HomeMy WebLinkAboutPermit Correspondence 1982-6-30
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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
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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
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VICINITY MAP
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Installer
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Tax Lot
form c55-11
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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
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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
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Dat"
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FOR SANITARIAN'S USE ONLY: _I lB"'System Ap~~o~~L
COMMENT$: .A~./ .....~7" AL... ,~
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System Capacity
'1 a 1./ day Signatur"
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9'11/71
Total Length of Line.
(Model No.I_ - Pump
have been installed with this sewage installation.
Dat" ..
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o ?ysJllm Disapproved . ~eeds Correction
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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. ' --:::::.
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FINAL INSTALLATION RECORD FOR PERMIT # /i.S3.'Z'/
,<-~l; no 0//7 ('trj 1,j(1Tf INSTALLER /Q"fJY1.J./V
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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
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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
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J. Form must be filled out in BLACK INK. ,(
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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,
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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. ~
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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
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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
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CQt~~~ THIS BLOCf' PLEASE VSE BLACK INK AND PRINT.
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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.
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o PLANNING/ZONING: zonc_P /J
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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
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JfTV'. ~ ~~60 _ptJDL~ J I"rdMd.tU^
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Floodplain F~e S
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Subsurface Fees ~~
Building Fee $
Sewer/Storm Drain,wdter ~
Plumbing Fixtures $
Mechanical $
Plans Check Fee $
State Surcharge S
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TOTAL FEE $~
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~TRUCTION AUTHORIZED BY THIS PERMIT
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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
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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'
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FINAL INSTALLATION RECORD FOR PERMIT # 1~~-i\1
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INSTALLER I(/~~
ADDRESS
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Your Ce ficate of Satisfactory Completion for the above referenced
installation cannot be approved until the following corrections are made:
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~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
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I. Illegible
J. FOnll must be fi~ oU~ln BLACK I~K.,/. ~(
~Other rl'('~ U1 ctrir7t'UfKi) a;!J101 1/11)
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~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
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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.~
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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
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