HomeMy WebLinkAboutPermit Septic Tank 1986-6-18
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Lane County Author~zy.tion-for:
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FOR OFFICE USE ONLY
Application/ ,,~~~ ~~
Perm~t i /C 7' (7 b
I (!J:t, ~ Z ) T~pOUT OF
I T'oT/PARCEL I BLOCK
3!5'~/RES~/-7? ~~ ~(~~~~27 ~
STRUCTURES CURRENTLY ON PROPERTY~ . 1.........-: ..// ~
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u~PTION OF PROPOS;o WORK ~c.-3PECIFIC / / /_ / J DECLARED:;; VALUE
...:J~~/J(-, , ~ 7J~ re~~...:;-q~?4'';./'/~A?- L..67~
" OF //1 ~ [' OF ;;;74 I' O:;fk' I "ATER SUPPLV ~.6"vr.v' ~~~~~~~~~
O~'~E AND ADORE/..,.............( /. ~~.....__ ~, -r- /7 TE;;:~ONE NUMBER
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I HAVE CAREFULLY EXAMINED THE COMPLETED APPLICATION FOR PERMIT, dr,d do horQuy cett.ify t.hat all infol"'lllation hereon is true and correct, iIlnd that I
have the following legal interest in the property: Downer of record; 0 contract,. PllrChaser~uthorized agent.
I f'..:rther certify that any and all work performed shall be done in accoI:dance ....i th the Ordllldnces of Lane County and the Laws of the State of Oregon
pertaining to the ....ork described herein, and that NO OCCUPANCY ....ill be made of ar,y structure ....ithout the permission of the Building Division. I fur-
ther certify that registration with the Builder's Board is in full force feet as required by ORS 70t.055, that if "exempt the basis for exemption
is noted hereon, and that only contractors and employees who are in ompli ce with ORji701' 5 will be used on this project. I HAVE READ AND
CHECKED THIS APPLICATION TH '
~ /r/P??NAMi c:t?/ !f&~ 0-~~ fit
roW;~SHIP / tf' I RANGE
S;JBDIVISION, a.,'\u......ON {if applicable}
t:J~
PROPOSED USE OF PROPERTY
~eSidential 0 Industrial
O~ommercial D Public.
c::.c7-./ -
1/
Minimum Setbacks:
COM.HENTS: ~
/ l' /~
YOUR AUTHORIZATION ~AS
Zone ; / / ~ Partition It
, -"
C C . d
L~~/;?m;;;' e
BEEN BASED ON THE FOLLOWING CONDITIONS!
READ THIS SECTION CAREFULLY.
,
Parcel Size H'~
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Date: h--/f~v~
Parcel It
[] PLANNING/ZONING:
-
interior
rear
rY'SANITATION: S. I. II B. P. It Installation Record Issued? 0 Yes 0 No
7' . Installation Gallon Lineal Feet MaXl.mum Depth
Specifications: Tank of Drainf1e ld of Trenches
C""IENTS, ..:J.J^SL./~~fl-~~~~~~-
_J;;tJfu ~. b..__"t.~Mi>A..fL'.i-~:te' t ~Jo~A ~
ON: Type Louo Use
COMl-lENTS :
Dale:
n
....
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~RMIT APPROVED "BY BUJJ.:!f/NG otFICIAL/DESIGNEE (per ORS 456.805 (1)) - DATE
LANE COUNTY e9PARTMENT OF PUBLIC WORKS LAND MANAGEMENT DIVISION, 687-4061,
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
c:pp PPUPPC:P H'f1P TlI..TC:OP"''''Tf1M TlI..TPf1PMn.",Tf1T\T
.
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SETBACKS A~O OTHER CO~DITIO~S OF APPROVAL MUST BE STRICTLY OBSERVED. VIOLATION CA~ RESULT IN REVQ-
C':",10:, OF ,illS PERmT, cnAno:. UNDER PROVISIONS OF LANE COL'::TY'S INFRACTION ORDI::ANCE, AND/OR OTHER
RE~IEDIES ALLQiiEO BY LAW.
I<>HEN READY FOR IN?PECTION, CALL 687-~065. A MINHlU~l OF AT LEAST 24 !lOURS ADVAl~CE NOTICE fOR INSPEC-
l'lU:J K~Q(;t:::i1':; ;'IU:;.' U!:: (,.lvEN. Have tne tollowing information ready: permit number. job address, type
of inspection, when it will be ready. your name and pho~e nu~ber, and any special directions to site.
BUILDING DIVISION:
REQUIRED INSPECTIONS:
1. Foundation Inspection: To be made after trenches are excavated and forms erected and when all
materialS lor the toundation are delivered on the job. Where concrete from a central mixing
plant (commonly termed Rtransit mixed") is to be used, materials need not be on the job.
2. COncrete Slab or Under-Floor Inspection: To be made after all in-slab or under-floor building
serV1~e e~ment, conou1t, p1p1ng accessories, and other ancillary equipment items are in
place but before any concrete is poured or floor sheathing installed, including the subfloor.
3. Framina' Insulation Inspections: To be made after the roof, all framing, fire blocking, and
braclng are 1n place ana all p1pes, fireplaces, chimneys, and vents are complete and all rough
electrical and plumbing are approved. All wall insulation and vapor barrier are in place.
4. Lath and/or Gvpsum Board Inspection: To be made after all lathing and gypsum board, -nterior
ana-exterIOr, is 1n-pIaCe bUt cerore any plastering is applied and before gypsum board joints
and fasteners are taped and finished.
5. Final Insoection: To be made after the building is co~plete and before occupancy.
APPROVAL REQUIRED. ~o work shall be done on any part of the building or ~tructure beyond the point
indicated in each successive inspection without first obtaining the approval of the building official.
Such approval shall b~ given only after an inspection shall have been made of each successive step
in the construction as indicated by each of the inspections required.
NOTE: All building permits require inspections for the work authorized, such as but not limited to,
A. Block Wall: To be made after reinforcing is in place, but befo"e any grout is poured. This
~nspecrron is required for each bond beam pour. There will be no approval until the plumbing
and electrical inspections have been made and approved.
B. wood Stove: To be made after co~pletion of ~asonry (if applicable) and when installation is
compl~ Installation shall be in accordance with an approved, nationally recognized testing
agency and the manufacturer's installation instructions.
C. Mobile Home: An inspection is required after the mobile home is connected to an approved
sewer-or-siptic system for setback requirements, blocking, footing connection, tiedowns.
skirting. and plumbing connections.
1. Footings and piers to comply with State foundation requirements for mobile homes or as
recommended by the manufacturer.
2. Mobile home minimum finish floor elevation shall be certified when required by a flood-
plain management letter.
J. ~lobile home tiedowns, when required, and skirting shall be installed and ready for inspec-
tion within at least 30 days after occupancy. Tiedowns and Skirting shall be installed
per enclosure.
D. Swimmin9 Pool: Below grade when steel is in place and before concrete is poured. Above grade
wnen pool-rs-installed.
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 SUSPENDED OR ABANDONED FOR MORE THAN 180 DAYS.
SUSPENSION OR REVOCATION :.lAY OCCUR IF THIS PERMIT WAS ISSUED O~ THE BASIS OF INCOMPLETE OR ERRONEOUS
INFORMATION.
ANYONE PROCEEDING PAST THE P011:T or REQUIRED INSPECTIOl:S WILL 00 SO AT THEIR OWN RISK.
SUBSURFACE AND ALTERNATIVE ~ DISPOSAL SYSTEMS:
1. Permits shall be effective for one year from the date of issuance.
2. Upon completing the construction for which a permit has been issued, the permit holder shall
notify the Lane County Department of Planning and Co~~unity Development by submitting the
installation record form. The Department shall inspect the construction to determine if it
complies with the rules contained in this division. If the construction does comply with such
rules, the Department shall issue a certificate of satisfactory completion to the permit: holder.
If the construction does not comply with such rules, the Depar~ent shall notify the permit
holder and shall require satisfactory completion before issuing the certificate. failure to
meet the requirements for satisfactory completion within a reasonable time constitutes a vio-
lation of ORS 454.605 to 454.745 and this rule.
Setbacks - Subsurface Sewaqe Disposal
Septic ~ Drainfield
From: Ulterior property lines 10' 10'
Edge of rOild rlqht-of-way 10' 10'
8uildinq foundation 5' 10'
\<;el1s. other ....ilter sources SO' 100'
ACTI~Y INFORMATION ~EET
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CQMPLETE THIS SECTION. INCOMPLETE FORMS WILL BE REJECTED!
~
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..T /FA N a 19- 01../ ~ ON
PERSON MAKING REQUEST
E)5 IV. ~le.otC+{) umLl
MAILING ADDRESS I
EW~t!~ ()12. 77d/),1
{CITY STATE ZIP CODE
-.!!8 ;5-(", ~.l)O J./ ~-I J .7-t... '-/8' '-/ ~ tJ'I )
BUSINESS TELEPHONE # HOME TELEPHONE # BUSINESS TELEPHONE # HOME TELEPHONE #
2 PROPERTY ADDRESS. -:350 J ):j~I!'/JV a~, SY.JIZJ'nCj Fie'-/) ()F(
(IF DIFFERENT FROM MAILING ADDRESS) , ,
97$ Va-k .:;;/
MAILING ADDRESS
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CilTY STATE
97t/t;/
ZIP CODE
1
PaC/FI'C. Wtr.::.TeM '--B1?-NK
PROPERTY OWNER
3 MAP & PARCEL NUMBER. (from tax maps in Department of Assessment and Taxation.
(REQUIRED INFORMATION) or from tax statement)
1 8 O~ Db -'/ do cQ(') 6- Q / ~ f2
TOWNSHIP RANGE SECTION TAX LOT(SJ OR PARCEL # ZON NG
TOWNSHIP RANGE SECTION
TAX LOT(S) OR PARCEL # ZONING
TAX LOT(S) OR PARCEL # lONING
, C),,, '1 ACRES
TOWNSHIP RANGE SECTION
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP:
4 SUBDIVISION (if applicable)
LOT BLOCK
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5 REQUEST (state exactly what you plan to do)
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~ DIRECTIONS TO SITE:
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** FOR STAFF USE ONLY **
ZONE/LAND USE:
14:'33
LAND MANAGEMENT DIVISION / 125 E. 8th AVE., EUGENE, OR 97401 / 687-4061
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APP~ICANT CALLISON. JEA ADDR 315 WEST BROADWAY, EUGENE. OREGON
TL~ 1802064200501 SUBD-IV LOT BLK '!r
.NE.J BL.DG TYPE USE 1"; BDR,'IS 0 UNITS 001 S.,D1UES ':,BLDGS 001 PHONE: '1134 3.l\4~ e
OWNER NME PACIFIC WESTERN BANK, ADDR 975 OAK ST., EUGENE, OREGON
,: CJD [ APPL NO r;CnON Dr:::SCi,IPTION SQ FT UNIT CDST VALUrHION 1".1::[ DrW". ~:I
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MECHANICr~L I~I:T
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