HomeMy WebLinkAboutPermit Septic Tank 1991-3-8
"
'J
;
~-~~,~~~".~,,-,,~-<
~
RANGE
8ECnON
1/4 8ECnON
TAX LOT 8UBDlVISION I PARnnON
P / ()t)
;;;;Pff~ q7l/77
NO. Of' 8TORIES
NO. Of' EMPLOYEES
CONSTRUCTION COSfNAWE
--p, #-.
PHON I
-,i.f7-0'lOO
PHONE
I' t,
PHONE
- -
) MAIJ....f.ERMIT TO:
RIl!.:H~ (") 411 R~~r
NAME
P I have carefully read BOTH sides of this
1<, (!...1:/A-e D ~-f-
.-. PRINT NAME
~Ol
J
:zt e a~~ correct
. -~-9/
AlE
'" "" 'J
. . .. ...... .
7-J?-7/
""'~-"-"~
!iJWlllfJl!iJt I
/
/
C-7i "/- "3~/
5/~~ ?~~~_
\
VIOLA nONS
SBTBACKS AND OTIII!R CONDmONS OF Al'PROV AL MUST BB snuCJl.. Y OBSERVED. VIOLATION CAN RBSUL TIN RBVOCATION OFnDS PERMIT.
CITATIONS MAY BB ISSUED UNDER nm PROVISIONS OF LANB COUNrY'S 1NFRAcnON ORDINANCB AND/OR OTIII!R RBMBDIBS AlLOWED BY LAW.
.
.
'-~
A Mll\~ OF An lLEAST1A lHIOUlRS AJDV ANCE No'niCE MUST BE iGlMEN fO~ KNSl?':ECTION RlEQ1JJES';;'S
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 BNmR UPON LAND. nm COMMISSION, AND ANY OF rrs MBMBERS, OFFICERS AND BMPLOYBS, IN nm PERFORMANCB OF nmIR FUNcnONS. MAY
"'". "'^ UPON ANY LAND AND MAKE EXAMINATIONS AND SURVEYS AND PLACB AND MAINTAIN nm NBCBSSARY MONUMENTS AND MARKERS TIIERBON.
REQUIRED INSPECITONS ,
FOUNI?A TION INSPECITON: To be made after excavations for foo~gs are complete and any required reinforcing steel is in place.
UNDERGROUND r.u-ll-l"G INSPECITON: To be made after all underground 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 concrete is placed or floor sheathing installed, including the subfloor,
ROUGH MECHANICAL INSPECITON: To be made after all ducting and gas piping has been installed and prior to being,covered,
ROUGH PLUMBING INSPECITON: To be made after all plumbing rough-in is in place. prior to being covered,
FRAMING INSPECITON: 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 "t't'.... Jed.
INSULATION INSPECITON: 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 W ALL: To be made after reinforcing is, in 'pl,ace, but before an.y grout is poured. The inspection is required for each bond beam pour, There
will be no approv'al until the plumbing and electrical inspections have been made and aw.v ..ed. '
FINAL MECHANICAL INSPECITON: To be made just prior to the structure or remodeled area being occupied and prior to operating any equipment
FINAL PLUMBING INSPECITON: To be made just prior to the building, structure or remodeled area being occupied,
FINAL BUILDING INSPECITON: To be made 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 "t't'&~ved 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, 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 at't'&~.'al shall be given only after an inspection shall have been made of each successive step in the construction
as indicated 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 WITHIN 180 DAYS, OR IF WORK IS STOPPED OR ABANDONED'FOR MORE THAN 180 DAYS.
SUSPENSION OR REVOCATION MAY OCCUR IF THIS PERMIT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS INFORMATION.
AmrOW;& l?L'W:ClElEl.DlJING l?A~'lI' TlP~;g l?OlINTI' OW l~iEiQmNlEj]}) lIN~l?JliCTIOW~ WlIILl!... j]})iQ) ~O A'lI' 'lI'lHIElIN O'WW Lorr~r;<.
Your signature on the front of this form verifies the following: I HAVE CAREFULLY EXAMINED TIllS 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 holder 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 sources 50'
DRAIN FIELD
10'
10'
10'
100'
.-' -
'~
~;
~.
,
J
,
(l
J
\
.
---
~/~
~
----~
-
1
H t:> (.A.. S e...
J- .1
I
-1
-
- I
r!errrl?A.J wpt::J tJ
I
I
X,(,'
( Co-rrf)~pLJ
.- -'~
t
J- - ~
CeclnA/,v/A-~
,
&Nn..<hCI/A-t-
L? ~/J'1 ,0-/.P t!:' ~
1 #ft2.1J1'
-
.'
Pleas~omplete all lines inside white boxes, if possible.
'u"" ~d 4JLA'~.e. r
~i6tJ I ~~~~d'",..ev
'U""ke/?fJ>I9,vr #ru-- h
CITY. NA7Vct/ &t?P"e-
OWNER O~O~ERTY (If nof sam. aa above)
~I'
OWNERS ADDRESS (If not same as above)
..(.P..ve.-
~-.p-9/
UAlk
?Y7&:>9~
"HUNt
Existing Buildings or
Improvements on
Property
J:B;;!. House
CJ Barn .-
CJ Garage
CJ Mobile. Home
~ Shed
SEPTIC INSTALLED
IX1 Yes
CJNo
Water District
~A/...v~~
4'7~$~
ZI"
?i:r t!?9~a
ZIP
".:41
CUNIHAI;'UH
License .
,
~
\
J
MAP, PARCEL NUMBER
(F77 tax O~ln :2 7...:mg,~uat'on~iLM
lownsnip Hange 6ectlon 1/4 ::iect1on lax Lot
~/M.
pve,e.
7i:>
Township Range Section 1/4 Section Tax Lot
I owns/lip Hange ::;ecuon 1/4 ::;ecuon lax Lot
~..
;. c;.,p"u ~.D""
SITE ADDRE5J,? ~p
1
!II
~
, ),0':- ~
-, ,
~,e:
9'/7Y'?7
ZIP
. ~
;.
K2:SUL-TS
MAIL~TO: /?
;<6c~.4J G?/-e..-4e~;r-
NAMI;
/~p / /(::/"?~e rr~.
AUUHI;::;::;
~ VU:;' ~
/ /
Mobile Home
ent Onl
1;11 Y
Land Management Dlv. staff can
not be held responsible for
evaluations or recommendations
based on false, Inaccurate or
Incomplete Information
~lan 11111111.
~
~
.
n n I '
.
,-6-
.
.
\
.
.
. .
III
. A~~
. m
. .~
lD
...
n r c
,
. .f
w
0
0-
W
. .!
;..
r ~ ~
~
. .'"
.
.
.~
8
.
~
..
c
e!
~
...
o
3
-
.~
'I I I
.
c
.
-,
~1~'prICANT GILBERT, NANC~ANE COUN!Y D~b~RE~~4gGto~r8~QbOD ~T A ;1 ~~~INB~I~L8~0Agt
. TUI: 1703273308100 SUBDIV LOT Bl.K -.
NEW BLDG TYPE USE R BDRMS 0 UNITS 001 STORIES IBLDGS 001 PHONE 747 090~
. '
NME GILBEFa, NANCY ADDF~ 1340 COTTONWOOD ST., SPRINGFIELD, Q.iE
APPL NO ACTION DESCRIPTION SQ FT UNIT COST VALUATION FEE D~
. ^
. OWNEF~
CODE
BP
. ElF'
BP
, C BP
. BP
LC 71691 SDSV
7~5 A 00
.
(t
~
e:
l
D
~
W
.~
W
o
'1 i:
.~
~
...
PL
. MECH
SUF~
PCK
LR
.
t-FIX/BATH:
SWR:
FT. WTR:
MECHANICAL FEE
STATE SURCHARGE
Pl.AN CHECK FEE
FT.
RAIN:
FT
t-%
_> a
"sa.
.... 7.
o
e
. ~ ICATG: PLN
, J
. SEQU:
TAKEN BY RLH
.
RA
SDS ELE PCK
1
EST. COMPLETION DATE
ISS
':>
'...
/ SI
O'tR
DEPOSIT **
75.00
~
C.3
Q
S
&
e:
o
d
.~
.
.
~, ,
..
.
n~ ~
.
'.
, ,
.....J:-- ~
, J!f.
,.i
", .
.
...,'
.l t
, ".':
.-..... (
.
. .
tlOD
. -.
.
.
. .
~ ~ n. ' (
. .
.
\
\ ....
. .
. ,
.
~nu
.
.
/"
.
I~ 0
.
<->
"
.
.
\,
.
.
.
<_:_._ - _"~._._ - - -':'-_._ _:,_ - _.:--."- - _ _ ---i:---.--"._.:_ _ _ ___:_'._'_ ._"_'"
, '
.
.
.' ~I~'P(~ICI~NT GII...BEFn. N(.~NCV1:~NE COUNTY D~b~,:t~~4~]Gt()'l~~;;8~~b(!JD ~T. ~i ~?I\INBf:~11~L8~01~~~::
"fl :": ~ "70'';('J''''''iI.'';(08~ (.'0' S\P:{I)'[\/ ' I Tr Y.jll< .
.. II I \.. A:.. (\.)"..:. I 'I I. ,. A: . '9 .,.l. .\. ..
, NEW BI...DG TYPE USE R BDRMS 0 UNITS 001 STORIES IBI...DGS 001 'PHONE 747 09'~.
. OWNER NME GII...BERT, NANCY AD DR 1340 COTTONWOOD ST., SPRINGFIELD, ag~
~ CODE I~PPL NO (~CTIC)N DESCFnPTHiN S(~ FT UNIT COST\'/I~I...LJATIC)N . FEE . Dt-.S
BP
BP
,. ElP .
OJ U BP
. IlP
.
PI...
. MECH
("\)1:"
.~ . ,
PCI<
. L.F;:
:~:F I X/B('~TH :
<;'WF" ,
.-" \,
FT. l,JTF, :
MECHANIC(.:,L FEE
STATE SUI:;:CHf.1F:GE
I" I '1\1 .., I,j 1- (' 1< 1'"1''' E"
,,' ,,,(.il~ L -I:~, " :.~,
FT.
FMIN:
FT
I (" "1'.( 9~ <;'D"\,/
... .." I , <:). J I." t,}
-15" (: 0
t" ,\ ,)
.
~ol
.
I:~%
_. It
.'.) 1'- Ul
..:..,)/tJ
.
5~ ~C(':d'G: PLN
.-.. SEG~Lj':
TAI<EN BY I:~LH
,
I=< A
SDS
1
I'"~ ""r
:.S .
FI F pel<
'[ (" "
.. I.') l.).
':)
...
/
,., ]'
s..
OTF~
CDMPLETION DATE
DEPDS; I T ')f')('
')
"
75. ~)(~ eke
.
.
UI
.
'.
"