Spokane County Determination of Legal Availability Application Page 1
Application
Spokane County Determination of Legal Availability
for
Non-Public Water System Water Supply for Building Permits
**Well supplying the subject parcel must be constructed prior to application** Section 1. PROPERTY & WATER SUPPLY
Assessor parcel number: Property Address (if available):
Water Supply (Check 1):
Cistern Individual Well Shared well (note: cisterns only satisfy the legal availability requirement in WRIA 55)
Section 2. CONTACT INFORMATION Legal Parcel Owner(s):
Mailing Address: Contact phone:
Email: Applicant:
Mailing Address: Contact phone:
Email: Application Contact:
Mailing Address: Contact phone:
Email:
Section 3. MITIGATION CERTIFICATE
Spokane Valley-Rathdrum Prairie Aquifer Mitigation Certificate provided? Yes No Little Spokane Water Bank Stream Flow Mitigation Certificate provided? Yes No
Section 4. CISTERN (skip this section if using a well)
The use of a cistern requires approval by the Spokane Regional Health District (SRHD). After you have received a completed Water Adequacy Review Form from SRHD, submit the form along with this application.
Note: Cisterns only satisfy the legal availability requirement in WRIA 55.
Have you received a water adequacy review based on use of a cistern from the SRHD? Yes No SRHD Water Adequacy Review Form provided with this application? Yes No List the public water supply system that will be used as a source of water:
Spokane County Determination of Legal Availability Application Page 2
Section 5. WATER RIGHT PERMIT OR CERTIFICATE
To use a water right permit or certificate to establish legal availability for a building permit the water right must authorize an adequate quantity of year-round, uninterruptible domestic water use, and the project location must be within the place of use described on the permit or certificate.
Water right permit provided with this application? Yes No
Is the project location within the place of use listed on the water right or provided by Ecology? Yes No Does the water right authorize an adequate quantity of year around, uninterruptible domestic
water use? Yes No
SECTION 6. ESTABLISHED DOMESTIC USE
Was water used on the parcel for domestic purposes before October 26, 2016? Yes No Was the project constructed under a building permit issued before October 26, 2016? Yes No Is the water use associated with a structure recognized by the Spokane County Assessor as a permanent structure or built, placed, or reconstructed in accordance with a building permit accepted by the Spokane County Department of Building and Planning prior to October 26, 2016? Yes No
Assessor’s records provided? Yes No
Was a building permit for a building necessitating a potable water supply issued for the structure? Yes No Building permit provided? Yes No
If no, was a permit for an onsite septic system issued by the SRHD? Yes No SRHD permit provided? Yes No
If there are no assessor records, building permit or onsite septic permit please describe and provide documentation of the evidence of domestic water use associated with the structure.
Section 7. WELL
Is the well supplying the Property a shared well? Yes No Assessor Parcel Number of other parcel served by the shared well: Well Location:
Latitude: Longitude:
Is there a well log available for the well? Yes No If no, Well Location Affidavit provided? Yes No If yes, well log provided? Yes No Information from well log:
Owner Name: ____________________________________ Date Completed: ____/____/____
Start Card No. ____________ Unique Well ID _________ Location: _____ ¼ _____ ¼ Sec ____ T ____ R_____
Spokane County Determination of Legal Availability Application Page 3
Section 8. WELLS ON ADJACENT PROPERTIES
Distance to the closest well associated with an established domestic or beneficial use, a valid building permit, or a valid Determination of Legal Availability. Please attach a map. An example map is provided with this application.
_______________ feet. (If distance is greater than 500 feet go to Section 9) Parcel map provided: Yes No What type of aquifer is the well supplying the property completed in?
Sand and gravel aquifer aquifer dependent setback 100 feet Clay and silt aquifer aquifer dependent setback 200 feet Bedrock aquifer aquifer dependent setback 200 feet Basalt aquifer aquifer dependent setback 500 feet What type of documentation is provided for the aquifer designation? Licensed Well Contractor Aquifer Designation
Licensed Hydrogeologist or Engineer Aquifer Designation
If the well does not meet the 500 ft setback or aquifer dependent setback, provide a report prepared by a licensed hydrogeologist (LHG) or professional engineer (PE) licensed in the State of Washington that concludes the new use will not induce greater than 10 feet of additional water level drawdown in the closest well with an established domestic or beneficial use, a valid building permit, or valid Determination of Legal Availability.
Hydrogeologic report provided? Yes No
Section 9. SIGNATURE
I certify that I am the owner or authorized signatory of the parcel identified in Section 1, and that all information provided in this application and associated attachments are true and correct.
Signature (Property owner/authorized signatory) Date Signature (Second Property Owner if applicable) Date If signing on behalf of a separate legal entity, please include documentation confirming signatory authority.
APPLICATION INFORMATION
The well supplying the project must be drilled/constructed prior to application and issuance of a Determination of Legal Availability (DOLA). Please contact Spokane County Environmental Services at (509) 477-7579 if you have not yet drilled/constructed a well for information related to requirements for Determinations of Legal Availability.
FEE – a fee of $150 applies to all applications except cisterns or mitigation certificates issued by the Washington Department of Ecology. The fee is due at the time of application.
Section 1. PROPERTY & WATER SUPPLY
Provide the Assessor parcel number and address of the parcel where the project requiring a building permit will be located. If an address has not been assigned to the parcel use “not assigned.”
Indicate the type of water supply that will be used to supply the project. The use of a cistern to satisfy requirements to receive a DOLA is only allowed in WRIA 55.
Section 2. CONTACT INFORMATION
Contact information for the Legal Parcel Owner is required. If the applicant, or application contact is different please provide contact information. If the Legal Parcel Owner is a legal entity (e.g. trust, LLC, corporation) please provide documentation establishing signatory authority along with this application.
Section 3. MITIGATION CERTIFICATE
If the parcel is located within the boundary of the Spokane Valley-Rathdrum Prairie aquifer a mitigation certificate issued by the Washington Department of Ecology is necessary. Contact the Department of Ecology Eastern Regional Office at (509) 329-3400 for information about obtaining a mitigation certificate for this area. Once a mitigation certificate has been obtained provide a copy along with this application. If your project is located in this area and a mitigation certificate has been obtained there are no further requirements to receive a DOLA.
If the parcel is located within WRIA 55 a stream flow mitigation certificate is not required if any one of the following apply:
1. A cistern will be used;
2. A water right permit or certificate authorizes domestic use for the project; or 3. There is an established domestic use on the parcel.
Please consult www.spokanecounty.org/water for information about obtaining a stream flow mitigation certificate. Once a stream flow mitigation certificate has been obtained, the well that will be used must also meet the requirements for setbacks from wells on adjacent properties (Section 8).
Section 4. CISTERN
The use of a cistern approved by the SRHD meets the requirements for a DOLA for parcels located within WRIA 55. Contact the SRHD for information about applying to use a cistern as a water supply. Upon receipt and review of necessary documentation SRHD will provide a Water Adequacy Review Form which will be provided with this application. If a cistern will be used in WRIA 55 there are no additional requirements to receive a DOLA.
Section 5. WATER RIGHT PERMIT OR CERTIFICATE
A water right permit or certificate can satisfy the requirements to receive a DOLA provided the project location is within the place of use identified on the water right permit or certificate, the authorized quantity is sufficient to supply the project, the use is year around and uninterruptible, and the purpose of use is domestic. A copy of the water right permit or certificate is required with this application. For questions related to water right permits or certificates contact the Department of Ecology Eastern Regional Office at (509) 329-3400.
Section 6. ESTABLISHED DOMESTIC USE
A DOLA can be issued if there is, or has been, domestic water use on the parcel prior to October 26, 2016. For example, if a home located on the parcel was lost to a fire, a DOLA for new or additional buildings can be issued with no additional requirements (e.g. mitigation certificate or setbacks).
If a project was constructed under a building permit issued prior to October 26, 2016 a DOLA for new or additional buildings on the same parcel can be issued with no additional requirements (e.g. mitigation certificates or setbacks)
There are two requirements to receive a DOLA based on an established domestic use:
1. There must have been a structure on the parcel recognized by the Spokane County Assessor prior to October 26, 2016, or a structure built according to a building permit issued prior to October 26, 2016. 2. There must be evidence of domestic water use associated with the structure. Evidence may include a
building permit with plumbing fixtures, a completed and connected onsite septic system. Section 7. WELL
If a DOLA is not based on cistern, water right permit or certificate, or established domestic use then the location of the well relative to other wells that are currently in use is used to determine legal availability. Latitude and longitude of the well location can be established by use of a smart phone with GPS capabilities or
computer mapping software such as Google Earth.
If a Department of Ecology well log is not available to establish the existence of the well a well affidavit is required to attest to the existence and location of the well.
Provide information exactly as given on the well log. This information can be used by Spokane County staff to locate the well log from the Washington Department of Ecology well log database.
Section 8. WELLS ON ADJACENT PROPERTIES
The distance from the well that will serve the project and wells that are in use, or have a valid building permit, or a valid DOLA is used to determine legal availability. Contact Spokane County to determine if a well not in use has a valid DOLA or building permit.
Upon locating the wells on adjacent properties prepare a map showing the location of the well to be used to supply water to the project and wells on adjacent properties. Instructions for creating a map and an example map are available.
If there is a 500 ft distance between the project well and wells on adjacent properties no further evaluation is necessary and DOLA will be issued.
If there is less than 500 ft between wells an aquifer dependent setback can be used. To establish the aquifer that the well is completed in a licensed well contractor, licensed hydrogeologist, or licensed professional engineer must complete an aquifer designation form.
If there is less than the aquifer dependent setback a site specific hydrogeologic study can be completed by a licensed hydrogeologist or licensed professional engineer. To receive a DOLA the study must conclude that the new use as the result of the project will not induce greater than 10 feet of additional water level drawdown in the nearest well with an established beneficial use, valid building permit, or valid DOLA.
Section 9. SIGNATURE
A signature by the legal property owner or authorized signatory is provided to attest that the information provided is true and correct.