1994, 10-12 On-Site Sewage Disposal Review ppm )i gii
On-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 permit for this property. At the time that a building pennit 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 permit, the owner / representative will be responsible for
meeting such regulations in effect on the date of the application for the building permit.
Street Address: 1L0O RLt9cif Sptrr.*1 SKYj-,NE ALneB 12'Go S. 1U 14 C 121.•,.
Parcel Number: 4519 3. 07I6 n_�A�G/�
Legal Description: 5 e.L/ ITC
Property Owner: DA W Se1J Phone: cgs — 63-3 9
Mailing Address: 7 CO. _ A 3 i• ,= _ e ' 202
Signature: �..__
Date: /es/11 f 9 J-
PLANNING DEPARTMENT
_Dedicatory language within plat
Subject property is legally divided
//Q Certificate of exemption required
VUse authorized under the Zoning Code 5i.72/ 14-44
✓Setbacks meet Zoning Codes requirements 4i.c.€ e t .P7L ."�u"
2 -IKn '.-Ceµt4?/)
////ShorelVarian per pennit required
the ^ � ��4
�r/Variance required for the following reason: /►-t�t,E-,.( ��.¢.e�/
Other: J
Reviewed by:: Id .v I _ . '.,✓/ Date: /0 A
DIVISION OF ENGINEERING /
p5 Site drainage review required
Maintained county road
Approach permit required + I I J
f71'lood zone ° ;° i1
{� Variance requirements , 1 '
Other: aiig€-'L -' dA/%u _/cXjv ,y2'Z-w.--
Reviewed by: _I/I/ A_ A,' ' . c/ Date: /61/d-
•-.,.-
D/h"
DIVISION OF BUILDINGS TRANSACTION#: 1 141603
The Division of Buildings has advised the property owner/representative that an in depth review may be necessary when a formal
building permit applicatiot is submitted.
/ r
Reviewed by: /1/. _ /
, Date:
ii
U
ACTION: R SCREEN: LEGL USERID: ROBS N CHANGE-REASON:
H-
LEGAL DESCRIPTION
JURISDICTION= 11 ROLL= RE PARCEL= 45193 . 0716 YEAR= 94
PAGE= 1
LINE DESCRIPTION
01- 1 10 BEVERLY HILLS 1ST L16B6
02-
03-
04-
05-
06-
07-
08-
09-
10-
11-
12-
02-*L009 HEADER CHANGE
i
G� i
-9----- N 1 0.-8-F----9-61'
,� 37' is \ P�T00 5E1
4°'
• 0/0•1. " 500lc- 1 pW�E /3g
G\G• a cgA � �
• SIY .c �-4--14gz'
,�-;. —
2 cPA� 0��� ' _ �x1S_rJN_ _fTa 2c,
: 'IL._A��1' Ta3T HOLES
�s , , `�� �AQ�Cp06 _ _..v(F I CA 16 ,S
P�
Q544uINr'
Y G 3 a �°C" \�t I
sei2,k.
\j- .'
1 \ ,
1 NI- j
. . v
1\1\t") '1, P9-ilfr ,A........„
(45-r i
112-.52-- . . \
/ p,• /'rte
/-V ' �% /'a Ggr/
pp / I ....„.141,
---A - ,0 ,60 0, F- .-----
(5 ,ii6eet'i't- t'-' ,
riette
.. . ,ii..c. , 10,.._
„ ,,,..., I
ici��� / ,tip
tai 3' 0- $Ot3ERT T DAWSON RESIDENCE
. 10111. _1ZD0-$L.00,< Sot3T+4 S(1LINE PLACE
_pt)CO-L- .45193, 07.16
3 $7'oKANC', WA 99Z 17-
0
Z0
RECEIPT SUMMARY
TRANSACTION NUMBER: T9401803 DATE: 10/12/94
APPLICANT: DAWSON, ROBERT J PHONE= 509 954 0339
ADDRESS: 811 S COWLEY ST #37
SPOKANE WA 99202
CONTACT NAME: ROBERT DAWSON PHONE= 509 954 0339
TRANSACTION: ON SITE SEPTIC REVIEW
DOCUMENT ID: 1) 2) 3)
4) 5) 6)
FEE & PAYMENT SUMMARY
ITEM DESCRIPTION QUANTITY FEE AMOUNT
SEPTIC REVIEW FORM 1 45.00
TOTAL DUE = 45.00
TOTAL PAID= 45.00
BALANCE OWING= .00
PAYMENT DATE RECEIPT# CHECK# PAYMENT AMOUNT
10/12/94 00012056 9689 45.00
PROCESSED BY: BURRIS, ROBIN
PRINTED BY: KATHY CUMMINGS
******************************** THANK YOU ************************************