1994, 03-01 On-Site Sewage Disposal System 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 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 permit, the owner / representative will be responsible for
meeting such regulations in effect on the date of the application for the building permit.
�SL�t zl � �
Street Address: /-64f7.- .f S 1 /07 t* 1A ''" 79 .3 7
Parcel Number: 4/...5-o�3 .✓` Oo/ A
Legal Description: Jit/C9 Op/S / 7/ // ,'oZ
Property Owner: Q t//./ Se A,G y� Phone:
Mailing Address: /V�'/? 4 S f (/-1 vC^c �� " T��
e2-:?
Signature: t>De-W 4 Date: -.3/1::'/g
PLANNING DEPARTMENT
K4jDedicatory language within plat
'Subject property is legally divided
Certificate of exemption requiredfry' "Ter ' t/U
,Use authorized under the Zoning Cod "
WA,Setbacks meet Zoning Codes requirements
I\10 Shorelines permit required
NO Variance required for the following reason:
Other:
Reviewed by: Iv.1/1M' i %t / I Date: 311
DIVISION OF ENGINEERING
*Site drainage review required
Maintained county road
FILE
��• Approach permit required
.�,,r' Flood zone
rariance requirements
titer:
414 t Date:_"1 f
Reviewed b -�.�
DIVISION OF BUILDINGS TRANSACTION
The Division of Build'•Is has advised the property owner/representative that an in depth review may be necessary when a formal
building permit appf ation is submitted.
Reviewed by: /// / Oh/ Date: -F//
4
RECEIPT SUMMARY
TRANSACTION NUMBER: T9400367 DATE: 03/01/94
APPLICANT: DAVID SENA ' PHONE=
ADDRESS: 11919 E 12TH AVE
VERADALE WA 99037
CONTACT NAME: DAVID SENEY PHONE=
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
03/01/94 00002031 2122 45 . 00
PROCESSED BY: WENDEL, GLORIA
PRINTED BY: WENDEL, GLORIA
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