HomeMy WebLinkAboutPermit Septic Tank 1988-11-16
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1)~t\).:/' L&m
Lane County Authorization for:
SEPTIC INSPECTION FOR LOAN REVIEW
FOR OFFICE USE ONLY
Appl~ca tion'/'3 3 ""') 7 _ \/ D
Perm~t # ~ 0 f
17
03
22.4.2
TAX LOT UUU'l OF'
3000
- mw;,;sHip
,S~'BDIVISIO,N/PARTITION (if applicable)
I LOT/PARCEc.
BLOCK
PROPOSED USE OF PROPERTY
[XJ Residential 0 Industrial
o Commercial D Public,
RANGE
SECTION
, LOCATION ADDRESS
STREET
CITY
ZIP
543 BROOKDALE AVE., SPRINGFIELD, OREGON 97477
STRUCTURES CU~~NTLY ON PROPERTY
EXISTING SINGLE FAMILY DWELLING
DIRECTIONS TO SITE
COBURG ROAD TO HARLOW ROAD, EAST ON HARLOW TO PHEASANT" TURN LEFT ON PHEASANT, LEFT ON BROOK-
DALE, THIRD HOUSE ON THE ,LEFT HAND SIDE OF ROAD
u~SCRIPTION OF PROPOSED WORK - BE SPECIFIC
SEPTIC INSPECTION FOR LOAN REVIEW
DECLARED $ VALUE
NA
NA
PUBLIC
o Proposed
[Xl Existing
TELEPHONE NUMBER
746-5239
I # OF STORIES
NA
; O;,"NER' S NAME AND ADDRESS
, " OF BEDROOMS
# OF EMPLOYEES
\~ATER SUPPLY
DAVID AND KAREN LAFLEUR, SAME AS THE JOB ADDRESS ABOVE
CONTRACTOR'S NAME AND OSR #
-
TELEPHONE NUMBER
SAME
SAME AS THE ABOVE
, ?=:RJoIIT TO BE MAILED TO (NAME AND ADDRESS)
SAME AS THE ABOVE
TELEPHONE
SAME
u
L'4UL'lO.c,.r..
I HAVE CAREFULLY EXAMINED THE COMPLETED APPLICATION FOR PERMIT, and t10 here!..lY .ce ttlfy that all information hereon is true and correct, and that I
have the following legal interest in the property: OOowner of record; 0 contract. purchaser; Dauthorized agent.
I f:.:.rther certify that any and all work performed shall be done in accordancE: \o,li th th8 Ordinances of Lane. County and the Laws of the State of Oregon
.pertaining to the work described herein, and that NO OCCUPANCY will be made of an.y st.rl1cture vlithout the permission of t:-he Building Division. I fur-
.ther certify that registration with the Builder's Board is in full force ond effect as re~uired by ORS 701.055, that if exempt the basis for exemption
.is noted hereon, and that only subcontractors and employees who are in compliance with ORS 701.055 will be use~ on this project. I HAVE READ AND
CHECKED THIS APPLICATION THOROUGHLY.
KAREN LAFLEUR
DROP-OFF
11-16-88
NAME (please print)
SIGNATURE
DATE
READ THIS SECTION CAREFULLY. YOUR AUTHORIZATION ~AS BEEN BASED ON THE FOLLOWING CONDITIONS~
[] PLANNING/ZONING:
Zone
NA
Partition #
Parcel # Parcel Size NA
interior rear
Date: ]J]J-~ RI H D
Minimum Setbacks: CL, front
CL, side
COMHENTS:
Nn SPFr.TAI PIANNTNr, ArnnN RFnllTRFn
~
VII
Installation Record Issued? 0 Yes 0 No
Maximum Depth
~ ~ ........2'0"Oh.' ~.
Dot II~~ 4'.
o SANITATION:
S. 1. #
B. P. #
Installation Gallon
Specifications: Tank
C07lH NTS: ..u~ / ~ 5DS.
o ,~.~~ rJ
o PLANS EXAMINATION: Type Group
Lineal Feet
of Drainfield
Use
COMl'lENTS:
Date:
n
~~u'l ~~ " . II-;;j/
~~PRbV~ BY BUIL~G OFF~L/DESIGNEE (per ORS 456.805(1)) '~ATE
LANE COUNTY DEPARTMEMI OF PUBLIC WORKS LAND MANAGEMENT DIVISION, 687-4061,
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
SRP. RRVRRSE FOR INSPECTION INFORMATION
ro, /. ~')c;;. QQA_
;
~
SETBACKS AND OTHER CONDITIONS OF APPROVAL MUST BE STRICTLY OBSERVED. VIOLATION CAN RESULT IN REVO-
CATION OF THIS PERMIT, CITATION UNDER PROVISIONS OF LANE COUNTY'S INFRACTION ORDINANCE, AND/OR OTHER
REMEDIES ALLOWED BY LAW.
~HEN READY FOR INSPECTION, CALL 687-4065. A MINIMU~I OF AT LEAST 24 HOURS ADVANCE NOTICE FOR INSPEC-
TIO~ REQCESTS NUST BE GIVEN. Have the following information ready: permit number, job address, type
of inspection, when it will be ready, your name and phone number, and any special directions to site.
BUILDING DIVISION:
REQUIRED INSPECTIONS:
1. Foundation Inspection: To be made after trenches are excavated and forms erected and when all
materials for the foundation are delivered on the job. Where concrete from a central mixing
plant (commonly termed "transit mixed") is to be used, materials need not be on the job.
2. Concrete Slab or Under-Floor Inspection: To be made after all in-slab or under-floor building
servi~e equipment, condu~t, piping accessories, and other ancillary equipment items are in
place but before any concrete is poured or floor sheathing installed, including the subfloor.
3. Framinq & Insulation Inspections: To be made after the roof, all framing, fire blocking, and
bracing are ~n place and all pipes, fireplaces, chimneys, and vents are complete and all rough
electrical and plumbing are approved. All wall insulation and vapor barrier are in place.
4. Lath and/or Gypsum Board Inspection: To be made after all lathing and gypsum board, interior
and exterIOr, lS in place but betore any plastering is applied and before gypsum board joints
and fasteners are taped and finished4
54 Final Inspection: To be made after the building is complete and before occupancy 4
APPROVAL REQUIRED. ~o 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 shall be given only after an inspection shall have been made of each successive step
in the construction as indicated by each of the inspections required.
NOTE: All building permits require inspections for the work authorized, such as but not limited to:
A. Block Wall: To be made after reinforcing is in place, but before any grout is poured. This
inspection is required for each bond beam pour. There will be no approval until the plumbing
and electrical inspections have been made and approved.
B. Wood Stove: To be made after completion of masonry (if applicable) and when installation is
complete. Installation shall be in accordance with an approved, nationally recognized testing
agency and the manufacturer's installation instructions.
C. Mobile Home: An inspection is required after the mobile home is connected to an approved
sewer or septic system for setback requirements, blocking, footing connection, tiedowns,
skirting, and plumbing connections.
14 Footings and piers to comply with State foundation requirements for mobile homes or as
recommended by the manufacturer.
2. Mobile home minimum finish floor elevation shall be certified when required by a flood-
plain management letter.
3. Mobile home tiedowns, when required, and skirting shall be installed and ready for inspec-
tion within at least 30 days after occupancy. Tiedowns and skirting shall be installed
per enclosure.
D. Swimminq Pool: Below grade when steel is in place and before concrete is poured. Above grade
when poo:-rs-installed.
APPROVED PLANS MUST BE ON THE JOB SITE AT ALL TIMES DURING WORKING HOURS, THIS PERMIT WILL EXPIRE
IF WORK DOES NOT BEGIN WITHIN 180 DAYS, OR IF WORK IS SUSPENDED OR ABANDONED FOR MORE THAN 180 DAYS.
SUSPENSION OR REVOCATION :1AY OCCUR IF THIS PERMIT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS
INFORMATION.
ANYONE PROCEEDING PAST THE POINT or REQUIRED INSPECTIONS WILL DO SO AT THEIR OWN RISK.
SUBSURFACE AND ALTERNATIVE SEWAGE DISPOSAL SYSTEMS:
1. Permits shall be effective for one year from the date of issuance.
2. Upon completing the construction for which a permit has been issued, the permit holder shall
notify the Lane County Department of Planning and Community Development by submitting the
installation record form. The Department shall inspect the construction to determine if it
complies with the rules contained in this division. If the construction does comply with such
rules, the Department shall issue a certificate of satisfactory completion to the permiti holder.
If the construction does not comply with such rules, the Department shall notify the permit
holder and shall require satisfactory completion before issuing the certificate. Failure to
meet the requirements for satisfactory completion within a reasonable time constitutes a vio-
lation of ORS 454.605 to 454.745 and this rule.
Setbacks - Subsurface Sewaqe Disposal
From: Interior property lines
Edge of road rIght-of-way
Building foundation
Wells. other water sources
Septic Tank
10'
10'
S'
50'
Drainfield
10'
10'
10'
100'
"
.... .........
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ane..{J ..... ........../;;'[JI '?Ji .. . .'Jiq '.' ./
r .-i>urytyH~~~~M~H~~~IJ'!~rtHiy~1251:;~thAY~. .~4ijene; OR 97401
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Please complete all lines inside white
f) ()Jj ~ d fi' '< f.Arp ,1, LAS-: k ,-ur
YUUH UAU~
~ ...e:;4.~ 8rcokda../e. !:V-LYl..ll..P,
yuu;r<Auiltfl:l;;\>
~'pl-inoj;e'/d
CITY c v/
~SMt~,
5tUn-L
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boxes, if possible. Existing Buildings or
/ I IthkR Improvements on
Property
UAII: ~. House
'lLjt&-5~ .~q CJ Barn
HONE CJ Garage
CJ7'-f77 CJ Mobile. Home
ZIP CJ Shed
SEPTIC INSTALLED
E). Yes
I'HUNI: CJNo
Water District
ZIP ;ea.": "L'\j(.t)
-
.,~
License .
,
OWNER OF PROPERTY (if not same as above)
OWNERS ADDRESS (if not same as above)
Hange Section 1/4 Section
lal Lot
Directions to site
from Courthouse
Cobu.r;a R.ead Ie
fltlr!r)/!t E!ic:,-fon lIark'lL
: -/0 PIJI-'.:1.:';unl TUJrr; : t.-f+
: i>f'} fJh~ac;{iI'd. Left'on
p,Y"JIJk.d l.Li~ /lV'!.fr'iJ.L~.
Brei hO!Js:.. OJI I~#
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CUNIHAl;IUH
,
MAP, PARCEL NUMBER
(Found on tax maps In the Assessment & Taxation DepL)
/ 7 C/3 ~~, ~2.. ~P'c.:?
townShip -Hange 5ectlon 1~ s~ctlon ~8X Lot
Range Section 1/4 Section Tax Lot
S 'E ADDRESS~'l./::? /S.n'?..Ib? - ..:~_ .//~~
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97'177
ZIP
MAIL ~MIT TO:
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CITY {
,:.:~
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ZIP
For Mobile Home
Placement Only
Brand
Year
Size
No. of Tip-outs
No. of Bedrm"
License #
"
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STAFFEVALUATlON<i+cOMMENTS1H ...... .. ..... '..
Information Request OnlyofOLLOW,::UP(PartitionISUbdiVISlon..
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TRSVerlfied CJYes. .....NoCJ
Allowed Use ..... c::JYes No r:=:J
;.
Land Management Dlv. staff can
not be held responsible for
evaluations or recommendations
based on false, Inaccurate or
Incomplete Information
lot & Block
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