1985, 09-04 On-Site Sewage Disposal System LtrSpokane 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: 4GfT '6 , 1985
RE On Site Sewage Disposal System
REF : Describe Proposal: } is(%gF.}C
SIGNED:
Proposed Oer\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.
Property Owner •(lL 1
Road Name >.Z11j2W{
Parcel Number 07 k -d7 -i -t' C,f6c
Street Address :,,,a'ry(tt,_.¢s+041,
Legal Description: gRp�k)
Date: q
Yes/No/N.A
Dedicatory Language within Plat
v1// Subject Property is Legally Divided
11✓Certificate of Exemption Required C.&---Le-35
-tis
Use Authorized Under Zoning Ordinance
5 Setbacks Met in Zoning Ordinance
Shorelines Permit Required ttoRe iN»A leo 1 ,(f €tc1
,JA- Variance Required for Following Purposes:
Other:
Planning Department:
Date: %-y_
NORTH 811 JEFFERSON
SPOKANE. WASHINGTON 99260.0050
TELEPHONE (509) 456-3675
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
)( Flood Zone
Variance Requirements
°Other:
Engineer's
Date: 9 y-js
3. The Spokane County Dep•('ment of Building and Safety,has advised
the property owner/representative that at such time a structure or
building is to be placed/constructed on the.roperty, 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 prdperty'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.
2