HomeMy WebLinkAboutPermit Septic Tank 1992-3-31
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PERMIT # / / a-::>
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REQUEST
FOR:
SEPTIC SYSTEM VERIFICATION
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SEcnONO 5 . 21/: 4ECTION
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SU8D1VlSlONIPARTlTlOH
LOT / PARCEL Bl.OCA
LOCATION ADDRESS
1058 CLEARWATER LANE, SPRINGFIELD, OREGON
STRUCTURES NOW' OH PROPERTY
EXISTING SINGLE FAMILY DWELLING, MOBILE HOME AND SHED
PROPOSED USE SEPTIC INSTALLED WATER "STALLED 1'fO. OF STORIES NO. OF ....PLOTEES COHST!'UCTION COBTIVALUE
PRIVATE USE
DESCRIPTION OF PROPOSED WORK
SEPTIC SYSTEM VERIFICATION
NO. OF IEPAOOIIB
t1IRECTIONS TO Ifl~ FADM COURTHOUSE
SOUTH ,LND TO JASPER ROAD,
LEFT,
APpROX.
SIX BLOCKS TO CLEARWATER LANE,
FIRST HOUSE ON THE CORNER ON THE RIGHT.
APPLICANT NAME .. ADD"ES~
EVELYN STEPP,
OWNERS NAME'" ADDRESS
JAMES BRADY, SAME AS THE JOB ADDRESS ABOVE
PHONE
687.,1663
PHONE
726-0865
CONTRACTOR NAME
NA
) MAIL PERMIT TO:
EVELYN STEPP,
, NAME
.
I hava carafully raad
EVELYN STEPP
OSR UCatSE . ,
NA
PHONE
NA
r
707 MAIN STREET, SPRINGFIELD, OREGON 97477
ADDRESS ,
BOTH sldas of this apPII~ca Ion and haraby c:rt,).:,at all Information Is true and correct ~
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<\ READ CAREFUL,~VI
\ PRINT NAME
FEES DUE: $
APPROVED BY:
~ ---- DATE
r-7-77 ---
CALL FOR INSPECTIONS (SEE'BACK OF FORMnFOidli'sTRUCTlONSj 687-4065
SEPTIC permits are good for one year, ALL other permits expire after 180 days unless Inspections are
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current.
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VIOLATIONS
SETBACKS AND OTHER. CONDmONS OF APPROV ALMUST BB STRlcn. Y OBSERVFD. VIOLATION CAN RESULT IN RBVOCATION OPnDS PERMIT.
CITATIONS MAY. BE ISSUED UNDER. TIlE PROVISIONS OF LANE COUNTY'S INFRACIlON ORDINANCB AND/OR OTHER. RBMEDIES ALLOWED BYLAW.
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A MlNIMUM OF AT LEAST 24 HOURS ADY ANCE 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 nwnber - Any speciiU directions to the site
PUBLIC OFFICIAL RIGIITTO TRESPASS ON PRIVATE PROPERTYORS nS.080
POWER TOBNrnR UPON LAND. 1HB COMMISSION, AND ANY OF ITS MBMBERS,OPPICERS AND BMPLOYES, IN 1HE PERFORMANCE OFTIlEIRPUNcnONS,MAY
B.'VI'ER UPON ANY LAND AND MAKE EXAMINATIONS AND SURVEYS ANDPLACB AND MAINTAIN1HB NECESSARY MONUMENTS AND MARKERS nmREON.
REQUIRED INSPECflONS
FOUNDATION INSPECTION: To be made after excavations for footings are complete and any required reinforcing steel is in place.
UNDERGROUND PIPING INSPECflON: To be made after all underground piping has been installed, prior to any backfill.
CONCRETE SLAB OR UNDER,FLOOR INSPECflON: 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 concrete is placed or floor sheathing installed, including the subfloor.
ROUGH MECHANICAL INSPECflON: To be made after all ducting and gas piping has been installed and prior to being covered.
ROUGH PLUMBING INSPECflON: To be made after all plumbing rough-in is in place, prior to being covered,
FRAMING INSPECflON: 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 approved.
INSULATION INSPECTION: To be made after all insulation and vapor barriers are in place, prior to covering.
LATH AND/OR GYPSUM BOARD INSPECflON: To be made after all lathing and gypsum beard. interior and exterior, is in place but before any
plastering is applied or before gypsum board joints and fasteners are taped and fmished.
ADDITIONAL INSPECTIONS MAY BE REQUIRED, such as but noi limited to;
BLOCK WALL: To be made after reinforcing is in place, but before any grout is poured. .The inspection is required for each bend beam pour, There
willJ?e no approval until the plumbing and electrical iJ:lSpections have,been made. and approved. ' ,
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FINAL MECHANICAL INSPECflON: To be made just jJrior to the struCture or reniOdeled area being occupied and prior to operating any equipment
FINAL PLUMBING INSPECflON: To be made just prior to the building, structure or remodeled area being occupied,.
FINAL BUILDING INSPECflON: To be made after fmish.grading and the building, structure or reniodeled area is completed and ready for occupancy.
MOBILEjMANUFACfURED HOMES: An inspection is required after the mobile home is connected to an approved 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 days after occupancy. Ti~downs shall be ins~l1ed 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 approval shall be given only after an inspection shall have been made of each successive step in the construction
as indicated by each of tl}e inspections required. .
APPROVED PLANS MUST,BEON TIlE JOB SITE AT ALL TIMES DURING WORKING HOURS. . . ".
TIllS PERMIT WILL EXPIRE IF WORK DOES NOT BEGIN.l\'ITIDN 180.DA YS..OR IF WOR~ IS SlOPP\lD OR AB~ONED FOR-MORE TIlAl'i,180 DAYS.
SUSPENSION OR REVOCA nON MAY OCCUR IF TIllS PERMIT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS INFORMA nON,
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~ ~',' ~~O~E PROCE~~~.G.~~~?, T~F:~?INT OF REQUIRED INSPECTIONS WILL DO SO A T TlI~I~'Y~ ~~~'.j~, _,~ '
Your signatUre on the front of this form verifies the following: I HA VE CAREFULLY EXAMINED THIS COMPLETED APPUCATION, and do
hereby certify that all information hcireon 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-
tajning 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 701.00S 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 sl'bmitting the installation record
form. Aninspection will be made by a qualified sanitarian. If construction co~pIies with all rules a certificate of completion will be issued to the permit
holder. If cOruf;ruction'do~s not comply with rules,Jh~ pennit.hol<!cr will be notified, and all correction,sshall be made before a certificate of completion.
will be issued:-- Failure to meet satisfactorY completion withih uie allott~'time constitutes a violation ofORS 454.605 to 454.74S'and this rule.
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SUBSURFACE SEWAGE DISPOSAI.; SETBACKS' SEPTIC TANK'
From:
10' '
10'
S'
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DRAINFIEI.;D
10'
10'
10'
100'
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Interior property lines
Edge of road right-<Jf-way
Building foundation
Wells or other water sources
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Please complete all lines Inside white boxes, If possible. Existing Buildings or
~ Improvements on
G;;/.,t7L.j ,,A c..J~ /J1/7/'.30m~: Property
L~"~\. 'to . l. ) . /. UAf'I:. 1;ZlHouse
707 ).--#/j 1/1 ( \#-z/6T ~97-/~ CJ Bam
ft..../. luunl:.~. ",RbN~: c::J Garage
SDr"u tI\ +; <€' /0/ oP 97(/z.z..- ~ Mobile, Home
CITY , -.)' ZIP ~tShed
'0([ ,,\ r;:) a,j, I I_-M'{"S' ~.SEPTICINSTALLED
OWNER OF ~;; I"'" .;",~ .; r....j ~l , , ' j 1f?'f . CJ-::,s
/0s% cl'f' t} /y'( .I J{l fef I.. ");,1'( ~ t?h {J ! tJ/ 5!Z(/7? Water District //_ \
OWNERS ADDRESS (If nol AIM .. aboye) I' - ~. ZIP ( 1 )/ '/ {~ 'hit" ~
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Directions to site from
nearest ml/ln Intersection
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MAP, PARCEL NUMBER
(Found on 10 mapa In lhe MMument . y...Uon Dept.)
T!.f, ~n; ~~ 1/4~Ut IC~
Townahlp ~ 8tctlon 1/4 &.clIO" Ta Lot
lownsnlp ~ DMlllOn 1/4 ~llon 'ax Lot
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X MAIL PERMIT TO: r Mobile Home
&)~tfvf. S+,pT %E1A (lhdes €iit~&drj/I Bem:nt Only
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.,,; <S'(ll'/;A5 h efd.' f1e q~;J77, ~~~~::?\
~r '~~::t,~/rom M~ ~
ii ~ater sew~ ,I
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Land Management Dlv. statl can<"::
not be held responsible lor :::\.
evaluations or recommandations i
based on talse, inaccurate or .:i../"..:
~LM014S1. 2/92 incomplete InformatJon,..::::;L::/::i\
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2.Assessment map and tax lot number(s)
3. Road. Name
4.North arrow
5.Show dimensions of all property lines
6.Locate existing buildings, and identify them
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will be from the nearest property lines
_ 8.Show septic tank and drainfield locations
_ 9.Show replacement drainfield location
_IO.Show location of any water on the property
For example: well, creek, pond, river, etc.
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drawing does not have to be to drawn to scale
BUT MEASUREMENTS MUST BE ACCURATE
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