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Home My WebLink AboutPermit Septic Tank 1991-5-10 SEPTIC SYSTEM VE~IrICATION -- ~ lOWNSHIP 17 RANGE 0 3 SEC1ION 2 llf. SEC.IlON 2 . Lf . L lAX LOl 3 00 0 SUBClVISION I PARnnON LOll PARCEL BLOCK LOCA110N ADDRESS 543 3ROOKDALE STREET, SPRINGFIELD, OREGON SlRUC1URES NOW ON PROPERlY EXISTING SINGLE FAMILY DWELLING PROPOSED USE SEPnC INSlALLED WATER INS1ALLED NO. Of'STORIES PRIVATE USE NO. Of' EMPLOYEES CONSTRUCTION COSTNALUE DESCRIP'llON OF PROPOSED WORK NO. Of' 8EDROOMS SEPTIC SYSTEM VERIFICATION DIRECTIONS TO SI1E FROM COURTHOUSE COBURG ROAD TO HARLOW ROAD, TO PHEASANT LANE TO BROOKDAlE. APPLlCANl NAME ~ ADDRESS BETH FROSLM:D, OWNERS NAME & ADDRESS KIM & BUCK PEREA, CONTRACTOR NAME N /\ > MAIL PERMIT TO: 7 0 '{ BETH FROSLAi~D I ) NAME I have carefully read BOTH BETH F;10SLAND _, PRINT NM1E PHONE 687-1663 7l.~,l-4778 PHONE SAME AS THE J03 ADuRESS ABOVE OSR LICENSE' PHONE NA :1 A MAIN STREET, SPRINGFIELD, O?-EGON ADDRESS 97477 J and her\.~_b c ceerr~tIffYYl1t thhaatt a/I) Information Is true and correct ~ $-lo.-9} DAlE . . I , "C~'R'E~~'l"lYI'''' '"'y~'~'~~~~;~~~~~~~~~?~~ "rh;"F;i7;;!;g;.~C~~d'ltlo~S ~ ' FEES DUE: . ,4 ' $ APPROVED BY: DA TE CALLFOR/~SPECT;ONS' (SEE BACK OF 'FZ;~iVj"FoR""/istRUC:;;ONS)D~8'7.'~~~5;n,n, "~".," ",' ''''','''''''',,'' SEPTIC permits are good for one year. ALL other permits expire after 180 days unless inspections are current. ., """, "",,,,,,,.,," "",' ",,,.,, ",'~'''~,.~..."''''''~..'._'. '"----'".".~.~"'.".,.". ,,'~~,_..,' ", .., .. -...~.,,~~~....,.,'"''"''''' ,.",,,, " .",.11 ./' VIOLA nONS SETBACKS AND 0TIlllR CONDmONS OF APPROV AI. MUST BI! STIUCJ'L Y OBSERVED. VIOLATION CAN RESULT IN RIlVOCA TION OF TInS PERMIT. CITATIONS MAY BIl ISSUED UNDER nm PROVISIONS OF LANIl COUNTY'S INFRACI10N ORDINANCI! AND/OR OTIlllRRIlMllDms ALLOWllD BY LAW. .. A MINIMUM OF AT LEAST 24 HOURS ADVANCE NOTICE MUST BE GIVEN FOR INSPECTION REQUESTS Have the following infonnation ready when you call: 687-4065 Permit number - Job address - Type of inspection required When it will be ready Your name and phone number - Any special directions to the site PUBLIC OFFICIAL RIGIIT TO TRESPASS ON PRIVATE PROPERTY ORS 215.080 POWIlR TO ENTIlR UPON LAND. nm COMMISSION, AND ANY OF ITS MEMBERS, oFFiCERS AND EMPLOYES, IN nm PERFORMANCI! OF 1lIEIR FUNCI10NS, MAY ENTER UPON ANY LAND AND MAKE EXAMINATIONS AND SURVEYS AND PLACI! AND MAINTAIN nm NECESSARY MONUMENTS AND MARKERS THIlREON, REQUIRED INSPECTIONS FOUNDATION INSPECTION: To be made after excavations for footings are complete and any required reinforcing steel is in place. UNDERGROUND Yll'lNG INSPECTION: To be made after all underground piping has been installed, prior to any backfill. CONCRETE SLAB OR UNDER-FLOOR INSPECTION: To be made after all in-slab or under-flocr building service equipment, conduit, piping accessories and other ancillary equipment items are in place but before any concrete is placed or floor sheathing installed, including the subfloor. ROUGH MECHANICAL INSPECTION: To be made after all ducting and gas piping has been installed and prior to being covered. ROUGH PLUMBING INSPECTION: To be made after all plumbing rough-in is in place, prior to being covered. FRAMING INSPECTION: To be made after the all framing, fire blocking, bracing and roof are in place and all pipes, chimneys and vents are complete and the rough electrical, plumbing, and mechanical inspections have been made and "yy.vved. INSULATION INSPECTION: To be made after all insulation and vapor barriers are in place, prior to covering. LATH AND/OR GYPSUM BOARD INSPECTION: To be made after all lathing and gypsum board, interior and exterior, is in place but before any plastering is applied or before gypsum board joints and fasteners are taped and fInished. ADDITIONAL INSPECTIONS MAY BE REQUIRED, such as but not limited to; BLOCK WALL: To be made after reinforcing is in place, but bef9.re any grout is poured. The inspection is required for each bond beam pour. There will be no approval until the plumbing and electrical inspections have been made and app... ..ed. FINAL MECHANICAL INSPECTION: To be made just prior to the'structUre or reinodeled area being occupied and prior to operating any equipment FINAL PLUMBING INSPECTION: To be made just prior to the building, structure or remodeled area being occupied. FINAL BUILDING INSPECTION: To be made after finish grading arid the building, structure or remodeled area is completed and ready for occupancy. MOBILE/MANUFACfURED HOMES: An inspection is required after the mobile home is connected to an "Pt'.vved sewer or septic system, prior to covering sewer or water lines, for setback requirements, blocking, tiedowns and plumbing connections. Footings and piers to comply with State foundation requirements for mobile homes or as recommended by the manufacturer. Minimum fInished floor elevation shall be certified when required by Floodplain Management Tiedowns, if required, shall be installed and ready for inspection within 30 days after occupancy. Tiedowns shall be installed per enclosure. APPROVAL .REQUIRED No work shall be done on any part of the building or structure beyond the point indicated in each successive inspection without first obtaining the approval of the building official. Such approval shalLbe given only after an inspection shall have been made of each successive step in the construction as indicated by each of the inspections required. APPROVED PLANS MUST BE ON THE JOB SITE AT ALL TIMES DURING WORKlNG HOURS. THIS PERMIT WILL EXPIRE IF WORK DOES NOT BEGIN WfUllN 180 DAYS, OR IF WORK IS SJOPPED OR ABANDONED FOR MORE THAN 180 DAYS. SUSPENSION OR, REVOCA TION,MA Y O<;:CUR IF THIS PERMIT W A$ ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS INFORMATION. ANYONE PROCEEDING PAST THE POINT OF REQUIRED INSPECTIONS WILL DO'SO AT THEIR OWN RISK.-' '. ... '.'" '-. Your signature on the front <if this form verifies the following: I HAVE CAREFULLY EXAMINED TillS COMPLETED APPLICATION, and,do hereby certify that all information hereon is true and correct, and that I have a legal interest in the property as owner of record or authorized agent. I further certify that any and all work performed shall be done in accordance with the Ordinances of Lane County and the laws of the State of Oregon per- taining to the work described herein. I further certify that if I am not the owner of the prVt'<-H/, my registration with the Builders Board is in full force and effect as required by ORS 701.055, and that if exempt the basis for the exemption is noted hereon, and that only subcontractors and employees who are in compliance with ORS 701.005 will be used on the job. SUBSURFACE & ALTERNATIVE SEW AGE DISPOSAL SYSTEMS: When subsurface construction is complete, the pennit holder shall notify the County Land Management Division by submitting the installation record form. An inspection will be made by a qualified sanitarian. If. construction complies with all rules a certificate of completion will be issued to the permit holder. If construction does not comply with rules, the pennit holder will be notified, and all corrections shall be made before a certificate of completion will be issued. Failure to meet satisfactory completion within the allotted time constitutes a violation of ORS 454.605 to 454.745 'and this rule. SUBSURFACE SEWAGE DISPOSAL SETBACKS SEPTIC TANK From: Interior property lines 10' Edge ofroad right-of-way 10' Building foundation 5' Wells or other water sources 50' DRAINFIELD 10' 10' 10' 100' ~ Please complete all _~I.h _ " -~ \' .oT'po....... 'tUUH NAMt: lines inside white boxes, if possible. S" /0 -<1\ UAIt: toCf.l-llob3 PHONE 9/'fC<! ZIP 7'-1I-lf 7 7 q PHUNt: qiL{f! ZIP ,,~"- 4'11. YOUR ADDHt:SS ~ LA C -e/\Af2... J ktl'V\ ,Slf.~ OWNERS ADDRESS (;1 nol same as above) CITY -\- CUNI HAl.: I UH License II Township Range Seclion 1/4 Seclion Tax Lol TownshIp Hange Section 114 Section lax Lol , I SITE ADDRESS \5Y- 3 ~ro0kJa(e Existing Bulldlngs or Improvements on Property r,.(.House 6 'Barn- CJ Garage CJ Mobile. Home CJ Shed SEPTIC INSTALLED CJ Yes CJNo Water District "'~ '. "j , Directions to site from Courthouse U, 1,VV\..1- }o l\"'(). t-'\ ~e-\.. J ~ ~4~~ ~ AfbnWak:>~ ~j '\l , # ~ ~-r~ V\-S\-l ~ \d -' Of- ZIP , ": .. Ii.. MAIL PERMIT TO: ~~ ~O~\f:Vv\. A NAMt: AUUHt:SS 101 1\I\n.~ V\ "<;9r ~ ^-5<=' e_\ J ~ Ilff} ZIP De- 1.:11 Y '" q-, '-t 'l I For Moblle Home Placement Only ~ Bran~ ./' Year .x' Si~ " ~. of lip-outs "'" No. of Bedrms " License # ~~ ~~1'- -h:l ,~cR ., I' v<:~~~ /~;/;o \J9-~ G~p0 54 3 6lookd~ Ie SPrl'j P:~IJ ../ \-. I' I' 4' , ~\ f' r [II' .! 'j ~ i ,", I~ it ~ >: ~ < .. !i . " ,~ ,": Q t Ii r, . " '" 'I!) ,~ " "1" I ',... '" ~ , " w il c: ~I , , r r ' I " ,1 '1\ I f "'1 -! 'i , , " 'W: 5 :LANE COUNTY'DEPT ENV MGT RECEIPT ~ 138491 DATE 051391 , f~' F' PI... I C (i N "j' , PYPE i~'~: .; i< J h.?;,: B UC i< t., D D r;: ~:~: 1.~,3 'Bl~~ (JOI< D(,I...E s'r., S.' F' F: I i'~ G;:' I EI... D ".LTI...:li: 'j 70:::~:;?~;.~4:~?()30(-)(') S.'I...IE:DIV : III I.!.\ ) I' h I, I fl,! E ~'J E: L D G T 'y' P E ' USE F~ E{ D F;,: H S 0 1...1 f',.j IT,,::,:,:, .,{.,',.,. ~,:I:,:~,~J ~I:~,~.),', 'j 1,:.:".'.',;:.; :.'~'~)' 0 i,'I:,,:,":,I:.,I.,:,.,II',:',~J' :~,::.'I i.o','.. r...,.' :'.'..., :l'~.:, ~!t.":,,.{., L. :.~.~~ ~~!~ ::.':: , .) '.:~.:,'.;: ,':.i.,. .1'."'... 1'.:1:.: ~I:.'.'!i II~':~':':';"~I::':~"; 1',:1:'.: 1'.':', '1:.=,). :.:I',:..~) "(' ::.:' .j" ~;:: 6 :,~\" . 'I OWNER NME PEREA. KIM & BUCK .: " :,' I' CODE APPI... NO ACTION DESCRIPTlbN SQ FT UNIT COST VAL.UATION FEE' DA~S BF' ~ DP BP I-:.:P DF' F'L :11: F I ;<o'/ B (, T H : /'/j [: C: H {~I i i I:;' l I L"( .,,' '. i, ;::CI< LF~ " ,LC .j :::)(;)49 'j SDS'V sIJ.jr;~ : F''(' ~ ~,.iTr:: : jviECH(.':)i'..j I C:(,I,,, FEE ST(lTE S.'URCH(.:,F;:GE ;:'I...(iN CHEC:I< FEE FTo'. F:(',IN: FT :::;:;.;"; . ~! '1 I ....,1::.,'/ ~:.. ..l /u "?:::;o"OO i,.;p, 11..,' : ;:'1... f"'! ::';:E(;.:'I...1 : 'f (,I< E f\l E.: Y E{ :0: I':~ i::i S'DS' E:L.E PCl< ... "".": 1,:,,:, ,,/ SII DTF: ::.~:: EST. COMPL.ETION DATE DEF'el::';.' I T 1(':11' '~;.: ~::: ... () () t..: t<. '