HomeMy WebLinkAboutPermit Plumbing 1995-4-28
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AUTHORIZATION FORM
Land Management Oivi$lon 125 E. 8th Ave. Eugene, OR 97401
~REQUEST
FOR:
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Septic System Installation
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~JADDRESSING
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~ TClM'olSr 7 RANGE 0 2 SECTION
LOCATION A"S
30 Hayden
STRUCTURES NOW ON PROPERTY
Barn; Garage; House;
PROPOSED USE SEPTIC NSTALLED WATERINSTAUED NO OFSTORI~ NO OF EMPLOYEES CONSTRUCTIONCOSTNALUE
Res. No See SI 95-ll2 Ra~nbow
DESCRIPTION OF PROPCSEO WORK
Installation of sewage disposal system.
DIRECTIONS TO SITE FROM NEAREST MAIN INTERSECTION
Mareola Road to 28th Street; left to Hayden
r~1ON . 3 T~T '
Bridge Rd.,
~Ulf!SICN I PAR'rnloN
LOT i PARCEl. ei.oi::K .
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Springfield
NO OF 8WHOCMS
Bridge Road; left four houses
to site.
APPLICANT NAME & ADDRESS
Darin Thompson, 3063 Hayden
OWNERS NAME & ADDRESS
Mervyn Thompson, 3l5l5 N.W.
CONTRACTOR/INSTALLE'" BUILDER NAME
Byrons Triple R Enterprises
~ MAIL PE(1MIT TO: '
Dar~n Thompson, 3063 Hayden
) NAME
I have carefully read BOTH sides of this
Darin Tnompson
69 gcgsg
PHONE
746-5241
PHONE
647-2914
PHON~6l_307 5
Bridge Rd., Springfield 97477
Beach Rd.
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~ PRINT NAME
Springfield 97477
."ioy lIIat all information
~PLANNING;ZONING (~:~~.,:~.~"~:.~.LL~,: Your Authorization Is Based On The Following Conditions ~
~OME
~LOOO PLAIN
MINIMUM
WEYLANDS AccEss LEGAL Lor SETBACKS FRONT LoT UNE P/LSIDE INtERIOR nAil RIPARIAN
COMMENTS'
APPROVEO BeY, bAn;: f "
~~/~rInM . ~' , '~" ~' :;,. '1tIIINSTALL DI$1,,'$'1S1I;M peR~' ';/[; ,/,C\.!<,,' "
I '.JI',- I ""'5f . "'7 "7. (~pPRO\leo PLOr PLA~, OAr EO , I, Y '"
: v) L~ ~ -P' 0 rHE SYSTEM APPl!;ARS ro llE WORKI ~
I. iiiJ" &."- 11 IN$T, Rec IllS'D ANK!Ii} LIN" FT. D F MAX TRM EPTH RJGllt, IF SYl[lTEM FAII.S, YoU
;AJ' /.....-7A../~ 5'0 C' /./1;./1 r ~/J/'A~/\ MUST APPLY' ~OR A Al!;pAIA plillMlr
r "7 rTK" V 7' rl J...J It:!.-""PLVYV """ 0 HOOK 1'0 l!;~IStIN(lIlVSTEM
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FEES DUE:
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APPROVED BY:
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CALL FOR INSPECTIONS (SEE BACK OF FORM FOR INSTRUCTIONS) 687-4065 j
'Ii SEPTIC permits ,are gOOd, for one year. ., ALL other permits expire after 180 days unless Inspections are current.
LMD 040 Rev 6/92
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VIOLA nONS
~ ,.. " SETBACKS AND 0TImR CONDmONS OF APPROVAL MUST BB snucn. Y OBSBRVBD VIOLATION CAN RESULT IN REVOCATION OF TInS PBRMIT
-, ,,"' '. ' CITATIONS MAY DB ISSUED UNDBR nIB PROVISIONS OF LANE COUNTY'S INPRAc:nON """,u,ANCE AND/OR 0TImR REMBDIBS A1LOWBD BY LAW
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A MINIMUM OF AT LEAST 24 HOURS ADVANCE NOTICE MUST BE GIVEN FOR INSPECTION REQUESTS
Have the following information ready when you call: 687-4065
Permit number . - Job address ,- Type of inspectIOn requrred -. Wlien It will be ready
Your name and phone number - Any special directio~ to the site \'1.:
PUBLIC OFFICIAL RIGlIT TO TRESPASS ON PRIVATE PROPERTY ORS 215.080
POWER TO BNTIlR UPON LAND nIB COMMISSION, AND ANY OF ITS MBMBBRS, OPPlCERS AND BMPLOYES, IN nIB PBRFORMANCE OF 1llBlR PUNc:nONS. MAY
"".."",- UPON ANY LAND AND MAKE BXAMINATlONS AND SURVEYS AND PLACE AND MAINTAIN nIB NECBSSARY MONUMBNTS AND MARKERS THBREOl;!
REQUIRED INSPECTIONS
FOUNDATION INSPECTION' To be made after excavations for footings are complete and any required reinforcmg steel is in place.
UNDERGROUND t'il'lNG INSP~CTION: To be made after all underground plpmg,has,been mstalled, pnor to any backfill.
CONCRETE SLAB OR 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 placed or floor sheathing mstalled, includipg the subfloor.
ROUGH MECHANICAL INSPECTION' To be made after all ducting and gas piping has been installed and prior to bemg covered
ROUGH PLUMBING INSPECTION: To be made after all plumbing,rough-in is ~ place, prior to bemg covered.
FRAMING INSPECTION: To be made after the all framing, fire blocking, bracing and roof are in place and all pipes, chrmneys and vents are complete
and the rough ~lectncal, plumbmg, and mechanIcal inspections have been made and approved. . .
INSULA TION,INSPECTION. To be made after all insulation and vapor barriers are in place, prior to covering.
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.
ADDITIONAL INSPECTIONS MAY BE REQUIRED, such as but not linuted to;
BLOCK WALL' To be made after reinforcing is m place, but before any grout is-p<;>ured. The inspection is required for each bond beam pour. There
,
will be no approval until the plumbing and electncal inspections-have been made and ayy,...ved.
FiNAI:'MECHANrt~ INSPECTION: -To-be made just pri~@the structur~~r reITI<i\eled area bemg occupied and prior to operating any equipment
FINAL PLUMBING IN~PECTION: To be made just prior to the bUilding, structure or remodeled area being occupied.
- FINAL BUILDING INSPECTION' To be madf: after finish grading and the building, structure or remodeled area is completed and ready for occupancy
MOBlLE/MANUFACfURED HOMES: An inspection is requrred after the mobile home is connected to an approved sewer or septic
system, pnor 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 finished floor elevation shall be cerufied when required by Floodplain Management
Tiedowns, if required, shall be installed and ready for inspection within 30 days after occupancy. Tiedowns shall 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 first obtauung the
approval of the building offiCial. Such "'yy.u val shall be gwen only after an mspecllon shall have been made of each successive step in the construction
as mdlcated by each of the inspecuons required.
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APPROVED PLANS MUST'BE ON TIlE JOB SITE AT AUL TIMES DURING WORKING HOURS
TIllS PERMIT WILL EXPIRE IF WORK DOES NOT BEGIN WITHIN 1~0 DAYS, OR IF WORK IS ST~PPED OR ABANDONED,,FPR MORE TIl,~ 180 DAYS
SUSPENSION OR REVOCA nON MAY OCCUR IF TIllS PERMIT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS INFORMA nON
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A~ON~ :PROCEEDING PAST .tHE'POIN:](.qF_REQUlR.ED'IN~PECTION~ WILL DO SO, AT THEIR- OWN RISK.
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Your signature on the front of tlus form verIfies the following: I HA VE CAREFULLY EXAMINED TillS COMPLETED APPClCA TION\ and do.
hereby certify that all information hereon is true and correct, and that I have a legal interest m the property as owner of record or authonzed 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 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 that if exempt the basis for the exemption IS noted hereon, and that only subcontractors and employees who
are In comphance with ORS 701 005 will be used on the Job. -
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SUBSURFACE & ALTERNATIVE SEW AGE DISPOSAL SYSTEMS:
When subsurface construction is complete, the permit holder shall notify the County Land Management DivisIOn by subrmttIng 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 permit
holder. If construction does not comply With rules, the permit holder will be notified, and all corrections shall be made before a certifIcate of completion
Will be issued. Failure to meet satisfactory completion Wlthm the allotted time constitutes a violation of ORS 454.605 to 454 745 and thIS rule
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SUBSURFACE SEW AGE DISPOSAL SETBACKS SEPTIC TANK
From: InterIOr property lines 10'
Edge of road right-of-way 10'
Building foundation 5'
Wells or other water sources 50'
DRAINFIELD
10'
10'
10'
100'
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TENTATIVE PARTITION MAP FOR
DARIN
1/4.
THOMPSON
S.W. 1/4. SEC. 19. T.17S., R.2W.,
LANE COUNTY. OREGON
W.M.
N.W.
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FEBRUARY 10, 1995
SCALE, 1 "=~c.O/
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.. PROJE<:I'I 1t ~ CUENT
PR~~~L '" TENTATIVE PARTITION MAP DARIN THOMPSON
LAHO ~URVEYOR I' TAX MAP 17'02-/S-,j-2
TAX LOT 201
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PROP€/tTY LorE
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DA\lO l.. BROWN
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EXPIRES DEt. 301 IlJ95
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REVISIONS
NOT~
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I DATI FTQ#WARr '0. 1995 I
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REQUEST FOR ASSISTANCE
LAND MANAGEMENT DIVISION 125 E. 8TH AVE., EUGENE, OR 97401
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Your Address
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Owner 01 Parcel (II-ftot same as above)
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Owner Address (II not same as above)
h'y,e-""..s ~/~ ~ ~ ....tern ~es
Installer,I'Hulld~V Contrad~r
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Please complete aI/lines Inside white boxes, If possible
Y/fg.a-r
Daie
7Yt'-S-ZY/
Phone
??y77
6~7-.2.qll
J ExIstIng Buildings 01' lm-
provements on the PlOpeI'fy
...
Phone
House
,( Barn
L Garage
Mobile Home
Shed
SEPTIC INSTALLED?
_Yes SEE
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Water District
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Zip
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Phone
CCB License /I
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Request for: S-e#IL_ ~~
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Directions to site from
nearest main Intersection
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MAP, PARCEL NUMBER ZONE
(Found on tax mapa In the Aaaeaament" Taxation Oept)
/7 02- Iq 32- 201
/
Townahlp Range Section 1/4 SectIon Tn Lot
Township Range SectIon 1/4 Sec:tlon Tax Lot
Townahlp Range Sec:tlon 1/4 Sec:tlon Tn Lot
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Site Address 3 ?
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Mail permit To:
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Name3v~,7 ,A/AyA: $,.,,4~ A'd
Addre.. ..54-" ~ &},4:e ~ d-e.-~OPt..
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\. For Mobile Home/
\ Placement Only
Brand
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No Bedrro/
Ltcense <No always starts With Xl
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rl ance ~Moblle
me to:
Lot & Block
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Staff Evaluation
Information Request OnlyD
TRS Verified Yes ::J No D
Allowed Us. Yes ::J No 0
Comments I Follow-Up
LMD staff can NOT be held
responsible for evaluations or
recommendations based on
false, Inaccurate or Incom-
plete Information.
Partition I Subdivision
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LCPW 149
DATE
STAFF INITIALS
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~UCorY TIn~242 LANE COUNTY DEPT ENV MGT RECEIPT I 138495 DATr 04299-
. (:jf-'PL I C(.\N r TI.HJMP SON, DAR I N AD DR 3063 HAYDEN BR I DGE RIL u."~~1if.[ NGF l E:L D
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NEW BlDG TYPE USE R BDRMS 0 UNITS 001 STORIES IBLDGS 001 PHONE 746 524a ~
OWNER NME THOMPSON, MERVYN ADDR 31515 N.W. BEACH RD., ? & ~
GODE APPL NO ACTION DESCRIPTION SQ FT UNIT COST VALUATION rEE DAfS ~
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The Lane County BUilding and Samtation Division cannot proceed with processing your apphcatton because'
1 0 Incomplete application (Items deficient).
o Address and/or directions to application site.
o Proposed number of bedrooms in dwelling.
o Approvable plot plan (see attachment)
o Nottfication of date test holes will b~ ready.
2. 0 Verification of eXisting system required (see attachment).
3. 0 Two test holes (2'x4'x5' deep) required for expansion or repair of existing sewage disposal
system In the area of the proposed dralnflelds.
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SIGNATURE
If no response has been received In regards to this matter by
the application Will be demed.
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OFFICE HOURS
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LANE COUNTY ENVIRONMENTAL HEALTH SERVICES
Courthouse-Public Service Bldg. /125 E. 8th Ave. / Eugene, OR 97401 / 687-4051
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