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1985, 06-12 Sewage Disposal System Info04-7/29 C64iecis c S Spokane 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: Gi , 198 `5 RE On Site Sewage Disposal System REF : Describe Proposal: Property Owner • Road Name • Parcel Number • Street Address • Legal Description: SIGNED: flier- ,. c. t ( At- nc-Nu SOHN GW2ltSC� 1421- 60 Gc azt . 421t- 60Gcaz ora Date: ;� 2 2t C Pro used Owner or Authorized Representative 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 for. Requirements reviewed for property as of the date set forth hereinabove. Yes/No/N.A Dedicatory Language within Plat� � Subject Property is Legally Divided d k Certificate of Exemption Required.- ,teak Cf- Use Authorized Under Zoning Ordinance Setbacks Met in Zoning Ordinance Shorelines Permit Required Variance Required for Following Purposes: Other: er iirlde Planning Department: Date: NORTH 811 JEFFERSON • SPOKANE, WASHINGTON 99260.0050 • TELEPHONE (509) 456.5675 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 Frontage Approach Permit Required— 30, Flood Zone Variance Requirements Other: uo Engineer's Offi e: . /felfeida Date: 6 3. The Spokane County`s "partment of Building and Safety has ativised the property owner/re.resentative that at such time a structure or building is to be placed/constructed on the property, a building permit will be required. Building and Safety Department: Date: 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.