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HomeMy WebLinkAboutSpecial Inspection Building 1974-1-22 .' , f173 v REQUEST FOR S IrE I NSPECT 10K ~ S.I. #7Lj-Lj~ -l '. "-1 Block #~ ~\t { In ~ "'~ i ~ "- , ~: I ~ ~~ _ For Office ~ Use O.nly . Rece i~ d bY.' Code d6 ~fI)JS{). -rfLA') C.T. Number Special Permit Area Yes No} Urbanizina Area -,'\ THIS IS A PRELIMINARY REPORT WHICH DOES NOT INSURE THE ISSUANCE OF A FUTURE BUILDING PERMIT. PLANS OR EXPENDITURES MADE IN RELIANCE UPON THIS REPORT ARE AT YOUR OWN RISK. ~.p lE A S E P~I.N T'. . If Subdivision - Name: 1-- a L~I7:4'" 1; &",-,t~AA-"",J7(J.r/~_# b . I v " /7 {).J W iJl?-..,"tue./ C~sI.:Cd Yes)O No Township Range Section Tax Lot No. Owner of Property Owner's Co~sent ?Ja.st;t/.bv' c:::o.....:/te<:/i;,;.:~ ~ No. of Sites / $ /5" 00 Name . ';;'~' i.,fe 3 Y 1114,tk No. of Acres $ Mai I ing Address ~ . ~~;",'r~/Il :o~ ..--#}.1 ./ ~~~~I 7'1 7-4 ? 7/, .X /!T~.~:" &c../~.:"'"'" ~~f';{? Check Telephone #S i gnature of App I icant .Dat"e'/"""d .' $ K.oo Owner )c Seller Proposed Use '/ r / Afpp I icant' s I nterev Buyer of proper~~: ')"'';t'I.e- f7l."i-t~ .a~~'i~perty: Other (Specify): tB-i -~2- C&'4.t~kvv sr 4J(j.""..e- Property Size Legal Access'- Road Name Existing ~tructures on Property Realtor Is Property Within One Mile of C,.jty? Yes y What City? ?.Pv"'.....y.J~ N ; v o ' Proposed Water Supply Publ ic V District: Sp ring' We II 8'k igJ Other (Specify): Property Location (Directions): When Will Test Holes Be Ready? MARK TEST HOLES WITH OUR FLAGS ' II ~)..-/7 ~ . (Date) l3o~j O;.J - c.. Ov to v..:.:J. 5~ Location of Test Holes on Property~ , " Draw diagram of property showing location of any landmarks and relationship of test holes to these landmarks: '-' . #,9~-;.J-;-'-~ ~.. /306 I-o'v~y 1/ --v v/111- h ",. -,,# ~~ MAKE CHECK PAYABLE TO: HEALTH AND SANIT~TION MAIL TO: LANE COUNTY BUILDING AND SANITATION DIVISION, 135 E. 6 th Ave., Eugene, Oregon 97401 C55-55 -l r- :tl:: " , . ,/ APPROVED V' NOT APPROVED REASON FOR NON-APPROVAL STATUTORY AUTHORITY ORS 431.130 and 447.020 ~~ r-0 Vrt~ c..~.) "^" (--- I )'-\-0--"1 IV S' ~O\ ",d Ct ~ J S" ~D" r:; DS ' pit> + pi ct'^- ~V\J:J 11'\: JeJ w~~ rb-..spec+/~--- ;<:;; u.\^.'{'e.J\'st,'c-,onci . lA. """ Vt ( c -e.-F';"'~ I v~: ' OAR 41-020 Par. I Insuffici~nt lot size for (~ individual sewage disposal and ~ I Ie water supply. OAR 41-030 Par. I A'e-~ Heavy imperv ious non- absorptive soil. OAR 41-020 Par. I , Water Table above minimum. state standards. Ot he r Engineered Site Modification Feasibility: Possible Not Recommended \\\\lLQ~ ( \'\,~Authorized Signaturli! . \ ) } () ~') .-"j' I ~- II J_'- . 1 ""f Date \ ' ~' ..\ ':J .'1: # ~ -,,' 0' FIELD INSPECTION SHEET Completed By Sanitarian Location: sect.?-t./ T. /1 R.O :5Tax Lot or Acct. No. Are public sewers available or nearby? (Distance) Are'there zoning or environmental considerations? r ~X~ 9-! Size of property: Are other systems in area malfunctioning? ~ h Is there room for future expansion? PHI (-R/Dt Surface feature considerations: (Explain) Slope: e> Flood plain: Plants: Rocks: Low area: Drainage way: Streams: Water suppl~ and utili ties h c 'b I I 0 0 _I Conunun~ ty water: I\""' Cl \ V'-' 'OLu 1\1 /5"/. Private water: Location: Water lines: Gas lines: Wells on adjacent properties: TEST HOLE RESULTS 11 c /'7. )?\ 1- ( /"") #1 Test Hole I : #2 Test Hole 0" -rd/ 5"4hcj- ioco-;. 0" -6(: 5'7/>41 oa~,: 0" . . Soil Classification (If Known) : Is curtain drain required? REMARKS: (JJ ~+e.r i--Otlu/-e C1.f 6"' %P-f . Interim Form #6 i' , , ! . j: Permit #- "7 '(-/0 1- f).1). - 7 L( LDt 6 0(,A ) c(Oz bk #3 Test Hole .-( ) .5--/1ck! . . PRO.. L BSURFACE SEWAGE DISPOSAL ~Eh Ins er: Complete top part of fo~ signature and submit both copies with application. ~'~~ .2/iJp~, Instal}er's Name bJ.~r;v~ ~ r"V~Crf:..""l e.c" No. Living units Bedrooms .J Septic Tank: Ft. ,from well Inside Dimensions: Length Width Applicant Name Mailing , r,~. i L I I j , \ r' ... I~ . :00 II)) i , i- L [..---"..... .... . I ~ I Steel Ft. Diameter (Exhibi t No. I) I Property Address Lv'l (, 13 j"v/t ' :1 Baths Basement Yes_ NoL Permit No. 1 ~ q-LcIt~' 1; e.-'/;'v/''uoY Water Supply Community, Public ~ Other-List 2- Concrete XJ No. Compartments Gal. Capacity .1 c?J~ 0 'Tile Disposal Field: Distribution Box: Yes _ No_ Other Distribution - Type Depth t) -i?~t:~ e-.. .'f f t.4-,._-'h"'..... e. ,r t ,.,.. " Feet from Well Lot Line :Front ((;, Side'~ Rear 10 Ft. betweenFilter'. ~'lter.'6ePth Filter'D-ePth I ' -- '21 . i( ove "" i be ow . . 1nes;, Type -?'f .Ie" n. tl. e 6 1n. Foundation /0 I Ib2.~' ..1,...-+ .....,:,..., , I / ,.. I, 10 : .'- : ! "/1 I ., .,~ ...."..-..' _.... 1 l L 21 [j 1. i "h1c. i "" , Address 5" ,J; a ,All:':-~:' .., "'.~, r~.. " ...' . Length of Lines' - Ftf Trench Total sq. 1. fli 2.~.r 3 .~{ 4.~' 5 .i>( 6. s-< Width 2.. ft. Plot PI, a.n (~ee instructions): , 1 I . I II i, ~,': [,.. , ...+,,--i- ,i .. t .. I r ! ~ - ' ~~ ~ ' ! ~.. : ~ 11'1 I' '~ I -K" I ! I ~,. I ~ /... ~... i ~'" \... f... !..,. .!~, 'f ~ ~I~ ~ :!.. ... . -~ .t---~ I L' i fl. i iT T f () .! I ~ 1'1 I i I ~. j_ I 1:.. ?1~r' ~ ., - - ~'~,.. _..l ~ 0/: ~ ~:~-~Jo; " ! I I """" ".1i.l~';/,~ ( ~ Q., r 1 r"~- ;0--. I'.' -~. ?,U L".;)( Q, ... ~ - 11,.. ~, ~I. f~O~ ~-- ..._.L, I ____~AIU,I, I ~I I ! ),/ ~ , ( [' 'I r ,; /P ,3-01.;,,' I I I I I I I Date . j::~ ./, , /f""~ I i 1,1 ~ ",. -. ' ~, ~L ~T"="- ~ "~ ,::) ~ ~ I !1' ~:t:~ .. ~/~ I ~~ 01 i .) ~' . "'.~ to j .". " ,m . l- ID >- t)l, ':) Cl) ~ I.U I- z <( () 1.1 I I, ' ; ..-- -.. r .-.. I I I -:t / . =,0 , , I 1" !:s:> ,0 ,-1(, ~ ......-.--1 'j--'-.-- ,'~ '\ r .../ ; " ')O/_~ ...._,,.J / 1S=>- "'") .---- ;% ... oo~ Signature , . /,,-,,, 5' 0" "..scAL..i""''''''-c:.. -... '...,c;) ._~',.." ".,..,",..",'...."..-....,,",.-., T~z::<.J~ _ ~ For Sanitarian Use Only: CJ Approved: System Installation Conforms to DEQ Rules for Subsurface Sewage Disposal o Disapproved: Does not Conform to DEQ Rules for Subsurface Sewage Disposal Date: Remarks: State of Oregon Department of Environmental Quality Sanitarian's Siqnatur.e t ..~-im Form #2 . BUlLDI~G' SiTE EVALUATION . JYCHo , ) Bu i I ding Permit App I i cat ion No. .!>K Site Inspect ion 7 '/-'/6 ( ) Pre-Pe rm i t Investigation LANE COUNTY PLANNING DEPARTMENT NOT app I icab I e I. Zoning Ordinance Compliance ( ).. (Zone rR _ ~ ) 2. Subdivision Ordinance Compfiance () 3. Requ i red Access ( ) 4. Building Site (Area, Width, ( ) Frontage, Setback) 5. Other (see comments) ( ) COMMENTS: '/ I Pl/~ n-1~ ~ 'if T /7" -.S:L S 'Z t..j TAX LOT CENS\,. rPj\f.T . 1ST fidei. tv C.a I7le.r 6l//v 1I ( G~3 APPLICANT: hi ..j./ /' NN1E 1M . O//'fr" CtWlf L-i.JfJ .. ADDRESS PHONE DATE J-:l y..:.. 7Y NO YES DATE NAME. (,.y" (~ (~ (~ ( ) ( ) ( ) ( ) () () ~S t/ tf/ (1 ~~~- .GV / - ;;;J.. 5"'- 73 ~""'A BUILOfNG INSPECTION SECTIDN NOT NO YES NAME DATE aDD I ".cab I e 6. Plans Submitted ( ) ( ) ( ) 7. Soil Stabil ity (footings) ( ) ( ) ( ) 8. Flood Plain ( ) ( ) ( ) 9. Other (see Comments) ( ) ( ) ( ) C:1I~L /-31 - 7 l./ , A COMMENTS: V NOT NO YES aPD~i)able(~ (~ ~.(~ () (/ ( ) ( ) 13. . Other (see Comments) ( , () () COMMENTS: ~/6 f P74v...."r[.A..b~'-7f-.e.r) w;fk S-l~, ih50ec.:.f..n,~- Cfr>.e./ rh~ -Wr-fl-. Y")'\,'">+ CtcC-f:r:,Tq..lle.. v nu \, ~ \. ' , ,I '(>' '\.. ,,,.;' SANITATION SECTION 10. Sewage D i spos a 1 11. Usable Area 12. Water Supply TO APPLICANT: S2~~~~our ~~ 8u- rw \~ ill~ 1-12-7t--( ~/;L//7L( DATE r ~ t.{ h rec...Il .s,l ~ Building Permit / Site Inspection: Can be app roved. Cannot be approved at this tim~ as indicated on item NO. \) above. Questions and further information on items I through 5 contact the Lane- COUNTY PLANNING DEPARTMENT. Questions and further information on items 6 through 13 contact the Lane County Buildinq and Sanitation Division. Will be held in this office until you can resolve the problems indicated. Is being returned. Your building permit appl ication fee is being returned under separate cover. ( ) ( ) ( ) LANE COUNTY PLANNING DEPARTMENT 135 Sixth Avenue East, Eugene, Oregon 97401 PHONE: 342-1311 EXT. 231 C55-28 LANE COUNTY BUILDING & SANITATION DIVISION 135 Sixth Avenue East, Eugene, Oregon 97401 PHONE: 342-1311 EXT. 411 '--'{,;.:l~!;~.i. ~~ L U:.. (.-/ c.~ ':.::- )'O.cU... U.0.:JA:.~~tA.../ .. . j .~ ("~-' -~"'... ('t~f'!)n ~1~'l~r) I':" ~:1-~:'=)n (;- rrr f\t?"(~ . ~1J:J c;~ 1:1' . ',' .. . Surname Twp' ./. '. Name and Address , ). '--c:.-- ~ ~>"r't()"':"'r~1 'ir nt ") 5~;;;(~ -~G.di ...;-<:-.r ~:,/" . <)._fl- C)lf), ~i ~ -;. ,\",ryx-f: ry r~~ ~~ trt r;,.....;-C", f.. Section;) ,. Tax Lot Code ~ ry;~-^':-~" .., -" ..::;J / ..:.7.:c:-' u ,t:'-.,,/ I 1...../ / /v-- .'.0 Census Tract n,;:~ Range .. Receipt No. IDate " ,. _fiPt"iltr;L.":-.";,1 ~>..~ '~()?g~ ~:~~(', ~"'~110'" ~"'rfiI"" ~ . Owner \ Owners Consent Yes \1 No :~\ -p . REQUEST FOR SITE INSPECTION THIS IS A PRELIMINARY REPORT WHICH DOES NOT INSURE THE ISSUANCE OF A FUTURE BUILDING PERMIT. ANY PLANS OR EXPENDITURES MADE IN RELIANCEUP9WTHIS REPORT ARE AT YOUR OWN RISK: t1eg\<:i?1vQr to['iJ5\c7'lDC~ hJi1I I!;o. ~ :Ii ~ e; , V)(u) No. Sites $ No. Acres TOTAL $ R~.;f)T:: 4o~4 f,4t: P fR1 5r'l7' CAGY p n TI rc;L {fi)ri'!:>llfj~'Mf11 Telephone No. 7b.i7,..,("J~"?TI Property Size Applicants Interest in Property Proposed Use of Property l!'R;f?I\\':-r.> ",h, Hr'; C;v 1,..7.l K II ~# tflr-q,.", ~ n ~ .Site Urbanizing "Area Yes No ~I of a City? Yes \1 No !fIr'llm!')'" ~ ~ 1/1',"1] ".. Legal Access - Road Name Special Permit Area Yes No ~ Is Property Within One Mile What City? ~~ri't~~~tmTI~ other Specify Existing Structures I'J~'71n Proposed Water Supply Public v District Sprin~ Well Property Location: (Directions) .~,..' APPROVED 'nf (See Below) NOT APPROVED i~;i~:,i".OTHER>'H." i': r;, ~"'.""l' . ,'- ..'"0,....< REASON FOR NON-APPROVAL STATUTORY AUTHORITY ORS. 431.130 and 447.020 5i~G m~o~g m~~Nm~ID 5~0~0 ~t~~~Drdg ror Sow@ge i))i5['@S@U Sv~~em'l. OAR 41-020 Par. 1 Insufficient lot size for individual sewage disposal and water supply. OAR 41-030 Par. 1 Heavy impervious non- absorptive soil. OAR 41-020 Par. 1 Water table above minimum State Standards. other Pl@t ~IGn Dubm~teGd ~~th I!to Ingp8ctlon 15 MnrG~Ui$tic a~d ~heref~rG ~~~CCG~~ob~e. Engineer~d Site Modification Feasibility: Possible Not Recommended: BEFORE CONSTRUCTION IS STARTED bring this form to the Building and Sanitation / Division and make application for a building permit. If the property is a portion only of a tax lot, a metes and bounds description of the parcel must be furnished. Exact specifications for the sewage disposal system will appear on the building permit. Two sets of the building plans and plot plan will be required. LANE COUNTY BUILDING AND SANITATION DIVISION 135 EAST SIXTH AVENUE, EUGENE, OREGON 97401 ~ /J1J) A ^" .,.?:_/)J..., ..ll...lJ -"'::Y - Alitnorr:Zed s.:rgna-L)i're .~ ~ ~ ,.....' v -,' ,/1' ./ .n::?\r.'~'.:;',ii"U t 1, ~ C)'ib. Date C55-32