1995, 07-19 On-site Sewage Disposal Sytem ReviewOn-site Sewage Disposal System Informational Review
NOTICE
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 construed as a vesting of a right by the owner /
representative to obtain a building pennit for this 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 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 state or local laws, ordinances or regulations, in the event such items
change between the date of this document and application for a building pennit, the owner / representative will be responsible for
meeting such regulations in effect ion the date of the application for the building pennit.
Street Address: l ///9
�!
Parcel Number: 445/ UJ . O bes.E !
'
Legal Description: M\/
Property Owner: %�Of 6 -/;?--f Phone: 91:22
Mailing Address /70/ 80>Z• / /0 / 5P(>/lG 1 /l,7247
Date:
Signature:
PLANNING DEPARTMENT
Dedicatory language within plat
ubject property is legally divided
Certificate of exemption required
Use authorized under the Zoning Code
Setbacks meet Zoning Codes requirements
Shorelines permit required
Variance required for the following reason:
Other:
Reviewed by:
�le
DIVISION OF ENGINEERING
N 4- Site drainage review required
Maintained county road
Approach pennit required eridi.;)`_SeAAk,
Flood zone
AI Other :
Variance requirements
/
Date: /7. ff"."-
��/--
Reviewed by` /✓,A-1-' e-,.ir �'
Date:
7//yAs-'
DIVISION OF BUILDINGS
TRANSACTION #: 1 Q5 . /rig
The Division of Buildings as vised the propertxovvncr / representative that an in depth review may be necessary when a formal
building permit applicat'.n is submitted.
J
Date: /// I/95
TRANSACTION NUMBER: T9500995
APPLICANT: DON MERKLE
ADDRESS: P 0 BOX 13101
SPOKANE WA 99213
CONTACT NAME: DON MERKLE
TRANSACTION: ON-SITE SEPTIC REVIEW FORM
DOCUMENT ID: 1) 2)
4) 5)
FEE & PAYMENT SUMMARY
ITEM DESCRIPTION
SEPTIC REVIEW FORM
PAYMENT DATE RECEIPT#
07/20/95 00006485
PROCESSED BY: WENDEL, GLORIA
PRINTED BY: WENDEL, GLORIA
DATE: 07/20/95
PHONE= 509 922 0008
PHONE= 509 922 0008
3)
6)
QUANTITY FEE AMOUNT
1
TOTAL DUE =
TOTAL PAID=
BALANCE OWING=
CHECK#
2733
45.00
45.00
45.00
.00
PAYMENT AMOUNT
45.00
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