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HomeMy WebLinkAboutPermit Septic Tank 1985-12-12 - Lane Count Authorization for:- SEPTIC DISPOSAL SYSTEM INSPECTION FOR LN. REV. G-&- I [}.--f 0 FOR OFFICE USE ONLY Applicationt7/-L'A t. ~ Perm1 t # ~ 7l,/ /- <To I RANGE 03 S~BDIVISION/PARTITION (if applicable) 'l',JWi';SHIP 17 SECT ION 23.4.4 I Tll~T I OOUT OF PROPOSED USE OF PROPERTY [Xl Residential D Industr ial o Commercial D Public. LQT/PAiK'C:' BLOCK LOCATION ADDRESS STREET 2520 Oumas Dr., Springfield STRUCTURES CURRENTLY ON PROPERTY CITY ZIP 97477 Dl~~TrONS 1U SIT~ Coburg Rd. to Harlow to Hayden Bri. - Dumas Dr. across from Page School ~ESCRIPTION OF PROPOSED WORK - BE SPECIFIC DECLARED S VALUE Sep.tic disoosal system = OF BEDROOMS J ~ OF STORIES O;~'NER I 5 NAME AND ADDRESS FITCH, Charlotte A. inSDec. I for loan onlv it OF E~jPLOYECS WA.l'ER SUPPLY o proposed 1X1. Existing TELEPHONE NUMBER 726 0258 6756 Dogwood St., Springfield 97477 CONTRACTOR'S NAME AND OSR # MEDFORD, Bil~- 1216 Mohawk Blvd., P::;RNIT TO BE MAILED TO~E AND ADDRESS) AI . j 0 Springfield 97477 TELEPHONE NUMBER 746 7613 TELEPHONE NUMBER I HAVE CAREFULLY EXAMINED THE COOPLETED APPLICATION ~'OR PERMIT, and ,]0 hcrclJy certify thdt all lnfol"1l1atioll hereon is true and correct, and that I have the following legal interest in the prope~ty, Downer of record; 0 c{.,ll'"rd<.;t purchaser; ~authorized agent . I f:....rther certify that any and all work performed shall be done in uCCOldullCP. with the OrdlnanceS of Lane County and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will b", made of ar,y st_rncture without the permission of the Building Division. I fur- ther certify that registration with the Builder's Board is in full force and effect as resuired by ORS 701.055, that if exempt the basis for exemption is noted hereon, and that only subcontractors and employees who are in compliance with ORS 701.055 will be used on this project. I HAVE READ AND CHECKED THIS APPLICATION THOROUGHLY. 8,// ~p)=prD NAME (please print) BU )y;~~ - SI,NATURE /.2-10- gs DATE READ THIS SECTION CAREFULLY. YOUR AUTHORIZATION ~AS BEEN BASED ON THE FOLLOWING CONDITIONS~ o PLANNING/ZONING: Zone Partition 11 Parcel 11 Parcel Size Minimum Setbacks: eL, front eL, side! interior rear COMHENTS: FOR LN. REVIEW PURPOSES ONLY. NO SPECIAL PLANNING ACTION REOUIRED. 12-10-85 Date: f) ffi o SANITATION: S. 1. i B. P. 11 Installation Record Issued? 0 Yes 0 No M.aximum Depth of Tren~hes ~AA:VU . . ~ Date, l.zO-/~..,?j4 Installation Gallon Lineal Feet Specifications: Tank of Drainfield CCWIENTS, ~~ ruL,~ - <,ns:. "" .t1l~-4.-k1 - ~ A J ~A~ -::ez. P]' RuJJJ{f.~I..;/r /j,AJ.4 ',,/l J.I~ I . o PLANS EXAMINATION: Type Group Use COMHENTS: Date: n ~u) ~_ /<,S 1.2~/? ~7J ~tT APPROVED ~ BtrrLoIN~~~CIAL/DESIGNEE Coer ORS 456.805(1)) DATE LANE COUNTY DEPAFTI/dlENT OF PUBLIC WORKS LAND MANAGEMENT DIVISION, 687-4061, 125 EAST 8TH AVENUE, EUGENE, OREGON 97401 SEE REVERSE FOR INSPECTION INFORMATION C 14-25 R84. . . SETB,\CKS A~D OT!ICR CC:;OITIO::S OF APPRO';'\L }:UST BE STRIC7LY OBSERVED. VIOLATIO~ CA:-< RESULT IN REVO- C;'7IO;.J Of' TillS rf.J1.mT, Cl1;\110:1 U~DER PROVISIONS Of' LA:>;'E ;:OU~TY'J INfRACTION ORDI:;A~CE. AND/OR OTHER RENEDIES ALLOWED BY LAW. WHEN READY fOR r:,SPCCTION. CAL:' 6B7--I065. A mNINU:,! OF AT LEAST 24 lIOURS ADV,\i:CE NOTICE FOR INSPEC- nUel KJ::Qt:l::~7::> ;';:';:;T tJE GIV::,,,. Have tne tollowing in!o:"::Iation ready: permit number, job address. typo: of inspection, when it will be ready, your name and ?hor.e number, and any special directions to site. BUILDING DIVISION: REOUIREO I~SPECTION~: 1. Foundation Inspection: To be made after trenches arc excavated and forms erected and when all ~atCrlalS lor tne toundation are delivcrcd on the job. Where concrete from a central mixing plant {commonly tcrmed ~transit mixed~l is to be used, materials nced not be on the job. 2. Concrete Slab or Under-?loor Inspection: To be made after all in-slab or under-floor building serVi~e e~ment, conOuit, pipin~ accessories, and other ancillary equipment items are in place but before any concrete is poured or floor sheathing installed, including the subfloor. 3. Frami~~ ~ Insulation ~o!ctions: To be made after the roof, all framing. fire blocking, and braCing are in place a~d all pipes. fireplaces, chimneys, and vents arc complete and all rough electrical and plumbing are approved. All wall insulation and vapor barrier are in place. 4. Lath and/or Gv!:'sum Board Inspection: To be made after all lathinq and ~ypsWll board. ',nterior ana-exterIOr, is in place but betorc any plastering is applied and before gypsum board joints and fasteners are taped and finished. s. ~ Inspection: To be made after the building is complete and before occupancy. APPROVAL REQUIRED. ~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 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. NOTE: All building permits require inspections for the work authorized, such as but not limited to; A. Block Wall: To be made after reinforcing is in place, but before any grout is poured. This rnspiCtlOn is required for each bond beam pour. There will be no approval until the plumbing and electrical inspections have been made and approved. B. Wood~: To be made after co~pletion of masonry (if applicable) and when installation is complete. Installation shall be in accordance with an approved, nationally recoqnized telJtinq agency and the manufacturer's installation instructions. C. Mobile Homo: An ins~ection is required after the mobile home is connected to an approved sewer-or septic system for setback requirements, blockinq. footing connection. tiedowns. skirtinq, and plumbinq connections. 1. Footings and piers to comply with State foundation requirements for mobile homes or a. recommended by the manufacturer. 2. Mobile home minimum finish floor elevation shall be certified when required by a flood- plain manaqement letter. ~ 3. Mobile 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. swimmin5~: Below grade when steel is in place and before concrete is poured. Above grade wnen POO! is installed. ,\PPROVED PLA:~S MUST BE ON THE JOB SITE AT ALL TIMES DURING WORKING HOURS. TillS PERMIT WILL EXPIRE IF WORK DOES NOT BEGIN WITHIN laO DAYS, OR IF WORK IS SUSPENDED OR ABANDONED FOR MORE THAN 180 DAYS. SUSPENSION OR REVOCATION HAY OCCUR IF TillS PERMIT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS INFORMATION. ANYONE PROCEEDING PA.ST THE POINT or REQUIRED INSPECTIONS WILL DO SO AT TllEIR OWN RISK. SUBSURFACE ~ ALTERNATIVE ~ 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 submittinq 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 comply with such ruleS, the Depar~ent 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 II reasonable time constitutes a vio- lation of ORS 454.605 to 454.145 and this rule. Setback~ - Subsurface Sewaqe Disposal Septic ~ Drainfield Fro~: Interior property lines Edge of road riqht-of-way Building foundation wells, other ~ater sources 10' 10' 5' SO' 10' 10' 10' 100' ... '. A2TI~Y INFORMATION a-IEET Idne county <I , .- COMPLETE THIS SECTION, INCOMPLETE FORMS WILL BE REJECTED! 1 11' .-ef}-k-J) ~~ tZ! d~ '4 ~SOr( MAKING REQUEST PROPERTY OWNER L:J.!? JntP/~. $.J.vfl .175'(.. f)&t?w~ .)/ MAILING ADDRESS MAILING ADDRESS ~~;J Ifk. 97~/7 f~' "..;.-/7 ~..l- 97~77 . / .It:ITY STATE ZIP CODE ~Y STATE ZIP CODE 7L/1.-7~ /3 7:Jt-O.::J.-5f: BUSINESS TELEPHONE # HOME TELEPHONE # BUSINESS TELEPHONE # HOME TELEPHONE # 2 PROPERTY ADDRESS ~ d- 62 <9 D (,LM v'\-~ nt?_ ~lA" Co L.: Ai (IF DIFFERENT FROM MAILING ADDRESS) V l~' 3 MAP & PARCEL NUMBER (REQUIRED INFORMATION) (from tax maps in Department of Assessment and Taxation or from tax statement) ~ ts 03;;..3 -'/. '/ f/1 T W SHIP RANGE SECTION TAX LOT(S) OR PARCEL # ZONING TOWNSHIP RANGE SECTION TAX LOT(S) OR PARCEL # ZONING TOWNSH I PRANGE SECTI ON TAX LOT(S) OR PARCEL # ZONING TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP: 4 SUBDIVISION (if app1 icab1e) AJit?ft.wn-/l 0;.'1, 3~.t1rid LOT /1 ACRES BLOCK_ ~'f 5 REQUEST (state exactly what you plan to do) ~~rc' ~h- .-/AA~~~ f G~ (/~r~ -Ca-eP ~ ~ fJJo,....- 7'16-7613- 6 ~IRECTIONS TO SITE: X~I.j~~I/a..A__'-J -b, N'7L $/1-. <1)~~ glt. ~~ ~.:~~sd. ** FOR STAFF USE ONLY ** - -- NUMBER DATE .. -; '" c.n . -; r-: ZONE/LAND USE: BY: DATE: TIME IN: OUT: LAND MANAGEMENT DIVISION / 125 E, 8th AVE., EUGENE. OR 97401 / 687-4061 . . ... I") L,^,^.J~-.a-- 8>' ,J;. '2 s-zo .--- ~\ '<l ~' .s. ~"Ttt.. l'f ~ ". Ii, ~r~"'''- yJ 'g. ~I'l '-0 I ~ L ~ I ~ I i / J . I ACT_ITY INFORMATIONe;HEET Iclne county ~ . COMPLETE THIS SECTION. INCOMPLETE FORMS WILL BE REJECTED! 1 PERSON MAKING REQUEST PROPERTY OWNER MAILING ADDRESS MAILING ADDRESS CITY STATE ZIP CODE CITY STATE ZIP CODE BUSINESS TELEPHONE # HOME TELEPHONE # BUSINESS TELEPHONE # HOME TELEPHONE # 2 PROPERTY ADDRESS (IF DIFFERENT FROM MAILING ADDRESS) 3 MAP & PARCEL NUMBER (from tax maps in Department of Assessment and Taxation (REQUIRED INFORMATION) or from tax statement) TOWNSHIP RANGE SECTI ON TAX LOT(S) OR PARCEL # ZONING TOWNSHIP RANGE SECTION TAX LOT(S) OR PARCEL # ZONING TOWNSH iP RANGE SECTI ON TAX LOT(S) OR PARCEL # ZONING TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP: ACRES 4 SUBDIVISION (if applicable) LOT BLOCK 5 REQUEST (state exactly what you plan to do) 6 DIRECTIONS TO SITE: ** FOR STAFF USE .ONLY ** NUMBER DATE . --l ::c Vl ZONE/LAND USE: BY:' DATE: . --l r-: TIME IN: OUT: LAND MANAGEMENT DIVISION / 125 E. 8th ^VE., EUGENE, OR 97401 / 687-4061 . . . . . .. . " rl't . . . t I. .~ I I . . . . ,. i": ~ . . , . . .. . , . . . . III.. . . . I" . . W: 5 LANE'COUNTY DEPT ENV MGT RECEIPT I APPLICANT FITCH, CHARLOTTE ADDR 6756 DOGWOOD ST., .TLI 1703234400119 SUBDIV NEW BLDG TYPE USE R BDRMS OWNER NME FITCH, CHARLOTTE . CODE APPL NO ACTION DESCRIPTION . BP BP .BP ElF' I I tcp . PL MECH . SUF~ PCK LR . . 340185 DATE 121085 SPRINGFIELD, OREGON LOT BLK. o UNITS 001 STORIES IBLDGS 001 PHONE 726 0258 I" ADDR 6756 DOGWOOD ST.. SPRINGFIELD, OREGO",. SQ FT UNIT COST VALUATION FEE DAY. ~ .~ I L.C 340185 SDSV 60.00 , .i , < < .1 1 ,r,! . OFIX/BATH: SWR: FT. WTF<: MECHANICAL FEE STIiTE SURCHARGE PLAN CHECK FEE FT. RAIN: FT 4% 25% . CATG: . 'SEQU: .TAKEN APP 1 BY RLH RA FP SDS SI PCI< OTH ISS 3 TOTAL FEEH. 60.00 ., i ; 10 ! CI< .. ! l l .. 2 EST. COMPLETION DATE .