary School Portable Classroom CZC DES A. Vicinity Map Conditions Document 2 Prospect Elementary School Portable Classroom CZC DES B. Site Plan (dated: 6/21/2010) j Ok \\ ,, _ ■ r•. is � 1 1ago i 1 ... ... . MEN Conditions Document 3 Prospect Elementary School Portable Classroom CZC DES C. Existing Landscape Plan 0 EXISTING FOR REFERENCE ONLY 11V \\ � r`.,,, ...,ori IUS�p� "■ w ���� ����`` "" "'" mg'l. ............. .r +fr-- �� I sa�rt� PI% �►cua■'�w.�..._�,�ca.�,�,:zt" Conditions Document 4 Prospect Elementary School Portable Classroom CZC DES D. Building Elevations (dated: 6/21/10) WNT EMATM MOM 8"ATM Mwrw Conditions Document 5 Prospect Elementary School Portable Classroom CZC DES s IDIAN�- �aaHo Planning Department ADMINISTRATIVE REVIEW APPLICATION Type of Review Requested (check all that apply) ❑ Accessory Use ❑ Alternative Compliance 0 Certificate of Zoning Compliance ❑ Conditional Use Permit Minor Modification 0 Design Review ❑ Private Street ❑ Property Boundary Adjustment ❑ Short Plat ❑ Temporary Use Certificate of Zoning Compliance ❑ Time Extension (Director) ❑ Vacation ❑ Other Applicant Information STAFF USE ONLY: File number(s): 01 -2c. --10-c Date filed: Assigned Plam Related files: ,A Fes,/ Applicant name: Hutchison Smith Architects Greg Bush Phone: 208-338-1212 Applicant address: 270 North 27`h Street Suite A, Boise, Idaho Zip: 83702 Applicant's interest in property:❑ Own ❑ Rent ❑ Optioned 0 Other Owner name: Meridian Joint School District No.2 Wayne Hanners Director of Maintenance Phone: Owner address: 2301 Lanark St. Meridian, Idaho _Zip: 83642 Agent name (e.g., architect, engineer, developer, representative): Greg Bush Firm name: Hutchison Smith Architects Phone: 208-338-1212 Address: Zip: 270 North 27d' Street Suite A Boise Idaho 83702 Primary contact is: ❑ Applicant ❑Owner 0 Agent ❑ Other Contact name: Greg Bush Phone: 208-338-1212 E-mail: bush e hsaarchitects.com Fax: 208-338-0011 Subiect Property Information Location/street address: 4300 N Red Horse Way Meridian Idaho 83646 Assessor's parcel number(s): R3508200010 Township, range, section: 4N1E32 Total acreage: 12.72 Current land use: SUB Current zoning district: R-4 33 E. Broadway Avenue, Suite 210 • Meridian, Idaho 83642 Phone: (208) 884-5533 • Facsimile: (208) 888-6854 9 Website: www.meridiancity.org (Rev. 11/4/08) . Proiect Description Project/subdivision name: Havasu Creek Subdivision No. 04 General description of proposed project/request: Place one 28'x 64' -1792 s f portable classroom in lawn area northwest of the existing building on the Prospect Elementary School Campus Proposed zoning district(s): No chance Acres of each zone proposed: Existing 12.72 no change Type of use proposed (check all that apply): ❑ Residential ❑ Commercial ❑Office ❑ Industrial Q Other Education Amenities provided with this development (if applicable): School Who will own & maintain the pressurized irrigation system in this development? Existing Which irrigation district does this property lie within? Nampa Meridian Primary irrigation source: Existing Secondary: Existing Square footage of landscaped areas to be irrigated (if primary or secondary point of connection is City water): N/A Residential Proiect Summary (if applicable) Number of residential units: N/A Number of building lots: N/A Number of common and/or other lots: N/A Proposed number of dwelling units (for multi -family developments only): N/A 1 Bedroom: N/A 2 or more Bedrooms: N/A Minimum square footage of structure(s) (excl. garage): N/A Proposed building height: N/A Minimum property size (s.f): N/A Average property size (s.f.): N/A Gross density (DU/acre-total land): N/A Net density (DU/acre-excluding roads & alleys): Percentage of open space provided: N/A Acreage of open space: N/A Percentage of useable open space: N/A_ _(See Chapter 3, Article G, for qualified open space) Type of open space provided in acres (i.e., landscaping, public, common, etc): N/A Type of dwelling(s) proposed: El Single-family ❑Townhomes ❑Duplexes ❑Multi -family Non-residential Proiect Summary (if applicable) Number of building lots: Exist Other lots: Exist Gross floor area proposed: 1792 S.F. Existing (if applicable): Hours of operation (days and hours): Monday — Friday 7-4 Building height: 15'0"f Percentage of site/project devoted to the following: Landscaping: Exist Building: Exist Paving: Exist Total number of employees: Exist Maximum number of employees at any one time: Number and ages of students/children (if applicable): K -6t` Grade Seating capacity: 49 Total number of parking spaces provided: 149 Exist Number of compact spaces provided: Exist Authorization Print applicant Applicant signE 33 E. Broadway Avenue, Suite 210 • Meridian, Idaho 83642 Phone: (208) 884-5533 • Facsimile: (208) 888-6854 • Website: www.meridiancity.org (Rev. 11/4/08) 2 HUTCHISON SMITH ARCHITECTS June 22, 2010 Meridian City Planning and Development 33 E Broadway Ave Suite 210 Meridian, Idaho 83642 Re: Certificate of Zoning Compliance Narrative Prospect Elementary School — Modular Classroom Building HSA # 10.143 To Meridian City Planners: The scope of this project is to place one 28'-0" x 64'-0" modular classroom building northwest of the existing Prospect Elementary School building. The new modular building will be placed on the existing lawn area. It will be provided with an adjustable aluminum ADA -compliant ramp and stairs that will access the new classroom building. We will provide a new fire alarm system that will be a stand alone system with (2) dedicated phone lines. The exterior paint will match the existing Meridian Joint School District standard portable building color. This modular building placement will give the Prospect Elementary School staff (2) additional classrooms to help with their overcrowding due to the current enrollment. Thank you, Greg Bush Project Manager GB:gb HUTCHISON SMITH ARCHITECTS June 22, 2010 Meridian City Planning and Development 33 E Broadway Ave Suite 210 Meridian, Idaho 83642 Re: Public School Facility Supplemental Checklist Narrative Prospect Elementary School — Modular Classroom Building HSA # 10.143 To Meridian City Planners: Below is an itemized list of the items that need to be shown on the site plan: School Bus circulation plan -existing see bus loop Sheet A1.0. Access safety -existing no changes to the schools current site plan. Pedestrian plan -existing no changes to the schools current site plan. Crossing guard plan -existing no changes to the schools current site plan. Barriers between highway and school -existing no changes to the schools current plan. Location of school zone -existing no changes to the schools current site plan. Need for flashing beacon -none Need traffic control signal -none Anticipated future improvements -N/A Speed on adjacent highway -existing no changes to current set speeds. Traffic volumes on adjacent highways -existing no change Effect upon the highway's level of service -existing no change Need for acceleration or deceleration lanes -existing no change Internal traffic circulation -existing no changes to the schools current plan. See Sheet A1.0 Anticipated development on surrounding undeveloped parcels -existing Zoning in the vicinity -existing no change Access control on adjacent highways -existing no change Required striping and signing modifications -existing no change Funding of highway improvements to accommodate development -N/A Proposed highway projects in the vicinity -N/A Thank you, Greg Bush Project Manager GB:gb P-9 rlM9 "o ji [_� = u■■■Inr1Nrr■r■nj►�: �■■1■�■. . /ra'�`�—I Il r■ /�i n sell ii ri■awVAINE vnnu.■ ���i■r■■■.�m■■ � 1 r�i:� 1i r;'•� ,l`►�� ,. �r�'� IIIN ■ nu�i �► . _ i r■■ ;i::1 �S lallrN-ilk ., . 11 i■� �r■ur�� i��,��i�I ji�pl1r�1111r111M�1�I� IIII�ra11111IirJ� �". tr urnq► ' .�--- ■Yid a �� - INS sold Irrllll �una� RLi■� �� a■rnr�1 � #■unnr■nrrrl /a RAN ■■r► irr��w ■ ��� I ■ r ►� ��►��/_ Iii_ �t t ��• "all. 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RED HORSE WAY -Iwdv S LD3 LIHDws r� - H I IL�iS I� MOSIFIDIf1H J m ml NVId 3dVOSONVI N OPM oHro, �� AVM MWHM Out •J z ON lIOCHNO 100HOS iNior IV WWI � 3,e; J o LLJ Z z F " O 0Wb z a o m LL U a m 0� (r) Z Z W m [if ! c=n z a a W Cl) r7 d- � U- X W W X ,. -.«I SNOIIVA313 UO1831X3 Q S S L��Z IHO2Id (� - r ■ t19O ONY01 NYgl19\AYM 38tlOM03tl OOC� i HIENS z ON MIUSia 1OOHOS iH�oP rrnaa3w NOSIHOLI1H aokmvsmwv..!20Wa g 6 y ®og �?spig si: �2 "a W�g$�3 egg o w Jb W yg 0.2 � _o z z _o g � a a > J- W W 3 z J S f W tl 31 4 1� w.. 2 �y$r o s� EIDIAN iDAHo PW100 FORM Date: 6/14/10 Meridian Development Services Meridian City Hall, Suite 102 33 E. Broadway Avenue Meridian, Idaho 83642 Ph: (208) 887-2211 Fax: (208) 887-1297' www. meridia ncity.org! The following property has been researched by The City of Meridian Public Works Department. Project Name: PROSPECT ELEMENTARY SCHOOL Address: 4300 N. Red Horse Way Suite #: Zip Code: 83646 Lot/Block/Subdivision: 22/12 Havasu Creek #4 1) The address has been assigned based on available information. This address should be considered temporary (Development process has not been completed, so the address may change) 2) This address will be required to connect to municipal services. _X_ Water and Sewer mains are available for connection to the Municipal System. This property does not currently have services available. (Development process has not been completed) 3) This is an existing structure that is connected to municipal services. EACH SET OF PLANS WILL BE REQUIRED TO CLEARLY REFLECT THE CORRECT ADDRESS AND SUITE NUMBER (IF APPLICABLE). Terri Ricks Land Development Services tricks@meridiancity.org CiWIDIAN--- IL l'l�+,nrnq De Planning Department CERTIFICATE OF ZONING COMPLIANCE Application Checklist Pro'ectname:rroS PCF Oerh,ev4arSCGrovI For4r,61Q File#:CSC- 10-059 A licantlagent: All applications are required to contain one copy of the following unless otherwise noted: Applicant ' Com leted & si ed Administrative Review A lication Narrative fully describing the proposed use of the property, including the following:➢ Information on any previous approvals or requirements for the requested use I(Description (i.e., applicable conditions of ap roval or Develo ment A reementRecorded warrandeed for the subject roe Affidavit of Legal Interest signed & notarized by the property owner (If owner is a corporation, submit a copy of the Articles of Incorporation or other evidence to show that the person signing is an authorized agent) Scaled vicinity map showing the location of the subject property .y N Fire Marshall approval for access and tum around (stamped, fun size site plan) ,� 1Nplan) Sanitary Service Company approval for trash enclosure & access drive (stamped, fait size site F.r4( F4(056' ✓ Civil Site/Dimension Plan - I full size co folded to 8 ''/z" x 11" size -' • �+4.3UAn A photometric test report for any light fixture(s) with a maximum output of 1,800 lumens or more see UDC11-3A-11 ✓ Copy of the recorded plat the property lies within 8 %:" x 11" Address verification letter from Public Works 898-5500 -'` Plan -4 copies (folded to 8 %z" x 11" size) %/ The The followin items must be shown on the siteplan: • Date, scale, north arrow, and project name (scale not less than 1"=50') • Names, addresses, and telephone numbers of the developer and the person and/or firm preparing the plan • Parking stalls and drive aisles • Trash enclosures location • Detail of trash enclosure (must be screened on 3 sides) • Location and specifications for underground 'irrigation (Pressurized irrigation can only be waived if you prove no water rights exist to subject property) • Sidewalks or pathways (proposed and existing) • Location of proposed building on lot (include dimensions to property lines) • Fencing (proposed and existing) • Calculations table including the following: ➢ Number of parking stalls required & provided (specify handicap & compact stalls) ➢ Building size (sq. ft.) ➢ Lot size (sq. ft.) ➢ Setbacks ➢ oning district • Reduction of the site plan 8 '/2" x 11" Landscape plan - 3 copies (folded to 8 %:" x 11" size) Plan must have a scale no smaller than I " = 50'(1 " = 20' is preferred) and be on a standard drawing sheet, not to exceed 36" z 48" (24" x 36" is preferred). A plan which cannot be drawn in r its entirety on a single sheet must be drawn with appropriate match lines on two or more sheets. The followin items must be included on the landscapeplan: • Date, scale, north arrow, and project name 33 E. Broadway Avenue, Suite 210 • Meridian, Idaho 83642 Phone: (208) 884-5533 • Facsimile: (208) 888-6854 • Website: www.meridiancity.org C ACRD Acceptance: Applicant shall be responsible for meeting the requirements ofACHD as they pertain to this application. All impactfees, ifany, shall bepaidprior to the issuance ofa buildingpermit. If any changes must be made to the site plan to accommodate the ACHD requirements, anew site plan shall be submitted to the City of Meridian Planning & Zoning Department for approval prior to the issuance ofa building permit. Your buildingpermit will not be issued until ACHD has approvedyourplans and all associatedfees have beenpaid 33 E. Broadway Avenue, Suite 210 • Meridian, Idaho 83642 Phone: (208) 884-5533 • Facsimile: (208) 888-6854 • Website: www.meridiancity.org (Rev. 211112010) • Names, addresses, and telephone numbers of the developer and the person and/or firm preparing the plan /� • Stamp/signature of a landscape architect, landscape designer, or qualified N i nurseryman preparing the plan • Existing natural features such as canals, creeks, drains, ponds, wetlands, flood lain, high groundwater areas, and rock outcroppings • Location, size, and species of all existing trees on site with trunks 4 inches or ✓ greater in diameter, measured 6 inches above the ground. Indicate whether the tree will be retained or removed A statement of how existing healthy trees proposed to be retained will be (protected from damage during construction • Existing structures, planting areas, light poles, power poles, walls, fences, berms, ✓ parking and loading areas, vehicular drives, trash areas, sidewalks, pathways, storrawater detention areas signs, street furniture, and other man-made elements • Existing and proposed contours for all areas steeper than 20% slope. Berms shall be shown with one -foot contours ti • Sight Triangles as defined in 11-3A-5 of this ordinance • Location and labels for all proposed plants, including trees, shrubs, and V- groundCOVers (trees must not be planted in City water or sewer easements). Seale shown for ]ant materials shall reflect approximate mature size • A plant list that shows the plant symbol, quantity, botanical name, common name, V minimum planting size and container, tree class (I, II, or III), and comments (for spacing, staking, and installation as appropriate) ✓ • Planting and installation details as necessary to ensure conformance with all required standards N • Design drawing(s) of all fencing proposed for screening purposes • Calculations of project components to demonstrate compliance with the requirements of this ordinance, including: ➢ Number of street trees and lineal feet of street frontage ➢ Width of street buffers (exclusive of right-of-way) N/� ➢ Width of parking lot perimeter landscape strip ➢ Buffer width between different land uses (if applicable) ➢ Number of parking stalls and percent of parking area with internal landscaping ➢ Total number of trees and tree species mix ➢ Mitigation for removal of existing trees, including number of caliper inches being removed Reduction of the landscape plan 8 Y:" x 11"' ✓ Building elevations showing construction materials — 3 copies folded to 8 %" x 11" size'` Reduction of the elevations 8 %z" x 11") i Electronic version of the site plan, landscape plan, & building elevations in pdf format " k"' ,, submitted on a disk with the files named with project name & plan type (i.e. site plan landscape plan, elevations, etc.. We encourage you to submit at least one color version +^k u If applying for approval of a public school, provide additional information as required by the Public School Facility supplemental checklist per §67-6519 Fee f this project had prior approval on a site plan, reduced fees may apply) ACRD Acceptance: Applicant shall be responsible for meeting the requirements ofACHD as they pertain to this application. All impactfees, ifany, shall bepaidprior to the issuance ofa buildingpermit. If any changes must be made to the site plan to accommodate the ACHD requirements, anew site plan shall be submitted to the City of Meridian Planning & Zoning Department for approval prior to the issuance ofa building permit. Your buildingpermit will not be issued until ACHD has approvedyourplans and all associatedfees have beenpaid 33 E. Broadway Avenue, Suite 210 • Meridian, Idaho 83642 Phone: (208) 884-5533 • Facsimile: (208) 888-6854 • Website: www.meridiancity.org (Rev. 211112010) CWEPlanning f�* Department 1 PUBLIC SCHOOL FACILTPY ■ Supplemental Checklist Project name:- Applicant/agent: All applications are required to contain one copy of the following: ippltcant - _ = = _Taff �escripIton The following items need to be shown graphically on the site plan or described in the - narrative per requirement of §67-6519: School bus circulation plan Access safety_ Pedestrian plan Crossing guard plan Barriers between highways and school - Location of school zone Need for flashing beacon Need for traffic control signal -- Anticipated future improvements Speed on adjacent highways Traffic volumes on adjacent highways Effect upon the highway's level of service = Need for acceleration or deceleration lanes —= Internal traffic circulation Anticipated development on surrounding undeveloped parcels Zoning in the vicinity = Access control on adjacent highways Required striping and signing modifications =_ Funding of highway improvements to accommodate development --_ Proposed highway projects in the vicinity- Any other issues as may be considered appropriate to the particular application APPLICATION WILL NOT BE ACCEPTED UNLESS ALL ITEMS ON THE CHECKLIST ARE SUBMITTED. 33 E. Broadway Avenue, Suite 210 • Meridian, Idaho 83642 Phone: (208) 884-5533 • Facsimile: (208) 888-6854 • Website: www.meridiancity.org (Rex 11/4/08) - Ada County Assessor Page 1 of 1 Main Menu Home Assessor Main Page Help Index FAQ About Us Contact Us Disclaimer Property Search Search by Parcel Search by Address Search by Subdivision Online Documents Interactive Map 2010 Property Details for Parcel R3508200010 2070 �j Change Year Back to Parcel Search l [Print Viewl Details Valuation Tax Districts Taxes Characteristics Parcel: R3508200010 Year: 2010 Zone Code: R-4 Total Acres: 12.723 Tax Code Area: 03 Instrument Number: 104051415 Property Description: LOT 22 BLK 12 HAVASU CREEK SUB NO 04 Address: 4300 N RED HORSE WAY MERIDIAN, ID 83646 Subdivision: HAVASU CREEK SUB NO 04 Land Group Type: SUB Township/Range/Section: 4N1 E31 Contact Us I Disclaimer http://www.adacountyassessor.org/propsysNiewPareel.do?yearParcel-201OR3508200010 6/21/2010 -05( ADA COUNTY RECORDER J. DAVID NAVARRO 1 BOISE IDAHO 04128/04 04:40 PM DEPUTY BonnieOborbilli0 RECORDED — REQUEST OF III IIIIIIIIIIIIIIIIIIII'IIIIIII'lllll ® Title One AMOUNT 3.00 104051415 Order No.: A0315971 WARRANTY DEED FOR VALUE RECEIVED, MARTY GOLDSMITH, AN UNMARRIED MAN The Grantor(s), do(es) hereby grant, bargain sell and convey unto JOINT SCHOOL DISTRICT NO. 2 whose current address is 911 MERIDIAN ROAD MERIDIAN, ID 83642 the Grantee(s), the following described premises, in Ada County, Idaho, TO WIT: Lot 22 in Block 12 of HAVASU CREEK SUBDIVISION NO. 4, according to the Official Plat thereof, filed in Book 88 of Plats at Pages 10158, 10159 and 10160, Official Records of Ada County, Idaho. TO HAVE AND HOLD the said premises, with their appurtenances unto the said Grantee, its heirs and assigns forever. And the said Grantor does hereby covenant to and with the said Grantee, that he is the owner in fee simple of said premises; that they are free from all encumbrances EXCEPT: Subject to all existing patent reservations, easements and right(s) of way of record, and other matters of record, including exceptions 8-20, as set forth in Title Commitment No. A0315971 as revised April 14, 2004, zoning ordinances, and applicable building codes, laws and regulations, and that Grantor will warrant and defend the same from all lawful claims whatsoever." Dated: 04/22/04 _:M6 Y ✓" Qx. X MART DS IT STATE OF IDAHO) COUNTY OF ADA) ON THIS 23RD DAY OF APRIL, 2004 BEFORE ME, THE UNDERSIGNED, A NOTARY PUBLIC PERSONALLY APPEARED, MARTY GOLDSMITH KNOWN TO ME OR PROVEN TO ME ON THE BASIS OF SATISFACTORY EVIDENCE TO BE THE PERSON (S) WHOSE NAMES ARE SUBSCRIBED TO THE WITHIN INSTRUMENT AND ACKNOWLEDGED TO ME THAT TAEYEXECUTED TO SAME. A•SO + "..., yo` Jo t if NO ARYPUBLIC-_TAME*LOVrE N -,-Ry RESIDING AT: BOISE, ID MY COMMISSION EXPIRES: 12-02-2009 t vT_ t/B Lt •: AFFIDAVIT OF LEGAL INTEREST STATE OF IDAHO COUNTY OF ADA i, Livlda 0,1"k. 1303 E. Cattw briue- Altai d to h (name) -T6(=ess) (city) (state) being first duly sworn upon, oath, depose and say: I. That I am the record owner of the property described on the attached, and I grant my permission to: (name) (address) to submit the accompanying application(s) pertaining to that property. 2. I agree to indemnify, defend and hold the City of Meridian and its employees harmless from any claim or liability resulting from any dispute as to the statements contained herein or as to the ownership of the property which is the subject of the application. 3. I hereby grant permission to City of Meridian staff to enter the subject property for the propose of site inspections related to processing said application(s). Dated this 15iti day of J ..0- 20 10 e at,/ �1 (Signature) SUBSCRIBED AND SWORN to before me the day and year first above written. CSA A. �� s 7'A& Lt✓ Q - ••••"'•••. ��, (Notary Public for Idaho) q� ,�OTAR p 0%. Residing at: /s'U' d-za4' o S• UB L1G �� My Commission Expires: tP o OF �� 33 E Broadway Suite 210 • Meridian, Idaho 83642 Phone: (208) 884-5533 • Facsimile: (208) 888-6678 • Website: www.meridiancity.org C9 0 zm 0 EAo � os g vi� N v n 8 d' yy R k U M 21C 4i o o: aqF s -aoi�> - -3 E p W9 0 yyd U 3p 1;3 NeIF di ie q$ � d€ d lug am 3MNo Lsn= 'N � lilt _- n s 1 I I I rt1,EM1 C 'ONI NOISELWOB )113tl0 InSV1tll{ I I+�'G•� r -r--- t� lalf� �_�j-�I_�5 ry J 11 II �m I II 1 N O = X11 9 Z- 8Z—Aa — 0 all �fOn 1 1I Is — — AVM 35xOH 03x N — '� g jOL j L L 'ON NO SIAl0911��� NiSV9 3 900 1� WI U M 21C 4i o o: aqF s -aoi�> - -3 E p W9 0 �U am 3MNo Lsn= 'N � lilt _- n s 1 I I I rt1,EM1 C 'ONI NOISELWOB )113tl0 InSV1tll{ I I+�'G•� r -r--- t� lalf� �_�j-�I_�5 ry J 11 II �m I II 1 N O = X11 9 Z- 8Z—Aa — 0 all �fOn 1 1I Is — — AVM 35xOH 03x N — '� g jOL j L L 'ON NO SIAl0911��� NiSV9 3 900 1� WI IDIAN�-- IDAHO 33 E. Broadway Ave. • Meridian, Idaho 83642 Date �%"�'L� �� CJ• v Applicant � Address D N • Phone. ✓�o ^� v1 L EC CHp NAME ON CHECK IF DIFFERENT THAN APPLICANT JEN-0 f Lf <7 9 1 DESCRIPTION• 100 l e --7? Ica I 1 I I I TAX I I TOTAL PAYMENT DOES NOT INDICATE ACCEPTANCE OF APPLICATION Received 18 911 55747 p