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HomeMy WebLinkAboutPermit Plumbing 1990-11-26 V66-S,Pr~ SEWAGE DISPOSAL SITE EVALUATION T~S, TL /7--t?3- 2? /, Z ~ / 3t:?O Job Location (I r 7 ~Lp/?~ L ~ WriltenDirections /$cj/j?:- /V/C:-..J/ )~ ~b7/'7~ .....-~'2::.'l ~ ~ ~m;~ A;-;-:t:~~" ~~ ' Lot Block ~L7Z."~ WATER SUPPLY' ~... /..... APPLICANT'S NAME AND ADDRESSc- -r -c;-7(7A~r~E: /d1/~ JA1Y:.(".r;: ~c/,c,€97Pf -?7 4/~7 Phon..~/9-/..r.z.:f' OWNER'S NAME AND ADDRESS' T~.d'/ y 4~..... Zf?/4-..::?-!!:?J.r-- (;?~ /:::k.~~--./ ~.. -:?~p. 3S-..?;? STRUCTURES NOW ON THE PROPERTY. ~ r;7...r~ ~~ ' PR~POSED USE OF PROPERTY/~ \ ~~...-::- r_- , :>.. ~ s.I.#_9c:;:J-Z;9'<f? /p'~/.~~ Subdivision: I hereby certify that the above statements ere true and accurate, and that I have the following legal interest in the prope7~~e f record; _contract purchaser; _realtor or agent. r further certi~ that (if not the owner) 1 am authorized to act for the owner of record. and that said ow: . . I~ FA proves of this action. TEST HOLES READY~~ / ~ Signature ~ _ Oat" /0-/'7 - 7...-./ ,o......... '*"""" '" * * ,o... ,o... ,o.... * * *.... *...... .*..... **--.. *.... ,o... ,o... '" ",,o... ** * OFFICE USE ONLY BELOW THIS LI~' / *.*.. ...,o.,o.,o. *.,o... *..,o.....,o.,o..*.* *,o.,o.,o.,o.,o.,o.,o...,o.,o....~.... I I. SITE MEETS STATE STANDARDS YES NO YES Standard System ){ 0 Low Pressure Distribution 0 0 . Sand Filter .~ g Holding Tank 0 0 Zoninn 1 Foot Capping Fill .n -EJ Other 0 0 Partitioning # I'V"tential buyer; LAND USE COMPLIANCE 77. -):>( /qo) 4creage or Lot SiZ8_ . Il~ ~TAL) Parcel # .f35 COMMENT"" V64'-Y,FuQ ( ) Completed ( ) Pending Ai..-LA'fJlR.L =-lOr .5ui?.su~ d., I' . r ' J , . fSfXI<:'cLI ':7dY cJ1t?" atvP.AI,~ &..:E?~IIPA .o16"T: o/~vz_ '-' / ' , .~~~- , CXl:lJ'- j o Approximate Study Area . o Detailed Study Area THIS IS A PRELIMINARY REPORT WHICH DOES NOT ENSURE THE ISSUANCE OF A FUTURE BUILDING PERMIT. ANY PLANS OR EXPENDITURES MADE IN RELIANCE UPON THIS REPORT ARE AT YOUR OWN RISK. IF SITE IS APPROVED, SEE REVERSE SIDE. (--:?/~ .L J,t.., ~u"I<L/ ///2(../90 AUTHqfiiZED SIGNATURE I pATE LANE COUNTY ENVIRONMENTAL HEALTH, 125 EAST 8TH AVENUE, EUGENE, OREGON 97401 (687-4051) C55-32 o Floodway FLOODPLAIN INFORMATION All or part of this site may be in a flood hazard area for which 100 year flood levels have not been established. Extra precautions may be appropriate to assure that the building site will be reasonably safe from flooding. All or part of this site may be in a flood hazard area for which 100 year flood levels have been established. A building elevation above the 100 year flood level may be required. All or part of this site may be in a flood hazard area in which a f100dway has been designated. Building may be prohibited subject to demonstration that the cumulative effect of proposed development will not increase the 100 year flood level at any point. / MEMO TO: APPLICANT FROM: LANE COUNTY ENVIRONMENTAL HEALTH SUBJECT: CONDITIONS OF SITE APPROVAL lane county @ Any alteration of the natural conditions in the area approved for the on-site system or replacement area may void this approval. This approval is given on the basis that the lot or parcel described above will not be further partitioned or subdivided and that conditions on subject or adjacent properties have not been altered in any manner which would prohibit issuance of a permit in accordance with O.R.S. 454.605 through 454.755 and Administrative Rules of the Environmental Quality Commission. Any such subdivision, partitioning or alteration may void this report. WARNING: This document is a technical report for on-site sewage disposal only. It may be converted to a permit only if, at the time of application, the parcel has been found to be compatible with applicable LCDC-acknowledged local comprehensive land use plans and implementing measures or the Statewide Planning Goals. The Statement of Compatibility may be made on the attached form or its equivalent. Authorized Agent approval is required before a construction permit can De issued. This report is valid until an on-site sewage system is installed pursuant to a construction permit obtained from Lane County, or until - earlier cancellation, pursuant to Commission rules, with written notice thereof by the Department of Environmental Quality to the owners according to Department records or the County tax records. Subject to the foregoing, this report runs with the land and will automatically benefit subsequent owners. Only persons having a valid license issued by the Department of Environmental Quality under ORS 454.695 to install subsurface sewage disposal systems or an owner or contract purchaser or his regular employees may install subsurface sewage disposal systems. A certificate of satisfactory completion will not be issued if persons other than the above perform the installation. . . , cept.h . Text.ure SITE EVALUATIOn FIl1.D WOR. r 3'00 Evaluator: Cr(//' ( r:: hr; 4 . rate: I tlzJYO , I- (/ /u I 16 phZ p(r;." \.... ' , Soi~ Matrix Color and Hot.t.~ing (Not.at.ion), \Coar~e Fragments. Root.s, Struct.ure. Layer Limit.ing Ettect.ive Soil Cepth. etc. ' 9CJ -z y~ App11cant /7-o,-ttz.IZ- - ( ..J l 16-1-\..( S Se.. . tu RcteMlDCe 1t 1 , :5>( h,., ,I....... ~-5Z- %'_4~ (OI1Z. ~___ -:6 ~d, (~'-- cJ J:- ~<--.rn_ 5// lo~ '.f(:- .b.-c'v ~. p<1~'>" f"CCS'"t..> '" I "+ H? " :1t , 1 l1t .1 t..aWc:apo Notea ...{.-(;" -T- ' .lopect Grouodwater Perh7~+ Slo"", Other Site NOt.e3 =ml SPECIFICATIONS .' 1)-?> 51_tel: IIl1tial 5 tc;!,.- 51_tem SUing 7.b ~ '150 g. .~ /"/IIJII Y ;::::(...(./ Sy3tem S1.%1ng 5peQ141 Cor.d1t1ooo F1 'r.::,t;. 171:.-( pia;'" .s0.;.,- v( ~<\ /6-C ;n6.cf~C/C- 'GC '/I/UfZ"Cl ~f>~ / c;. r::(LPr=:ll"?'ic/d'I-,(?V f";}htl- ofa...n_ -J 1 I I Do..1gD Flev ~b'();t 76-= ;;:2..$- S- b~r~-5 ~x. Cepth Absorpt.ion FacUity (in) 3-'c Replace::ll:ot /150 g. Max. Dept:h Absorption Facilit.y (inl' ~ S/<.e 7.? 4/~a)~ '7/, ...,- X I YO J - - - -- . 2..f, P '/;<1, -Fe. y z. .5>~ // A. -R- -o-..<<'~~ trec>F:;..~:( , ------- ,...........-, . ....:.... ....--_._.._..___~__.__h.__.__ + , . ......,.... \,..1...-""" . 'CO/onrd st:-, "'-V \~ I ,. ., '.. JJI.:::..~, ".-..-.-.-.-.-. ~---~-_.~.~..~- .........:.._-,...~--_.. .._..._____..,.._. _._...."....__..,~... ~ I (. t L N ~ -.7.,....~.'Ste::.._2..!:_._: ;._.._~'..... ...:.~.__.,_~~__. 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P';\L r.,r.....,:.;,) i',:)':I>~. t~'.lf..A/.~":r ....~_.;"..;';'.~".:..~ :''l'\~~~'r''';:'''''~'''''''':'\':~(~-1'''',\'':~::''':~;P.l'U..~( . . :'., .' . :~I ::.lJ' . \',".".,. ,.... .'..~.,...I".~.....~~~.. ,.,~'l. ~f'~~~"'~' .. ~ "':....N.I-:~..,~~ 1'\~._ ":"1.._,.._ ..-n~1......~'l'Il;,..~~~'\-/. .y~.-_ ....;,-." ,:....".~1:~;<t/~'~....:.::.,.l":,:.l1J.:...~'SI:.....~..lot!!i! _..... ,.":..:,'Ii'f";':.r .........h;.:.,..'J.......... <:1..., .. .~ '.. ...- ,... _ . " , _.' _,'1::.'-'11", _ -,,'(-"".' ,..\....., """'!~~,. R 'lio..-_,-~c.-,Q._ .:~_.~fti.i!:~.. ... , , .j .' :~, F . . ~anE ~ ~OUilty - REQUEST FOR ASSISTANCE Land Management Div. 125 E. 8th AVe. Eugene, OR 97401 , Please complete all lines inside >Uuu dfrr'( (- \~ .!?';,lr ,Uu" Aufxt2~ AJ ,'?rrl (\+- ,\"nkj.{)-t>(J;, of) CITY I s.", c':!'d I) t' art! OWNER OF PfOPERTY (il not s:rme n abov/r !1'f()~ 11",.1"/4< i/,I()..J OWNERS ADDRESS (if not ume n abor) . , white boxes, if possible. /0 -/'7-'70 UAIl,: .J:t/-,r'.Fl1 C; 7 -(<J 1- ZIP 7(((, -JrvV'I t'HU}.(~ {..<::;d~ Cf7<f 7 7 1 ZIP l.leen,.. (;;UNI HAl,;lUH , MAP, PARCEL NUMBER (Found on tal[ m.p. In th. Aueumanl & T....tlon lHpt.) IL3h.P -k ~~,!: 1~4'l:on ~{1o~ Township R;;;g;"" Seelion 1/4 Seclion Tn lol lown.'np ~ ~ If''SeC:lion IULOI SITE ADDRESS /) ( / tJ<J,v ..('",.1- ~tJ..d C 0d-f Cc.,(U,J, 'c. U--r ~ F , ,- , 11111111 MAIL , PERMIT TO: :,k~ (J..re I J..<.{EJ "7<= < (' 'i'JPr.L/ I - .., ?V,..JJ ZIP ... Btirkc; II !-- i t':JfJ NAME A~UHt:::;::; 1,;11l' .. ... ~ ;ST A'FF EVARLe....qUuAeTs/t 0.. oNn'..:.:,...:...y.:'.:....:........:....................,.....;..: :.~:':fnfC;~'~.~.iion . . " :CQM&E,~r~;! F01.LOW3UP ....:<,. : .......:)...Partition.ISubdivislon .,' ...-'......,.... .. -.,.. .. "d .._, ....0_'.. . :.TRSVcrified ....c::JYes/Noc::J Allowed Use .=Yes >.:No'.= , :.......,.:-..,..'-,."..",.:...,.,. ... land Management Div. staff can not be held responsible for ovaluatlons or rccommcndations based on falso, inaccurato or Incompleto Information .. , ~.~ ~; ",'" .'-- ::~~:-'::. ~3 ~ ~. lAND MAIll.C[M(HI Ol'(\~OH " ExIsting BuildIngs or Improvements on Property c:J Houso ~ ~~ c:J Barn . / C/O ~. c:J Garago c:J Mobilo. Homo c:J Shed SEPTIC INSTALLED c:J Yos ,t;!s.No Water District ? PM.LIMr..J .' '. DIrections to site from Courthouse ,VOR MiA/! /. ~v",-l.J_-f/.;'_1 ;:r ~r 'I "....' ....". I ...-1- vt4-.."tu-y A-2i:r. " /. 0: ~,..1 ,.-/, 'u.J,:.t4L,J.- ~ / /1- ? -1.1. -/J_ -Odd ,~ -rf. AJ P... (" ",(' A____r .. " ~ rr Z~P~~--: e & ~I ::';' m. ". ".J,.;;~ For Mobile Home ~ t Tf! - ., Placement Only Brand Year Size No. of lip.outs No. of Bedrmoe: License # '. . " Lot & Block j j I I U.lft J'.II/"".'. ) . '.' .' :' '?~k:.;'~~~: era ~~G. (B)'\'" '~~;.;~}I .' ~. 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" l " .. \5. . ,,, '-,' ,.. ;'n~l '- . ,. -.. -,.-~ ~~':.\.\" ~: :1,~t;;~~ \ ...: ~ ;~'~::~~i ,-,.'. "'-. . .... . . .... , i r ; ~I {(at . . '! l\ .' .~: ~.. -, G. ( F<...ce. '"f: . ho~.r} . , .' i. , , . ..:.;:' ,i;l ~.~ , ~~. , ;, l,.b I \( ~n~ .... ,/ !NS '~\: .. . . 'j . U:GEND ~J o fOUND SUR'IEY MOIlUMENT . SIT 518'" IRON ROD \VI SURVE~ CAP SCALE: ,"= 100' RECORD OAT4 .li ;, EXISTING OLD FENCE If.E. CORNelt "iI. 3TCVflf' O. L. C. 110." FOUND u.- """ _~~D\ - '..) ".41J-..O'44.E. - 42'5.]5" (UI'."', "- '~ ", "-'" , . , '" -. 0 '" -Q cf'", , ."" .... ...Jt, tJ1~ '" ~. ,., "' ..... ,,'. WAY " 5" o .. ,.. /!C.4 "'~J '\ '\ '\. , .,. '\~" , !.D. ,,,' I '\.~" \. _.. N..'-51'4;'-E. - "0,76' .u.. ....... ~,. R"'?::i,.;,,\=-~-- --- -- - - - - - - - .., - -- -- - I ~ 40' a:::I: "- '\ 4~7 12' - N.S9.57'40"E. ... '..... "- "t" "- en.o '\.~.... "- ~ ~"'''''~ "'"'1....<"0 '\. ;zi ~,p'.J' "\. . ",.." '..0 .. ,d>~ "\.. 1> '\. ' "! "1> . ~.... "../ '~N!J. IRONROOW,TH;JIOAGE !I') ;'10. '''ON floO ~C'. " CAP. ,'f.E. CaR. LOT 8 r . 60' WITH POAGE CAP '\. '\. /~"CAN COM",. "ARK ._...-', \.. 557.87' - ,~9.55')3"W. ~~ "2D~ ~. .. ~ ~..,.. '-.J='~' ..... , " '. . ,-. ... --445,67 "" . " . "-_ )~\ '.00' r: ~:~::. "" o L.C. : ''''.0.-:004 '",.'W. ~. ~~ "'-. .-".00' ~.. <^ ~ RAO!V5' ~ . . :'\. . - c30 '-d-..", ~O ~ ",p :.0',. '0.,.. d-." .", . .~;, "- 4 '. '. '\ '" .' -0 '" BELTLI NE ROAD ~ 'L -u .., , " "~-~ qo -2.,'1S' '10-2-'1 " F~O 3/4- IRON P'PE , FNO. S/S'"'RON ROD . . . . ( '15 00 , j " - , . ._n__ N.S9-" 40 E. - )7'.04............ ' ~..---. :.. ~ ~ ... ;:) :t: PARCEL , '" '\.. " :'.:)T /, ... o .. _LQ PARCEL COLONIAL DRIVE 40' .-.-- ,. . >( , X r~)/I 10+ ~?i . ~"8 A ~')ur;<ffx ID.5Uf .~ "{3/1 '- 'K- --- : l.."r fO~,I" -f ," " '~,I (!,;r;;- ~ ....; 1rtl-.. <i ""' ' (I 71. S;,' I 71. S' 'i ..L L t ,fI.' s€- ---k[ .~ ~ ~n La .! 1<,..".1 PARCET.:-- Tr:.-/ <.. ~ ;. I t F."JD. J/Z.'RON;>IPE It!,,,N'ltGI g 2. \ .-- . ~.".1405l"8"I~. -O.2J'OF r~J€CO""'ER 'vi -----~ 6256". _ (EAST J '", ~ iO -.. ... ., <0 .. ~ on " <> '" " '\ "- "< Jl'~_2.5' - S. ilp.4.,;'?ri'W, r'i. .. . , H. ><, " " ': lANl COUNTY SUIC'/EYCns OffICE I C.s. FilE "40. 'J. ~"\ I; (; . -i !;llNG DATE.1...:2:.tYl rz: J \ 1-. cJ is . it" (8 II -fa 6 f? jJ to rf, 't. 'o,<h?JJ F'"<:,,..,. fle.rc<I!i #). 71A.'K L~ r p ~-17-0J-JJ.-I)-(.s()O PARCEL 3 (/JOT SUilVEYEDI iJ-lO. 38' = -(wEST/ \~ ,S: 'm - .o~ 0" ';0 .... \; (209.00',' EAST I :j "2)" ~r (S.C.. :3'(. "-: !\ ~I I I . , . , . . " . . . . nil: I II ~! ,~ ~ . .( . .( I . . .t - , . . .! . , .IHI 1111~ . . . ., ! r . .! .' . .: - - - - . . LANE . APPLICANT JANIS'SE, MITCHELL fL; 1703221201300 SUBDIV ~L~EW BLDG TYPE USE X BDRMS 0 UNITS 001 STORIES '." OWNEF~ NME JANISSE, MITCHELL. ADDR 1240 ~IAY CODE APPL NO ACTION DESCRIPTION SQ FT UNIT BP .;tIP ~W BP rw . PI... -MECH "->UR ["CK ~\, '~I ."[ ... SDEQ COUNTY DEPT ENV MGT RECEIPT ; 900298 DATE 101990 ADDR 1240 JAY ST., EUGENE. ()I~EGON . LOT BLI< IBLDGS 001 PHONE 689 1828~i~1 ST., EUGENE. OREGON . COST VALUATION FEE DAYS LC 900298 SI SI FEE 160.00 13~). 00 160.0'0 130.00 30.00 I~ .', ,t ( .~ I . e~ ~ ~ !,:I 't .. ~ loFIX/BATH: SWR: FT . WTF~ : MECHANICAL FEE STATE SURCHARGE PL.AN CHECK FEE 1 1 FT. f,(AIN: FT 5% . CATG: PI._N S'EQU: .fAKEN .BY 'F(LH . RA SDS ELE PCK ISS I SI 1 OTR EST. COMPLETION DATE DEPOSIT *l(. 320.00 CK 1 5. ! r .~ "H i ','l'L .~ . 'I~U , ' ) , . COLONi'ol '\~ ~ , , , fr.:>?/J1'4'7 (f~lV<' ~ W<':S+- (" -1" ~ ~ , '" '" "- t-- 'J '" ,,~ ...;: () '- ~ ! ~ I I \ I St. I l i , 1 I !. j ) I \ i , , 1 L I i I ! .-...-~...._- (7-1) '--..../ ~c."'Dfl f..""SIi!. - I 'L- - .., 'cI I)..D ,., /j.).y ~ -- ---- s! s:.J .. t. ~~,,, -- "" ~ecr ~f"'..", d I So.a 7 .' 7.'> .- '\ ) ScaLe ) ,N "'0/ - / . - Jf- ' (.,)&; +e~ SIt'''''' ,'..t t..... 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