HomeMy WebLinkAboutPermit Septic Tank 1989-10-10
~
REQUEST
FOR:
\
SEPTIC SYSTEM VERIFICATION FOR LOAN
~ TOWNSHIP
lB
.......
02
SECTlON
05
1J4 SECTION
2.4
TAll LOT
7900
auaavWOH I PARTlllON
LOT 'PARCEL aLOCMt
-LOCATION AOORUS
1021 Dixie Drive,
"'iTiWCTURES NOW ON PROPERn'
SFD
Sprinqfield, OR
9747B
",OP08CD USE
RESIDENTIAL COIAIIi:RaAL INlXlSTIUAL PU8UC
MO.CJlI8TOIUD
NO. or HDROOIlD
NO. CJlI OIJfLOYUS
COHSTAUCTION COITIYALUI
R
DESCRIPTION CJlI P..OPORD Wl;lRK
IEPTIC"1ITALLED
WAURIHBTALLED
SFPTTr TNSPFr.TTON FOR LOAN REVIEW
1iiii:cno"Ns "TO llii'fROM couilritou~i.
Main St. East to 42nd; right on 42nd
5th house on left (qreen house)
-APPUCANT NAMl . "OCR...
Hines, Lisa M. (site
OWHIRI H...... . APDREBS
patricia Green 4615 Scottsdale
CONTRACTOR H.......
yes yes
to Jasper Rd; right on dixie dr;
addr)
eugene, OR 97404
OSJI UCENB.'
PHOHI
747-B024
PHOHI
6BB-3125
"HONI
,
'MAIL PERMIT TO:
Rlck & Lisa Hines
~ HAMI
I have
Lisa
!
(site addr)
ADDREsa
carefully read
M. Hines
BOTH
hereby certify that all
IYl. t-\.- h{J A-
Information Ie true and correct
10- to -'69
DATi
~
PRNTNA',II;
.
. , . ,.,
".,,:.:,. ,..,::
Authorization 10 Based On The FolIOwln!! Conditions
:~\~\f: :
,
FEES DUE:
$
APPROVED BY:
/7
~
"
'~(.
--
DATE
CALL FOR INSPECTIONS (SEE BACK OF FORM FrMflNSTRUCTIONS) 687.4065
SEPTIC permits are good for one year. ALL other permits expire after 780 days unless Inspections ere current.
, .
C74-213
,~q2 \t!\o\J ,
..' VIOLATION8I I
SBTBACKS AND onmR CONDr3r0p APPROY AL MUST DB STRICI1. Y OBSERVED. VIOLATION CAN tn.TIN RBVOCATlON opnm PERMIT.
CITATIONS MAY BB ISSUED UNDBR nIB PROVISIONS OF LANB COUNITS INPRACI'ION ORDINANCE AND;OR 01HBR RBMEDms AlLOWBD BY LAW.
"
-.
A MINIMUM OF AT LEAST 24 HOURS ADVANCE NOTICE MUST BE GIVEN FOR INSPECfION REQUESTS
Have the following infonnation ready when you call: 6874065
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 RIGIn' TO TRESPASS ON PRIVATE PROPERTY OKS DS.OIO
POWIlR TO BNrBR UPON LAND. nm COMMISSION, AND ANY OF ITS MEMBERS, OPPlCBRS AND BMPLOYBS, IN nlBPBRPORMANCE OP1HEJR PL...... ......"'. MAY
ENrnR UPON ANY LAND AND MAKB EXAMINATIONS AND SURVEYS AND PLAaI AND MAINTAIN nIB NBCBSSARY MONUMENTS AND MARKERS 11IERBON.
REQUIRED INSPECITONS
FOUNDATION INSPECITON: To be made after excavations for footings are complete and any required reinforcing steel is in place,
UNDERGROUND PIPING 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 equipmen~ condui~ 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, flre 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 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 fmished,
ADDITIONAL INSPECfIONS MAY BE REQUIRED, such as but not limited to;
BLOCK WALL: To be made after reinforcing is in place, but before any grout is poUred. The insp;,.tion is required for each bond beam pour, There
will be no approval until the plumbing and electrical inspections have ~ mad~ and approved.
FINAL MECHANICAL INSPECITON: To be made just prior to the strUcture'orremodeled area being occupied and prior to operating any equipment
FINAL PLUMBING INSPECITON: To'be made just prior to the building, slIUcture or remodeled area being occupied.
FINAL BUILDING INSPECITON: To be made after finish grading and the building, slIUcture 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 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 approval shall be given only after an inspection shall have been made of each successive step in the construction
f!S indicated by each of the inspections required.
APPROVED PLANS MUST BE ON TIlE JOB SITE AT ALL TIMES DURING WORKING HOURS,
TIllS PERMIT WILL EXPIRE IF WORK DOES NOT BEGIN WTIlIIN 180 DAYS, OR IF WORK IS STOPPED OR ABANDONED FOR MORE TIlAN 180 DAYS,
SUSPENSION OR REVOCATION MAY OCCUR IF TIllS PERMIT WAS ISSUED ON TIlE BASIS OFINCOMPLETE OR ERRONEOUS INFORMATION,
ANYONE PROCEEDING PAST THE POINT OF REQUIRED INSPECTIONS WILL DO so AT THEIR OWN RISK.
Your signature on the front of this formverifles the following: I HA VE CAREFULLY EXAMINED THIS COMPLETED APPLICATION, and do
hereby certify that all information hereon is true and correct. and that I have a legal interest in the y....t.........). 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 pennit holder shall notify the County Land Management Division by submitting the installation record
form. An iru>pcction 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 pennit holder will be notified, and all corrections shall be made before a certificate of completion
will be issued~ Failure to meet satisfactmr 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 Y'-Y-'J lines 10'
Edge of road right-of-way 10'
Building foundation 5'
Wells or other water sources 50'
DRAINFIELD
10'
10'
10'
100'
--- ..,-_.. ,"._nn__ --' en -. :, "<'"i
y ,.'.
M'N. OHAJtV YIELD AS R1!Q ~.I!.D -". .\. ::~~'
... t:lYL.ANJtGOr..'N"7''I.''i!^!.~'''i_....,.::~.:..:. ~'};:~~,:f~
. . " '~\:"~~'''1
'. , #,'.,' '." "":" ~:j'.:. ...
_.'__... _~~:;l..r,_",
:' .. :. ~-:-~'-~.~.}~~
--'
, I
I l-
I
. !
4J
'"
.(
ill
'"
...
ptl.:: -l
~. . j:. "-
~ ,
u ~.:
'-
..J "
CD ~
" , ")
- ..
l?
j ,
, ..I~
" . ~6 ..
----
--
--
\.
..-:;t"--
"
;
i
1/
"
MU.'~
E.A.R.
J .~...
"._" .~~".,. _~.., ..... h .#
<;r,~,;.~,'j,:,: ';i~_'.. ._:;
, .:.~~'~""~:
~; . '.' ,"
'~}\,i,".j{r
K_'r
"
~.
'/
I
':>..
(,',
"
",
) n ") ~
....~- --- .-..- .--.- .-.-..-
"-'''".
. ... .::;~:.~, ..;.~...:
~ ,.'. :i:.",' .,.-
.-;.. ~'~..
yr() L ) N .1:. '}/ 'F' E
r )..1;>' ~
.....
. Please complete all lines inside white boxes, if possible.
"HONl:.
Existing Buildings or
Improvements on
Property
c::J House
c::J Barn
c::J Garage
c::J Mobile, Home
c::J Shed'
SEPTIC INSTAllED
c::J Yes
c::J No
Water District
~r},'r, 'IJ::lS.PPLhor,
L-i')A M rh't'\eS
\'UU" "AMt;
10'/..1 Dix.le.. Dr.
YUUH "UUHt;~::i
10-(0-1:6'1
UAllo
rL11' 9.0"2 -I
So(rcl
Clni ..
'?CL.+vLUO-..- Gvreeh
OWNER OF PROPERTY (ft nol __ _ abo")
lj 10 15 Sc..otl'i. deJe..
C11'flQ
ZIP
1cq~,~11.5
"HUNt:
OWNERS ADORESS (If not ..me .. .bow)
~lA.~ ' 0re <il'-lo~
'17-folf
ZIP
~
t;UH I "A\,; I UK
~>t
Directions to site
from Courthouse
><' (~+ 0>' h-lU~t:.;;'1
~
~
Uce".. .
......Cl.J,..V\
0",
Tax Lot
1C>1.1 'DiA,e.:\lr
Towne.hlp Ra;;OI Section
lown.llp ~ lHCliOn
"" MCuon
luLoI
tkAse
.
~~,."
.
SITE ADDBESS
102..1 UiX'lt"
1)..... .
S'P~ Iel:
ne.
,
.
.
>>.'~', ",=".,"'"'..,.0 ~w...,. ....,., '->.." >.."... N'
C{?Wl'i
~
~)Oo""" .
,
ZIP
. ~ .,... , .
ZIP
t:f;'"
For Mobile Home
Placement Only
Brand
Year
Size
No, of lip.outs
No, of Bedrm-
Uconse #
"
1111
""'-'.
MAIL PERMIT TO:
~. k.iLK. .,y LIse..
lO?1 1l t' k' l-e
AUUHS.,')V llr~ ""!i e ( c(
......t J
J-\.,ne"
D\r,
()re 91'-h, <i
land Management Dlv. staff can
not be held responsible for
evaluations or rocommendations
based on falso, Inaccurato or
Incompleto Information
",
. ~.,\'
" ",
...,"
:-..,
.'
r n . .
."
.
.... I'
,
.
.
.
" :
i"j " ,
. "
.',Z
.
; "
i
.
.
r" ,
.
.'
.
.
.
1-. .1
- '
\
:;,i.
.-
W: 5 ' LANt COUNTY DEPT ENV MGT, RECEIPT 1285089 DATE 100689
. APPLICANT HINES; LISA r~DDI~ 1021 DIXIE DR., SPF([NGFIEL.D .
TU' Hl02052407900 SUBDI V LOT BLI<"..
NEW BLDG TYPE I USE R BDRMS 0 UNIT~ 001 STORIES OBL.DGS 001 PHONE 747 8024
. OWNEF~ NME GREEN, PATFnCIA, ADDH 461 ~> SCOTTSDALE, EUGENE .
CODE APPL NO ACTION'DESCHIPTION SQ 1"1 UNIT COST VAL.UATION ' FEE DA"S
BP .-
eBp
.. r' BF'
, :' '})p
.BF',.
.
~
.
F:'L. ~+IX/BATH:
. MECH
SUF::
PC\(
. U~ LC ~lEl~>0B9 SDSV
SWR: ,FT. WTR:
, MECHANIC,~L FEE
STATE' SLJI:~CH(4F~GE
Pt.,AN CHECI< FEE
FT. RAIN:
. FT
~)%
2~5%
.
I"
60 :00
.
,
.
.
CATG: API"
.SEQU: 1
TAKEN BY BB
F~A
FP
SDS
, S1
PCI(
OTH
ISS
3
DEPOSIT *If
l'
. .
60.00 CI(
:2
EST. COMPLETION DATE
.
.
~{
.
.
.
00 i, . t ..
~.~ '
.
.
.
'.
fie I
.
.
.
.
u .
.
.
'z"
, ,
.,
I t. ,.
I
"
"
-:-,-~--\-.'-:-"-;-:--~:-'-'~ -~-
1-#.->
.
e
/'
.
"
.
.~
,'.
.
DUO
.
<.
"
\
\
.
.
.
~fiU
.
.
.
.
-1-
+--<
.
"-
W: 5 ~ANE COUNTY DEPT ENV MGT RECEIPT . 285089' DATE 100689
. APPLICANT HINES, LISA ADDR 1021 DIXIE DR., SPRINGFIELD ' ..
TLI 1802052407900 SUBDIVLOT BLK ,~~R
., 'NEW BLDG TYPE, USE R BDRMS 0 UNITS 001 srOklES' OBLDGS 001 PHONE 747 802.uU
. OWNER NME GRi;:EN, PATRICIA AD DR 4615 SCOTTSDALE, EUGENE '.
CODE APPL NO ACTION DESCRIPTION SQ FT UNIT COST VALUATION FEE DAY~
lip
.BP
'" ~P
0\ 'Lw
~.BP
PL IFIX/BATH:
.MECH I
SUf<
peK
.LR, ,jlC 285089 SDSV
.. "
H ~ATG:
.WQU:
/r~N
,
.
AF'P
1
BY -BB
.
.
~
""
FP
SWR: FT. WTR:
ME(:HANICAL FEE
STATE SURCHARGE
PLAN CHECI< FEE
SDS
pel<
SI
2
EST. COMPLETION DATE
,FT. RAIN:
51.
25%
OTH ISS
3
DEPOSIT IH