HomeMy WebLinkAboutPermit Septic Tank 1988-8-22
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Lane County Authorization for:
SEPTIC INSPECTION FOR LOAN REVIEW
FOR OFFICE USE ONLY
Apphcatwn"-7? 00'. ('/rV
Perml t # .-.,/~ -J ~ ~ - /f 6
~ :-0'1'1 ,SHIP
RNJGE
SECTION
18
02
06
12 I TA 3~~~ UOUT OF
! LOT/pr~r\(::::" I BWCK
I
I :01,Of'DSED us!:: OF PROPERTY
~ Re'>ldentlal D Industrlal
-I 0 Con.merClal 0 PubllC
S~BDIVISION/PARTITION (~f appl~cable)
LOCArIO'T ADDR1:.SS
SfkEE:.T
II ,
ZIP
3733
Cherokee Dr~ve
Sprmgfleld, OR 97478-6436
S?RUCTURES CURRENTLY ON PROPERTY
SID
lJiRECTII.)i'lS TO SITE
East on Jasper Road to 37th St
North by Douglas Garden School, nght on Cherokee
Second house on r~ght s~de
J:SCRIPTION OF PROPOSFD WORK - Be SPCCI21C
Septlc Inspectlon For Loan
= OF BE~ROOMS I fI OF STiR1ES I F 01 E:.~';LOY!:C~ ~
Q,,'"'\jER' 5 NAME AND ADDRESS
DECLARED ~ VALUE
\.JA1'ER ~UPPLY
Corrnnlmty (Rambow)
Lmc1a & Kenneth Tomberlm 3733 Cherokee Dr~ve
CONTRACTOR'S NAME AND OSR ff
Sprmgfle1d,
o Proposed
t><J,Exlstlng
TELEPHuNE NUMBER
747-0181
TELEPHONE NUMBER
?:::RNl'l' TO BE MAILED TO tNAME AND ADDRESS)
TELEPHONE NUMBER
Jlffi Weese 200 E 11th Eugene, OR 97401-3247
683-5332
I HAVE CAREFULLY EXAMINED THF COMPLJ:T!:.D APPLICATION tOR f!:.RMIT dilJ k h"I:"t.' cettlf, thJ.t all lnfOlOl1atioll hereon i5 true and correct and that I
have the follow.l.ng legal interest l.n the property Downer of n..u.Jld 0 CC,h"'l 'j( L J}lrcha"Lr ~uthor~zed agent
I f _rther cert~fy that any and all work performed sh..d 1 be. done In a(.L.<hU" H ~ '" l ::IJ tit. ')~d.lllclnC~~ of Lam. County and the Laws of the State of Oregon
pLrtaln~ng to the work descrlbed hereln and that NO OCCUPANCY 1>111 bL .::!('2 0(" 5 r Ktllle ...ltbout the pClllllsslon of the BUl.ldlng Dlvlslon I fur-
ther cert.lfy that rcg1strat1.on wl.th the BU11der's Board 1.S ln fIlII torcf' Ind effect <'IS re("u1rcd by ORS 701 055, that lf exempt the bas1s for exempt10n
1.S noted hereon and that only subcontractors and employees who are In compllanco wlt~ OR~ 701 055 W1.1l be used on thlS proJect I HAVE READ AND
CHECKED THIS APPLICATION THOROUGHLY n ~
Jlffi Weese ~ \bAA ~~~--L-- a.~- .?7/'yP?
NAME (please pnnt) r / SIGNATURE ? DATE
READ THIS SECTION CAREFULLY
YOUR AUTHORIZATION 'iAS BEEN BASED ON THE FOLLOWING CONDITIONS I
[] PLANNING/ZONING
Zone
Part1.t~on #
Parcel #
Parcel S~ze
M.l.n~mum Setbacks
C
L, front
CL Slde
J nter~(J~
rear
COM.'IENTS
~EPTIC INSPECTION FOR LOAN REVIEW--NO SPE CIAL PLANNING ACTION REQUIRED
Date 8/22/88
~
~ ~ANITATION S I #
Ins talla tJ.on
Spec~f.l.catJ.ons
B P
Installat~on
Record Issued? 0 Yes 0 No
Max~mum Depth
... of Trenches
Gallon
Tank
LJnE._al Feet
uf IlJdJ nf.l€ld
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Date /'<IJ - 2-.5"- 0 y Ii
COMHENTS
[] PLANS EXAMINATION
Type
Group
u,.
COM}lENTS
Dale
n
~&!a- // ~/()-;;1-J'-IrV
PERMIT APPROVED BY BUILDING OFFICIAL/DESIGNEE (oer ORS 456 805(1)) DATP
LANE COUNTY DEPARTMENT OF PUBLIC WORKS LAND MANAGEMENT DIVISION, 687-4061,
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
SEE REVERSE FOR INSPECTION INFORMATION C 14-2~ RR4-
..
SET3,C"S 1,"0 OT":, CO "~TIO;;; O~ ,,"'PRO" I "U<'T BP STRIC~ ~ O"::oSt{'::::D VIOLA-IOl C,,\ q~::'IJIT I'l RE\O-
C -10 OF -'liS ,> <. Hi C1- ,TTO L D::::R PROVISIO"S 02 L....:": ~J'- 1\ ; I'-rll.iCTIO'J orDl -.....C< I,D/OR O-'IER
REIEGIES AllOWED Bi LA..
,d!:." RE".D\ ~OR I Sf'Cl ~IO C\~~ 687-..06J i "I'll \1..' Or ,~ L:"ST 2~ 1l0LRS iD1.-, ~E '\01'1CE rOR I'JSP!:.C-
'i 'U ht.',.'\.:..o, ~ ~~T t.J!... CIVL -t..l-----elrJ.:--olloW.l'lg 1"1 O""13~ 0'1 '"eadv "",(H1l1t n\Jmb,-r Job ac'drcss type
01 ln5p~ctlon when ~t wlll be ready JOUt ~amc and ~~o-c ~~"1ber ~)~ a~\ s-cclul ClrectlO~S to Site
BJILDI\G 011;1510'J
RPQUIR=~ I SPCCTIO"S
Foundatlo~ Inspection To J~ mad~ after trenches are
r<ltcrl,ls ~Ol t'1f..- to,..mdatlon drc llcl1-vcrcd on th2 ,ob
plant (commonly t<:nmed trans~l mixed) 15 to be u;ed
e^Cil\~Lca afl(' for'llS LrectC'd am' wnen all
\herc concrete fro~ a ce~tral m1xlng
Mater~als need not be on tne Job
Co~crete ~laJ or Under~~loor Ins~cctlon To be mace dtter all lo-slab or unoer-tloor bUlld1ng
se""l_e e,ul[l"nent, CO'1C\_1: p1,Hng ilCCcssorles d'1C' ot'1er a'lCl11ar~ equ1pment 1tems are in
place out be ore any concrete lS poured or floor sh~atb1'1q lnstalled lnclud1ng the subfloor
Framlnq ~ Insul~t1on Insnectlons TO be made a~ter the roof all framlng flre blocklng and
brac_'lg are 1~ Jldce il'1d all plpes, flreplaces cr1~neVS and verts are conplete a'1d all rough
elect.r1cal anc plunbl'1g are aoproved All wall 1nS\..lat~on ane. \a:Jor bdrrlcr are 1n placc
Lath and/or G\osum Board Inspect10n
a'1d e~rIOl:~l'5ln nlace but :'a..tore
<1'10 rasteners are taped and flnlshcd
To be made ar~er all lathlng and qypsum board nter10r
any plasterlng lS applled and oe:ore gypsum boa~d J01~tS
F~nal InS.Jectlon
TO be made after the bUlldlng ~s complete and before occupancy
ApPROVAL RSQJIRED lo ~ork shall be done on any Dart of t~e bU1ldl~C or structure bevond t'1e pOlnt
1nd1cated 1~ each success~"e ~~spect1on w~thout fl~St obta1nl'1g the approval of tne bU1I~lng off~c~al
Such aop"oval shall b~ gl,eo only after an 1nspect~0~ shall have been made of each succeSS1ve step
~n the caostruct~on as lndlcated by each of the lnsoectlO'1S ~equl~ed
'<OTE All bUlldlng oermlts requ~re ~nspect1ooS for tne ,",ork authorlzed such as but not ll'\l~ted to
A BlOC" I-Jall To be made a+'ter re~nforclng 1S 1'1 plaCG but befo"e any grout ~s ooured ThiS
InSPect10n ~s reoulred tar each bond beam pour There wlll be '10 approval unt~l the plu'\lbl'1q
and electr~cal lnspect.~a'1s rave been made and apDroved
B ~ood Stove To be made after complet~o~ ot ~asonr (If dopllcable) and ....hen lnstallat10n 1S
compl~ Installatlon shall be 1n "lccoroance ....ltn a'1 aooro\ed, '1atlonally rec..og'11zed testlng
agency and the ManutacturGr s 1nstallatlon 1nstructlonS
C 'loblle Home An .ns~ect1on lS requlred after the mob~le home lS connected to a'l ilPpro\ed
sewer or sept1c s~stem tor setoacy requlrements olocklng tooL1ng con'1ect~on t1edo....ns
Sh1rtlng and plumblng conncct~ons
Foot~ngs and plel:S to comply w1th State foundatlon reqUlrements for moblle homes or as
recommended bv the nanutacturer
lob~le home mln~mum fln~sh floor elevat~on shall be cert1f1ed ....hen requlred by a flood-
plaln ~anagement letter
\lob~le home tledowns when ~equlred and ""lrtlng shall be lnstalled and reaay for 1nspec-
tlon wlth~n at least 30 days after occupancy T~edo~n~ and s~lrt~ng shall be 1nstalled
pel: enclosure
D
SW1mm~n9 Pool Below grade when steel ~s 1n place ane before concrete ~s poured
when pool-rs-~nstallcd
Above grade
"PPROVED Pk,S lUST BE ON T'1E JOB SITE AT ALL TIMES DURI'.JG \-JORKING hOURS ':'IlIS PER..~nT WILL EXPIRE
IF ~ORK DO~S ~OT BECI~ wrTHI~ 180 DAYS OR IF WORK IS SlSPE'<DED OR ABA~DONED fOR ~ORE 1HA~ 180 DAYS
SUSPENSION OR REVOc..."TION lW OCCUR IF TillS PFRcnT WAS ISSUED 0" TilE B"SIS OF J~COMPLETE OR ERRONEOUS
I'lFORMATION
A~YONE PROCEEDING PAST THE POI T OF REQUIRED INSPEC~IO S ~ILL DO SO AT THEIR OWN RISK
?UBSURfACE ~~D ~L~ER~ATIVE SEhAGE DISPOS~L SYSTEI1S
Perm1ts shall be effect1ve for one year [rom thL ~ate of issuance
Upo'1 co~pletlng the corstruct1on for Wh1Ch a parmlt has been 1ssued the permlt holder shall
notlfy the Lane COLnti Department of Plannlng and COmmun1ty De,elopment by subm1tt~ng the
Installatlon record form ~he Department shall 1nspect the construct1on to determ1ne If lt
compIles wlth t~e rules contalned 1n th~s C1v1s1on If the construct1on does comply w~th such
rules the Department shall l'"sue il cert1flcate of satlsfaclory completIon to the permit, '"older
If t'le constructIon (loes not compli w1th SUC'l rulLS the DC',)artment ~Ihlll notII,. the p,-.rm1t
holde~ dnU shall n..'1ulre satIsfactory complet1on before 1ssu1ng the certltlcltc Fil1lure to
'\leLt t'le reqUIrements ~or satlsflc..tory complct~on ~lth1n a rCilsonable t1me const.ltutes d V10-
latIOn of ORS 454 605 to ~5~ 745 and LhlS r~lc
~e~b<lcYs - Subsurl ..c.c S~,;,,<!!:. D,spo<;al
...,t~~lor propcrt, l~ncs
Fr'jE' o~ rOld rlC;1 t-o[-way
Bu~lulnQ G 1Or;',~ on
~Jlls other ~~~~r sOurces
SLptlC "'~n~
10'
lD
5
'0'
Draln~leld
<~O"l
]0'
]0
10
100'
6P-~t:J51
" "-. ,nE
, Bounty
-
ACTIVITY INFORMATION SHEET
I1\IlD
,"Nt, ...~..~ ...,...... n ~ ,...
U~n __ ... ......~~
Please complete all Items above dotted Ime
FILLING OUT * LINES WILL GET YOU INFORMATION ONLY
*DATE
I
I
* PERSON
MAKING '1/~ LUet'5.e
REOUEST -J
ADDRESS 219<9 .E. If 1-4
CITY E (J foE'I1JF
j
TELEPIIONE (BUSL!i'lSfo7'ii'l (HOMEI
* PROPERTY ADDRESS
OR
MAP & PARCEL NUMBER (Found on lax maps In the Assessment & Taxation Depl)
STAFF WILL DETERMINE_
?~ (r-/5 ~r/?
Zoned Flood .Pla-m
STATE oft
ZIP Q7'!CI / CITY
~NE (BUS)
ACTUAL
PROPERTY /' I
OWNER LII1cI'1
ADDRESS ~;r:3~
S P FL j)
~ #11/JP!h -JC;lhj~/I1
Chp/'Oke D.
STATE CJ,{} ZIP 975/7(1
(HOMEl 7L/7-1'J/8/
If
();L
06 V 3000
Township
Range
Section
Tax Lot
Township
Range
Section
Tax Lot
Zoned
Flood Plain
Township
Range
Section
Tax Lot
Zoned
Flood Plain
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP
ACRES 3-4e&( ~~~
, ~-/4?~-d
//ls..oe c I-- <;;e/O he
fJ:
J
*REQUEST(descrlbe what you want to do) ?lehlse
HIZ 1=11 A- L C4//1 q.t:Jp/, OUc,/
~ 1l'Y/J
11;yV1/tr -
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_ El4f'OT c//1/ J/k;~Ejf! Ie:)) TO 37 -f-L, g T
DD'-i<:/t:i s Gr.-de", s~4oo I r1"j1, f- 0/1 Chf?fOk~e
/.),.-, . r- I";A. -f- h~"c! ~ Ide ~_iJ-,,-.. .
SF[)
Directions to site
clO No te. +1, 11 '-'
_g.,f't<m rI /-,,,,,,,", ~
....................Staff Use Onry....................
Comments:
Land Management DIvIsion, Public Works Department 125 E 8th Ave, Eugene, OR 97401 phone 687-4061
ft}61- -+17 Sct+le /
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