1988, 05-04 On-Site Sewage DisposalSpokane County
Department of Building & Safety
JAMES L. MANSON, DIRECTOR
ON-SITE SEWAGE DISPOSAL SYSTEM INFORMATIONAL REVIEW FORM
For Single Family Residences
TO - Spokane County Environmental Health Division
FROM: Spokane County Department of Building and Safety
DATE: --(/�y �� , 198
RE : On Site Sewage Disposal System
REF : Describe Proposal:
Property Owner
Road Name
Parcel Number
Street Address
Legal Description:
SIGNET):
t v1 CPlea-PERT y F-072. SA L_E_
REuJC1r A n t -F
CB
ACDiss 7:DLAT A
2.OP (200 F -T C F F LJC R
Proposed Owner or uthorized Representative
Date: S/y/5'
1. An initial review of the above -referenced property has been
conducted by the Spokane County Planning Department and the
following items are noted. An in-depth review of the property will
again be made at the time a building permit is applied fo`r.
Requirements reviewed for property as of the date set forth
hereinabove.
Yes/No/N.A
Dedicatory Language within Plat
Subject Property is Legally Divided
5 Certificate of Exemption Required
Use Authorized Under Zoning Ordinance
Setbacks Met in Zoning Ordinance
id Shorelines Permit Required
04—Variance Required for Following Purposes:
Other:
Planning Department:
NORTH 811 JEFFERSON
Date: J�/�/�fir
SPOKANE. WASHINGTON 99260.0050
•
TELEPHONE (509) 456-8675
On -Site Sewage System Review Form
Page 2 of 2
2. An initial review of the subject property has been conducted by
the Spokane County Engineer's Office and the following items are
noted. An in-depth final review of the property will again be made
at the time the building permit is applied for.
SPECIAL REQUIREMENTS:
Maintained County Road Fron e
Approach Permit Required
Flood Zone
Variance Requirements
a Other:
Engineer's Office:
3. The Spokane CountDepartment of Building and Safety has ad<ised
the property owner/representative that at such time a structure or
building is to be placed/constructe ,on the property, a building
permit will be required.
Building and Safety Department:
Date:5///5e
NOTE: The review by the various departments as provided for herein
is solely for the purpose of advising the Spokane County Health
District of the subject property's compliance with various codes and
regulations. The issuance of a permit by the Spokane County Health
District for the installation of an on-site sewage disposal system is
not to be considered as a vesting of a right by the owner/rep-
resentative to obtain a building permit for the property. At the
time that a building permit is applied for, the subject property must
comply with all applicable federal, state or local laws, ordinances
or regulations with the exception of those relating to the issuance
of a permit for the septic tank/drain field on-site sewage disposal
system by the Spokane County Health District, pursuant to this form.
Accordingly, although as of the date of this document the subject
property may meet certain federal, state or local laws, ordinances or
regulations, in the event such items change between the date of this
document and the application for a building permit, the ow-
ner/representative will be responsible for meeting such regulations
on the date of the application for the building permit.