HomeMy WebLinkAboutPermit Septic Tank 1993-8-11
I REOUEST
FOR:
REPAIR EXISTING SEPTIC SYSTEM
.
I""""", ...... 3..en<><
17 0
LOCATlCfll ADDRESS
573 COLONIAL
lilHuCfuAf.$NOW ON PROPERTY
EXISTING SINGLE
22".''f':''2
i~'
~~ rnJE,
f1t'I5 0 &""t!ftHr''''''
SPRINGFIELD, OREGON
LOTIPARa:1.1IlOCK
..
97477
FAMILY DWELLING
PAOPOSEOUSE SEPrCNSTALla) WAnRNHAU.&D NO OfSTMES
RESIDENTIAL USE RAINBOW
DESCRPllCNCF PACJl(6El)'NCI'Il;
REPAIR EXISTING SEPTIC SYSTEM
OIRECllONS TO SITE FROM NEARCST loWN ~ECTlO'\l T
GAME FARM ROAD, WEST DOWN COLONIAL DRIVE, SITE IS ON THE LEF .
NO.OFEMi'LOVED ~CXlSTNAlLlE
.'''''in.
APPUCNfTNAMc' ADtmESB
RICK AND EILEEN SANDERS, SAME AS THE JOB ADDRESS ABOVE
OWNERS NAME. ADDRESS
SAME AS THE ABOVE
CCHTRACTOR/NST Al.lEA' BUILDER NNolE
'.0'''726-7862
PHONE SAME
cau
PHONE
OWNER
'MA/~ PERMIT TO:
M-AIL PERMIT TO THE OWNER AT THE JOB ADDRESS ABOVE
~ ~ STREET arv
.
I have cerefully read BOTH sides of this ap~.1I V<!" JJnd her,'?Y c~lfy th~all Information
EILEEN SANDERS uffiJlA 1/. ~
, PRNTNAME I r~'i1t.
c. .. ......,.".....,..,...... .........,... ,', ...,..'.,.... ."..,... ", ....'
. "\,,',,.'.' .
tI
...
1
Is tru;, t,nd correct
?:.~~~
,
Your Authorization Is Based On The Following Conditions
.'
..:..:/ i:.h.: "\',:-,:r: ~.,~~ .~:.::::'::.~<:/:3~.:: ~..<~\~~~:~.:..~.~~.::.: .:'~,.~~';:'~:: : ~~:.~::. <<' \~ <:<~ '", ::"," ': . .,'
."A;~~~~~~.BY:~:1~;.~~' ~ATE
:!.
CALL FOR INSPECTIONS (SEE BACK OF FORM FOR INSTRUCTIONS) 687-4065
SEPTIC permits ere good for one year. ALL other permits expire efter 180 days unless Inspections ere
$
I
FEES DUE:
current.
f
LMD 040 Rev. 6/92
,
.'
I
VIOLATIONS 1
SBTBACKS AND onmR. __'''''.._.''' OF APPROVAL MUSTBB snucn.. Y OBSERVID), VIOLATION CAN RBSULT IN REVOCATION OPnBS PBRMIT.
CITATIONS MAY DB ISSUED UNDER nm PROVISIONS OFLANB COUNTY'S INPRACIlON ORDINANCE AND/OR OlHERRBMBDIBS AlLOWBD 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"': ,,:_l, ,
PUBLIC omClAL RIGHT TO TRESPASS ON PRIVATE PROPERTY ORS n5.01O
POWER TO BN1'BR UPON LAND. nIB COMMISSION, AND ANY OF ITS MBMBFRS, OPPlCERS AND BMPLOYBS,IN rnRPBRPORMANCB OF nmIRPUNCTlONS, MAY
BNrnR UPON ANY LAND AND MAIm EXAMINATIONS AND SURVEYS AND PLACB AND MAINTAIN nIB NECESSARY MONUMENTS AND MARKERS THEREON.
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-floor 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 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 INSPECTION: 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 exterinr, is in place but before any
plastering is applied or before gypsum board joints and fasteners are taped and futished.
ADDITIONAL INSPECTIONS MAY BE REQUIRED, such as but not limited to;
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 llie structure or remodeled area being occupied and prior to operating any equipment
FINAL PLUMBING INSPECflON: To be made just prior to the building, slrUcture or remodeled area being occupied.
FINAL BUILDING INSPECflON: To be made after finish grading and the building, slrUcture 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 fO\Dldation requirements for mobile homes or as recommended by the manufacturer.
Minimum futished floor elevation shall be certified when required by Floodplain Management
Tiedowns, if required, shall be installed and ready for inspectinn within 30 days after occupancy, Tiedowns shall be installed per enclosure.
APPROVAL REQUIRED
No work shall be done on any pan of the building or stIUcture beyond the point indicated in each successive inspection without fast 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.
~ "
APPROVED PLANS MUST BE ON THE JOII'SI'm AT AU, TIMES DURING WORKING HOURS.
TIllS PERMIT WIU, EXPIRE IF WORK DOES NOT BEGIN" ....." 180 DAYS, OR IF WORK IS STOPPED OR ABA..,uu,",'O FOR MORE THAN 180 DAYS.
SUSPENSION OR REVOCA lION MAY OCCUR IF TIlIS PERMIT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS INFORMATION.
ANYONE PROCEEDING PAST THE POINT OF REQUIRED INSPECTIONS WILL DO SO AT THEIR OWN RISK.
. '.
\. .
,
Your signature on the front of this form verifies the following: I HAVE CAREFULLY EXAMINED THIS COMPLETED APPUCA TION, and do
hereby certify that all information hereon is true and correct. and that I have a legal interest in the Y~V}''''U)' as O'Mlcr 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.
taining to the work described herein. I further certify that ifl am not the owner of the ~,u~~"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 pennit 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 pennit
holder. If construction does not comply with rules, the pennit holder will be notified, and all corrections shall be made before a certificate of completion
will be issued, Failure to meet satisfactory c~lI!pletio,! w\tJ.:in.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 ~,u~_'i lines 10'
Edge of road right-of-way 10'
Building foundation 5'
Wells or other water sources 50'
DRAINFIELD
10'
10'
10'
100'
J
-t-,-
_I I
__J
,
----1 I
I I
- I i
--, I
I I
j
I
- __ - I
I
i-tH1 I
- i I I
-I : I
;
i I
,'-- - -t-
.--+--. -----
:-!- --
,i I
,-t--+~ .--
I " '
-:-1-1
+---'
It--
I
----
_ -I" __J
-I ~oO-t !
I. I
:',- - f~; J_i
.1 I-I I
I I'I
,-I : I I
~r-I
- I .
I
-I
I
1
___I
I, ..., "-t-'
_i<I<:-\2, .~' f~\ ~!. '-c..U.: ('~-~-:-~
I ,-~4-' -r- ~
1 I I 'S13~~C>~l~bt-,,_~ i i ·
L; I ~I"-~\-.. ",\g-~~\-c\~Q~-J-----i
I' . (.2..C>-*&-b ~' , I. ~ ,I
I i ~-r-: r- i I -.i
I ----I 1 ,! I --t-- , -.
I~ i I I !, --H ; 1-1 :;
" : I q I I- .1.+~U.r-11 ~:
I I I '
I J I J' ~ I'l--=.i- : fi ~+.
~.1b"'l-- ,\6-;- \-I(,,~ ~ J I' ,
! I ~I -- ,~ _nut -'-=+- :~
'~-l' -- I, I I I
1''1- iL-I n~' ,....,..... . ~--r--1
,- 1 -L1 . --- ~' 'L_ ~. I ' ,
-;2.~- ..,~. I " -....
I I --Ii., ,,,"~ - - I _1-
_ ,~,.;)o ~I..' I --i
: . I r -, I! i" I - --1...:'1' ~I~,}~/~~ --t.... ~-;--l-- ---;---'-- ~'
. ,_ - - .' I . "'~ ~ I ' ,I I:'
;, . '1' I :, ...1 ";1'. -~ - -+-1 -;--Ii -+ .-r- t -~I
!i--i_~_,=-_u_n_- -T .. . t . r ,t- 1.: .... - it--r '-I: -I" j
I --- ---l-+10+---' I. ,I ,
t I , - ---j- ,- +. --- .; t
. . r- ' I' I,:' ,': I I ,
: : L t \ ~cD I I -I l,..\ \4~-;--.-: -,- ~ ~. ~.
, : I I, I J' I ' ,; . I . -t-..-,
i.' <a JOHI'd.,/ IPr;I'. I ~ I. I I I'!
'I ". ! , ' I I " I I I i
. I ," I
I : I' I I \~' I,. _ '" T: '-I _ : ------:- - ; _-1._;
I Dtot:.c-IJ I L::,' '
I I ,0 J\~ L' '. -~-."-j-_~~_+n.t ~I
_I _--;.CbT..'~_\_ '.I.\.)_-<:'.c. I I
i --;- n nt-t--j
I I " :! I I I
1__1' ,I :,' ;LJ'~~t 2- 0e-~I-..+-!--t-;:
-t-- I Ii' I - ='---r- ~ t.... -. .....
! I~Z2(t4"-t.3l-: -j-~---, --l,i-+-.....--~-T-t
i ~EWAGE [msPGSAlL :--i-Ti - .---t ~ t,-+-t-1
rL2!~~~.AP~~~rEU' .! ,:-t~. -.--,+-+
1~~iJl<;-;~1 L =~~-=U-+-~:
I ,. _.~~ - I t-.
,EN O,NMENTAC HEALTH;SERVICES I - - j -----r---I. - - ---t' - -' -t
, ,-te-EAST-STtt-JAVIi.NUE- ----L fl"
, ,EUGEt E. OREGON 07401 ---t---~- i --+--t- ' . --., - - r----~
I--.j- , _.J I I' , I ' I
I I 1 I I 1_1_..1.--_11__-_1 .-:-.-..,
I I ~ i -I~~~ L+-~1 i- -= = =-J
I I'
I -- i i +-t -;--t---+
---1-1 - r-~-~ ~t1_-=jl
I : I'
! - +-+---+- t- -t
I
I
I '
i I--~-.'
"1 I--r- I I
.: I I
~PF: \:'~~->' ~
, 1-~ITi
! I
I
! I
i I
I I
I-I
i
,
.. I
I __1___
--I
-. '---1' 1
- -- --+
I
I I
! I
tn',
I I
! I. I
----r- .....,
I ' ,
I
I \'-,- I
+---'------+
I I
I 1
! I
,
-r
I
1-
I" t----~-':"C
. i I I -~I
, :
i
I
,.
..
,
I,
/
".
''>J~ /!; w
Y'~ii'
~.
i r-a, ~ .
M':ul
c'
( -..... z"
r G'l~! ~: UI~:
: :r:.'J f-{)>;'
, ~g" ~:a 08,
i\ ail ; 0 ~,
ol! ,. _8,
~lfIL--;;; ...M"~'"
,'1i 0(, ; :''-{j;
')> . ::e I -'
__.~ J> ~~
'iJ" , -< """""r-
1 t" l a~
'A 8 i I Z8!
~ - .\L,
-It.. = _~.-..:: J. I,' COUNTY
. . .
<
.
-f
.
... 110' If 01 ..
o
<D
,
o
0'
.
:/
~
.'
I,
'w
, I
.- .
N,
8
8
- ~. - ~ -, - .- - b . -'- ~.,
, z
l ~ : A jt
~ ,I
~
8' t
I,::"
;.t ~
m,
;.N
\'I
~ '
~\
\
.~'
r-'
o
o
~
I
,~ ~I
-" .d
If,:
I ,
r'l
r
!il
.~ '
/>1-; .
\J r
, JJ L
'""l"U:-
".""-
'If'/"
B
I'
A
I
,
:-':.'"
i;"::~l
--
n .4. ~1 . i.....~' 8
'~. :. !"""Yj: It
. ,. ~.; l;~._-",:":,, g~ ...: :,:; :.~S _, i~;;
4 ROAD ' '. .. '.' NO :l c.9-vvJ
--- .-:-
.....01110111 "
t ~-
.:~
),
,~
'" I l
\ . '.
,~.., '
. "
1 ii,
: ~ ~ I..
..-.
'. ii~
~~
8J
~:
I
~,
.
, 8
~
:~,::
, ' '
. '.._l
. ,.-J.______~.....:..;._.
- '
N '
. I
d
~ .
O.
I:
(:
I
r
-t
a
~
o
iD
, '
o
10
~
~
i
r
I
:;
8
D
I
I
I
I
I
i
-%
I
I
---
"
Il
i I~ ~
1 L i
+
~~
me
;. l
B. ~ i
~ ~
,I
t
I
I
.-
t
,
'IJ~~~
,. Dlstanc" from Mobll~ 'I
Home 1,0: ""-
CI. .;,PartIIIClrlISubdlillsloI]Lol & Block ,
COMMENTS";,iOLLOW''UP'" ',' Water Sewer/Septic,
".TRS.Verilied'ClVes NoCl:.
.,rAllowedUee . ,;;=Ves' ..."No.=':..... .
".. .
Land Management Div. stafl can ..
not be held responsible for ;.
evaluations or recommendations '
based on falso, inaccurate or
lMll"'.2192 Incomplete information
, ,
,..................... ..............,
j;_i@~~il:i!;;8Em1!1Es~lIlDBISSJSimfJeE
t_
if Pltf:h 3
LAn:. [
7c:3e. ~1 Ktt1;).
q iJ--77
.
Please complete all lines inside white boxes,
~cl. ot--Ellc'(/J 514/lJdr LS
" 57~ &-ftNu A p; Af
!i/t/i1~ ~
ZIP
~
OWNER OF PROPERTY (II not Nl'IlI .. .bove)
..HONl:
OWNERS ADDRESS (11 not ..me .. above)
ZIP
II'Gt I AU.II:;i"l I UUIUII:." I ""v..., I'U"".I un
LIC'"" .
. -
~~ij:'~~~l&~o/M~'~~~:
I. .
"j.::.;-.:
Ow'
..,.,....,.;.'<.-.
.
MAP, PARCEL NUMBER
(Found on tu ;5' '"2.L....men'i Tautlo~~
.J!l."lliOOO _.~" 1~ 7;~~
Tow..hip ;;;- Section 114 BMtlon Ta Lot
PLAIN.
.,,".-
lownsn.p ""JI;;;g;- IMemon 114 lMCuon I.. LOI
itJfE ~!!ES~~~ ?3;e
-:5vJ.-& ~
I)
,
MAIL PERMIT TO:
f!. ./1'; 'Y.p; / e <eA 5fJ ~S
.1:J~i)l3 W~ fJ-y
AUU"~~~~~
I,;llf V tJ '
q)l/; I
ZIP
.
......,...... .
:.':STAFF :EVALUATlON>..
.) Informetion';, Req uest :" Onl)'.:
;.:Kt'::::;...... " ... '... ....;.".
""";::-,,
";LMI~'I~II!~ll\!
n:t;...;}.::::;~. .~.<::~~~~'~::;':~:~;:~:;",~t:::{%\~.~~ll~~:;:~.li~f.'l!~1..r.~~~.:~,:0\~~'
.,.,.:.,.".,-.-,...,..,... .. ,,," .
,.01,.
.
Existing Buildings or
Improvements on
Property
Iial House
CI Bam
lliEI Garage
CI Mobile. Horn.
CI Shod
SEPTIC INSTALLED
-\3-Ves
ClNo
~A:j
..,
, Directions to site from
.: ~arest main Intersection
i ~J~ f]t:uPl
1,. f(.dJ WIMD ~)
tftI~ ~,
: I1TI "l/~J~
'ii< o/$t.~ &,
3
Q)(j.7?
ZIP
.
.,,4.
For Mobile Homv
Placement Only
~ .
y~~"
Size ,,/
No. of Bod'&
License .1 T"- \.
,
",.""
1'114-68 02/92
" "~ ,. .
".:,
. ........ ,
.
.
.
.
( \
v'
.
~~
J-7D~~r3
~+i)~
,
~./'"
))h
~ "
.
','11
"'Ir-
: ~ : I ,
.
.,
.
.
.
iJ,
.
.
.
.
.
.
.
.'
tinl',
.'
W: 3 . . LANE COUNTY DEPT ENV MGT RECEIPT ~ 270593 DATE 072993
. APPLICANT SANDERS, RICK ADDR 573 COLONIAL DR., SPRINGFIELD, ORE~N
TL~ 1703221200400 SUBDIV 500 LOT BLK"
! !I'i'. NEW BLDG TYPE'" USE R BDRMS 0 UNITS 001 STORIES ~BLDGS 001 PHONE 726 78;;:.!,
. OWNER NME SANDERS... RICK ADDR 573 COLONIAL DR., SPRINGFIELD. ORE ~N
CODE APPL NO ACTION:DESCRIPTION . SQ FT UNIT COST VALUATION FEE D~S
BP , A
. . BP . ~
" BP ~
BP ~
.', BP
.~
.!
iil\:~
100.00 ..'~
10.00 ill
.G>
!)]
.~
.
.~
DEPOSIT ** 110.00 c-i
.i
1'~ 'I
.-
PL ~FIX/BATH:
MECH '.'
SUR
PCK
SDS ~LC 270593SDSR
SDEQFEE
SWR:
FT. WTR:
MECHANICAL FEE
STATE SURCHARGE
PLAN CHECK FEE
FT.
RAIN:
FT
5X
25X
SDSR
.
CATG:
. SEQU :
, TAKEN BY RLH
PLN
RA
SDS
1
EST. COMPLETION DATE
ELE
PCK
ISS
2
/ SI
, OTR
.
I'!!ll"
c I, ~
.