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Home My WebLink AboutPermit Septic Tank 1995-10-27 :~PERMIT # '" 353if-Qs- . .~ 1'REQUEST FOR: \II ~Ti7 '03 Septic Repair SE~ 1/4S.4~ 2 T~~O 0 SUBOMSlCN/PARTlTJa'.l LOT/PARCEl BLOCK LOCATIQII ADDRESS 571 Brookdale Ave., Springfield 97477 STRUCTURES NCNI QII PROPERTY House; Shed; PROPOSED USE SEPTIC NSTAUBl WATER INSTAllED NO. Of STORIES NO, OF EMPLOYEES CONSllUJCTION COSTNALUE Res. Yes Rainbow DESCRlPTlCN Of PIlClPC6CIlWORK NO. Of BEORC:lCMS Repair of existing sewage disposal system. DIRECTIONS TO SITE FROM NEAREST MAIN INTERSECTIQII Pheasant & Harlow Road; North on Pheasant to Brookdale Avenue; West one block to site. APPLICANT NAME & ADDRESS William R. Curry, OWNERS NAME & ADDRESS William R. Curry, CONTRACTOR/INSTALLER' BUILDER NAME 571 Brookdale Ave., Springfield 571 Brookdale Ave., Springfield CCSM 97477 97477 PHONE 746-2522 PHONE 746-2522 PHONE ~ MAIl. P.-EflMIT TO: Wllllam R. Curry, ~WME I have carefully read BOTH William R. Curry \II PRINT NAME ( 571 Brookdale Ave., Springfield STREET 97477 ... . "'. ... '''' ..... ..... .. ,... H' BEAD CAREFULL VI CIY 2lP sides of this application and hereby cert~ Jhat all Information is true and correct '(I ~/i/L.::- ~vz.... ~ /cJ - Z7-~ (~' ~ (-UATE On ~h.Fo":~'n~ '~ondltl:~~ ] $ APPROVED BY: DATE ",iii '" ,f" " " "'" '" ,......, '''', "':)" ..' CALL FOR INSPECTIONS (SEE BACK OF FORM FOR INSTRUCTIONS) 687.4065 SEPTIC permits are good for one year. ALL other permits expire after 180 days unless Inspections are current. " LMD 040 Rev. 6/92 I' 4_1'i..'~ ',').1,,1'''''''' '-"'1~;~'''':;;';''"''' IN'" ..... 1::J'.[;.,,,io l1't.'c::!'W'" y ~,.~..:~....~ :"-'--i.'~f.~'''' \~". -~\J''''''''''-''-' . ~.~tV"Vi'--\",\"il"ll"l"~"'"n\"~"."".1 ;' \ -.rM-'''1," '.1"'.)t~~ii~\4;;'. . ., -~r~'!:~'. '1. \-. -. 'r VIOLATIONS SETBACKS AND 0TIIIlR CONDmONS OF APPROV AI.. MUST SB snucrL Y OBSERVBD. VIOLATION CAN RBSULT IN RBVOCATlON OF nus PBRMrr. . crr ATlONS.MA Y. BB ISSUED UNDER llIB PROVISIONS OF LANB COUNTY'S INPRAcnON ORDINANCB AND/OR 0TIIIlR RBMBDIES AILOWBD BY LAW. , . A MINIMUM OF AT LEA~T 24 HOURS ADVANCE NOTICE MUST BE GIVEN FOR INSPECTION REQUESTS Have the following information 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 RIGHT TO TRESPASS ON PRIVATE PROPERTY ORS 215.080 POWER TO IlN'rnR UPON LAND. llIB COMMISSION, AND ANY OF ITS MEMBERS, OFPICERS AND EMPLOYES, IN llIB PERFORMANCB OF llIBIR PUNcnONS, MAY IlN'rnR UPON ANY LAND AND MAKE EXAMINATIONS AND SURVEYS AND PLACB AND MAINTAIN llIB NECESSARY MONUMENTS AND MARKERS TliERllClN. REQUIRED INSPECITONS FOUNDATION INSPECITON: To be made after excavations for footings are complete and any required reinforcing steel is in place. UNDERGROUND l'il'li-l'G INSPECTION: To be. made after;;}l und~ground piping has been installed, prior to any backfill. CONCRETE SLAB OR UNDER-FLOOR INSPECITON: To be made after all in-slab or under-floor building service equipment, conduit, piping accessories and other ancillary equipment items are in place but before any c6ncrete 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 tieing covered~ ROUGH PLUMBING INSPECTION: To be made after all plumbing r01,lg~-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 app<vved. INSULATION INSPECTION: To be made after all insulation and vapor barriers are in place, prior to covering. LATH AND/OR GYPSUM BOARD INSPECITON: 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 Qe made after reinforcing is in place, but before 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 approved. FINAL MECHANICAL INSPECITON: TQ bemac!e just prior to the structure or,remodeled area being occupied and prior to operating any equipment FINAL PLUMBING INSPECITON: To be mRde jUst prior to the buiiding, structure or remodeled area being occupied. FINAL BUILDING INSPEcTION: To be madfi after finish grading and 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 app<v.'ed 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 d~ys 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 a}'}'<v Jal shall be given only after an inspection shall have been made of each successive step in the construction as indica~e<:l by each of the inspections required. , APPROVED PLANS MUST.BE ON THE JOB .SITE AT ALL TIMES DURING WORKING HOURS. THIS PERMIT WILL EXPIRE IF WORK DOES NOT BEGIN WITIDN 180 DAYS, OR IF WORK IS STOPPED OR ABANDONED FOR MORE THAN 180 DAYS. SUSPENSION OR REVOCA nON MAY OCCUR IF THIS PERMIT WAS ISSUED ON THE BASIS OF INCO~PLETE OR ERRONI;:OUS INFORMATION. ANYONE PROCEEDING PAST I DJ!"POINT OF REQUIRED INSPECflONS WILL DO SO AT 1'huA OWN RISK. . .'. . . ". .' . Your signature.on the front of this form verifies the following: I HA VE CAREFULLY EXAMINED THIS 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 property, 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 permit 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 permit hol~er 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 SEW AGE DISPOSAL SETBACKS SEPTIC TANK From: Interior property lines 10' Edge of road right-of-way 10' 'Building foundation 5' Wells or other water soutces 50',~ ". DRAlNFIELD 10' 10' 10' ;.100'.' " ;. .~ I .:. ".,::, . '\ /o'.......:p> , Ib l' f\. 1'1 I \'? \1 44- I "- ~ '~ \' ~b;) -, 'L 't .t' ,~ ~ ~~ .ex i o~; V1 "')..- Z I' ~-r -- -- - ~~ i~\~ P tlrZ .y ~fl,t: ~~ 0'1 f ~ "1' .~.:::.,.. H-()tA ')L l>>; 1\', Ci-wI Cu iZ rl "\ 511 C~WDt(~,i ,"".. i"... .'.. ~ ! --- ..~. ;.. .. ~- , i'.... .:, . "() .k .. "_' .( '~:~,' ...:, . .,,' ~^~ P.. .- ..... ~71 /d .-' , :/ SEWAGE DISPOSAL P~~it~P~~9r~ DATE lQ(~' / BY , ~ ENVIRONM~ ALTH SER ICES . . ~ST 8TH AVENUE EUGENE, OR 99401 .t2~ ~5h\ "--,)r. 31 ti Ill"- i \.-- f --e--c,( I cc.- /0 '7 I' 2-15' -hJ~( )\ , ......... \) N .......... I ~J , ~tHt:~e.. '~J7;::;"v J'f ,121..~(,S. el{ fltfLK- tJ..K-e.. /~~f'-tnha ~n-e ~ ~L c:- gS/ )' " ExIstlng Buildings 01' lm- provements on the PtOperfy X. House Barn Garage Mobile Home ;t:.. Shed SEPTIC INSTALLED? ~Yes _No Water District ~nH0 Please complete all lines inside white boxes, if possible IAJjll~a.lI\A R CuRR.4 YourS?t BfC.ovk k( e 4v :~~f;;j)1S ~ d) 0 y ..5 tW-1 Z Owner of Parcel (il not same as above) 10 -2 7-q~ Date 'lift", - 2 S z 2.... Phone CJ7L/77 Zip Phone Owner Address (il not same as above) ~ Zip MAP, PARCEL NUMBER (Found onu mapa In tho AAeaament& Tuatlon Dept) r7 ?53 z "2- 4z- ~.?Ct:5 Township Range Section 1/4 Section To Lot Township Range Secllon 1/4 SectIon Ta. Lot Townah/p Range Secllon 1/4 Secllon To Lot Site Address b ~ d ( ~ SLJ[..! .?7/ flo l> c.-- e , , < Directions to site from ? ;earest main Intersection ..................... fJ h.. (ft..,) t1url J- ~ #-Ctf'Z I tnv tV. (lon k.. fY\ fA ~Jc-I'. -h /lZoo/L~a) e A-/. f)J~~+ ~ <. 1c1//) v L H ctMYLC:,~ C}7<{77 ...... .. ZlD. ....7... " '.' .... "'.............. ............ ..... ....... . .................. ..... . . . ::::\; .... .... ..... . ~r Mobile Home .. cement Only '.' Bran Year "'-... ""- Name q7l/77 ZIp LMD staff can NOT be held responsible for evaluations or recommendations based on false, Inaccurate or Incom- plete Information. LCPW 149 . '. , ~ ~ r ! I, \ .. .' I [ ~ ~'-- , I ~ 1 .\ : \ i... :t 8 :ll 1M o Si iB: o 1 ~ ~ ~ 8. o ::> I ' iR ~ , Q') rn Z m C/) ill p '" ~ g .. c 3 ~ " ~ ~ ~ '" i _.. .-" COUNTY DEPT ENV MGT RECEIPT 0 353495 DATE .10279_ ADDR 571 BROOK DALE AVE.. SPRINGFIELD ~~~ , LOT BL.I< UNITS 001 STORIESOBLDGS 001 PHONE 746 2522 . ADlm ~;71' BROOI<:IMLE AVE., SPI:UNGFIELD SQ FT U~IT COST VAL.UATION FEE W: 3 LANE l j' t \'t-lPPLIC(.1NT cura<y. WILLIAM ""ru:: 'j 703:~.~24203200 SUBD I V NEW BLDG TYPE USE R BDRMS 0 OWNER NME CURRY. WILL.IAM CODE APPL NO ACTION DESCRIPTION, BP BP BP BP BP PL ~! ~ ~IiIECH r SLm ' PCK :~:FIX/Bf~TH : \ , SDS LC 353495 SDSR SDEQ FEE ADM FEE TECH FEE CATG: PLNRA SEQIj: T AI< EN BY ML.C' Il, f h 'SWR: FT. WTR: MECHANICf~1... FEE STATE SUI:<CHt-.I:;:GE PLf~N CHECK FEE ,FT. F::AIN:. .. FT ~:;A: 2~5% SDS1:~ i 6 ~5., ()i;; 30.00 ,~.~~ ~j .\ ~~ ::> ~5. 00 SDS ELE PCK 1 EST. COMPI...ETfON DATE . J: S' ~;I ;' S1 OTR ..., ~~ DEPOS' I T .jt.jt 2 :~~;i A::.::::> DA'&.S: 3: 8 ~ o 8 ~ ,~ 'II I &. g " m Q m Z m C/) Iii o '" ~ g .9 i [1< ' ~ " ~ ; ~~ i