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HomeMy WebLinkAboutPermit Septic Tank 1991-10-30 " . . .""" R1\1D",:, ,', '- """ . , I . ~ - '" u 681..sPFL.~- AUTHORIZATION FORM ".-----------~---~ 8cb~7-9/ Land Managamant Olvlalon 125 E. 8th Av.. Eugane, OR 91401' ~--~ --; REQUEST FOR: SEPTIC SYSTEM INSTALLATION r:.:~RESSING QVAUO .,:-<:,:0 NEW ~ \-iV'" COD' ; ~ TOWNSHIP 18, 03 LyeloTlQI\I ADCI'!.ESS 205 DORRIS ST., SPRINGFIELD STRUCTURES NOW ON PROPERTY HOUSE; B~R~j ~ARAGf; ~HEp' PROPOSED USE slOI'nc INITALU:C WAUM frjSYALLlD J:lF I Y~T!: Dis(:l'llI'TlQl\l w ~OPOUD WORK INSTALLATION Qf SEPTIC SYSTEM DIRECTIONS TO 8ITE FROM OJUR1"~U&1i r,n SnllTH nN S. 2ND ST. TO DORRIS: DRIVHIAY IS OPPOSITE S. 2ND: ....G. SECTION 02 114 SECnoN TAX LOT 802 8UaClYtSlOM I PAAnTlQN LOT/PARCU IIl.OCK NO. Of STORIES NO. Of" EMPLOYEES CONSTRUCTION COSfIVAWI NO. OF IIEDAOOIIB GO DOWN OR I'I..E..\'I.J\.,( T<L RARNS .J'PLlC...N~ NAIl' ... AggHUS rJFD r~ARFTA. , t;, N. OWHl!AS NAME' ADDAISS HIli AM AI ANF PARK I< CONTRACTOR NAME 4TH ST.. SPRINGFIFID 97477 RFrRFATlnN nISTRI~S' tJ. 4TH ST., ~ oSR uCDuil' PHONE 726-~335 PHON&: SPFLD 726-4335 PHONS , . MAIL PERMIT TO: Hili ~ANF PARK R. ~ NAMI!: I have carefully read BOTH tJED rJABETA " PFDlTNWE RF(,p.FATlnN~p.lrr, ,6;11. 4TH ST.. SPFLD 97477 ADDRtin 1 sides of this appllcatlo and )1ere),y cQl'lIfy.that all Information Is trj an}! correct t/ ~- ~ 7,/"l../ 11 - -~- ~._-~-_._~_.~-_.~-. ~-~_'~--,._'----~~- . "-. ._._~-_.-'---- {/.._----.=-~- ._-_.__._-------------~ .----- ------ 'PLANNING/ZONING"'_l'l~~~,~C~~~i~~cL:.l' _~~ur,.;?ut;'orI2Cllon I" Bco~cl On Tho ~ollorJln{j~ol!ciltlono ~.. MINIMUM ',P, , ~~~~- SETBACKS 'RONTLOTUI/',~.~..~ IHTlIUOR l"lAft RlPARWil <~ -^ /~....,r1.. f~"P'" ~~r/dl:,:r4~=>~(;~~::'~::j;;;.i(V ~-4~~~~:'~", 1::;:;;;......y~~~Ji~~-:;;:;:..~,. . ~::."". ~:~l~.- ~~;r-~- ~~ --I, V i=-~, ZONE .PPROllIiD lilli, .;(.)?.,;,.;. 1')/.4:.:1) ~--r:1? -/f!/j- 7.> ;( " ./'" #~. ~.x~/'~/ CO....ENT8= I'SANITATlON I 0 INSTALL DlaT. .vaTOl PER ~ /_.f't"">o>~\_ '1d f APPROVED l'lOTPlAN, DATED ..,.~ Y e;<;.r 0 lHl 8'lITEM "'PURl TO 81 WOfUQNO ~.. _4~=~~~~~h~~ )~~G'1:,r<J'1n~v.:~ ~(r'j1J'LA"-. ""0". ." ~. '..hA'" /(J ':JO-- f/ (/ tt;, MfJ j,/ f) (OWl' ../ ,] ('fi'l' )/11 / uvt4' / h.L //~q'/ / / l't' /W '/;-0/.1."'. / dlf Ltk ~tpp6VED BY: _~ ~.P?.A.-:--- DATE If) -J.tJ.J1/ y. ..- iili~~;'~fit~NS -jSEEBA~/( OF FORP.1 FOR /lvtlRUCTIONSJ 687-4065 SEPTIC p~yj::if:/lgao ..!o~ol1~JeDr._A~L ~ther permits eltplre Dlter 180 days unlass Inspections are curront. -~ W-r ~~J11 -. __u.. "Pi QROup eOMYiHTGl l FEES DUE: t hATE 1 1 , . -- , VIOLA nONS SH11IACKS AND crmBR OONDmONS OF APPROVALMUST BB STRJCI1.. Y OBSERVED. VIOLATION CANRBSULT IN REVOCATION OFnm PERMrr. crrATIONS MAYBE ISSUED UNDBR nIB PROVISIONS OP LANB COUNTY'S INPRACIlON ORDINANCE ANDJQR. otHER RBMEDIBS AlLOWED BY LAW. ~ , . A MINIMUM OF AT LEAST 24 HOURS ADVANCE NOTICE MUST BE GIVEN FOR INSPECTION REQUES'TS Have the following information ready when you call: 6874065 Pennit number - lob address - Type of inspection required When it will be ready Your name and phone number - Any special directions to the site PUBLIC omCIAL alGIn" TO TRESPASS ON PRIVATE PROPERTY OKS ns.OIO POWER TO HN1l!R UPON LAND. TIm COMMISSION, AND ANY OP ITS MEMBERS, OPFICERS AND RMPLOYRS, INTIIB PHRPORMANCB OP1HBIRFUNcnONS, MAY EN7ER UPON ANY LAND AND MAKBBXAMINATIONS AND SURVBYS AND PLACE AND MAINTAINnlB NBCBSSARY Mm."UMENTS AND MARKERS . '~". REQUIRED INSPECTIONS FOUNDATION INSPECTION: To be made after excavations for foolings are complete and any required reinfon:ing steel is in place. UNDERGROUND PIPING INSPECTION: To be made after all underground piping has been installed. prior to any backfill. CONCRETE SLAB OR UNDER-FLOOR INSPECTION: To be made after all in,slab or under,floc~ 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 INSPECTION: To be made after all ducling and gas piping has been installed and prior to being covered. ROUGH PLUMBING INSPECTION: To be made after all plumbing rough-in is in place. prior to being covered. FRAMING INSPECTION: To be made after the all framing. fire blocking. bracing and roof are in place and all pipes. chimneys and vents are c:cmplete and the rough electrical. plumbing, and mechanical inspections have been made and approved. INSULATION INSPECTION: To be made after all insulation and vapor barriers are in place. prior to covering. LATH AND/OR GYPSUM BOARD INSPECTION: 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 INSPECTIONS MAY BE REQUIRED, such as but not limited to; BLOCK WALL: To be made after reinfon:ing is in place, but before any grout is poured. The inspection is required for each bond beam pour. There will bo no approval unti1the plumbing and electrical inspections have been made and approved. FINAL MECHANICAL INSPECTION: To be made just prior to the stnlCture or remodeled area being occupied and prior to operating any equipment FINAL PLUMBING INSPECTION: To be made just prior to the building, sttucture or remodeled area being occupied. FINAL BUILDING INSPECTION: To be made after fInish grading and the building, strueture or remodeled area is completed and ready for occupancy. MOBILE/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 foundation requirements for mobile homes Of 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 8S 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 ISO DAYS, OR IF WORK IS S .vrrw OR ABA, 'uuH~D FOR MORE TIlAN 180 DAYS. SUSPENSION OR REVOCATION MAY OCCUR IF TIllS PERMIT WAS ISSUED ON TIlE BASIS OF INCOMPLETE OR ERRONEOUS INFORMATION. A:\'YO:>rE ?ROCJ;:E:JDlG PAST THE POINT OF REQUIRED INSPECTIONS WILL DO SO AT T.-:EIR OWN ZUS:L Your signature on the front of this form verifies the following: I HAVE 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 YA_Y_A.J 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, raining to the work described herein. I further certify that if I am not the owner of the r.~~"'i. 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 permit 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 will be notified, and all corrections shall be made before a certificate of completion will be issued. Failure to meet 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 property lines 10' Edge of road right-of,way 10' Building foundation 5' Wells or other water sources 50' DRAlNFIELD 10' 10' 10' 100' Nec\ N'et6-h ? 17 O( \N; U o..\'Y)Clla,~ P tAA..-t:. 'I- e~c.... ))1 if APPLICATION # ' .J 0 b - 1. IS 1 tJ. Lfp.. Sf. 0 . LOCATION ~/i'/~.x# /j,~ tP [) ._/L /J I_i. _-.' I, ......"'. ~ NAME 11 ' di 'J_,,~ .,:;c;;:: ~~, J ~ v , . _I:.: ~d::).l_______:_~..Ir?ti, ~__ '(,i dj J The Lane County Building and Sanitation Divis~n'faQnot proceed with processing your application because: 1. ~comPlete application (items deficient).l', o Address and/or directions to application site. o Proposed number of bedrooms in dwelling. IJ6" Approvable_' plall.:(see attachment). o Notification of date test holes will be ready. . . . i t". .-... -, ..: HOLD SLIP .' >. .. ADDRESS ZIP CODE lanE . - OJ -tJ ~ ~ \ ~ 2. 0 Verification of existing system required (see attachment). 3. 0 Two test holes (2'x4'x5' deep) required for expansion or repair of existing sewage disposal system in the area of the proposed drainfield .' 4. 0 Other: ~ ~Ji . -, 7 .:si:)S,hA _d~~~ /,,~--A../ a.... /u:.I!u;;."..PJ)/ 'ki{, ,;--')~~tJ~. I7/P-'!'fiUAL- 4 CV 4'VJ;(f4!.PkJ. --(1)~~' ~;lrljJ-r {J;.:~;!?~{'-"-' () , -!tJ.c'~ A As?"" - tip. 'tf:.. -' .-?...P;(/- . 5--(' /f)./~ r, ~ fJtlj&_MCiZ~;;,-t!6~_ ~ 0'C:'~~r:?J 0 ::.~ f~<_ ~ I . .,d If jV"- \ / I ,t~ 11' '1/ ..- .' /' /7' I> /Or~"t/ SIGNAT~~E v'~ L>:~/ to {' ;eo 0f!..7 r 71:;r.; from OFFICE HOURS ,./ //.. . PHONE- If no response h,as been received In regards to this matter by II r 2.. '7 r q r the application will be deryied. j/! I . / /J I1ANE COUNTY ENVIRONMENTAL HEALTH SERVICES Courthouse-Public Service Bldg. /125 E. 8th Ave. / Eugene. OR 97401 / 687-4501 , l c;; to -' ~ ~ I '" ~ I ... '" , i~""h!} <[I Z;--;;;;~:s--;;':;~5:;;'~/- 231 7~~ .'. ~~:.( SE.PTIC ?LOT ?LAN AND I .. .LJ....... i~(~L"Vl/~~:DEVE!LV7lf~;:~~tV .... '.' ...~.,.~O,:._o-.. .~. ilY7 \' ",. ,. 0 /0 ~()"'o 5"0 .' " ~ \'. ~ II.. . . 0;0:. ::~, mVAGtms".,;f'o/,POsc2a' pa.vJ,//13 Area.. ,"/ ~i PLOT PLA~. A;Pf.C~ED . . . Vo, . A perm. reqUIred . .' I . I pnor to starti,.,., Construction. , . o. .' 'PAIf' ?-Jf.o-'11 \ ."~' BY .-<1.~ ,~GoA(..7" ;57?JNG'f> " d. Environmenr.:1 Hltit1ls21tices '\ : '. . 125 E.,j 2;~ 'lIY;..U" 0, ." Eugc.,e. Orr-:=. <h:: 1 . ". c,".9 .~. (!) .'.,.. " ...\1' C," . ,-, ,," . . . - <:J " '. c...Q..... II . _...- '0'-' . ~.~l~~~?.'- ':'ffi- \\~~\'...' Exh';i"~9 ,,':. _ .~ \ . f3/0c.e. IOWn< ~ ,. PCIZIMG'r5c \I ~. ". ,II bal'i't ~")m'l~A<:S DIUl/IJS \I . .~. t. ,\. : ::.,!- -:'\ \l (. . . _ _ - \ ,{ . ,<2G$7)iCOM /<8T7<<JF'/r :-...::;:'. - \1. ...-:-;: \ \' .....;...... , 3. _ \ .2:;::-:"v ';;""/"~'. . . \. :::;:.::. -..:;.:::; \ ; ~t/ r."J( 'V:I ~ '.\,. ~~.-"'" 0 ...----~::._~\~. \.,' ~~;~~y ~p~~~I~ '\ .. y" ~".J. : ':'.'~-. .' .1 .' . . . c. j:'\ " ~" . . 11..- ~ , ,.,' /' . /ol.nlWtIGD OAW . ". " .-~'~ DRA-'I-'AG& lY7l;:,J.JG5 1" ~. 0(' /~" )(WINTefZ.)" . -~ ....\ ~ Y . ~. h....... '. ,;.:...:./ h . :"(l~ ,,:"'~"""'l /"~, '..~T -: . ;.\ ", \I" // .....":'--.,.!! . . .~/RI-IGI..O ." -n .\ .0\\\ ~':) ,,~'>--:'" .' \... II . .. '<-""'-tZ"pW& f ,q.... ,. . . . ..r')'...... . ..":JKf' , z.'~ ~ " ", ......~' ......, ~ '. '. -.,.-'\ I'. . . ". ~. ,.:> .... '..... ....:::..t~-.;. ~tVM!.V '. '. . '--...........: ............. . . /....>....~1" ...... ..... " o.cvVAlt=ICLD .:__ '.' tl'~~";''''1 . ,"', ,~ " " '- U~T10J..( ''\'. '.~.., .' ('.{ "'J "~',. ..'<',........ ';",. !ZcPf./.CEI-1ENT V ...\ /.<-{PNJlIC./) OArW' I:, '-', ............. '..... ......" ...... . Af?EA) D/~"l/N.I"~G Dlre/l _ \ ..'. . "'"'....; Jt ", . (~/Ir.jrC/2...) ---k.~ !.~ ':.' .:. '(""? .> J r -.-~ f W//lama/CV1e l~';,'! -./.....~.. '.\ p~ " ~G477OV =~rR/cr _ ~;'~ ':::.~~~;.__l ('a;;_~~ I M~I!/@ ",- '...., '.'0 . . ~..--:-:-o. . 'Ik '/''' . . . '-'I" ~. wdng &r)? Wm/ ~ -' FV'/UM ~V6:w~tc l'N2A'NS .. '. . ..-' -.' ._-,.~,/'- . } . .. I_~ (... , - .. \ .4F?t..: <->--h' "",.+1= 9/- 2.3 / --.-------- V' ,.-~ --~~ ~('v-yYJ / ( //J: ( "' / ( OaL Wood/a.nd 't;/ ~: (;! Hvb7Y /)/t'vc.- < )v/~ac/ol'/ Orchard .1 1 \ ~: . \ . ~.~'---^-''---^--'~ \ ,-X ,11>;1' . OAT" J;~ j' ~ " \_:Y~:;!,,, BY , ./7.4-r;rf ,) ~~C \ \ ( ~~ Environmental Health Se I" I \ ltJ J . 125 East8thA..nue 1 \ ,.. /l" [ugene,OreEl'n 97,01 . n'/~rf Q (',~ ~ofJ. . Iii, ~ .):... /20 ~, l TYpn"'& I \ l./l ,- V . ~~:~~ H;' '/' _\\ ~~ \~ ~:..; '''......\\'---- ~::::;:.e/t+ .,..:::<_-:.:::.> "- ) (~"\ Di~~~5':<" ~~;:j.,~ \-- j r~~,\( "--f1~jr:-v-.rI~\_>'~} J7Ji( \~ \-( . J . ~ A/bed orcha.r~::-I/ . '.. t ~( . DORRIS ~~~CH . I" 0 \. \~ +- Jll/,U,l'tMALArJE. PA/Z;t:. J , il !?EUZCAr/or-I Di-o;;r)Z./C-t Oo..L Woodlal/d - ~ 2070' 1'0 e. PJ'Pf'. u;.e.. 3. < , ,-' . . .- .. , , ,... "C. ,....... ," ..:,".",w. .'.....':..:. ?::.'):" 'l::'" "'::~~'e ...'..'..'..,... e.. .unty :;..:::\,..~':.:}::... "fRE QUEsJiittRii;4SS/ST7tNCE' land Managemeril~iv:ii25>E:8ih:Aiie; Eugene, OR 9740f . . ", ..' ','"-," .. .'......:.... . .', -. ...;.'.~........ ..', lAND MANAGEMENT DIVISION '." ,', -\.' "", . Please complete all lines inside white boxes, if possible. .....~ Willamalane Park and Recreation District OWNER Of PROPERTY (iI not ..me.. abov.) 726-4335 ExIsting BuildIngs or Improvements on Property CXl House CXI Barn ." CXl Garage o Mobile. Home. . CllJ Shed SEPTIC INSTALLED CXJ Yes (By house) ONo Water District S.U.B. Np.d Nabeta '1VUH N.4.MI; 9/26/91 0.4.11; 151 North 4th Street .726-4335 YUU" AUU"I;:;';:;O I""UIIIII; Springfield . CITY ",' 97471 ZIP ..HONI::. 151 North 4th Street, Sprinqfield OWNERS ADDRESS (If not ..flU u above) 97477 ZIP Not selected yet (;UHIHA(,;IUH } . License . . MAP, PARCEL NUMBER (Found on tu maps In the A.....m.nt " Tautlon Oepl) 18 03 02 00 802 lownNllp TaniiO ~ec:uon H"~ehCln la)( Lot Town.tllp 0;;;- Section 1/4 Section 1.. LoI lownNllp TaniiO ~lIClIon "4 ~Chon lax LOI Di;ections to site from Courthouse E. on Franklin Blvd. Go across Springfield <ridge Turn rt. on S. 2nd St. Sonth on S _ 2nd St. to Dorris Drivewav is ODDosite S. 2nd Go down driveway to barns i .....-.-.............,.w... SITE 205 ~ '"",... " ~J ZIP J , Springfield, OR 97477 ..........-............-.......'... ,':'.;:'- Mobile HoVe Plac ent Onl Bran Year 'V Size / '" NJl.-'6f Tip-outs '" ~o. of Bedrm: " License # ""'" ':_:t '. MAIL PERMIT TO: Ned Nabeta Willamalane Park and Recreation District f\IAhllt: 151 North 4th Street AUUHt:::>::> Springfield, Oregon 97477 1,,;11' z,p , ~'''' ..... ..., . ,... :-:""':"".;;:.:.:;,,:.:. . ,,'. ....... . '.' .... "','.-.' -- . Sr.' . .. ' . . .}t?(;OfAME~'fSji ,!':,5!i~il~li~~~~i~t~~~;~iesi, F 0 L L C1!Y5Y Pi! :,lr~~~i~~iQ~')i;~~::'!~~~ . ,,,,:,:,:,".' .-.-'-' - -... "--',-" ,'--'" '.-...-.:..-/.,.... ::.-':::':::;;..:': -----..-- ........... .. ..... ".W .'_'._._.'_" " -.-.-.....-...--....:..-.-.....:.:.'-,.:.:.,.:.:,'...:"...'-.'-':. .. ....>...0...-.- i/iP. 3.rtillonIsubdhiislonii' .... ....... .._-......... -.--...'...-;..'-.-,-......-...-..-...-.-.-.......c... .' : ':::":'" "-':;:'~';:::-:,.,:. .:: Land Management Div. staff can not be held responsible for evaluations or recommendations based on false, Inaccurato or Incompleto Information ~:,;::,::"-'-'-' ;:::--".",;,..'-. "':":-'-:;';';:"" -..----. -'--'-'-'-". ".-" - .....,... ::,,-'::,: .':"-'.:.;..--.-. ". . '-."-:,. .:. _. :..:.:.... -:::;c_;;_:,,::~' . ..... .'...L()!"& Block . , ,:c._,::.,..:::'......,...._, . " U~I., ~I..IIJ"""'. I ) APPLICANT NABETA.. NED LANE COUNTY DEG~pE~~IM~T R~~E~~T Ip~'~7~iFI qATE 100791 A ., I.) ^ 4 ".,:s h ls J..: ,:1- .,.. TLt 1803020000802 SUBDIV Lul blk NEW BLDG TYPE USE R BDRMS 0 UNITS 001 STORIES IBLDGS 001 PHONE 726 4335 OWNER NME WILLAMALANE PARK & REC.. ADDR 151 N. 4TH ST., SPRINGFIELD CODE APPL NO ACTION DESCFdPTION 'SQ FT UNIT COST Vf~LUATION FEE D"'S 131::' BI:' BP BP BP . . '.11 I bft . . . . II i r . . . . il'll . . . . . . Pl. MECH SUI:: PCK SDS . . SDEQ . . 'II'FIX/E<(.\TH: LC 3067')1 SDSS FEE . CATC;: F'LN SE(IU : TAI<EN BY tiLC r',,,' nh . e - SDS' . \ SWI!: FT. WTF!: ~iECHAN I CAL FEE ST r-\ TE SUF:CHAI!GE PLi;N CHE:CI< FEE: ELE PCI< 1 EST. COMPLETION DATE: ISS 2 .. I::'T. . 5% 2:};~: / SI I!AIN: OTI:: DEPOSIT .lH. e- . 4'11 . .. .~ I'! .~ ! " .~ " , I ~ ~ ~ 1 , .. ,!II f! . .~ " '.~ I I · .',11..... .~ . , I " ". . I'T . 160.00 . 10.00 1-:"1 . '/ '; 70.00 c'f ~ .f ;r j er < APPLICANT NABETA, NED LANE COUNTY D~G~RE~~,M~! ij~~Ef~!. !p~~~Z~lELBATE 100791 TL~. 1 B0:~020000802 . SUBDIV LOT Bl..I(. NEW BLDG TYPE USE R BDRMS 0 UNITS 001 STORIES OBLDGS 001 PHONE 726 4335 OWNER NME WILLAMALANE PARK & REC_, ADDR 151 N. 4TH ST., SPRINGFIELD CODE APPL NO ACTION DESCRIPTION SQ FT UNIT COST VALUATION FEE BP' f.<F" BP ElF' BP r .: .. . Hm . '. . . Q:m . . . . m~ -. . . . IH~'" ufiut . . . . m,v . . . . !.', .~. ... ...".. ._. '. . \: '~.." .. ~ . .. -- I:'L ;:.FIX/BATH: MECH sur~ PCI( SDS LC 306791 SDSS SDEQ FEE SWR: FT. WTR: 11ECI'MN I CAL FEE SHiTE SUF,CHAf(GE PLAN CHECK FEE FT. RAIN: :>% 2~3~~ CATG: PLN SE(n!: T,'\KEN BY MLC F:A SDS EL.E F'CK ISS / SI OTf( 1 ,., ~ EST. COi"iPLETION DATE DEPOSIT *.)(. . . ~HHH . . . . ma . . . '--. . ~HHY . . D~S 9BU f~ . . FT . 160.00 . 10.00 Hm . ',' 170.00 C. . . '/ .. .~ - '-. October 28, 1991 Greg Gray, Registered Sanitarian Lane County Environmental Health Services Lane County Public Service Building 125 East 8th Ave. Eugene, OR 97401 Re: Dorris Ranch Septic Disposal System Application #3067-91 Dear Mr. Gray, Enclosed is a set of drawings for the rest room building and the Clivus Multrum Installation Manual for your information. The two lavatory drains, drinking fountain drain, two floor drains, basement sump pump, and Clivus Multrum liquid removal pump will be connected to the septic drain system. The liquid removal pump is located in the front of the Clivus Multrum tank which is located in the basement of the building. Any excess liquid will be pumped up to the septic drain lines. ~se-call me if you have any questions. ~uickly as possible. .'. /-...... s~~rr', d~ ~~--- Please process this permit as Ned Nabeta Landscape Architect Planning and Development Enclosures(2) Administration Building. 151 Nonh Fourth St. . Springfield, OR 97477-5498 . (5031726-4335 FAX (5031726-2751 ~ RECEIVED 0 C 1 2 5 1991 HOLD SLIP - ., N ~ d Wet 6. io... \\.J~ I (CLI'Y\Q.+fEW'f+,U<..J:, ci- t'.e.c. D~t-, I 5 I l0, I...J T'" .5;;+. $p-yi r:.5f.~e lef, oe q 7'177 Lane ii - :::ATION #_ ;Yo h 7 - Cj'1 Urn./! //\ .xii 'ION " _NAME _ADDRESS ~ The Lane County Building and Sanitation UIVISlon cannot proceed with processing your application because: 1. ~comPlete application (items deficient). o Address and/or directions to application site. o Proposed number of bedrooms in dwelling. [g' Approvable.j:Sf plan$ee attachment). o Notification of date test holes will be ready. 2. 0 Verification of existing system required (see attachment). 3. 0 Two test holes (2'x4'x5' deep) required for expansion or repair of existing sewage disposal system in the area of the proposed drainfieldn 4.0 Other ,:;UJ.,/. n~ J'L')S' ~ J~A<~ (,(~./ ",,- /'1_IUaUIP---!.! I /J I!.e-:;-J(,. ,'-' ~Jtr:vJ2:'J:;.~f".J. I)J'Aoo./UJl,C -.d c:v J;H/(~J-ct!-pp (O~A4, if;,-;?fJ-f' (L..&.~"1~-;;.J,. o c4M(:-'''.;Lc;t j - t1.fA./J//..-, /7~:iJ- ~-:!f}:- ~~'f':J1 ' ~ (, ~ d"~~' . :-~) Xk ("'.rr1~~A D PIL, M 'A-, _ 20 A5.2.... (7c:C>>1-..<!J-z;;-,~~Y. tI c/ /7 4~~y-- SIGNATURE r7 // (J:.orr to 7' ;&'0 OFFICE HOURS '" 10 ~"f~. 1'(1 DATE - , h{?7 --.71, (7 from PHONE -' ~ ~ , '" '" '" to If no response has been received in regards to this matter by the application will be denied. I ( r 2.. -=-/- q ( I u. LANE COUNTY ENVIRONMENTAL HEALTH SERVICES Courthouse-Public Service Bldg. /125 E. 8th Ave. / Eugene, OR 97401 / 687.4501 r) - , Installation Manual Multrum Model M-15 c-,'!'llf"';:::--~ '."~/' . . \:7 ,,<" (/' ~ / ~. .: / .L,> ',/ , '" ~r a:l l~ -, - C\ '2. Cj '\<3<3\ ~ G ,yIIl-~i . ."'~u\~ '1y '-~ / R> ./ ,. is'~ ~ ..~ U.S. Palon! Numbor 4,084.269 10/21191 , ~ - Hello: Thank you for your Interest In Clivus Multrum@. The Clivus Multrum@ is a carefully engineered and manufactured system that will give years of trouble.free life if properly installed and maintained. By following these Installation Instructions, you will ensure that this highly efficient waste treatment system functions as It was Intended. Anyone with basic carpentry skills can install a Clivus Multrum ~ by following these instructions. The basic tools and materials required are listed in the instructions. The average Installation time is approximately 30 hours for each unit. If you have any questions, please contact your local representative or Clivus Multrum @, Inc. anytime. Sincerely, Clivus MUltrum@, Inc. IMPORTANT: The warranty on your Clivus Multrum@ Is only valid If these Instructions are followed exactly and the Installation certificate form has been filled out and signed by an authorized representative of Clivus Multrum~. Be sure this appears In your specifications. KEEP THIS MANUAL HANDY FOR FUTURE REFERENCE OR SERVICE. A MAINTENANCE MANUAL IS AVAILABLE FOR YOUR REVIEW. THE MAINTENANCE MANUAL INCLUDED WITH THIS SYSTEM SHOULD BE GIVEN TO THE OWNER. Clivus MullrumC!l is a r&gistered trademark of Clivus Munrum~. Inc .1991, Clivus Mullrum(!l), Inc. ~. - , . TABLE OF CONTENTS 1. Receiving the Shipment 2. typical Configuration 3. Process Description 4. Plllparatlon, Tools 6. Construction of Wood Tank Support . 6. Tank Assembly Front Baffle Air Ducts Rear Baffle Liquid Drain Cage Manual Liquid Removal Assembly Automatic Liquid Removal Assembly-AC Automatic Liquid Removal Assembly-DC Organic Matter Chute and Vent Pipe Locations Tank Cutouts Tank Top and Compost Access Lid 7. Chutes 8. Toilets 9. Urinal 10. Ventilation System 11. Automatic Fire Suppression System 12. Electrical Wiring 13. Optional Liquid Storage Tank 14. Test and TrOUbleshooting Procedures Appendix A-Multiple Tank Configurations page. 1 2 4 5 5 7 7 7 8 8 9 9 9 11 11 12 12 13 13 14 15 16 16 18 18 19 A Maintenance Manual Is available from your local authorized Clivus Multrum representative. #,.. .. 1 1. RECEIVING THE SHIPMENT Check lor Damage ExamIne the outside of the Clivus crate carefully for evIdence of damage or rough handling. Minor Damage: Do not Sign the shipping receipt until the carrier has noted the damage on "s "bill of lading." Slanlflcant damage: DO NOT SIGN the shipping receipt. Refuse the shipment and immediately call Clivus Mul1rum. Inc. CHECK PARTS IMMEDIATELY Most 01 the Clivus system components are packed Inside the tank for shipping. If the shipment Is accepted, immediately cut the strapping, open the package. and remove the components packed Inside. Do not open IndIVIdual kits until needed. Remove and discard any packing materials. Refer to Figures 1 and 2 to Identify the parts and check them against the packing list. Damage. shortages, and discrepancies must be reported to your local authorized representative or Clivus Multrum, Inc. wfthin 5 working days. NOTE: IF CLIVUS MULTRUM,@ INC. HAS NOT BEEN NOTIFIED (WITHIN 5 WORKING DAYS FROM RECEIPT OF GOODS) OF ANY CONCEALED DAMAGE OR MISSING PARTS, CLIVUS MULTRUM,~ INC. WILL NOT BE RESPONSIBLE FOR THEIR REPLACEMENT. AFTER THIS PERIOD, ANY ADDITIONAL PARTS REQUIRED MUST BE PURCHASED AT THE CUSTOMER'S EXPENSE. _. , 2 2, TYPICAL CONFIGURATION 1YPIca1 Configuration Clivus Model M-15 4t tit 3 Figure 2. Exploded View-Clivus Model M-1S and Internal Components Natural Process The Clivus Is a low-maintenance organic waste treatment system that uses natural blologioal decomposition to convert toilet wastes into a small amount 01 safe, stablilzed end-product. Moderate TDmperatures Near the top 01 the waste pile, oxygen-using soil organiSms, including bacteria and molds, rapidly break down the substances that are readily degradable, releasing heat. Since a relatively small amount of material Is added each day, the temperature rarely rises above 90. F. The material In the midsection 01 the pile undergoes continued gradual conversion 01 nutrients to fertilizer and further slow breakdown 01 organic molecules. Bulking Agent Needed A 50/50 mixture of peat humus and planer shavings (prelerred) Is mixed with the waste by periodiC additiOn through the toilet. This material ensures that the waste has the proper texture for composting, that liquids are readily absorbed and drained, and that air can easily penetrate the pile. Redwood, cedar, and trealed lumber do not work well and must not be used. Liquid End.Product Tl'eated In cool, humid climates, a small amounl of liquid end. product may be produced. Althe rate 01100 uses per day, the maximum amount of liquid end-product would be 5 gallons per day. Conditions within the tank support the organisms responsible lor the treatment of liquid. The liquid, which Is derived mainly from urine, undergoes extensive biochemical changes as it passes through the filtration bed, so that It reaches the clean- out compartment as a stabilized fertilizer and salt solutiOn. Ventilation Provides Oxygen The blowerlfan, assisted by the high vent, creates a draft which pulls air into the compost removal section, then through the air ducts within the waste pile. and finally up the vent as shown in Figure 3. The oxygen reaching the waste material by way Of the air ducts supports both the decomposition process In the center of the pile and the treatment of the liquid. The ventilation air then carries away moisture and the carbon dioxide produced by the decomposition 4 Figure 3 process. When the toilet lid Is opened, air will be drawn down this opening Into the container and then up the vent, thus preventing odors from entering the toilet room. Disease Organisms Reduced In a Clivus, disease-eauslng organisms are not killed by heat. Rather, they die because condnlons there are not favorable to their growth, and because they are consumed by the very active population of deco~oser organisms. These organisms are responSible for the thorough composting In the Clivus. Stable End.Producta Although much of the Input material Is converted to carbon dioxide gas, which exits via the vent. a small amount of thoroughly decomposed material settles to the bottom of the tank and Is removed via the compost access lid at the front of the tank. For the yearly maximum of 36,000 uses lor the Model M-,S, about 12 cubic leet 01 compost are produced. Both the compost and the liquid end. product are Slable biologically and do not have an unpleasant odor. The compost has a bacterial content, texture, and ~olor similar to that 01 topsoil and is valuable for Its fertilizer and organic matter conlent. Additional lnfonnatlon Available Detailed Information on end-product testing can be obtained by requesting our publication "Heahh Testing." A booklet describing compost organisms is also available. , 4. PIlEPARATION, TOOLS Hoff: Clivus recommends that two people wotfc togeth9r when Installing the tank portion of this system. Read Inlltructlons Read the entire Installation instructions belore assembly. Check shipment lor supplemental InSlructlons. If there are any questions. contact Clivus Muttrum or your local authorized representative. Use Checklist An Installation Certification Checklist lollows these Instructions. During assembly, the completion 01 each major task Should be noted on the list. Kit Provided Sufficient sealant, screws. nuts, botts and washers are . provided for each tank. Toot. Required hammer plumb bob SQuare assorted screwdrivers compass hand saw adjustable hole saw caUlking gun wrench 7/16" level sheet metal shears drill bits (1/8", 3116", 5/161 tape measure saber saw or keyhole saw (power saw recommended) several extra metal-cutting saw blades Materlala to be Obtained Locally 10ft. of '14.2 Romex wire malerials for tank support (see 5) 25 gallons of water duel tape 60 cubic feet of 50/50 mixture 01 peat humus and planer shavings (preferred).. (00 NOT USE REDWOOD, CEDAR OR TREATED LUMBER OR ANY WOOD CHIPS). . 5 . SUPPORT . This structure Is designed to support the sloping underside of the tank and to provide a SlOP In front 01 the tank. The flat bottom. 01 the tank rests dlreelly on the floor or concrete pavers. The tank support should be placed on a level concrete floor which remains dry, or the support and the lIat bottom of the tank should rest on concrete pavers. Materials: All lumber should be .40 pressure-treated or "wolmanized" S2S construction grade pine or Ilr. wtthout excessive crown. The following materials are needed: 1 1/2" 4 x 8 plywood 2 2x4x120' 5 2x6x96' 1 lb. 16d galvanized nails 1 lb. 8d galvanized nails Construct the support according fo the plans contained In Figure 4. . 4t, 6 I 72" Figure 8. Wooden Tank Support I For Model M15 ~ 2 x 6th... required /~30" .40 Pressure-Treated 10' L.. notch for 2 . 4 Lumber Must Be Used 4,1- .1: I. For your convenience 30" 30" r 30" WOOdentanksu~portg ..I are available In It form - Consult the speclflca. tlon Sheet for details. B A 48" T B 24" 1 plywood DUlling 'ayoul lop vlow II I II B I A Ixe 33" 2.4 -' 10" I I II 2x8 I II -, II q alde view back vlow r 2x4 1 ~.,. I ! 51" lNlug 2 X 4 ",.rnat lank and anchor to ald. of .redla ""- \........ .. ........~ 2xv \- -' I "'- h hloeper 108" '~1 31" l c -2x4 30" ;1;: - 6. TANK ASSEMBLY . This section provides assembly instructions for a Clivus Model M.15 tank. Figure 2 shows an exploded view 01 the various tank components. NOTE: Only the sealant supplied In the Clivus package must be used when JoIning Clivus parts. NOTE: If you plan to Install more thsn one tank at thIs slte, plesse read Appendix A now for Important InfoffTIatlon about multiple-tank Installations. STEP 1: FRONT BAFFLE Position the front baffle in the bottom section 01 the tank as shown In Figure 5. Align the holes in the baffle flange with the corresponding holes on the sides 01 the tank. Fill each hole wtth sealant, and bott the lront baffle to the tank Irom the outside using six 01 the 1.1/2" bolts and washers provided. For each bott use two washers. wtth one placed inside the tank and the other outside the tank. NOTE: After Installing the front baffle, .nsure a thorough seal with the tank by applying sealant around the edges where 1M baffle and lank meet. STEP 2: AIR DUCTS Insert the two longttudinal air ducts Into the front ballle's triangular cutouts 8S shown In Figure 6. Make sure each duet Is Inserted open side down Into the ballle openings. Position the free end 01 each duet on the step at the rear 01 the tank. Slide both duets forward until they are wedged firmly Into the triangular cutouts. ---.--.....-----.------------ Figure 5 Figure 8 ~ ~;"l'~:~ ~lj... . . STEP 3: REAR BAFFLE Insert the rear baffle as shown in Figure 7, gilding the air ducts Into the notches at the bottom of the baffle. Align the holes on each baffle flange wnh the corresponding holes on the side of the tank. Bon the rear baffle to the tank using 1- 112" bons Inserted Irom the outside. Use two washers lor each bolt, with one placed on the outside of the tank and the other Inside the tank. Sealant Is not necessary lor the llIar baffle. 'STEP 4: LIQUID DRAIN CAGE (for gravny draining of liquid) NOTE: <<the tank you are Installing will Include a liquid removal pump assembly, 8klp this step and move on to the next. << Installing a multl.tank configuration, be sure to read Appendix A before performing this step. Using a hole saw, cut a 3-112" hole in the plastic bottom portion of the drain cage and posnlon It inside the tank as shown In Figure 8. The cage can be placed anywhere along the bottom front edge of the tank or on enher Side as close to the front as poss ible. Belore placing the cage In the final position, remove the screening and apply sealant to the outside bottom surface of the cage. Place the cage against the tank wall, making certain that the sealant is well distributed. From the inside of the cage, attach the cage pennanently, using two #8 x 518" stainless tapping screws provided. With the hole saw centered inside the 3.1/2" opening, cut a 1.7/8" hole through the tank wall from the inside out. Screw the 1.1/2" thru-hull fitting wnh the gasket In place through the hole from the Inside. TIghten the thru.hull filling wIth Its nut from the outside. Install the willi mesh portion of the cage by snapping It into the grooves provided. The drain cage can now be oonnected to a greywaier system. leach line or storage tank. , 8 Figure 7 Figure 8 ~ .. 9 , . STEP 5: MANUAL LIQUID REMOVAL ASSEMBLY NOTE: II the tank you are Installing wfll Include a liquid removal pump assembly, skIp thIs step and move on to the next. II Installing a multl- tank conflgllratlon, be sure to read Appendix A before perfonnlng thIs step. FIgure 9 Place the hand pump assembly inside the tank against the sidewall 01 the compost removal area, as Shown in Figure 9. Position It as close to the side flange as possible with the pump outlet about 8 Inches from the front of the tank. Using the mounting holes as a template. drill four holes through the side of the tank wnh a 5/16" drill bit. Apply sealant to the holes and mount the assembly using. 1. 1/2" bolts and washers inserted from the outside of the tank. STEP ~: AUTOMATIC LIQUID REMOVAL ASSEMBL Y-AC APPLICATIONS Cut and attach vinyl tubing to the pump inlet and outlet, securing each tube with the hose clamps provided. NOTE: II the tank yoll are Installing does not Include IIn automatic liqUid removal assembly, Skip this step Bnd move on to the next. II In- stalling a mllltl-tank configuration, be sure to rHd Appendix A befO,. ".rtonnlng thIs step. Place the PIK (pump Isolation kit) In the front of the tank where desired (see Figure 10). Place the AC electrical submersible pump and attached float switch Inside the PIK, bringing electrical cords through the hole in the top of the lid Of the PIK (not shown). Drill a 1" hole either in the side or front of the tank above the bucket to draw the electrical oords through. The pump can then be plugged Into the switch cord, which Is , In tum, plugged Into a ground fault protected AC electrical outlet. A 1- 1/4" discharge hole Is needed In the side 01 tank for the l' PVC discharge line, which should be located above the top 01 the PIK. Alter the discharge line Is properly Installed, apply sealant on the inside of the tank around the PVC discharge pipe. STEP 7: AUTOMATIC LIQUID REMOVAL ASSEMBI.Y-DC APPI.ICATIONS Figure 10 Place the PIK with the Rule 1000 DC pump and float switch mounted to the bottom In the front 01 the tank ~.""-. MI ~~ Figure 11 ~ i: . Mount tl:le PVC electrical box on the side closest to the PIK (see Figure 12). The electrical box should be above the lop ollhe PIK. Using screws provided, secure the eleClrical box to lhe tank wall. Place a PVC strain relief in the lower socket 01 the box. Feed the wires from the pump and floal swnch through the strain relief and into the electrical box. Drill a 1. hole In the side of the tank located near the strain relief and above the electrical box. Place the 1. f\lbber stopper in the hole. Feed the electr\callines lrom the DC source through the center 01 the slopper and into the electriCal box. (See Figure 29 for wiring diagram.) , ".",," .'-j -t""~ /. .. 10 Figure 12 . ~ STEP 8: ORGANIC MAllER NOTE: ThIll I. . very Important part Of the InstallatIon process and must be completed be1o,. proceedIng 10 the next step. Set the tank bottom on Its wooden support and place It In Its permanent locatiOn 8S specified by your plans. Dump approximately 60 cubic feet of 50/50 mlxtu,. of peat humus and plant1r shavIngs (preferred) into the ,'evated end of the tank. Bulking material can be added eIther through the toilet chute or through the maintenance door on front of tank. Rake the bulkIng material so that It Is distributed across the length of the interior of the tank so that the air channels are completely oovered. Do not use redwood, cedar, or treated lumber. Thoroughly wet the entire pile with approximately 25 gallons of water. Water will start to collect in the front of the tank when the pile Is thoroughly saturated. T1Ie wet pile must then be tamped Into place to the approxImate level shown In FIgure 13. Be sure 10 cover both aIr ducts completely with st.rter material. Any unused material should be saved and used later for periodic maintenance requirements. STEP 9: CHUTE AND VENT PIPE LOCATIONS To determine chute and vent hole locations. consult the plans drawn prIor to installation according to the Information contained In the site planning manual. Plaoe the tank top on the tank bottom and temporarily hold It in place using a 1-1/2" bolt at each oomer. Do not lighten the bolts completely. On wood floors, mark the position of the toilet and vent openings and drill a small hole through the center of each circle. Drop a plumb line down through each hole to the top of the tank (Figure 14). Mark these oenter points on the tank top and check to lee that they agree with your plans. .. 11 I. front baffle Blatter material . '-. : pump or drain cage Do not use redwood, cedar, or treated lumber. Figure 13 Figure 14 , $TEF> 11: TANK CUTOUTS . In ord.er to cut ohute and vent openings, you may need to remoVe the top half of the tank. Find the center points you plumbed, and uslng the vent and chute connector plates as templates. mark the openings for the top of the tank. Cut each hole only slightly larger than the Inscribed circle. The table below shows normal hole sizes for the variOus toilet types. Part No. hem OpenIng A.F108 Fiberglass 14-7/16" diameter A.F109 Fiberglass Handioapped 14-7/16" diameter Mount a connector plate for each toilet chute on top of each hole and apply sealant all the way around the plate, on both the inside and outside of the tank (Figure 15). STEP 12: TANK TOP AND COMPOST ACCESS liD Clean all surfaces where the top and bottom sections of the tank are to make contact. Be sure the tank top and bottom flanges are dry and free 01 dust. On the bottom section, run a high "S" bead of sealant around the flanges of the tank bottom and front baffle as Indicated In Figure , 6. Use two tubes of sealant and do not smooth out the bead, as thIs will ensure a good adhesion and seal. Position the tank lop on the lank bottom, aligning the pre-drilled holes. Lower the tank top onto the tank bottom and Into ftrs proper position. Align the holes In each flange and place the aluminum stiffener bars, one on each side, underneath the flange of the lank bottom. Fasten the tank top to the bottom portion of the composllng tank using the' -1/2" x 114.20 machine screws and fender washers supplied (see Figure 17). The compost access lid attaches to the top section of the tank as shown in Figure 16. Align the holes in the piano hinge with those in the tank wall and baffle lip behind it. Fill each hole with sealant and fasten the cover with 1-1/2" bolts. Be sure to use the washers inside the tank. NOTe: Saalant must bllapplflld to ." Inside seams of the tank, Inclurllng where the lip of the front baffle mlHlts the tank top. " 12 Figure 16 FIgure 17 , ~ .... . 7. CHUTES NOTE: Different tol1.t types r<</ulre dIfferent chute lengths. Det.rmlne toIlet type lrom packIng fist and plans. ThIn fHd thIs uctlon t:arefUlly before contInuIng wIth th. InstallatIon. Cut the chute opening in the wood floor according to your plans. . Insert the orimped end of the toilet chute Into the chute connector plate on top of the tank (Figure 18). Assemble any additional sectiOns with the crimped end clown. Tape each joint all the way around using duct tape. Orient the toilet ohute so that the seam is toward the side of the toilet. JOin the chute to the connector plate and seal around the bead of the chute where It joins the connector plate wllh sealant, as shown In Figure 18. Cut the uppermost section of the chute to the appropriate length as described in the table below. Do not apply sealant or duct tape yet. . pa'" No. Item Measurements A.F108 Fiberglass cut 3" above tloor A-Fl09 Fiberglass HandiCapped cut 7" above floor 8. TOilETS NOTE: Toffet must be Installed ",fore toilet chute. Fiberglas. toilets (Models A-108 and A-109) Remove the toilet chute before Installing the toilet. Follow steps outlined In Figure 19. For all toilets and urinals, affix the "' -2-3" user plaques within easy view of user (on Inside of toliet stall door facing toilet, on the wall in front of the urinal, etc.) NOTE: Sealant must be applIed to the InsIde 01 the tank .round th. toilet chute openIng. Figure 18 In. I: IOtew tollll IlonolT'l Irl.to 1100'. l toU,1 "ttom / T .. &11!' ~: 'USh chute town lI'\tOt.lgh trIO". eft"'. ct.A. tOp ). l , above tloo' (7" lor / hancll"P~ 1011e' 1"11). f ~ , \/ r- ...., 10, &11!' 3: \ Lowe' toll.t ~,~..~ \ / IIrM lMo chlA'. t ....... Molt Into front 1I",r lalcft. eo. lOP and f ) .onom togllt\.' c ..... ~Ol1 ... ~ l ...... Figure 19 '. 9. Uf'lINAl Cut a 2" hole In th~ 1I00r for the urinal drop tube according to site plans. Insert the PVC drop tube through the hole wnh the S-bend toward the top, The tube may have to be cut shorter to ensure that the piping beneath the floor will slOpe downward to the tank. " so, remove the excess from the bottom end of the tube. Urinal PlumbIng Afler mounting the urinal, faslen the drop lube to the wall fmm~diately below th~ S'bend so it cannot slip downward. Use the clamp and screws provided. See Figure 20. Under the floor, continue the 1-112" PVC plumbing using the elbOws. couplings, primer, and cement provided. Make sure the pipe slopes downward to the tank In order to drain completely. Where the pipe meets the tank, drill or cut a 2" hole In the tank top. Trim the piping aCCOrdingly, insert the end through the hole, and apply BBalant as shown. NOTE: Searant must be applied to the /nll/de of the tank around the urinal pIpe. -'''' .' 15" '-=--1 " \ r 26-1/2- Urlnll ~ ... y~ wld'st poInt 'I 16-1/2' . , 14 -. .~-..~-.--..-~~..--..--..---.---.--- \ ~ ~Iag b~lts A , mounting ~ bracket , - , 40" to top of ~ mtg.bracket- , from 1I00r \ , \ \ \ \ \ , drop tube ~ elbow ~"> ~ o I' Urinal 11.3/4' ..... '10 one"way bolt to wall , PVC pipe (two 5' length! supplied) tank top o lag bolt pre-drilled holes In bracket D lag bolt MOUNTING BRACKET ENLARGEMENT Bracket hooks Into squar. opening In back of urinal Figure 20 .. , 10. VEN1ILATI N SYSTEM When Installing the ventilation system. make sure that the vent IS as straight as possible, with only gradual bends when needed, and no horIZontal sections. The exterior vent must extend 2 leet above the roof peak. and air movement above the roof must not be restricted by nearby stNctures or trees. InterIOr Vent Pipe and AC Blower The AC blower should be mounted on the side 01 the tank near Ihe lrontlor best ventilallon (see Figure 21). Drill a hole on the tank side to acoommodale the ." diameter ptpe on the blower end. Apply sealant to the lank side where the lIange 01 the blower will contact the tank. Using the screws provided, mount the blOwer to the tank side. Connect the 6" diameter flexible ventilation pipe Into the e" diameter collar on the other end of the blower. WIre as shown in Figure 28. DC Ventilation Fan For DC applicatIOns, a 100 elm DC ventilation Ian Is supplied, which attaches direetly to the top 01 the tank, as shown In Figure 22. V.ntl/atlon Fans for Multiple Systems (Into Plenum) II multiple systems are Installed In one building, the multiple flexible ventilation piping should be brought up through a ehase, where all the pipes join at the top In a plenum (see Figure 23). An AC electrical blower Is plaeed outside the plenum. Various sizes of AC blOwers are available, depending on the number of ventilation systems installed In the chase. Consult Clivus Multrum lor the appropriate size blower neoessary for each installation. Vent Support Box and Exterior Vent Pipe Installallon Cut a hole In the roof to fit the support box. Hold the box In the hole, level It. and mark the roof line on all four sides. Cut the comers of the support box and bend down the sides to give the box top the same slOpe as the roof (see Figure 24 and 25). Nail the support box to the rool and insert the two sections of 10" extedrlor vent assembly above the roof. The rain cap is then Installed on the top section of the exterior vent assembly as shown In Figure 26. Note that a storm collar Is provided to support and weatherproof the ventilation stack. Connect the flexible ventilation pipe to the bottom of the vent support box with se~ tapping screws provided, and secure with duct tape. II more than the 26' "cllon ot venlllatlpn pipe supplied Is needed, join two sections with the optional connector available from ClivuUlons wllh the optional PVC connector piece. ~ 1S .. ". ~ . ~. ~."..". Figure 25 . i: ~ - . SYStEM ; The fire extinguIsher Is mounted on the TOP of the tank. Drill a hOle as Close to the exact center of the tank as possible. (It space Is a consideration. the extinguisher can be placed near the front of the top of the tank.) The nonle of the cylinder should be Inserted Into the hole, and the fire extinguisher will extend back 21" and will be 5-112" higher than the tank. (See Figure' 27.) The position of the cylinder can fluctuate to accommodate the pOSitions of toilet chutes. For maintenance reasons. the gauge should be posnioned for easy reading by the maintenance person. (See the . Planning Manual for examples of placement locations of the exllngulsher.) For wiring the fire suppression system to the DC electrical system, see Figure 29. All electrical wiring should be done by a licensed electrician fOllowing all applicable state and local COdes. The fOllowing generalized wIring diagrams apply: AC Environment: · The fire extinguisher is wired in series w<<h the AC blower. · A separate circuit shOUld be used to provide AC power. · The plJlT'4) plugs directly Into the back of the float IWlt0h plug. · The pump and float switch (tOgether) plug dIrectly Into a GFI circuit outlet. ~------_. ffo",-: ",.... 11:1 '- Figure 26 111 VAC, ,....p lit. .lltI,ngol., ""-I"Pply ~--'.:~onbob r JJ AC I blow... J~ d ~ ", VAC 0_' ero."" '-.11 proltCltCl - I,. VAC.'...p ....p pump UKf . 1101\ owl1oh Figure 28 DC Environment " . 17 '. · The fire extinguisher is wired In series wnh the 12 VOC fan on the 1+1 pole 01 the motor. The polarity ot the fan must be matched to the polarity 01 the power source (+ H +). · The 12 VDC pump Is wired in Series wnh tile float awltch on the {+l pole of the pump motor, · The (-) lead from the pump and the 1+1 lead from thl flolt swnch arl passed through the tank wall Into a pump junction box mounted on the outside of the tank. · The pump junction box is connected to the main Junction bOx making certain that pOlarity is maintained. oeD F.. &.~:~I- . '_notion boo ~~_I ,0 l I 1lVDC _.r auppl, lrf:J-f,."~" boo 1ZVOC lUmp pump Figure 29 , 18 Drill a 1-118" diameter hole in the top of the storage tank and mount the 90-degree Ihru.hull plug. applying sealant to each fitting flange. Connect the storage lank In rei 10 Ihe Cllws drain wnh the tubing and clamps provided. . PROCEDURES TestIng Pump Operation Fill the bottom of the clean-oul chamber with water until the blue strainer on Ihe bottom of the pump is covered. LUt the float switch until the pump runs and stans pumping water. If the pump runs but does not pump water, reverse the connections lor the black and wMe wires in the pump electrical box. If the pump does not "In: 1. Check all wiring connections. If DC pump, 1. Check all wiring connections and DC polarity. Testing Fan/Blower Operation Hold a blown-out match near the edge of the lollel seal while lifting the cover approximately 1/4 Inch. DO NOT THROW MATCHES DOWN THE TOILET. If the fan is operating, Ihe smoke will be drawn Inlo the toilet. If the fanlblower does nol run: 1. Check an wIring connections. If DC ventilalion fan, 1. Check all wiring connections and DC polarily. ~ " 'I' : . . 19 If Installing a multiple-lank configuration, refer to this appendix when performing installation procedures for liquid drain and liquid removal colT1X>nents. Gravity Drain Systems Figure 30 shows a typical set up for a multi.tank gravity drain system. Follow the Instructions In STEP 4 to Install liquid drain cages where Indicated. Connect the tanks with 1-112' PVC plumbing as shown, using PVC primer and cement per the Instructions on the can. All rigid piping Is supplied by customer. 'High Intercomeots" are used to connect Several tanks In series in order to provide a second pathway of flOw In the event that the gravity drain becomes clogged. Locate the high Interconnects 6' above the flOor of the tank using exactly the same equIpment and procedures outlined In Step 4 of Section e. I(Note that extra drain cages must be specially ordered for this purpose.) 1-1/2" flexible hose can be used to connect between tanks, attaching to the barbed end of each thru. hull mllng. The gravity drain manifold can be constructed of 1.1/2" PVC and secured to each tank's thru.hull conn8C\or using a threaded female adapter. '.-j :..' '. :-",; ( 'k..omatlC LiquId Removal System-!JIII '. ., , 20 . . :Flgure 31 shows a typical set up for a mu~i.tank automatic nquid removal system. AI$o shown Is an optional nested ventilation system. Follow the Instructions In STEP 4to Install liquid drain cages where IndICa1ed. Follow the Instructions ,In STEP 6 or 7 to Install the automatic liquid removal assen1lly In the last tank. Connect tanks with '-1/2" PVC plumbing as shown, using PVC primer and cement following the instructiOns on the can. :There Ire aeveral options avalllble for liquid removal. A sub.floor storage compartment in the building could serve as a IPU~ station for the Uquld end-product. If this Is not possible, an angned sump pu~ In a holding tank could serve as a I PUfT1l statlon, )1 Clivus Multl\Jm~, lno., 21 Canal Street. Lawrence, MA 01840"801 Tel.: 800-962-8447 FAX: 508.794-8289 ~ 'RoY. "IV'"'. Ro~2: 1lIl1llel. !lev.l: 1lIl"'. !lev..: K'lII. N-/c..c;e) qu:.HAtZO IN~.-...... ..... p~""U, 1111(" Al2.l!;"A .(~,~~ ,~~~) .__",-m",."'N-" ~,_",---__ '_,!,"_-" <""~ ~,~..,.""- ~~ ,-' ~";::'c;~-F.-;-._,'7""::"":'),;.~ '''''il''<'t --~_X'_,_.".. I~_~!,::!\~. 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QF:.\l~" g '.S .;~ ....6':.,~ I ~ ....0 .0 " '~'1' d ~./': '. 24-0" ""0' L_..._,____.__ Io'-~ ~',o' e.z-o' _ "_.__m,_" _ . VIC,INITY MAp I-I.t.<;" '1 " ":~,,-. :--~:'~'" ." , '", ,-' .. -,,_i. '. ',I.,'. ".," ,,'. .' "" ;C"'';' -~" "..w..t_"~' ,:F;iI'~"'-4_j -'. -'. j ~ " I ~i .' I 't; , ! ~ I j t I () ,- , C) '3 ~ II ,,,~I 1 ' l"~ L.~.- DONALD L PETING Historical Archited & St.ructures Consultant Eugene, Or (603) 346-1093 q,'{Mi:}OL.'? ~ey ~ d l-MU WAu" . c,' f1MMf:' wAU,.. - 1/"'. ~~E:oTrz.a.1'- ~pt .<?l~ ~ f'tAT f1Z.Nv\lOt1 WA!,....v -1/1.! ~Het;it1l1"1'- e:t~E>'t7 ~1t7e:l"'... C,j2.OUN17 fAUL.'1 I""T~tJrr~ OVU::>T' 1<;4 A~"e; f.f.' a.uAViUpt..e-)C. olJft.,~r - I.,' AP...o"~ f:f: ~wlr~... 6.1 4':7' A'MNFE::: r.t:: ~~ u(.,~t ft~T\Jp.e WN...J.,. 'MWH~. I:) f1~TU~~ ~t.U~~ I~~~'J~~? ?/'--4~ ~rEU-r"F- N"r~ '::>N~e:. rA4~ t;;>IAME'>I~ ~A~ f'~N"", I C'..... ANV fL-cq'" l7JlAJ N~ l) ~///////////// //r// ., /. .~~~~!/,////.:~// ;~'f-~ I] EJ , 'ZJ(~u..I-ell:Ie. ~, f-.. 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VEo'NT OU'-T TO jU'OP UNIT' <?6-Ef NOTe 1$-'1 & t ,(jl t. 2'-0' AU.e:~ 17"olt-. 2'-0' A'f>CJ"Je; f."f- ~. ~OVl V'6"/~ It-! '/oIA~ '7Jy'('l-'/' ut--l6"' 1tJIn-;1~1. ~J~_n"~~'~ ~.. ; ~/"'/.~ //////.{/.' '////..//~; '" " ,.- - . \ /, / ~ / & I '''I..I'..'V<?' ~ ; 4- "'\g..= / '--, TNJI'- ill ...-; \.V ~'+'i- .-Y i _.; /~//,//, /// // //////..'/.~-//~ '4~ '/."0' ~'.O. . _ _L__ ~_" __ ~ Id-ell I t;"~4. - -'.,. "1"'-- --- r1'~1~~E:::NT Pl...AN t..I EB " " ''','' -_""~ ".c-..'._.'-,--- . i7'~:_<l:" ~:':'<:v';'<I'~;~:r;f-~~ ' '~~~J . .~~ ~::~}. qi~;':: "'l'" . .~ ;:~;" .":~/~~~~' , . .J';' ~, i,~ ~'i" _'f!oo tl. Z 'S o ,;!l ~dQ ~ 0 ct ~ ~'i' ~O..'.~ o rd' ~: U1J~ Z~'~' . ~ij = . ...1\"':,., "',~... -'<~~~'.:d-:&~;:i ~ .......(,).'. " c; ~:' <(4 ~.'. . O'S !::1 E-40~ (f)Q' ~. ~ - r ... ~ . !.l - . i' ~ ,;. - ~ ~ d 0 ~ .~ ~ ~SJ i 1 d '. r2. -'~- ,~. 2 ;_ ",_,,,,,.,,,'_'" .......... '.'~_"." .. _ w .. _ ____ _ _ ;....?l'..".. .v.. ..___."'.:~ -,.""",,.. . .~.~,*-'_.. -. _.~.,.....--....._..... ~ w.__ .___~. _ ____,..' ,.. W'r...~_T. ., - r-.,,,~<;';<"",,""';7 Jl . -- ,~,~."..> . .-. .",- _".~ ...-w~,~... ,.'---~~ .~. ., ,",_' "" ..... --Iii:"" ,. '.0- ,".'111..<:' ,.."P-'.. 1! ~:.-':l'cX~'; , < Nor~~'. ~A[2-N lX'~ Trt~ ~ ~C;HiHt4~~ ""~Wjth ,')(!)' ~ ~AiW p.l17~ M1NUM \U'Ofi"lu O'I~ e.JfIN~t.e~ 10' 4' a.NU~ ~r &.1TAG-tc: 1iAAJ~ P<<f" ~IW~ __,. L. l , -...J..._~_,I -rL (_.L,~ -Lr' :..1 , IrI-;.- ~ '-, '-'-T -L.ri", , L._ I " I I I J I TL .L~ ;- '\ '" ~ " . ~ "\ W~T aE:NATfON //4' .. 11-0. ~~ ~of ~ww I'W-Lh 8:A0T ~D.n Ot--j 1/4' ='- 11-0'1 ',"_-"~ ''''.~','''''_,.-' _,In'.'-'-'~ ',,-~'O' ...... ......_...~~-...., . - ~ -~ -"~ ..,..". ""."_"._ ~. ~. '>, _~. ',.:' .... . _."",,"'-.~,~_.'..~ .. -...-, _ """'--'.''''' .... ... ,..>.,J-.:_......".<\.. ":>0 Ju-. .,_:"-,, ;':'. ..-r.. ~ ,_ .',.....~ . _ ~..,...:.:.. Jk!"._.' ;--'d"~,:_-_' ,,' J:)ONAlJ) UP~NG ,> HGrorf~al;,Afth1mb,& .,,_., ",il," ',..... ",: . Stxv<:t\lJes CQM\1,.' I~rit Eu"eJie.Or (503)~7m ~~'. ~~~tr~~~T ~~~~~~~AJ~~ . d~e'i'-If4~o-1tJ I~ tzuNN1I--Ic. ~NP W1t-.lc;>~W.~ f12-OM G?<1e.,-rJN4 ~ & r(pl~tJ i2..eI"'~f'OlU-M~Hi f"b..rtE::fl.N , ; l' ---. -' '--" L' ~ _. _~:~ '. -T-'''y.-- ___ --' -'.- -=-- - - -. fllLT~_LT IlL '" I .1' !~~71.~',~11 "-,ijL" ~IJ::-I ,I ~ II JI ~-:-:'.'l; L..L I IR-L---L~: t__~~ -- __ ,"-, I 11 I.'. I tt=-' -+- -+- --IF:t: -t- '11 -- -' ~" t-. .,~' -+- - - .f........ 'H- + -+ . ri '.......L.r-'-L "II T--.-.tr--1H'T"rt' .o.'-, , j--j I II" "~I .( I-l.j fj' ~ Tl~;-~-LTI.S= '-'1- ;~~,='~=~rIL-L I I ~ ~: 11 L1-. , . -fT,-l I ,_L.. ~rJ..I~~ ~ ,L ~ '-...1. -f.,L-r.LU . ,j .:cl ~-::.-:- -trr=. -.l=_:Ji.::,-:' .._'~ .tt - .. ,I- -- - - P -t- -I- --=f..l. -f* + _L I L i i II r i -Ii 1 ! ; I, . , I I I I II I III I .~: Ill. I I I I I I I . "',:';;;:<i!!i~ 4~itoi;!~,'ti.~:<' ~-"'-~*-;"':'~'-~'~'"-__~:"~~;" . '10rz.TH ~~ATIOt--.J 14~ ~. .11'0- ..-.. o " J.~t D:~J~~:'. . a\...~,' . ~ %riAl~ l. f'[Ti~G ~ ;~~~ t O}' \}\~ 1tW";fs ~ - ~w W/~ ______..____. _ . -. -.-.---"'-----_ __,_ _h __ --- .---,------ _~t.E::\)~~ ~.':f',., , I - '[ -'T'-j'-- ....._,.... - - I H-- \..,.,. I -- :'-;--1'--'1---' ;---cr: c-:::r- ,. 1U1' WAUh . ' I 1" ..J.. r "'L I I '1 t' II . -~-, TL~, L r' 'f -I' l' ~ do. I,' ,t'" I i.. T -. T ." ~-r, : ('-;'-r -I"~ 1" 'j-' i-L. ";- '-~"'~i'--'-Ii i r1::r' .'. I"', i - L, --- ; -:- 1-.1.1,- I I.. T ~_L: l__l_j_! r _. --.1.--1 ,- -..0. --IJ. ~_.L~ .... 1__L- --:-_____~;_-.L . I , ,~- ~1...__r.J- , "I I .L J I ,I,., I L . L. . -,'- r-'--- . . ' , '-TO. 1'-'1" ._.,._1....~. ..-1 ',- 'C'o.~._..,_.L~.....----L r' " r"-.,... L . -'-] L, ' r..l,..lrrL,.... .....-L:~ILT--i--o.--'- I, I , L..-l-~L-.-LJ 1..1' ~_l._]_L '1 .", I I.L[. ._- ,': 1 j . I l' . ,. j : I -- . L-r L:-.l..T.Lr -1- ,,].1. : ~:I =[,1., =:C_ ,-l=~~_T':L,:~:l_T__L~L~~~;';""r-Lr"j__~~_T: r .., ,~o.L'_ I 00lffH ~.bTION 1/4" ,; 11-0 II . ~- '... ~~-. .... '-"::r,itti<'_-':;:'.~,~-~ n!;,:-~':'~ ""~". ">:;"I~"~' I' : . V .' );1' ..i~ :;<.; ~ " '~..- ',. ...< -' . z.. "'< ,~'J . . .. ~'~ .~;~,~~S~;~ . . ~ z iil'l,rj :s w:~\}i ". OK::} j, J ~i '..,.-" ~ z 'a S.a~ ~ 3 if .~ ~1) ,8; . ~~ M" 0"0 ,Q, U~~1 ~.gl;; <~...~: = '. 1,14' >"";,'.a!.",;~~ ~/&.....l ~.~ .' 0'8 ~' ~8 ~'" " ~ ;: ~ . ~ :t ~ " r ~ ~ ~ ~, QQQ ~ ~.t :h :h .0 S .o-g~ ~ ~ .~ ~ .a ~ QU~ 3 ,'~' ~ ...- .- - -; ~. 1\ J. '~CO' ';-.' pro"~ Palf ~'alJilP WI\I..U;.- ",;. ,;t, ",",,-- +0 . ,-,..,,~, ,_:,..', ",'I' ',...,....:, ~"': "."" .......~' ..' ~~, -. ,',,'." NOT~~: . . , ~Gt-IVtJe:; ""''1PO<;7TIN(., UN If & . f't;-~"""'~-If f1';>l41wqzy.. 'V4' ~1B:t7 ~( t.t-J "" ~lC---P 't#)JOI~I&.1 1.'"/t:,, H\)IJ4 ~"t-1 GoMtJ WA.t...t.b ~ ~ ele> 10/ ~ F:F: . TW. . ..' .. . ,/ ~ ~" .L..._ / ,. ~( --..1.___ ~_ :--... 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I II I -_. -l'l'.><I'Z'ft'Ofl"'U. ~E:I.-O~ ?,,;OIl.-- ~~'.~),.~~_~~~__=_': _.:.) , /j ---flfT1.bND o:;,M.fOUHD. cOAnN~ .. ". ", ~".. _,' 11 ,. /~~ 4! ~cC'f' [/i?AIN l~TIf\~':~~'iiiTl- ~ .. . ".::", -- ~.' ~I;' :;4r=~c.~~l~~Ir-~n=:f' tl~IN ==-(!1I~' · II "/ \\l~ ;1\\ ~tI\ . ?~. =-~J . ; . "'\l . -.,'"'..-- " .... . \ - tl'l:::::. ' f~1 \t - ,..1 C I ;::'-_I\{I_lll==~lt::::,- :::-: \ = f7Af?-N WAL~ e:,{;-Cf(O"-1 II' -=-11-01' V '? .__.CO,'" .__",_...__ '___.~"":.- .~,~~_..{~~;.;.~<,~~f~(iri:'~' ~ . "bi'I.... '~.'.'.. '..'''';. '.. '~..' "~~ . ....,~ 1'1 j ..' ....'.......1"'.' "'. ,.<,'?";:i-f;;; ;; -:J. ".': ,,:'$' ,- ~~~:i {, -... '~''''''"'''t"!! ..."'6 V'J"-: d' (X) c. """ *" .'~ ~.. .,.w ..... UJ' ,.. . , '. ",< ,-~"!I} } ,...J ...... . I '.Q':;'F' . ....'.'.t.....'......'. ' '4' '_.'" ,.';;" ~ '- :: " ,~.' ,,~~>, i.............. ..' . ,:.; ,),'" : " ~.............::....~." r..'..' . .. I ,-. ,.... .. - . . . ',' tl .z ".s O fI).. 'M ~. O' OOd .. ~gl O:~fjj; uit~: ~'~Fl .~~~'; -~-~~..:d'. :\ .oo...~ ~Jt,.. . ~,',,:.~;' ;~ ~"I-'c T"_ ? ~ r. 1 ':!! ~ ~.: - <i' .. 0" .... 888 ~ \;0$ "1:' Qt:;lA ~ ~k$' ~ ~'....~; >. ..0. i ~~1: 8 a &t... .. , 5 ;' -( i; "":_" .0',,' ~~..l . . C"ANCELLA TION ~.;'" REFUND AUTHORIZA TION ~ .~ ... , . NAME LVI UAMALA tJE: PA (2..K.. <r i2..ECR.EATl DtJ "p 1ST TRSITU PLiM& "'NT ADDRESS 151 fJ. 4TH I 5 PRIf'J6nELb ! Of?- en t.t77 C&l APPLICANT a OWNER a CONTRACTOR REASONFORCANCELlATlON uvE"r<.. C HfH26c ot-J I tJ<; lALLA- T7 (; r0 PERMIH 3o/;:, 7-q I J 8' 03-02. - BOl.. PE/2fo.-/. II SIGNATUR" DATE Fees paid for waste disposal systems (site Inspections sndlor applications to Install the septic tank and dralnfiold) are ordinarily nonrefundable. Refund may be on building, planning, or plumbing portions according to the amount of the permit/application processed. FEES PAID %REFUND " 1(00,00 _10,06. % Flood PlaIn Fee % Building Permit Fee % Mobile Home Fee % Plumbing Permit Fee % MechanIcal Permit Fee % Plan Check Fee % State Surcharge #6{) CJD{ eA.'fJU ~~Septlc Disposal Fee % Site Inspection Fee ....., % DEQ Surcharge $--------------------- $--------------------- $--------------------- $--------------------- $--------------------- $--------------------- $ -------------------.-- $ ____k9..!_QQ._______.__ $ -------------------.-- $ -------------------.-- ~ % Land Use Application % Planning Director % Recording Fees % Partitions % Copies & Ordinances $ ---------------------- $ $ $ $ % Surveyors L----:-------pPf.------ Less Processing Fee $_____~---, ___ ~// ~L ~MOUNT TO BE REFUNDED $-L1ftt~_____________ Signatu~e ~~~ Date l..2{)eLYI TO DEPARTMENT OF FI~ANCE: . ., Building Permit Refund $ 24-0674/Acct.42120/Prog.020 State Surcharge Refund $ 24-0674/Acct.42123/Prog.020 Septic Disposal Refund $ ,,(/), OD 24-0427/Acct.42133/Prog.240 DEQ Surcharge $ 24-0427/Acct.42123/Prog.240 Site Inspection Refund $ 24-0427/Acct.42134/Prog.240 Land Use Application $ 24-0674/Acct.46202/Prog.010 Planning Director $ 24-0674/Acct.42150/Prog.010 Recording Fees $ 24-1870/Acct.46211/Prog.110 Partitions $ 24-0674/Acct.46202/Prog.010 Copies & Ordinances $ 24-1870/Acct.44419/Prog.110 TOTAL AMOUNT REFUNDED $_La ~ .I PLEASE MAKE CHECK PAVABLE TO: Receipt# Receipt# Receipt#+'....1Lj' Recelpt# Recelpt# Receipt# Receipt# Recelpt# Receipt# Receipt# NAME' tJJt LLAMALArJ~ 'PA t2 K.. q.. (2.f:(2. 1) I $T AI I ttJ: NED NABETl::t ADDRESS IS I to, LITH . .s pe, J\J6Ft E:LD, oe 0,14,7 M14-48