HomeMy WebLinkAboutPermit Septic Tank 1989-3-14
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tJ~- S'f?rCLJ _
Lane County Authorization
.
for:
FOR OFFICE USE ONLY
Application/ ~~~_ ~
Perm~t t J /c:;;;:J"6 /
SEPl'IC Th,,~u.:nON FOR LOAN RE.VIEW
'Nw;.;SHIP
RANGE
18
02
I SECTION
06.1,3
) TAX ~~O [JOUT OF
I LOT/PARCEL I BLOCK
PRO~OSED USE OF PROPERTY
r&1 Residential 0 Industrial
o Commercial 0 Public.
S~BDIVISION/PARTITION (if applicable)
LOCATION ADDRESS
STREET
CITY
ZIP
1038 DONDEA ST" SPRINGFIELD, OREGON
STRUCTURES CURRENTLY ON PROPERTY
EXISTING SINGLE FAMILY DWELLING, SHED
UIHL~TIONS TO 51T~
FRANKLIN TO SOUTH ~A~ STREET IN SPRINGFIELD, TURN RIGHT ON 32ND STREET TO DONDEA, TURN RIGHT
FIRST CUL-DE-SAC
~ESCRIPTION OF PROPOSED WORK - BE SPECIFIC
""""~.~C IN,,~u.:r~OO FOR LOAN RE.VIEW
= OF BEDROOMS l tf OF STORIES I It OF EMPLOYEES WATER SUPPLY
NA NA N A
O;~"NER' S NAME AND ADDRESS
DALE AND LUCILLE HOUGH, SAME AS THr JOB ~DDRESS ABOVE
C,JNTRACTOR' 5 NAME AND OSR It
SAME AS THE ABOVE
DECLARED S VALUE
PUBLIC
o prC:>PC?~ed
~ Ex~st1.ng
TELEPHONE NUMBER
726-1010
TELEPHONE NUMBER
SAME
P:;Rl'llT TO BE MAILED TO (NAME AND ADDRESS}
JANETMITZEL, 85815 EDENVALE ROAD, PLEASANT HILL, OREGON 97455
TELEPHONE NUMBER
726-0825
I HAVE CAREFULLY EXAMINED THE COM ICATION FOR PERMIT, and Jo hereuy certify that all information hereon is trUQ and correct, and that I
have the following legal interes 1n the prope y: Dow r of record; 0 contra haser; OOauthorizod agent.
I f:.:.rther certify that any and 11 work per' sh on 0 . c . nances of Lane County and the Laws of the State of Oregon
pertaining to the work descri cd herein, rllct e without the pcmission of the Building Division. I fur-
ther certify that rcgistrati n with t t as qui red by ORS 701.055, that if 'cxelllpt the basi. for exemption
is noted hereon, and that 0 8 n ORS 701.055 will ~usQd on this project. I HAVE READ AND
CHECKED THIS APPLICATION THORO . '. ~
JANET MITZEL~-f\!\. Q ,~; 7' \I\r.: -, - - -' 2." 0-?Jq
NN1E (please print} (' \. \ SIGNATURE' j- DATE
REAP THIS SECTION CAREFULLY. YOUR AUTHORIZATIlJN'~AS~BEEN BASED ON THE FOLLOWING CONDITIONS!
[] PLANNING/ZONING:
Zone
NA
parti tion It
Parcel ,.
Parcel Size
NA
Minimum Setbacks: CL, front
CL, side
interior
rear
CQM.\1ENTS:
NJ SPEX::IAL PIANNING ACl'IOO IIDJUIRED.
/ Date:
/ Instal'la
~
-08::89 j- ~ n
ion'ReC rd ~d~jONo
l-Iaximum Depth
of Trenches
,
n...t-l'I-
n
[] PLANS
EXAM~
~
I.:.iroup
.-..
/ Use /
/ / / /-(;,/
--. /1/1;:: // /
~' / (1/ ,'Y4 /
PERMIT APPROVED BY BUILDlm;-OFFICIAL/OES 'NEE (oe~RS 456fi (1)) ! L/ I DATE
LANE COUNTY DEPART~ENT OF UBLI~KS LA"N!;V~~~9'lEN-Y"~I~~7;Ml6li
~t:-~-r..r ,/~EAST8 HAVENU ,E &Y'o1'\~~9~~ j/ ~
/7~/ ~C/~E REVERSE FOR NSPECTION INFORMATION,
COMo'lENTS :
n
C 14- 25 R84-
\'
.
.
,
-.
SETBACKS A~D OTHER CmmlTIO~S OF APPROVAL }IUST BE STRICTLY OBSERVED. VIOLATIO~ CA~ RESULT IN REVQ-
Ct\TlO:.l Of TillS PER}llT, CITATIO,j UNO=:R PROVISIONS OF LANE COU"TY'5 INFRACTION ORDINANCE, AND/OR OTHER
REMEDIES ALLOWED B~ LAW.
WHEN READY FOR INSPECTION, CALL 687-4065. A MINHlU}l OF AT LEAST 24 !lOURS ADVA!:CE NOTICE FOR INS?EC-
TIO:.l I\EQL:t.::;T::i ~,uYr UJ:: GIVt;,. tlilVC the lo11owing information ready: permit number, job address, type
of inspection, when it will be ready, your name and phone number, and any special directions to site.
BUILDING OIVISION:
REQUIRED INSPECTIONS:
1. Foundation Inspection: To be made after trenches are excavated and forms erected and when all
matertals lor the toundation are delivered on the job. Where concrete from a central mixing
plant (commonly termed "transit 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
serVlce equipment, conauit, plping accessories, and other ancillary equipment items are in
place but before any concrete is poured or floor sheathing installed, including the subfloor.
3. Frami~s ~ Insulation Inspections: To be made after. the roof, all framing, fire blocking, and
Oraclng are ln place and all plpes, 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 Gy~sum Board InsRection: To be made after all lathing and gypsum board, \nterior
ana-eXEerTOr, 1S In-ptaCe but betore any plastering is applied and before gypsum board joints
and fasteners are taped and finished.
5. Final Inspection: To be made after the building is complete and before occupancy.
APPROVAL REOUIRED. ~o 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 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 authori~ed, such as but not limited to:
A. Block Wall: To be made after reinforcing is in place, but before any grout is poured. This
rn;pictTOn is required for each bond beam pour. There will be no approval until the plumbinq
and electrical inspections have been made and approved. .
B. Wood Stove: To be made after completion of masonry {if applicable) and when installation is
compl~ Installation shall be in accordance with-an approved, nationally recogni~ed testing
agency and the manufacturer's installation instructions.
C. Mobile Home: An inspection is required after the mobile home is connected to an approved
sewor-or septic 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.
). ~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 ~~Y OCCUR IF THIS PERMIT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS
INFORMATION.
ANYONE PROCEEDING PAST THE POINT or REQUIREq INSPECTIONS WILL 00 SO AT THEIR OWN RISK.
SUBSURFACE AND ALTERNATIVe: SEWAGE 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 Community 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 co~ply 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 Department 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 ~
la'
la'
5'
SO'
prainfield
From:
Interior property lines
Edge of road riqht-of-way
Buildinq foundation
Wells. other water sources
la'
la'
la'
100'
r
.>
.
-'t~ an.
."> ... i ~ciunty
-
lli\1D. . CANCEL LA TION ..
';'::.~.::::';;-":;:::::.".':'" REFUND AUTHORIZA TI01l PERMIT# S 01 S - () 9
NAME(PLEASEPRINT( ~ A. ",,\ ~\ NYl."\ ~ t:: L TRSfTL#/8...tJ:;J,- tJ6./, 3&r1dO
ADDRESS 8 S R l is E ~ 'c: N \J ~ I,.. S ~ ~. \::> I \-\. \j \c' C\ r'f.! 5 ~
APPLICANT (Xi OWN ER ( ) CONTRACTOR () . ...l.-
REASON FOR CANCELLING PERMIT(ORAPPLlCATION) ill j.l 1\ \ \Q.O':: \ F
. I
\.... , \( -1L\b-",)~I'"
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\,\ (\ , .,. ' -1"2 (,...;: Cl '6 ~.;- i
SIGNATURE .~ 'M. :t .~, L, J\ nAp: ~ - \ ~ - <;, 9
/" ,. iI'.,
FEES PAID FOR WA~TE DISPOSA~ SYSTEMS (SITE INSPECTIONS VAND/OR APPLICATIONS TO INSTAll THE SEPTIC TANK AND DRAINFIElD)
ARE ORDINARilY NpNREFUt:J,DABlE. SOME REFUND MAY BE ON BUilDING. PLANNING. OR PLUMBING PORTIONS ACCORDING TO THE
AMOUNT OF THE PERMIT/APPLICATION PROCESSED.
"
FEES PAID
1>/00.00
% REFUND
% Flood Plain Fee
% Building Permit' Fee
% Mobile Home Fee
% Plumbing Permit Fee
% Mechanical Fee
% Plan Check Fee
% State Surcharge Fee
/60 % Septic Disposal Fee
% Site Inspection Fee
% DEQ Surcharge
% Land Use Application
% Planning Director
% Recording Fees
% Partitions
% Copies & Ordinances
% Surveyors
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
(
SIGNATURE__
Minus $25. for Processing Fee $
\ .
~~ L~AMOUNT TO BE REFUNDED $
"
fao.OO
~/A
1.00.00 .
DATF8~ff
TO DEPARTMENT OF FIN,fN'CE:
Building Permit Refund,
State Surcharge Refund
Septic Disposal Refund
Site Inspection Refund
Land Use Application
Planning Director
Recording Fees
Partitions
Copies & Ordinances
Surveyors
\ TOTAL AMOUNT REFUNDED $
PLEASE MAKE CHECK PAYABLE TO:
NAME ,,-r4/7t=-r- /?J'rrZEL
ADDRESS~ .:;-,.p/, <;- ~/JE/}I/A1/tE .4A'LJ frFhlJ"R/.?T dz/, /?,e"EibcrV
, , 971-UJ- d
LAND MANAGEMENT DIVISION I Public Works Department I 125 E. 8th Ave" Eugene,OR 97401 (503) 6874061 CfJtJ 7
$
$
$
$
$
$
$
$
$
$
/-,.,1'/, ~
24-0674/Acct.42120/Prog.020
24-0674/Acct.42123/Prog.020
24-0427/Acct.42133/Prog.240
24-0427/Acct.42134/Prog,240
24-06741 Acct.46202/Prog .020
24-0674/Acct.46202/Prog.010
24-1870/Acct.462111Prog, 110
24-0674/Acct.46202/Prog.010
24-1870/Acct.44419/Prog, 110
25-0674/Acct.44451/Prog .01 0
~-
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Receipt# .
Receipt# . .
Receipt# ..,,?R k' Z--
Receipt# -
Receipt#
Receipt#
Receipt#
Receipt#
Receipt#
Receipt#
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p:se~:~r~i all :M~~~tXe;~e boxes, if P~S~b:_8<J
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CITY ,
8CL l'<2 " ~,^-c...L C\"" ~O,-,\o, ~
OWNER OF PROPERTY (It not ..me .. abon)
\ 0 ~ <M ~() h\2,'Q 0--
OWNERS ADDRESS (il noi ..m. .. :bov".)
ZIP
Existing Buildings or
Improvements on
Property
~
use
Cl Barn .'
Cl Garage
Cl.Mobile, Home
)Z5-Shed
SEPTIC INSTALLED
)E:r.ies
ClNo
Vi!!!er District
\2.C-\v.-~C'-.u
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MAP, PARCEL NUMBER ..,
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wn lp ~ tjecuon "~t;eCIlOn la. LOI .~L:
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Townahlp -n;;;:- SectIon 1/4 SnUon ru Lot
,
~
SITE ADDRESS
~
ZIP
\;11'
ZIP
For Mobile Home
Placement Only
Brand
Year
Siza
No. of lip,outs
No, of Bedrms
License #
,
~
.
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MAIL PERMIT TO:
NAMi:.
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land Management Dlv, stall can
not be held responsible for
evaluations or recommendations
based on falso, InaccuratG or
Incomplete Informetlon
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. ~., LANE COUNTY DEPT ENV MGT RECEIPT 'I 59389 DATE 030889
. Ar:'F'l.. I CANT HOUGH, DALE ADDI~ i 038 DONDEA S1'., SPf~ I NGF IEl-D, OI'(EGON.
TLI 1802061308000 SUBDIV LOT BLK
NEW BLDG TYPE, USE R DDRMS 0 UNITS 001 STORIES IBLDGS 001 PHONE 726 1010
. OWNEI:( NME HOUGH, DALE AI)DF( i 038 DONDEA ST., SPI:( INGFIELI) , Of([GON.
CODE APPL NO ACTION DESCRIPTION SQ FT UNIT COST VALUATION 'FEE DAYS
BP ~ '11
.1'" .
BP
BP
.1'" .
.
"t- r
~IPL IFIX/BATH:
.1ECH
SUR
PCI(
._R L.C. ~>9389 SDSV
SWR: FT~ WTR:
MECHANICAL FEE
ST(.HE SUF,CHAI'(GE
PLAN CHECI( FEE
FT. .r~AIN:
FT
.
5%
2~5%
t,0.00
.
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.
.
CATC;:
.;'EQU:
r' TAKEN
API'"
1
BY f(LH
RA
1"1'"
SDS
SI
PCI(
OTH
ISS
3
DEPOSIT lHf
1(.
60.~)0 CI('
2
EST. COMPLETION DATE
.
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.
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--------------------------------"""":""""----------
.
H ~: 5 LANE COUNTY DEPT ENV MG'r RECEIPT 'il 59389 DATE 030889"
. APPLICANT HOUGH, DALE ADDR 1038 'D\ONDEA ST., SPRINGFIELD, OREGON.
TL~ 1802061308000 SUBDIV " \ LOT. BLK
NEW 'BLDG TYPE USE R BDFmS 0 UNITS~\0Pl STORIES, \ '~BLDGS 001 PHONE 7~!6 1010
. OWNER NME HOUGH, 'DALE A 'DR \~ 038 DONDEA ST., SPRINGFIELD, OREGON.
CODE' APPL. NO ACTION DESCRIPTION . SQ'Z,.-t\ \UNIT\ COST VALUATION FEE DAYS
, , B)::' ' \\ ' eOD
.)f' I , \ .
BP J \
BF' ~
\\
ap ~.
Dlp[ ~FIX/BATH:
,.tECH
. S@
PC""
..R LC 59389 SDSV
'.
, .CATG:
.:tQU:
!o Til(EN
.
.
SWR: FT.' WTR:
MECHANICAL FEE
STATEr SURCHARGE'
PLAN CHECK FEE
FT. .RAIN:
5%
25i. .
.
FT
'60.00
.
m
.
APP
1
BY RLH
RA
SDS
SI
PCK
OTH
ISS
3
DEPOSIT **
FP
-2 ,
EST. COMPLETION DATE I
.
.