1990, 07-18 On-Site Sewage Disposal System Info .,Af 1 A 14 :V.'.. 1
Spokane County
� r :; -1: k_ = Department of Buildingg & Safety
•
. .•.n.,-, JAMES L MANSON,DIRECTOR •
j - -
. 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 : J1ty 18 , 19390
RE : On Site Sewage Disposal System
REF : Describe Proposal : ne-to rrsdenr.p_ -5um3le famrt
ily radae -
Property Owner : vi .sec it- t Jo re PYl.r!'A.v�'►earn n
Road Name : vary M(0.1- to
Parcel Number : 44051. 9165
Street Address : G.41.24 Van /k --Fe--
Legal Description: 14, Yz -5-24- -44
5P82-1112I3 Tract,%
SIGNED :
ell -earit.PACI1Date: ?-1$-9Y
f Pr000 d 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_
rte=
Yes/No/N.A
'iec Dedicatory Language within Plat .
• y./2' y Subject Property is Legally Divided
/J0 Certificate of Exemption Required •
• Yes Use Authorized Under Zoning Ordinance
yes Setbacks Met in Zoning Ordinance
4% SnoreH nes Permit Required
4 Variance Required for Following Purposes :
i Other :
Planning Department : ��,, v �_,,, � Date : V ',: / e)
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:
,moi- Maintained County Road Frontage
Approach Permit Required
Flood Zone
Variance Requirements
Other:
Engineer' s Office: � ' Date : 7 ^(e-g,
3. --The Spokane County Department of Building and Safety has advised
the property owner/represent t-iv'e;that, at such time a structure or
building is to be placed/constructeid'-6n the property, a building
permit will be required.;
Building and Safety ,Departure Date; L7 -19q41
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 CountyHealth
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 .
1 and issuance of
to sewage system may f w
Pound 1' pipe
R. P. ' s
Pound nail in P. P. , 26.88, M 10' E
Set tack L tag 703 in guy pole, 57 . ) .
Set tack and tag 706 in E'.P. , S8. 33,
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I44 .S/ l7a .O0 t 1 IN WITNESS WUEREOF ,
-.- - - — — - - T I seal this day
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re Fletcher , a widow ,
and wife , as the