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HomeMy WebLinkAboutPermit Building 1981-8-26 , " y~ '. /3- ;'2~ a:;'4,-e.: z",oe. a'\~ ' .~ · LANE C~UNTY~'I~~PECTION' Rlw OWN~'~E H---6lb. f-K. j co~'M~fL c~~ ~~~~TR~;;~~~~T~IDE WORK. AUDTHORIZED BY P.ERMITc, Ie ' ,.q!- , _-I....41.4--c.L-tf ' v;t'..., DIRECTioNS TO SITE -~ ."~ - ----. .-.,' '- ,". .-...---,. - ----"'..' .~~ PHONE NUMBER . INTERIOR 5 REAR Z) PHONE NUMBER nPLUMBING FIXTURES II ~ 1-.;2 / / tIt)..{Jr1d-e..Je/) ( o-u..i 3-;; rlk.l 10 /322 -- k / 5 ITE ADDRESS' .~~_.: ,,-C;:Sti.Ap-~) PERMIT NUMBER FOUI;:Il'lATION I NSPECTION "OR M~)LE HOME SET UP INSPECTION IV" // , V Correction DisapproveB Date 7-3/-81 Inspector--y"",,-.c:....-I LA I UNDER-"'tLOtRiNSPECTI~r<l h- - ~-~ ~ "P ~~ ~,..."P , Correction Disapproved Date Inspector ../l UNDER ji~1 ~UMBING GROUNDWORK INSPECTION Approved~ Correction Disapproved, Date I t /), ./Ll- nspec or, 10 ROUGH PLU~1BING INSPECTION Approved ~ Correction Disapproved Date f'-~,.yl Inspector Ie,J!. FRAMING INSPECTION Approved Correction '1- ,~ - Ii? I (1._8"....0 r..~ INSULATION I VAPOR BARRIER Approved ./ Correcti on Disapproved Date Inspector iNS~[{IO? I~_....;' JJ/../~ ~ Disapproved Date c;.I.s---X'/Inspector a.dj ~ LATH I GYPSUM~OARD INSPECTION Approved I~ Correction Disapproved FINAL PLUMBING. INSPECTION Approved V Correction Disapproved Da te/;;.'1 _ 1,bJ:!-1 nspector ~.,d' /1./ '/~ Date 7"-z/-R/lnspector FINAL WASTE DISPOSAL SYSTEM INSPECTION Approved >< Correction Disapproved Date ~/F:f Inspector f1)// FINAL INSPEC/fION BUILDING / MOBILE HOME (1 ,--/? Approved V Correction Disapproved Date 1~-I'1-8/Inspector YL<-f",---/ /P-'7-f?1 ~.(4/' ~ ~f', --.,-"~_.,,,,~~V Ck~ I tE.R{*Ict~ OfOCCUPANCY.u - . -- 7.. -, ~ "1UPO'RARY cfRfIFICArE OF OL'tGrANCY Approved Correction Disapproved Date Inspector Form C74,197 VICINITY MAP YHR-J'J S I. - ~C; n t'J~1 t:JE: :D).IJ 12. . , . .:3 .;2 'j S T. - ';T1lS l' E R 1'<0 . D o ,., o E A ~.:J Installpc 'QClJes6j--{!p~"'.s"A/ ITitle as shown on DEQ ~censel . -q<t-l-fL,~-r.,., i./ re. 1<.c..)1 NG Telephone _se No. ~~"YJ _ing mpany I , I t:'.r. Date~1 Dato ISignature01 Ownerl Applicant's Name & Address LAI2fl..." DIL13Ec-j.o( &{O/.!;,--' {3 I11A/p ~,-, ~ '" f1..&..' va ,~I c L /:) ) 0 a . ,,, , ( 9?Cf7'l -- ~ ~~~.~ J- c.. MUST BE IN BLACK INK form c55-11 Permit No. M.2.J - go ,L Twnshp. jog Range 00l.. Section ",6,. ~..;L Tax lot ~O::J, Standard System ~ Alternative System 0 (Specify Type) F~u II L VI ~ T 12.. 13 UTI ~ A/ Job Location (Street Address) I:J. II DotJ I>\: e , <:::., /UAAf. FIEL I). t? 6' Subdivision/Partition ,'I I Parcpl Lot Block DETAIL SYSTEM PLOT PLAN AS CONSTRUCTED Scale I .. = ...$a..,.. o I j) , ~ ' I l< A , ,II _J ,.." ,., T S To - N , P, ~I P, E, fl., 7 y' '7~~"~;\, !~~~ ~ '\ 8 ~">~.{i'.P' ! - ~ c~ .r:.~ ' \~ $/'" ',.' ,- '\,/ j'",- ''--2 .' " ~clvSii: , , fool 3'; ~'J9~ i~/5~ + S"C)'" ..3 :t.o' I J. :'0' ~'1-'...Jj, ___:.a.:.~___ _ ~':.f~A~e~e~r_1fl~" 'of .. ~~:J' ~15~ I ~ I N, E ./ / -~ USE BLACK INK ONLY FOR INSTAllER'S USE: Trench Depth I 'if .f - 3o'! Gravel Depth Below Tilo fb'" Tank Capacity /~t:J '1//1.. Manufacturer \AI IL l A ~ E'ri"E G-.e~V<"'7'"b A/ t:' Measured Distance from Well to Tank From Drainfield . Total length of Lines_I.~'Y.> ' COMPLETE THE FOllOWING IF A PUMP WAS USED ON THIS INSTALLATION: I (installer's name) certify that a (Mfg! and Mercury Float Switch IMfg, and No,) (Model No,' Pump have been installed with this sewage installation. Signaturp Datp FOR SANITARIAN'S j.J~E ONlY,'..LJJ ~SysJem !lPPJoY9d 0_ Syst7l'.9isappro~d.l";: J}~,ecis ~rrection COM M ENTS: ru/JJJJ 11./(, fKH:. m4tJ:b/ i cfkl;. UJx. C5)/ Jdffj atl'/! thJ7 ~ (4 ~,ac ~ "fJ System Corrected Dato\5",:&V'-Ob::> 8'/.. System Capacity-#"t) nal./day Signaturo ~ J?7.ilif Dato ~r 30 Er/ INSTALLATION RECORD & CERTIFICATE OF SATISFACTORY COMPLETION When signed by the County Sanitarian. this certificate is evidence as per OAS 454.665 of satisfactory completion of a subsurface sewage disposal system at the above location. Heturn thiS torm to: tJulldlng and SanitatIOn IJIV,. lJepl. 01 EnVIronmental Management, located In the oasement 01 the Public Service Building, 125 E. 8th Avenue. Eugene 97401. ' . --- , . ~NECOUNTY,OREGO~ DEPT. OF ENVIRONMENTAL II.""'GEMENT CO~LC'Jt5CT!lOli\ll . M(lJ)Ii'"U~1E CONSTRU:TION PERMITS & II~SPECTION DIV, 1)0 LO n E-A-- !O t) \ L I~ r;:::.-. 1< ;. .~... ~OT0 A'rrLC n:.c.E..SS !lAo~ 13-6 S;~.. +tPeL ." ~." ~ ~. E1- 't' lA r 60 0 r..0''-\.4.- fA- I A.J G, IF ,c:; SOJME:.. ~ LU n . _ m ~~,....A-t.-L- '5~ ulER ~D ~~ .UZ: f\Jc'LOS, IJ~E., ----fI) \A)eC)p c:;-m V~ R..R.lG-j< V)P--L' D ~ 1"I'~OcJ -F<:l ~ R F.;; I':) I JG F ~ e.. L e..A R ~ C. e..S AA U 0; 'C... 13 r;:. Jo..~1/ ~IG-l::'- - ~F'\ 17r.E::.p ~LFAR ~NC!.j~ SH-~~I _ ~ D ,) I..J..A-\/~ I c;. ~~ R C R.A~ t> f' A- (3t=. A~~ 10 E' ~ (!) 'J -r '- E.....,..- M () n F I .'~ - lIbl 0::. r ~L' - fZ f") 1-5...~ c&W I i...rcr _-i2~DJLl-Jr')~ C,rJ.o f{La-z:t"" r 5"f=W5,~T. . RIE-INBPIECTION REmUIREO Cf EA==' t=-- ~hlClnlS 18i18l7-~~18i5 FOR APPROVAL INSPECTOR:4A 1~:... . ......, ~t,,,,v \ JOB ADDRESS DATE I 2 - {4- - <if / BLDG. PERMIT: .I ::; '2... V ..... R' f J-AJ ...-;. )6.. D "\ C-E kA I , <.. ..,- Me UA.I'rFn ("")pJ~~ II Pr-N n .A- '-- A'rz. H- 0 r:=- , . ~ANECOUNTY,OREGO~ DEPT. OF ENVIRONMENTAL I\..AGEMENT CORRECTION . NOTICE CONSTRUCTION PERMITS & INSPECTION DIV, JOB ADDRESS /~ I r ~'?~ DATE Cj-/I-R/ TO: ~ BLDG, PERMIT: /322-8/ p~TE:0.~ Vt"A~_a~_~/&. ~~ ~_~--L.-<t4..e.,~ ,9/;-/~r:_e..&L/ ~~~- _3.'( ~ t" #_- '4.."~"-{;....' 61/_ &:td/--- . /_:/ .,,;;dN ~~ '~~ cJ.// ~- r~! ~-- _17 ~~ - u.c.4- A~ f-Z<l ~_~ ~ P,.--J("e'~'. ~~~~ ~~ ~ 2.)<. ~~:J/.L-~~ ~ 1'--<<1' L--- .-.~~ A,;/~~__ __~ ~. , p-- (/ (/ ~ f)tv-(J)_~/,.I.../I cLAJ'"J t:!k.J ~ .e.....L, L 'J.<,,f'--r-'.' L -f,J ~ W,,..-'I O~55@-~~~~~L', ~-INB'P~CTION REGUIREO (2. J ~ // ____ PhOi'11113l 1S18l7-4065 FOR APPROVAL 'INSPECTOR: ;~J.4_L~~