HomeMy WebLinkAboutPermit Septic Tank 1991-5-1
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REQUEST
FOR:
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SEPTIC SYSTEM VERIFICATION
I- tOWNSHIP 17 RANGE 0 3 BECnOH 15 114 aECnC>>l
"9~ 1j!P" ADDREsa
))) DEADMOND FERRY ROAD.
TAll LOT 4102 auaOlVISlON f PAlmnON
LOTfPAACEL 1lL0CI(
SPRINGFIELD. OREGON
97477
STRUCTURES NOW ON PROPERTY
EXISTING SINGLE FAMILY DWELLING, GARAGE
PROPQ9ED USE aEPl1C lNITALLE:D WATER lNSTAlL.Ii:O NO. Clf 8TORlEB NO. Of EIIPLOTIE3
PR IVATE USE
~R1mOH Of" "'''WOSED WORK
SEPTIC SYSTEM VERIFICATIO~
COHBTRUCTJOJ. Wul'/VAW& I (. /!. c.I--._
t:.cm/7l(/m'b! ~
iJ. 0lI' 8GflDOllB
D1AECTION8 TO "Bill 'ROllI COURTMOU8a
GATE~AY AREA, OFF GAME FARM ROAD. EAST END OF BELTLINE ROAD
APPUCA"T NAME . ADDRESI
MARVIN BRUCE BROWN, SAME AS THE JOB ADDRESS ABOVE
OWiiEii""N...ME . AoORlaS
SAME AS THE ABOVE
PHONa
747-1552
SAME
NA
,NONII
CONTRACTOR NAME OBR UCENII!: ,
NA NA
) MAIL PERMIT TO:
MAIL PERMIT TO THE O~NER AT T~E JOB ADDRESS A30VE
)NAMI ADDRESS
[ have carefully read BOTH sIdes of th[s ep~c# and hereby c~y that
MARVIN 9RUCE DRO':IN '~~JU
\- PRINT N.W& Sign8M. --
PHONE
all [nformatlon Is ~ and_c2rect
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· PLANNING/ZONING
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lONG
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MINIMUM
SETBACKS
'ROHTI.OT1.I\l1
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MEAlOR
....
RIPARIAN
CQNME~T'l
NO PLAN N I NG ACrrorJR EQVIReO
UGZSPRINGFIELD.
.i..IIII11ROVIO .Vi
ROGER HOLLIS'
hATtl
4/24/91
I SANITATION
Aid ,('f:<<W(
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) _-FrlJY Y'eI?I4r'.Bmul't.
BUILDING
;.PPROvtO .Yl
~tNaTAlL UT. eVltaI PIIIl
APPROVED PLOT PLAJri, aATIED
THleY'TEM APPEARS TO 81 WOLlU(lNO
. ~QHT, If 8Y8TEM ,AlL8, yoli
NuaT ...j1....y P!OIll A 1Il1PAlft PI!IWr
o NOOK TO IDlInNQ 8't'8TOI
INSTALUD PIA PiItlllT .UMlDl
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IS, AA~""i 1/41"'--61 ~
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COMMENTa~
APPROVED BY: JJJ//V (t'-tttk #J/{A/7116,
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CALL FOR INSPECrJONS (SEE GACI( OF FORM FOR INS7RUC7IONSj 687.4065
SEPTIC pormlts oro good for ono yosr. ALL othor permits oJtplr3 cfler 180 dsys unloss Inspections sro current.
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FEES DUE:
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$
DATE
5/;/91
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VIOLATIONS
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SHTIlACKS AND OTHER CONDmONS OF APfIROV AI. MUST DB S11UCIL Y OBSERVBD. VIOlATION CANRBSULT IN RBVOCA110N OP1Hl$ PBRMrr.
CrrA.TIONS MAY DB ISSUED UNDER nIB PROWIONS OF LANB COUNTY'S INFRAcnoN ORDINANCE ANDJQR onIER RBMIIDIBS AlJ.OWED BY LAW.
A MINilViUM OF AT LEAST 24 HOURS ADVANCE NOTICE MUST BE GIVEN FOR INSPECfION 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 nmnber - Any special directions to the site
PUBLIC OmcIAL RIGIITTO TRESPASS ON PRIVATE PR.OPUTY oas 215.0&0
POWER TO ENI'ER UPON LAND. nIB COMMISSION, A1\'D ANY OF rrs MEMBERS, OPFJCERS AND EMPLOYBS,IN1HB PBRPQRMANCB OPnIElR. PUNC'I10NS, MAY
Bm'BR UPON ANY LAND AND MAKE EXAMINATIONS AND SURVEYS AND PLACB AND MAINTAIN nIB NECESSARY MONUMENTS AND MARKERS ntBRBON.
REQUIRED INSPECI10NS
FOUNDATION INSPECI10N: To be made after excavations for footings are complete and any required reinforcing steel is in place.
UNDERGROUND PIPING INSPECI10N: To be made after all underground piping has been installed, prior to any backfill,
CONCRETE SLAB OR UNDER,FLOOR INSPECI10N: To be made after all in.slab or under.flocr 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 INSPECI10N: To be made after all ducting and gas piping has been installed and prior tD being cDvered,
ROUGH PLUMBING INSPECI10N: To be made after all plumbing rough.in is in place, prior to being covered,
FRAMING INSPECI10N: To be made after the all framing, fife 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 INSPECI10N: To be made after all insulatiDn and vapor barrier.; are in place, prior to covering,
LATH AND/OR GYPSUM BOARD INSPECI10N: 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 jDiots 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 inspection is required for each bond beam pour, There
will be nD approval until the plumbing and electrical inspections have been made and approved,
FINAL MECHANICAL INSPECI10N: To be made just 'prior to the sb'UCture or remodeled area being occupied and prior to opemting any equipment
FINAL PLUMBING INSPECI10N: To be made just prior to the building, structure or remodeled area being occupied,
FINAL BUILDING INSPECI10N: To be made after finish grading and the building, structure or remodeled area is completed and ready for occupancy,
MOBlLE/MANUFACTURED 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 fO\mdation 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
as 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 WfTIIIN 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 OF INCOMPLETE OR ERRONEOUS INFORMATION,
ANYONE PROCEEDING PAST THE POINT OF REQUIRED INSPECITONS WILL DO SO AT THEIR OWN !US:..
Your signature on'the front of this fonn verifies the following: I HA VB CAREFULLY EXAMINED THIS COMPLETED APPUCA TION, 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 cenify 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 wDrk described herein, I funher certify that if I wn not the owner of the property, my registration with the Builders Board is in full force
and cffect as required by ORS 701.055. and that if exempt the basis for the exemption is noted hereon, and that only subcontractoIs and emplDYees WhD
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 rules a certificate of completion will be issued to the permit
holder. If construction does not comply with rules, the permit holder wiH be notified, and all corrections shall be made before a certificate of completion
will be issued. Failure to mc;et 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 r'~r-"J lines 10'
Edge ofroad right-of.way 10'
Building foundation 5'
Wells or other water sources 50'
DRAINFlELD
10'
10'
10'
100'
,
Please complete all lines Inside white boxes,
If possible.
4/:25'/:;1'
1?1/1.e.v//v.B12ucc= 15ROW,J
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335 ZJEAz>moA/D F€?2,<2C/ P,P.
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CITY
ZIP
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OWNER OF PROPERTY (it not ..m. .. above)
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PHONI;;
OWNERS ADDRESS (if nol urn. as abov.)
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MAP, PARCEL NUMBER
(Found on WJ: maps In the A.....m.nt &; ra..tlon o.pL)
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SITE ADDRESS
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MAIL .r'aCFlfwJ/T TO:
NAM(4'1' :BR..LH7G BRDwJ
335 D~/l.ID ~
AUUHSPFL.b ~. q 7q77
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,:>STAFF
.
land Management Dlv. staff can
not be held responslb[e for
evaluations or recommendations
based on falsel Inaccurate or
Incomp[ete Information
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Existing Buildings or
Improvements on
Property
~ouse
c::J Barn "
j2iI:13arage
c::J Mobile, Home
c::J Shed
SEPTIC INSTAllED
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Directions to site
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W: 5 LANE COUNTY DEPT ENV MGT RECEIPT I 119391 DATE 042491
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NEW BLDG TYPE USE R BDRMS 0 UNITS 001 STORIES IBLDGS 001 PHONE 747 1652
OWNER NME BROWN, MARVIN ADDR 335 DEADMOND FERRY RD., SPRINGFIELD -
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W: 5 LANE COUNTY DEPT ENV MGT RECEIPT 0 119391 DATE 042491
APPLICANT BROWN, MARVIN ADDR 335 DEADMOND FERRY RD., SPRINGFIELD
.TU' 17031 500041 0~'. SUE<DIV ,L.OT BLI<.
NEW BLDG TYPE USE R BDRMS 0 UNITS 001 STORIES OBL.DGS 001 PHONE 747 1652
OWNER NME BROWN, MARVIN ADDR 335 DEADMOND FERRY RD.. SPRINGFIEL.D
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