HomeMy WebLinkAboutPermit Septic Tank 1993-10-7
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REQUEST
FOR:
REPAIR EXISTING SEPTIC SYSTEM
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LOTfPARCEL IILOCK
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lOCATICN ADDRESS
3374 GAME FARM ROAD, SPRINGFIELD, OREGON
STRUCTURES NOW Q\I PROPERTY
EXISTING SINGLE FAMILY DWELLING
'PROI'OSEDUSE SEP'TCHSTALLED WATERMTAU.ED
RESIDENTIAL USE RAINBOW
~OfPROPalEDWCA(
REPAIR EXISTING SEPTIC SYSTEM
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NO.\:lFB.lPI..OYEE:S- CXlNStRUCIl:lNCXlSTIVJ.L.U:.
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DIRECTIONS TO SITE FROM NEARCST MAIN MCRSECnCN
1-5 TO BELTLINE, EAST TO GAME FARM ROAD, SOUTH, 1/4 BLOCK ON RIGHT.
'APPlICANT NAME. ADDRESS
EMMANUEL CONST.,
otiNERS NAME & ADDRESS
TOM ELLIOTT, SAME AS THE JOB ADDRESS ABOVE
CCHTRACTOR !HOT AL.l.EW BUILDER NAME
PI-lONE
746-8351
PHONE
SAME
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PHONE
EMMANUEL CONST.
l MAIL PERMIT TO:
EMMANUEL CONST., 84591 PLEASANT LANE, PLEASANT HILL, OREGON
~ 'turM.. STREET CITY
. ~;~~~~~UI~o:;~ .BOTH sides of thlsa&~~~:bY~~~:~a~ll~f~r~atlon
#36546
97455
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Is true and correct
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( READ CAREFULLYI
Your Authorization Is Based On The Following Conditions
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APPROVED BY:
CALL FOR INSPECTIONS (SEE dtfCK OF FORM FOR INSTRUCTIONS) 687~4065
SEPTIC permits are good for one year. ALL other permits expire after 180 days unless Inspact/ons
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ara currant.
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LMD 040 Rev. 6/92
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VIOLA nONS
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SB'I1IACKS AND 01liER CONDmONS OF APPRQV ALMOST BE S11UClL Y OBSBRVBD. VIOLATION CAN RESULT nrf RBVOCAT10N OPnn5 PERMrr.
crrATIONS MAY DB ISSUED UNDER mE PROVISIONS OP LANE COUNTY'S 1NPRACl10N ORDINANCE ANlWR. 011fER RBMEDIRS AILOWED BY LAW.
A MINIMUM OF AT LEAST 24 HOURS ADY ANCE NOTICE MUST BE GIVEN FOR INSPECTION REQUESTS
Have the following infonnation 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 omClAL IltGHTTO TRESPASS ON PRtVATE PROPERTV OR! ns.oao
POWER TO BNTER UPON LAND. mE COMWIISSION, AND ANY OP rrs MBMBERS, OPPJCERS AND EMPLOYES, IN mE PERFORMANCE OPllIBJR PUNCl10NS, MAY
ENTER UPON ANYLAND AND MAKE BXAMlNATIONS AND SURVBYS AND PLACE AND MAnn'AIN mE NECBSSARY MONUMBNTS AND MARKERS TI-tEREON.
REQUIRED INSPECTIONS
FOUNDATION INSPECTION: To be made after excavations for footings are complete and any required reinforcing steel is in place.
UNDERGROuND PIPING INSPECTION: To be made after all underground piping has been installed, prior to any backflll.
CONCRETE SLAB OR UNDER-FLOOR INSPECTION: To be made after all in-slab or under-floor building service equipmen~ 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 INSPECTION: To be made after all ducting and gas piping has been installed and prior to being covered.
ROUGH PLUMBING INSPECTION: To be made after all plumbing rough-in is in place, prior to being covered.
FRAMING INSPECTION: 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 INSPECTION: 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 MAYBE REQUIRED, such as but not limited to;
BLOCK WALL: To be made after reinforcing is in place, but before any grout is poured. The inspection is required for each bond beam pour. There
will be no approval until the plumbing and electrical inspections have been made and approved.
FINAL MECHANICAL INSPECTION: To be made just prior to the structure or remodeled area being occupied and prior to operating any equipment
FINAL PLUMBING INSPECTION: To be made just prior to the building, structure or remodeled area being oc<:upied.
FINAL BUILDING INSPECTION: To be mad" 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 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 fmished floor elevation shall be certified when required by Aoodplain Management . . .. .
Tiedowns: ifrequired:-malfbe insi~l1~.and're8dy'for'iitspection wlthin 30 oays after occupancy,-'Tiedo~ shill.be ~ianed per enclosure.
APPROVAL REQUIRED
No work shall be done on any pan 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 the inspections required.
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APPROVED PLANS MUST BE ON TIlE JOB SITE AT All TIMES DURlNG WORKING HOURS.
TIllS PERMIT WILL EXPIRE IF WORK DOES NOT BEGIN WTI1JIN 180 DAYS, OR IF WORK IS S .uncu OR ABANDONED FOR MORE THAN 180 DAYS.
SUSPENSION OR REVOCA nON MAY OCCUR IF THIS PERMIT WAS ISSUED (jN THE BASIS OF INCOMPI,-ETE O~ ERRONEOUS INFORMATION.
ANYONE PROCEEDING PAST THE POINT OF REQUIRED INSPECTIONS WILL DO SO AT THEIR OWN RISK.
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Your sig'!:18mre on the front of this form verifies the following: I HAVE CAREFULLY EXAMINED THIS COMPLETE!? 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 y""y",nJ' 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 pennit 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 roles a cenificate of completion will be issued to the permil
holder. If construction docs not comply with rules. the pcnnit holder will be notified, and all corrections shall be made before a certificate of completion
will bc.issued. Failt!fe to meet satisfactory completion Y{.iJ.!lln the allotted time constitutes a violation of ORS 454.605 to 454.745 and this rule.
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SUBSURFACE SEW AGE DISPOSAL SETBACKS SEPTIC TANK
From: Interior property lines 10'
Edge ofroad right-of-way 10'
Building foundation 5'
Wells or other water sources 50'
DRAINFIELD
10'
10'
10'
100'
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Please complete all lines Inside white
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OWNER OF PROPERTY (II nOI aame .. above,
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OWNERS ADDRES8 (It not ..me .. above)
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MAP, PARCEL NUMBER
(Found on la m! In lh. Aaan.lMnt .. Tautlon D.pt.)
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FLOOD' PLAIN
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MAIL PERMIT TO:
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STAFF EVALUATION
....Information . Request'Only. c:J
iPartltlorfTSubdliilslon' Lof&Block
COMMENTS/FOLLOW.UP
'TRS Verifiadc:JYes Noc:J
Allowed Use ..t=JYes .No t=J:;..'
Land Management Div. stall can
not be held responsible for
evaluations or recommendations
based on false. inaccurate or
LMOUg.2/(I2 incomplete Information';
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M14-68 02/92
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Exlsllng Buildings or
Improvements on
Property
eg House
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SEPTIC INSTALLED
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nearest main Intersect/on
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For Mobile Home
Placement Only
Brand
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Size
No. of Badrms
License #
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Distance from Mobile
Home to:
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W: 3 LANE COUNTY DEPT ENV MGT RECEIPT . 365193 DATE 100793
. APF"L.ICANT ELI...HlTT, TOM "DDR 84591 PL.EASANT L.N., PLE:,,,SNT HILL, 01." .
TLO 1703221201800 SUBDIV LOT BLK
NEW BLDG TYPE USE R BDRMS 0 UNITS 001 STORIES OBLDGS 001 PHONE 746 8351
. OWNEF( N~jE ELLIOTT, TOM (.,DDI:( B4~';9; PLEASANT LN., Pl..E!,SNT HILL., 0'.
CODE APPL NO ACTION DESCRIPTION SQ FT UNIT COST VAL.UATION FEE DAYS
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W: 3 LANE COUNTY DEPT ENV MGT RECEIPT ~ 365193 DATE 100793
. APPLICANT ELLIOTT, TOM ADDR 84591 PLEASANT LN.. PLEASNT HILL. O.
TL~ 1703221201800 SUBDIV .' LOT ... ~LK .
NEW BLDG TYPE USE R BDRMS 0 UNITS 001 STORIES ~BLDGS 001 PH.ONE 746 8351
. OWNER NME ELLIOTT. TOM ADDR 84591 PLEASANT LN.. PLEASNT HILL. Oit
UIIUI CODE APPL NO ACTION DESCRIPTION SQ FT UNIT COST VALUATION FEE DA)~
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