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HomeMy WebLinkAboutPermit Correspondence 1982-6-30 .0 . . ..--,~- Lane County Building & Sanitation Division Mr. Gray, Enclosed are copies of the correspondance we had with Kathi Wiederhold. My husband did the repairs as she asked, he dated and signed the Plot Plan also. The only problem was we forgot to send in the Plot Plan Form, that is when she sent us the hold sl ip asking for the completed form. I hope this is all you need to issue a certificate of satisfactory completion. Sincere 'l~ I llJ . (--{Y)IvJ A.()1.m?C( q7 JaJi'Mi"' (Mrs.) Sandra Gabert ~mv~ JUN 30 198,\!> - ~ENVIRONMENTP.L C: MANAGP-'.:.lH LANE COUHTY <> \ r... 1\ A",; _ ,.~'''.,.;,i 'il-'~ . ...l:,'4-;"'-~-,;--:'-'~-'- _..~.---- .>1.;'.... , '~'.- - ~-!I_.-,- ___..__, - -,-~--""-,''''''!. ~'. . ',- ---- -------- : .. ..~ .-(D dltl.(,FlA ~"- 'Vvt.. \iJ~1t IV, ~ \0 uJiJ.I~' $fu1fJC 7 ~ t i w_ _.. . __. _CD~CM ~ ~ \t\CWL '1I\i \l~ LSU\tc\ PfU Jdv LII (fl{t-~ -. cl~L -. 'fpieDGM~ Y)A) 9~ &r ~ . ~CL " . ~ __,. Q). 1<rwvL .~ W)(. - ~\) %03 liTe- llv\L old- ~ W UJ .__.;..}" ._~~ ~ ~UlY\. b>>L ~_ ~\tM-.~ -. . _ ,_,;,';--,,@>-hll autt;WYY\ t~ LLji- Ceyz~vs~--C16}.0 Sl9no:JuM-t. _____' .. ~ /vt~ 4 ~~ - VY\oJ. \V) . . . .__~_'~.'~ ~\~~rI ~.lDo\: afrt-~<u~, ,Wi~j , ~~\ 4 ~ --- ..". ~ . . ~_.~.~ , ~.~,.,- ~~(iVv , " -... . . . .... _ ~,/ft1, Wl~~ . &tth3~- - ' __~. Ir~~ fZ . .. . -. . ..~~....-.~:_,~~,. -.i2,:,! ~. . __~_------:-__._'______._ ~_ _____'...._' _.__ . _ '4'__ .__ _____n~__.~~,_ ~ ,. /lLfCU../l, . c c')/ M-UST BEiN'IiLACK INK Permit No. j.9 .J 3 - (f Twnshp. -If? . Range _ (J.~ - Sjction ~J , a Standard System]!!< Alternative System 0 (Specify Typ'" Ii <> ,. ; - Job Location (Street Addressl '74~ .J1..fti c: 'lpr:"!J-P.DI..1 a r.. Subdivision I Partition # Parc,,1 Block DETAIL SJo&~M PLOT PLAN AS CON~&.aUCTED A t,:~(\N ~/ Scale~" = -L-' ~ ;".f 2.q~ ~l " ' ~ VICINITY MAP , '- 'l'rV:!J VI - --. - " ~ '1} .,- "- . l\, 0 IN. ,'}. ~ ~1.. N f~' E: J\l~2. ~ 198'2.'" 9 p''''IJ\NGI\I\~\OIl .. ,"a'\ OWl, S,. ".n .<<'1 '''' ..".. Cll\l.... .. ." ",",t. . /'> \ .... /-/r-;--,-- \~ ',-0 \ \ 6/'ZjgQ. 411 repoJ~ dOrl.e., o.ru:t,j~~ '/5 c.Dvered. &I#~ - (iX;~T";"9 f.kJvs6 Installer , Tax Lot form c55-11 IC/O I Lo' 1\ I SEPT/<:: '1'!!N~ ,.' (59!.( <) WElL I~ 2q~ /8'-- v v .. ;1/1. ,I Telephone License No. Bonding Company USE/BLACK INK ONLY FOR INSTALLER'S USE: I Trench Depth ::J Gravel Depth Below Til" Tank Capacity ~tJOO ~ Manufacturer Measured Distance from ell to Tank From DralDflelrl COMPLETE THE FOLLOWING IF A PUMP WAS USEO ON THIS INSTALLATION: I (installer's name) ". certify that a (MIni and Mercury Float Switch (Mlg. and No.!. ~ ~ Corrected ..r INSTALLATION RECORD & CERTIFICATE OF SATISFACTORY COMPLETION When '6ned by the County Sanitarian. this certificate is evidence as per QAS 454.665 of satisfactory completion of a subsurface sewage disposal system at the above location. Hille as shown on OEQ liCense' lSignalurBol licenseel II Installed ~j O~er- a~K,..h1.l.-, ISignalureof Ownerl Applicant's Name & Address 1=,/ &!Je..f'T 7<fS ,/)cJ rr;c; . '~"" rcJ~; "re. Dat" Signaturp DatrdiIP/y'/". / ' / FOR SANITARIAN'S USE ONLY: _I lB"'System Ap~~o~~L COMMENT$: .A~./ .....~7" AL... ,~ ~.. ")o.JJL. _ o/<.lJr-t ,-/~f2- <[~ System Capacity '1 a 1./ day Signatur" er..2....:../ e 1 9'11/71 Total Length of Line. (Model No.I_ - Pump have been installed with this sewage installation. Dat" .. / o ?ysJllm Disapproved . ~eeds Correction ~ .a..- AA.t . -' I'O,.~ - v .' Date Date7-I-YL . . Heturn tnlS torm to: l:SulIDlng anD sanitation UIV., uept. ot environmental Management,locateD In tne Dasement ot toe Public Service Building. 125 E. 8th Avenue, Eugene 97401. ' --:::::. ..... HOLD SLIP bne county (a -, ,. FINAL INSTALLATION RECORD FOR PERMIT # /i.S3.'Z'/ ,<-~l; no 0//7 ('trj 1,j(1Tf INSTALLER /Q"fJY1.J./V '1LJr;" ())/'(;J.. ADDRESS rr-b.l_t72/:;__/l9C11 , l/l///7/, r;(}(r:! ZIP YOu~ Ce~t~~icate of Satisfactory Completion for the above referenced installation cannot be approved until the following corrections are made: ]~INCOMPLETE FORM / INADEQUATE PLOT PLAN -- A. Township, range, section and tax lot description B. Address or street, road, etc. C; Applicant's name/mailing address D. Installer's signature E. Distances from tank & drainfield to well F. Pump & switch specification statement on plot plan G. Vicinity map H. Additional measurements needed r- o n )> -i - o :z o "T1 Vl - -i fT'I ~ J', 1. Illegible J. Form must be filled out in BLACK INK. ,( ~~~Other L/Jr.~'! (/,db/(([jlru/.'t'd\ )/-/}10;( lVI, JV ') - , ~.. ..., -, ('- _3.-CONSTRUCTION A. Water level d-box B. Grout box(es) (inside and out) C. Non-approved materials used in effluent sewer D. Trenches covered E. Incorrect grade on trench bottom and/or drainline F. I ncorrect trench depth j . . . I ? 'G'. Other d):.!"liTh, hk <1..1.", flip fnV/:p.J f'if///.//uA.f.evv'eV, J;t. (/oorft..;/ Ii/Tv I,!'Q. (}!J1.J1AiY:VfIIJOGICtJ.NJfJ);.,f,f;l(rfd./pICU1U2.,.. ~ M~ ~1-;, hflll <.) lA~J-i -hu, k~r: V'1~ I!./ ~')' (if) (jlrrp0Tf&; jJ);-e{; 1/('.161 D,)X IT! ,;:r/!Oh1!,tlf(/. . if Ufl..'kr1t1 If the necessary/correctlons are not made wlthln It) days,}the Certificate o~ Satisfa~tory Completion will be denied. ~ -J (; '(;,,/(11-- (/J1A^-... m.Mj f (\It "(/& J c. c. A~Pl icant Signature /f-rNJw //'..-, ,).7 U,;/i / tli ioDate fllt:!..;'" Z- Phone Ilit0/.},1Cl/') 8:00 - 9:00 A.M. .j , -1' " \<::::~ - , ' c. ~ ~ ~ 125 Building and Sanitation Division East 8th Avenue / Pub 1 i c (503) 687 ~4061 / I Environmental Management Department Service Building / Eugene, Oregon 97401 Wats Line 1-800-452-6379 , . - G) GtXG\ ~<1VL (1lC ~ I1DlLl~ ~'\lL- 1ow.lctvn6) ~? CV ~ ~T lLvtt 'if CJ1\;+(~{fr1'\ bDi t nt' 9rcwe{ Jfv~~ . Q) _'Q\,VQJl ~ ~ ~ %at ~It \lVlL cWt boy- \j) ,Cdmp~ ~ 1"ft'Y\/\- 'oo)l -+t d!lQJ.JV\llV\.Q.; '\ @ t1 [l~.;f(L~ tvJ~'" c9 I vY\Ol~ 1j'Ne.~ t ~ vY\Ov~ VtOW Cf1A (~ ~C~ - ~\~ CQt~~~ THIS BLOCf' PLEASE VSE BLACK INK AND PRINT. 'n li""r,I:r~ /6/ HMo" :.3 l.td~cR j 79~/ DO"' "I 'UBon'SI ,(;:h"'''' '}I/j;el I u4!ff I '''?t;g ?r:f.~~/~ ~/;;, 'c.""." ','DPe ";~~~:d~:;, / ':"~_':'"=~ lY~h '-'"'~/..#g."~".: ,. ~ 4-~/. ~~. ;7f/~l'sj/ C com;")R'SN~>1E~;i~ ?#?-ci;t? "7t0,i rJl:""""'q7~~~~/ ~,2~ - . ~.t//; ~7 "~,.,,. .//J.b...~ ~ / - . ?" - ..... t .. CAP' -'L.Y EXAAltWD TIF .'!'oll ,. /\f-'I.' ~i\" IN,F'' P "~lT. "I,d d(' hpr, r 111.f 'f ,I ~er th,lt oIIny ",nd all work 1~....t6nl' ::l ;hall 1:;- d(>w 10 J<.. ,n.I'!'", "'lth thf' rl (.u I,f 01 t thf' ...ork d,'.,'rlb-'d ~cr' in. .arId th/lt NO '':UiM;,-'Y wil _<to.f any aru, Il' It t r- that reqistu,tion with th~ BU11der's 81 ard i.s in ful force and eiff> 'I' as requir. db '1., It lC h"f' '. and t at Iy ub 'ntractorl' ard elllPloy('es wh AI"' in Dr'" ,lian. wth ~R' I., 11 U~ 1 APPLII~ATlON n y. F~/l{J! ~;, ~~ar- o PLANNING/ZONING: zonc_P /J ) /' .. c (~~"'%-5:;~'~"4'f2:-:~J .~?' ~ ", ~~~~~~~~~V.4'...b~~ >t. C;--C?7-J/ ~ o FLOODPLAIN: In fl~d h"drd dr .. ~ 0 y. >. ot d .' n o RURAL ADDRESSING: ORJD COORDI,^Tl , E ,t. D }iq' SANITATION: ,. L . B. P. . 77"9- 7/ 'Mddot, 0 D ,. Inst.lldt1on L ill ,on rL.~ J,... ,t 1")4 II th :'::::H~~~~==~~~e;t Id 'e_~*,~_ G-H"~~~~~;, no~~ !Ine.q ~_~~lsvtl~~b~! . ~Y;/JJiiW l<iVM::ULUJtlil1J..l\_~"\ ltc.W~1q_CU_qjl~ . JfTV'. ~ ~~60 _ptJDL~ J I"rdMd.tU^ ~ H ~ Floodplain F~e S $ .-?--~' Subsurface Fees ~~ Building Fee $ Sewer/Storm Drain,wdter ~ Plumbing Fixtures $ Mechanical $ Plans Check Fee $ State Surcharge S ~. TOTAL FEE $~ r .~ CONSTRufrION/PLACEMENT . PERM IT .~/I~~.r'~ r Irt ,tien F " ~TRUCTION AUTHORIZED BY THIS PERMIT -- Sq. Ft. Fixed Fee/ Unit Cost F' L )~ .Y \: 1 ,o/V'r-:::::? r: / l-'ermlt */ ()~{ ;-q( o l'WI,) COPJ.' Ol inS o "WQ ( o ~cl1aI .<.1 DVJumr J:lPl:H ~1 d Ie " I f 1anl '7hE'C 1 ,1 'Y n :0 ~h~ ,t :L " pC'!lOln ..1J.. D COI nf'relll D now ,.J Dput-lic v} .lIi ,. Id , ., " "' r , Am ." ~/ ~~hJ ~ o :JA " /~t~ -- FEESB:~ID ~) ~ D.te, /rfl 7 /-~/ ,kd.J.h) 1M IlanrfnpL-.^nrl_ _zilf1z't) l\l PER.'1IT APPi6'J~M~E:iI(''NEE (po'r ORS 456.805(1)) '~=l.'t. LANE COUN'l'Y DEPARTMENT OF ENVIRONMENTAL MANAGEMENT / 125 EAST EIGHTH AVENUE, EUG . OREGON 97401 C74-194 App\[UJJt!~ ~ l1am~o1 TOTAL VALUATION S . ", ~ SETBACKS AND OTHER CONDITIONS OF APPROVAL MUST BE STRICTLY OBSERVED. VIOLATION CAN RESULT IN REVOCATION OF THIS PERMIT, CITATION UNDER PROVISIONS OF LANE COUNTY'S INFRACTION ORDINANCE, ANOIOR OTHER REMEDIES ALLOWED BY LAW. WHEN READY FOR INSPECTION CALL 687-4065. A MINIMUM OF AT LEAST 24 HOUR ADVANCE NOTICE FOR INSPECTION REQUEST MUST BE GIVEN. Have the following 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 DIVISION: REOUIRED IIISPECTIONS 1) FOUNDATION INSPECTION: To be made after trenches are excavated and forms erected and when all materials for the foundation are delivered on the job. Where concrete from a central mixing plant (coll11lonly termed "transit mixedll) is to be used, materials need not be on the job. 2) CONCRETE SLAB DR UNDER-FLOOR INSPECTION: To be made after all in-slab or under-floor building service equipment, conduit, piping accessories and other ancillary equipment items are in place but before any concrete is. poured or floor sheathing installed, including the subfloor. 3) FRAMING & INSULATION INSPECTIONS: To be made after the roof, all framing, fire blocking and bracing are in place and all pipes, fireplaces and 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 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 finished. 5) FINAL INSPECTION: To be made after the building is complete and before occupancy. 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. 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 inspection 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 STOVE: To be made after completion of ma.onrv (if applicable) and when installation is comolete. Installation shall be in accordance with an approved nationally recognized testlng agency and the manu- facturer1s installation instructions. C. MOBILE HOME: An inspection is required after the mobile home is connected to an approved sewer or septic system for: setback requirements, blocking, footing connection. tiedowns, skirting. and plumbing connecti ons.. (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 floodplain management letter. (3) Mobile home tiedowns, when required, and Skirting shall be installed and ready for inspection within at least 30 days after occupancy. Tiedowns and skirting shall be installed per enclosure. O. SWIMMING POOL: Below grade when steel is in place and before concrete is poured. Above grade when pool is 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, DR IF WORK IS SUSPENDED DR ABANDONED FOR MORE THAN 180 DAYS, SUSPENSION OR REVOCATION MAY OCCUR IF THIS PERmT WAS ISSUED ON THE BASIS OF INCOIIPLETE OR ERRONEDUS INFORMATION. ANYONE PROCEEDING PAST THE POINT OF REQUIRED INSPECTIONS WILL DO SO AT HIS OWN RISK SUBSURFACE AND ALTERNATIVE SEWAGE DISPOSAL SYSTEMS (1) (2) Permits shall be effective for one year from the date of issuance. Upon completing the construction for which a permit has been issued the permit holder shall notify.the Department by submitting the installation record form. The Department shall lnspect the constructlon to determine if it complies with the rules contained in this division. If the constructlon does comply wlth 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 fo~ satisfactory . completion within a reasonable time constitutes a violation of ORS 454.605 to 454.745 and th,S rule. Setbacks - Subsurface SewaQe Disposal From: Interior property lines Edge of road right-of-way Building foundation Wells. other water sources Septic Tank 10' 10' 5' 50' Drainfield 10' 10' 10' 100' ~~~ I' ,~_ '_4.., L e. ~. /' CDAl CD ~ (S) ./ ~( ~: ,/ ., \-. \ (,,'~ --.; . _ I (7'S3 .-!l/ / 6 -() 3- 0 'Z 2.... _~LS- O~/ 196/ . _.... .s '01;- \) lei. ~ / ~WJQf1.." otr:)r()JMll-MJ '-I I: -h -\'l'tv' c~ b\.l-\to'rv'\ .QJ\AoJl D "P. f If\."- -~, ~ ........ -sLI)L I ,i ,,'0~ x.. l_ .. ~ ~ ,<' 'o0.~ ~ \ ~ I -I /~l9- < .> :) , I I . f Ilo1oiJ't -~,\ _ ,\'Oc>~J-c~ dN),),\:hi'~ - dVtvcj,\;\@) \"'2;/ .I-- I WV- .::. o~ C(}~\g.. iC;P v ,0.90 '. ~ I)I<<I~Q.C). otlCS \ by ,~>('., W~\\ -- f .~ I , ". rjy ~1I' :~/ ~~/. / /1 I I // . I" . I . /&" -' .&/ ~ l( ~ :\ ..,.... IAc.,~ 1- ..., " .. . BOLD . SLIP bne coonty ~ , . FINAL INSTALLATION RECORD FOR PERMIT # 1~~-i\1 0JIlJOJ1f/ ('7r1.JJ/lrf N4(- fbrtrii. INSTALLER I(/~~ ADDRESS ZIP Your Ce ficate of Satisfactory Completion for the above referenced installation cannot be approved until the following corrections are made: . r- o ('") )> -i ~ o :z o -., Vl ~ -i ITI ~INCOMPLETE FORM / INADEQUATE PLOT PLAN A. Township, range, section and tax lot description B. Address or street, road, etc. C; Applicant's name/mailing address D. Installer's signature E. Distances from tank & drainfield to well F. Pump & switch specification 'statement on plot plan ,G: Vicinity map . H. Additional measurements needed :i? '0 I. Illegible J. FOnll must be fi~ oU~ln BLACK I~K.,/. ~( ~Other rl'('~ U1 ctrir7t'UfKi) a;!J101 1/11) ~ r- ~NSTRUCTION A. Water level d-box B. Grout box(es) (inside and out) C. Non-apProved materials used in effluent sewer D. Trenches covered E. I ncorrect grade on trench bottom and/or drai n 1 i ne F. Incorrect rench p h l '1\1, . "'lJ.'- Other .l' '4'IW.l;f;'~) kJ .Jt. 12.. dw/ '/'rthaf c&5tclWJZ., ~ ~ ~ x.-UJ /'/fnff)Ikin/:: -zr"d; 1'V' ( 5 'IV'AJJ7"rUVl.lbUf . If the np.c~ar"l'cor ctlo~Lare ~a~ithin It) """'Ia\.~~he cer(tif_i~a~ctt~~m{,~~will be denied. ~- &D c.c. $rcant- '--:-----:Slgnature d:1IitJuJ~, J)J7PdOAfJiJdJate ld.:;:', '62- . . Phone &M--Jf~~ 8:00 - g:OO A.~ ? -~ " ~~ <::i .~ K t". . . "'''' .....~' ...... ~ .' .~ . .' Building and Sanitation Division / Environmental Management Department 125 East 8th Avenue / Public Service Building / Eugene, Oregon 97401 (503) 687-4061 . / Wats Li ne 1-800-452-6379 . . ,,;::j . .:: \ u, ,,\ . c' . !J.l~~ .W~ 2 1~\ _ 4_0S~nr. - ~11'