HomeMy WebLinkAboutPermit Septic Tank 1991-10-7
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REQUEST
FOR:
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f TOWNSHIP 17 1Wro& 03 SECTION 22. '111.L TAlC LOT 201 IIJIIllVISlOM I P.UlnnOH
LOl;jAPPA ",CCRua
t.;~lJ COLONIAL STREC:T, SPRINGFIELD, OREGON
1.01 'PARCiL. lLoat
STRUCTURE. NOW ON P"OPERTY
EXISTING SINGLE FAMILY DWELLING
PROPOSED USI SEPTIC INSTALLED
PRIVATE USE
DESCI'IIPllONOl" "'~OAI(
SEPTIC SYSTEM VERIFICATION
WATER INSTALLED
NO. DI' stORlD
MO. Of' EMPlOYED
f;ONSTRUCTlOll CQIITIVAl.UI
NO. 0lI' IIEDRDOIIII
DIRECTION. TO BIll ,..0Ill COURfHouall
EELTLINE TO GAME FARM ROAD, RIGHT, THEN RIGHT AGAIN ON COLONIAL STREET
APPUCANT NAMi .. ...DiiiiiSa PHON II
48L,-2214
PHONII
485-5241
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OWNERS ""Mi .. AtlbREU
CLYDE KELLEY, 5241 MIRAMAR STREET, EUGENE, OREGON
CONTRACTOfI NAME
oaR UCENU ,
PHOHI
NA NA
I MAIL PERMIT TO:
LORRI RAMSEYER, 1509 WILLAMETTE STREET, EUGENE, OREGON 97401
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I have carefu~ read BOTH sides 01 this apPllca~ an~ ~y certify that all Inlormatlon Is true and correct
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, PLANNING/ZONING' .:.\.. READ CAREFULL VI Your Authorlzetlon III Balled On Tho Following Condltlonll
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FEES DUE:
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APPROVED BY:'
DATE
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CALL FOR INSPECTIONS (SEE BACK OF FORM FOR INSTRUCTIONS) 687-4065
SEPTIC permits Bre good lor one yeBr. ALL other permits expire elter 180 dBYs unless Inspections Bre current.
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VIOLATIONS
SBTBACKS AND 01HER CONDmoNs OF APPROV ALMUST DB S11UCJL Y OBSERVED. VIOLATION CAN RESULT IN RBVOCATION OFnDS PERMIT.
CITATIONS MAY DB ISSUED UNDER nm PROVISIONS OF LANE COUNTY'S INPRAcnON ORDINANCB ANDJtlR OTIIER RBMEDIES AlLOWED BY LAW.
A MINIMUM OF AT LEAST 24 HOURS ADVANCE NOTICE MUST BE GIVEN FOR INSPECTION REQUESTS
Have the following infonnation ready when you call: 687-4065
Permit number - Job address - Type of inspection required When it will be ready
Your name and phone number - Any special directions to the site
PUBLIC OFFICIAL RIGlrr TO TRESPASS ON PRIVA'I1t PROPERTY cas 115.010
POWER TO BNI'P.R UPON LAND. TIm COMMISSION, AND ANY OP ITS MEMBERS, OFPICERS AND BMPLOYRS,INTIm PBRPORMANCB OF nmIRPUNcnONS, MAY
BN'TF.R UPON ANY LAND AND MAXBBXAMINAll0NS AND SURVEYS AND PLACB AND MAINTAIN nIB NECESSARY MONUMENTS AND MARKERS 1liEREON.
REQUIRED INSPECflONS
FOUNDATION INSPECflON: To be made after excavations for footings are complete and any required reinforcing steel is in place.
UNDERGROUND PIPING INSPECflON: To be made after all underground piping has been installed, prior to any backfill.
CONCRETE SLAB OR UNDER-FLOOR INSPECflON: To be made after all in-slab or under-floc, building service equipment. conduit. 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 INSPECflON: To be made after all ducting and gas piping has been installed and prior to being covered. .
ROUGH PLUMBING INSPECflON: To be made after all plumbing rough-in is in place, prior to being covered.
FRAMING INSPECflON: To be made after the all framing, frre blocking, bracing and roof are in place and all pipes, chimneys and vents are complete
and the rough electrical, plumbing, and mechanical inspections have been made and approved.
INSULATION INSPECflON: To be made after all insulation and vapor barriers are in place, prior to covering.
LATH AND/OR GYPSUM BOARD INSPECflON: 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 not1imited 00;
BLOCK WALL: To be made after reinforcing is in place, but before any grout is poured. The inspection is required for each bond beam pour. There
will be no approval until the plumbing and electrical inspections have been made and approved.
FINAL MECHANICAL INSPECflON: To be made just Prior to the siructure or reri100eled area being occupied and Prior to operating anyequiiimenL
FINAL PLUMBING INSPECflON: To be made just prior to the building, structure or remodeled area being occupied.
FINAL BUILDING INSPECflON: To be made after fInish grading and the building, structure or remodeled area is completed and ready for occupancy.
MOBILE/MANUFACfURED 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 or as recommended by the manufacturer.
Minimum fmished floor elevation shaII be certified when required by Floodplain Management
Tiedowns, if required, shaII be installed and ready for inspection within 30 days after occupancy. Tiedowns shaII 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 frrst 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.
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APPROVED PLANS MUST BE ON TIlE JOB SITE AT ALL TIMES DURING WORKING HOURS.
TIllS PERMIT WILL EXPIRE IF WORK IXlES NOT BEGIN WTI1IIN 180 DAYS, OR IF WORK IS S I vrrr.u OR ABANDONED FOR MORE TIlAN 180 DAYS.
SUSPENSION OR REVOCATION MAY OCCUR IF TIllS PERMIT WAS ISSUED ON TIlE BASIS OF INCOMPLETE OR ERRONEOUS INFORMATION.
ANYONE PROCEEDING PAST THE POINT OF REQUIRED INSPECTIONS WILL DO SO AT THEIR OWN RISK.
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Your signature on.the front of this form verifIes the following: I HAVE CAREFULLY EXAMINED TInS COMPLETED APPUCATlON, and do
hereby certify that all information hereon is true and correct. and that I have a legal interest in the property as owner of record or authorized agent. I
further cenify 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_
taining to the work described herein. I further certify that if I am not the owner of the property. my registration with the Builders Board is in full force
and effect as required by ORS 701.055, and thai 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 cenifIcate of completion will be issued to the permit
holder. If construction does not comply with rules, ~e permit J.iolder will be notified, and all corrections shall be made before a certificate of completion
will be issued. Failure to mcet satisfactory completion within t1ie allotted time constitutes a violation of ORS 454.605 to 454.745 and this rule.
SUBSURFACE SEW AGE DISPOSAL SETBACKS SEPTIC TANK
From: Interior r'-Y"'J lines 10'
Edge of road right:Of-way 10'
Building foundation 5'
Wells or other water sources SO'
DRAINFlELD
10'
10'
W
100'
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Please complete all lines inside white boxes, if possible.
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OWNERS ADDRESS (If nol ..m. a. .bo....)
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MAP, PARCEL NUMBER
(Found on tax maps In the A.....m.nt , T.nllo" OepL)
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Township Rang., Seellan 1/4 Seclion Tal lot
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PERMIT TO:
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Land Management Dlv. staff can
not be held responsible for
evaluations or recommendations
based on falso, Inaccurate or
Incomplete Information
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Existing Buildings or
Improvements on
Property
r:::tJ House
c::::J Barn "
c::::J Garage
c::::J Mobile. Home
c::::J Shed
SEPTIC INSTALLED
ISlJ Yes
c::::J No
Water District
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Directions to site
from Courthouse
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For Mobile Home
Placement Only
Brend
Year
Size
No. of Tip-outs
No. of Bedrmo
License #
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CODE AF'F"L NO elCTION DESCRIPTION S[~ FT U.NIT COST VALUATION FEE DA"...
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