HomeMy WebLinkAboutPermit Septic Tank 1993-8-16
~.
J
~
'ej
.c.
...J
....J
.
I~tn.~
-p '-...I " , ,r
~ W~~
-:.. I , v/
C. ; I"'+- ~
:r:J\~m3
..... .e....:- - CD
" C> -<>0
~C ~ ~
"- f. c.
~ ~ <il
_ en
en
~
~ ,I)of i f
~ ~5.c/):T
CD :1 (0 CD g
Q. .OZa>
cr 0 0
'<- 3 Jlc.
~ !~] ~ ;. ('
..., ~ ~ t\
I I ~ tI'l \ -
-Ob--.l~~
~".l'lJ1:'
~i~
g'
~~
o.
~ 11
!!-,
"
en
~
!f
-
~
>
t>
i-'
o ..,.
'" .
c;; l.
r:fX7 .
\ ":)
-'
r-- ......
, i-;
.J;; ~
.IV ~
)"
::J
u
c;;
:
\
I-
,
(
VICINITY MAP
.
N'
,^~..j
DC
P.,., \-\\;,_
G,~~
r<..J)
G.~"'c_~
. 'I
.~---.J~~
~ .;1. . '.
.:. .:." p
-7,..>
,
MUST BE IN BLACK INK
Permit No. 270's-9:!. Twnshp. 17 Range 0,3 pection :i...Z.' z-'Tax Lot
Standard System CJ Alternative System CJ (Seecjfy TYl;le) _ t<' -=--.r-.::ur
Job Location (Street Address) .._~7:z, C-oJoh frJ.Dr-..' .5,pr-,'--.q..J;'pId-
Supdivision/Partition # Parcel . LOt . . Block
lJl;Q5f,11 cj-
l':=;v0
DETAIL SYSTEM PLOT PLAN AS CONSTRUCTED,
-Scale~ .. = ~'
r...."\,,,^,'o.Il
0..,:....,_
'--"-' - - . 1../ I
'~Io~" "- ''-l>'-'''- ,0
~ 'l{/OI -
,- '1: I --
-_~o
50' ' -- ~-
../'
Ov~4~~
N
f: ,:5'\; "'"
\
!5T3 c.c\c",-,'d
I'
I,
, Pv",/,.I-:~
USE BLACK INK Of'lLY 11
FOR INSTALLER'~JtE: Trench Depth .2 t../ 11.w, -"'0' Gra~pth Below Tile ~ 5\
Tank Capacity Ar ManufactureJ lJ ,,, -\"F-r ~<,~:,,; :-
Measured Distance rom Well to Tank ~ A From DraihlieJrt "-l '=K. Total Length of Lines I t:;'0 I
COMPLETE THE FOllOWING IF A PUMP WAS USED ON THIS INSTAllATION:
I (installer's name) certify that a (Mfg.) (Model No.) Pump
and Mercury Float Switch (Mfg. and No.) have been installed with this sewage installation.
Signature ~'--'€ tJ,Q...O'A Date 8-/(..-'1'<.
FOR SANITARIAN'S,USlt ONLY: 'I-i System Approved
COMMENTS: C){IS"tiXtf-r"W<l 11
./ .
o System Disapproved
o Needs Correction
/l c(lSyst~. CorreQljj~- ,flate _ I I
System Capacity......lJ0 gal./day Signature )f//U1'./ ~Date 8J '8:!C(";
INSTALLATION RECORD & CERTIFICATE OF SATISFACTORY Cb'MPLETION When signed by the County Sanitarian. this certificate is evi.
dence as per OAS 454.665 of satisfactory completion of a subsurface sewage disposal system at the above location.
To request inspection, return all three (3) copies of this form 10: lane County Environmental Health Services, located in the basement of the
Public Service Building, 125 E. 8th Avenue, Eugene, OR 97401.