HomeMy WebLinkAboutPermit Septic Tank 1972-7-28
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SECTION fAX LOT CODE CENSUS T~AtT
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RE~ST FOR SITE INSPECTION Fens
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RANGE
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YES I y-I NO I I
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TH IS 15 A PRE LI M I NARY REPORT WH I CH DOES NOT I NSURE THE I SSUANCE OF A FUTURE
PERM I T. ANY PLANS OR EXPEND ITURES MADE IN REL I ANC!, UPgN WI SJlVORT. ARE AT
OI,IN Ri5K~ /~#"",,~~"'-u~
BU ILD I NG
YOUR
ADDRESS
777 rL ?7l ~"?L~
J~~. NOj4S
,,0 /4 No. 1\CRES
7.-____w/.-L/_ / /' ~ ....-... TOTAL $?...s:-: cJcJ
~-4!4~ ~/.. / ~_/~~<~~ (;~ /~;,"'~" ~
iEL'r;J'H%NO. ApPL I CANTS NTEREST I N, PROPERTY ROPO~ USE '3J ~PE~TY
// -:?1/-.2-2?J7<'J ' /;r'f.:'r/"--- ," A"~.A'L/~
17 ~P'ROPERTY SIZE I LE~ WESS..... !,0}9ffiME""pEC I AL PER~IT AREA URB,..r1 ZING AREA
~ ~Jc:://-17h? /~/L/~.#.h<-<-YES iVI NO I I YES iYl NO I I
~~ Ex IS~ 9-JRUS,TURES I 15 PROPERTY WITHIN ONE MILE OF A 'ctTY?
/ . F~ WHAT CITY? ,. '"AI YES I I NO l:s::::--r_
PROPOSEO WATER SUPPLY ~~ER
PUBLIC I I DISTRICT I I SPRING I I WELL !Xi SPECIFY
PROPERTY LOCATION: (DIRECTIONS1~,"7~:/ ~ ;--:' /f'.4/L ~a.-~-
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APPROVED :/" NOT APPROVED REASON F~ - #' - . r
STATUTORY AUTHORITY
ORS. 431.130 ANa 447.020
AND
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NAME
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COMMENTS:
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OAR 41-020 PAR. 1
'-I INSUFFICIENT LOT SIZE FOR
INDIVIDUAL SEWAGE DISPOSAL AND
WATER SUPPLY.
OAR 41-030 PAR. 1
I-I HEAVY IMPE ~~U5 NON-
ABSORPTIVE 501 .
OAR 41-020 PA . 1
I I WATE TABLE ABOVE MINIMUM
STATE STA OAROS
1-10 ER
YES I
NO 1-
ENGINEERED SITE MODIFICATION FEASIBLE
BEFORE CONSTRUCTION IS STARTED BRING THIS FORM TO THE BUILDING AND SANITATION
DIVISION ANa MAKE APPLICATION FOR A BUILDING PERMIT. IF THE PROPERTY IS A PORTION
ONLY or A TAX LOT, A METES AND BOUNDS DESCRIPTION OF THE PARCEL MUST BE FURNISHED.
EXACT SPECIFICATIONS FOR THE SEWAGE OISPOSAL SYSTEM WILL AEPEAR HE BUILDING PERMIT.
Two SETS OF THE BUILDING PLANS AND PLOT PLAN WILL BE REQUIR .
LANE COUNTY BUILDING AND SANITATION DIVISION ~11 o:~'
"" AUTHOR I Z / * I GN A T7Rl
CSS-32 DATi ~ - /.
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DATE
COORDINATES E
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CENSUS TRACT
SIGNATURE
PDS I liON NO.
CHECKLI ST
CRITERIA FOR DETERMINING SITE SUITABILITY
FOR DEVELOPMENT UTILIZING
SUBSURFACE SEWAGE DISPOSAL METHODS
GENERAL CONSIDERATIONS
1. DISTANCE TO COMMUNITY SEWERS
2. DISTANCE TO PUBLIC WATER
A.
MILES OR
fEET, SOURCE
A.
MILES OR
FEET, SOURCE
3. DEVELOPMENT TRENOS IN THE AREA (SHORT ANO LONG RANGE POPULATION OR HOUSING
OENSITIES) DU = DwELLING UNtT.
A. COMMENT 1 DU/AC~ OR LESS
, 2 - 5 DU/ACRE
, 6 - 10 au/ACRE
4. PERCENT OR NUMBER OF FAILING SEWAGE DISPOSAL SYSTEMS IN THE GENERAL AREA %
A. HAS ENVIRONMENTAL SURVEY BEEN CONDUCTEO YES
NO
DATE
5. PROJECTEO PLANS AND/OR STUOIES FOR PUBLIC SEWER OR WATER IN THE AREA. (tNDICATE
IF AOOPTED).
COMMENTS:
SPECIFIC CONSIDERATIONS
1. So IL CHARACTER 1ST I CS
A. Top so IL DEPTH AND TYPE
B. SUBSOIL DEPTH ANa TYPE
C. MOTTLING DEPTH
D. WATER T ABL E DEPTH
COMMENT
E. FILL FEASIBILITY
,
COMMENT
F. PERMEABIL ITY
G. PERCOLATION TEST RESULTS
M55-26
2.
SURFACE DRAINAGE
#
CHARACTERtSTICS
SWALES
DRAIN~AYS (DEPTH)
<
;
DRAINAGE OBSTRUCTIONS
COMMENTS
FLOODING
3. WATER SUPPLY EVALUATION - CHEMICAL, BACTERIOLOG(CAL, PHYSICAL, QUANTATIVE
A. WATER SOURCE: PUBLIC
AGENCY
SPRING
WELL
LAKE
RIVER
COMMENTS
GEN.AREA
SPECIFIC
SITE
B. WELL DEPTH
C. JOINT USE OF WELL, .(# OF PEOPLE SERVED)
NUMBER OF PERSONS TO BE SERVED
FAMILIES
4. ADOITIONAL AREA AVAILABLE FOR USE IN CASE OF SEWAGE DISPOSAL SYSTEM FAILURE:
No
YES
AMOUNT AND GENERAL LOCATION
5. ACTUAL USEABLE UNOISTURBED OR UNALTERED AREA AVAILABLE FOR SEWAGE DISPOSAL -
EASEMENTS, ORA 1 NAGEWAY5, TOPOGRAPHY, SHAPE, 5 I ZE, SLOPE
A. SLOPE l' /100'
C. TOTAL SIZE OF PARCEL
B. AMOUNT USEABLE AREA
REMARK S :
6. PREVIOUS SITE INSPECTION YES No DATES
7. DISTANCE TO: CREEKS , STREAMS , RIVERS CAN AL S
LAKES , PONDS , OTHER, SPECtn:
8. TYPE OF STRUCTURE AND APPROXIMATE SEWAGE FLOW: SINGLE FAMILY
GPO
MUL T 1- F AM I L Y
GPO,
INDUSTRIAL
GPO, COMME RC I AL
GPO
INSTITUTIONAL
GPO NOTE: SOIL ABSORBTION AREA IN SQ. FT.
AREA NECESSARY FOR SEWAGE DtSPOSAL SYSTEMS
-------------------------------------------------------------------------------------
DATE
REVI EWED BY :
ACTION:
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LANE
COURTHOUSE
EUGENE, OREGON 97401
HEALTH AND SANITATION
PHONE 341.-1311
July 26,11972
M & M Development
1074 Willamette
Eugene, Oregon
Re: Preliminary Subdivision - Headlee
Twp. 18. Range 2 Sec. 5
The Planning Commission has submitted to this department your
major subdivision plat for investigation as to its suitability
for the installation of individual subsurface sewage disposal
systems.
-. The requirements for preparing the site for investigation are -
outlined in the enclosed form. In order that we may expedite
your proposal, please make application for the site inspection
at the Department of Building and Sanitation, Lane County Annex,
135 E. 6th, Eugene, Oregon.
JOHN C. STONER, R.S., Director
Building and Sanitation Divisi'on
~.rv(?J..e~
~: Rubini, R.S.
SNR:rd
cc: Planning Department
enc.
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5 U B D I V I 5 ION
late-#72- Subdivision Name /r(:~;J{t7/-..... Ol~ner of Developer~
wp.-L1LRange Z Section .s-- Tax Lot 2-J...DV Census Tra::t :!--::- 1~____7-A
,creage involved PI Lot SiZ~-=t.5;.tJj70~;t .
Soil Type and Depth'/ A~~. &./VV'-..- .SU9s0IL.4.~ ~V\.J-~/2.U....-
"A. Proble.ms as~oc~ !'it this type of soil ,~ ~';-J/_~~L....I;,nh~~Wl' _
B. FILL F~AsAOI_ITY r . ...... ! / .
Hater table ...--vIAl Depth to r,10ttl ing ~
a. Problem a~sociated with this -
. Drainage-1::"? _ ._1-- -7 Il~ -d~_.d.A.A.-~ -
a. Flood pl a 1 n AA . .
b. Hinter problems' rr ......('\ ~7'-L P'-{~~'" k..v~\.) /1~ 4~
c. Distance to bodies of water- ....~',...:. ~ i_ 0 F-
Problems in area ~_ ~--'-^-'
a. Previous site inspecHons -~
b. Neighboring dV/ellings '/..,
c. Previsou environmental surveys made
,
-
Proposed water source (Public/Private)
a. Projected plan for rltIOlfC I-later "
b. Problems ~Iith this source, if any
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. Projected plans for publ ic SeVier .---yo ~." ." /1
a. Distaqce to sevlers .: ~~
Topography" 4,1 ~ /)~a~\J'I {} . ,
a. Slopes" . Y r\ '\.......-z.,.o-L~
b. Problems with'slopes o~ 25% ..
Percolation tests (if required)
. , ,
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Soil scientist's report requested?
./'V'V'tl
attached?
Geologist reports from subdivision engineer
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In urban service area
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T___. z_ S 5 TAX
C~TRACT 3S'-15"2...,lj
our d1'
LOT z, 2-00
BUILDING SITE EVALUATION
() Building Permit Appl ication No.
APPLICANT:
NAME ~..~ :Vp.//~~#_
ADDRESS /7""'''' a.n//A';"",,#e
EM,,,,,"~
PHONE 39'3- r?37 0
DATE -;? - Z-?"_ 7-r-----
RQ. Site Inspection /0/7/6
() Pre-Permit Investigation
LANE COUNTY PLANNING DEPARTMENT
NOT
app I i cab 1 e
I. Zon i ng Ord i nance Comp I i aJi9l () ()
(Zoneg:::.,.r )
2. Subdivision Ordinance Compl'iance () ()
() ( )
( ) ()
() ()
COMMENTS: }~/~.f u-U'vIJJ1'!.~
( r-'7~
/
1~3/-72-
NO
YES
NAME
DATE
3.
Required Access
( )
( )
( )
( )
4.
Building Site (Area, Width,
Frontage, Setback)
Other (see comments)
5.
,
Pl""~ I/-M"'~
"; ... -
-~_._._..-,.
., ," ..,..~---~
BUILD tNG INSPECTION SECTION NOT NO YES NAME DATE
aDDl icable ~/
6. Plans Subm i tted ( I) ( ) ( ) /
7. Soil Stabil ity (footings) ( ) ( ) ( ) ,r "') ""'--
\ / "
8. Flood Plain ( ~ ( ) ( ) ~I
9. Ot he r (see Comments) ( , ( ) ( )
- \
COMMENTS:
SANITATION SECTION NOT NO YES ~~- DATE
aDDl icable ~ ~/v/) ~
10. Sewage D i spos a I ( ) ( ) >-c.--tAA ,
.
11. Usable Area ( ) ( ) ( )
12. Water Supply ( ) ( ) ~
13. Ot he r (see Comments) ( , ( ) ( )
- >>/1.. .-.A? <2.- ~ ~ /'~
COMMENTS: ~
C' .,?_D ,Y' -~ -
-\. V
TO APPLICANT:
Your
( )
( )
Building Permit I Site Inspection:
Can be approved.
Cannot be approved at this time 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 i~ 6
through 13 contact the Lane Countv BuildinQ and Sanitation Division.
Wil I be held in this office until you can resolve the problems indicated.
Is being returned.
Your building permit application fee is being returned under separate cover.
'.
,..,
( )
( )
( )
LANE COUNTY PLANNING DEPARTMENT
135 Sixth Avenue East, Eugene, Oregon 97401
PHONE: 342-1311 EXT. 231
LANE COUNTY BUILDING & SANITATION DIVISION
135 Sixth Avenue East, Eugene, Oregon 97401
PHONE: 342-1311- EXT. 411
M55-28