1989, 01-23 On-Site Sewage Disposal System ReviewSpokane County
Department of Building & Safety
JAMES L. MANSON, DIRECTOR
ON-SITE SEWAGE DISPOSAL SYSTEM INFORMATIONAL REVIEW FORM
For Single Family Residences
TO Spokane County
FROM:
DATE:
RE
Spokane County /a/c-3
On Site Sewage
Environmental Health Division
Department of Building and Safety
, 198?
Disposal System
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REF : Describe Proposal:
Property Owner
Road Name
Parcel. Number
Street Address
Legal Description:
SIGNED:
7
Propowner
or L thorized Representative
1. An initial review of t
conducted by the Spokane
following items are noted.
again be made at the time a
Requirements reviewed
hereinabove.
Date:
he above -referenced property has been
County Planning Department and the
An in-depth review of the property will
building permit is applied for.
for property as of the date set forth
Yes/No/N.A
Ai Dedicatory Language within Plat t7'�
Subject Property is Legally Divided—
Certificate of Exemption Required= �a�
Use Authorized Under Zoning Ordinance=7 Sw)
Setbacks Met in Zoning Ordinance_ __,L,.fj�.
• ,j Shorelines Permit Required
7 --- Variance Required for Following Purposes:�� s'`"-'
Other:
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Date :/ -;5-
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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 Enginti'er'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 Permitt Requi,red8tf?t/*/73
od Zone JA//id
Variance Requirements
Other:
Engineer's Office: etfo�..(cC
Date:
3. The Spokane County Department of Building and Safety has advised
the property owner/representative that at such time a structure or
building is to,he placed/construct . on the property, a building
permit will be'r quired.
Building and Safety Department:
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.
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