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HomeMy WebLinkAboutPermit Field Test & Inspection Report 1978-7-14 ~, .,.' , ~,~, ' TRS" TL,/t-rLS'r-?3 ......1;,.. "-( f' . / ~ - - , ' /:::In I Job Location Written Directions \ ,I S'.I. #'/J{- /3/ C;</(} ~L/ AJ <' f ~~M I? . ... \. ~,.t"O, , 0/ /J - '-"'-1-' -- -/ U .. ~ .Ill? ./L~.:r A/ ':;;;;7...:;;~ ~//J / ~ f? <; ~ ~ Y1 ~ '" Subdivision: /;/ A- / / . , : Mail report to ( ) Applicant () Owner '. ,(:"')-Prefer to pick up. Call 7de.,,-L/L/r:lq Phone tc.) when ready. . ~ Block ~ ' . ' . . .,.~,~ ,.w'"'?'';; SITE FEASIBILITY REPORT FOR SUBSURF.&'CE AND ALTERNATIVE SEWAGE DISPOSAL .. _.' \ I - . ' , APP'L1CANT'S NA~EAND ADDRESS (~('1 ~ /0v)A{,L~rt: /t,qn _~ A" _<:::"AJlrO " /j fI- If' I I f/ "f' OWNER'S NAME AND ADDRESS Lot ::: . ~ . Ie) ~'... ,qUCTURES NOW ON THE PROPERTY ~, ,PROPOSED USEOF PROPER~'y'-'_:Sf::":/J .' -/ ", . ' .WATERSUPPLY '12r1J~A'lA?-',,(} 'WITHiN,ONEMILEOFTHE 'Y'OF'~-L '(NO)" . . '. -ff, V, , , I hereby 'certify th'at the above statements are rue and accurate,and that I have'the following legal interes In the property': ',;, '.' L---owner of record; cOlHract purchaser; potlilntial b~ye ~ealtor o~ ~gent. I further cer~th~zat.(if not t owner) I am ,authorize,~ to act for' the owner of record, and th,at said owner is aware and approv~s, ~ this .action~ :". y'" /. : JJ , TEST HOLES READY ~-/7-?R Signatur-p 'Hg I#!A~ Date} -/V-~(!j .. ' .#',' I - ,-/ H......,., - /7 ' , .~.i', * * * ** * * * * * .** ** * * * * * * * * * * *,* '*OFFICE USEO'NLY BELOW THI~/L}l<iE * *,/ * * * * .;. * * **' * * * ,* * * * * ,,'*"* * * * *' 'SITE~~,MEETS STATE ST~~L~~:RDS 4~~~,ES,~O % ME:ET ?TATE ~TA~DARDS." t., "_'" z6nin'ik}tt;E;U;S~,90MPLlANCE ~- ~~. ,.;J, .,;:/(;Z.L->" ~ -~~;..b~;--' h:r(!,Qh.-vrZ o.&\-0-~-;:r.n. ' '.,. ~ '. ".'. .' .iJ,Lf,'.. · 'Yy' . /,': '. .'.,...,1/ .<. 'if' AcreageoriLotSilP ,Yl/-)'g/,/)_'2-- (TOTAL) 110' ~ 1'i ~ ~ C--..a<- ~~fc.. r... Partit,oninQ#Mf".:5.r- JllJ~~:j~~ted . e ~~ k:"-,,, J~~ a~~' ,'parcel#, , " I,. , " . t " ~ 4~ ~F' ~..ef ~ 1" ~'~~C~(f~O~f2 ~" ~"_,,d. /J 1:-, IO-O'~' $/ .v _ , . ~ !AS 12 4- ", ' '. ~ (J', ' ~ <fF ...evv..:.,.~ ~ , , . THIS' IS A PRELIMINARY REPORT WHICH DOES NOT ENS E THE ISSUANCE OF A FUTURE BUILDING PERM.IT.ANY PLANS OR EXPENDI. TURES MADE IN RELIANCE UPON THIS REPORT ARE AT YOUR OWN RISK. "IF SITE IS APPROVEO, SEE HEVERSE S,!DE. -" ~ .:~ , f (.,-'.. , ..~ .....--"'" " (, 01A/l.A r~ ' A"UTHoRIZED SIGNATURE , r:)-/S -7fS ,:~ DATE ',', ' Permit processing Section' :125 EAST 8TH AVENUE"EUGENE, 'OREGON 97401 687.4061 .. . . 1..< -- . ".~ '< ..... : .) . " ", ~ . - ~ '.' '., -, .:,...ft ;~~ .:.;.;; . ~: '.' . . ::1',' ~ ,.. 'j ;-; . , -, ~ ;' : "' . ~ .r? ;. .).,: ': ~ , . , , '. '( " ...j.... . ' 1,,< ,J '., OAR Chapter 340, Division 7, Section 72-020(6): This report shall remain in effect until issuance of a permit to construct, -unless in 'the meantime conditions on this or adjacent properties have been altered in: any manner whiCh, would prohibit issuance of a permit, in which case this evaluation report shall be con. sidered null arid 'void., Techn,ical r~ule;changes \lIiil!' not" invalidate any evaluation report issued pursuant to this section. ;: '\.. -, '. Before' construction is start'ed bring this forrtd:o the Department of Environmental Management and apply for a building permit. Exact"specifications for'thesewage disposal system will app'ea'ron the permit; , . 'If the property-is only a', portion of, a tax 10Ca' pahitioning or subdivision must be approved before the ..permit will be.i~sued. ,.'\ "', ' '.,' '> ,'.' .".. ":"" , ':' " , ", ,'," . ," ,- -l _ i I~' ." . . "'.. . '. . '. ' . _ ',' ,,'-. ~ '. : ",' .' ,1 .~. ,""_' ~. ,-,..- Only persons having a valid license issued by the Department of EnVironmental Qlicility' U11der ORS '454.695 to install subsurface sewage disposal syste'Rls 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. ... '1 '1, I. ',S "7 ... .'.....~ y ~..;.!''':'' ...;,; '. ..; \...' .' :.0 ..,~ " :. ,-""'. -I' '\' ;~~l ) I ~ ::; f ,. I ! .~ I ~ ,~ i , ,. -.; ~ ',~ I . ,:.; I ,i: I -,I! 1t -} I - ? 1 ~,J i '/ ~ i II ~. ..~ ~ . ,,-' >J ,:"P'p\ ...>;....1._;).; It.: .,;~~.J,. \ :.,"f '_,; >: ?~;~~ ,/ ':: -;.. ...l'rITt0NE:k: ,~, , , · ; ~AM~L \':1'~ k k'_'e__:b,~.:', k.~ ~~.-,;~. fL~r"" -'?;,-\ ~ '~'. . ~ , . .re .' ",-,,-, 'lDbkss';, ,," ,;:-,- aO' C' ,]j~ f' I "'_:'".0L_ ' .0 I- 't, . , .tr>' ")t),,, ~ ...-"'t _, Q p-e""--,, ;. ~~: ~J~, . .~i ' >:.. .' .:<,~ ' ":; . ".. ~ '\ .- ; ,'" _:,it':;;-[;, :J[P(-->"'1"C:;,f:;, Vd " ,@Y'e'~ n..L' .' . . 'i.J ' "'J , 7" ,Lf' _' L/ I i.~:,; ,,-' PHoNE: I - -, L \ . W ,< 1~T~ST:;'f~h ~,Rop~~fu4':r:;: l~ i,H~ .k~r':,-':',;~'l::r~':~~f'~;. ;~lnd~t~t~t.,~.~~_:L' - d~e,f'~ <iohtraciti j>lir'chiisef,- :- ,'.- . ,-, . h ' -I..~.i;, .1, ',- . ':".L ; . ;~bpHo: holaer:'. , bthe't,) ,. _ J .: ;";'" . ..' :!. "" ~~J ~~~ti~J~:> "\~:":', ,I:~, '..:' " ,'I." ~~ \' "~~, -.;- -, - \!I~~:!; i':'i)~: :'~: _ J}::\> - ~l~,~(' :,{: : ';, " NAME. .' '];?t)e~,^ }4~..1 fY.,\,c Ii ':'t. ~Dri'L:. ';~\~~~'l''.::,! ~~ rl_ J: ~ ~, .;~ ,ILl~ii~~~,,:, :f;;i ~ ;'L;: :~::h. ~~ j .::#{vL::: {.;{.t : - i;' ,'.{J ~~:'.,;, A'~,"" -iI- ':_,( f,.(~j2_:,;:..O_;" re C,}5-.. ';.Di~.; e._ ,) )-. ~_; b,'NE, :.'" ; :{{~,il ":.;;,~' (I ':l"'f~:, . ,';'. "":i::~:, J.,.. 1'1 1._ _/l -r. 0"".., "'" "',,, ~Xxb~h ,i ~~'i;, .' ,:iWi #,L,~1~.9t,,~~ , ; '. ,;;Alf~M~~V' 0\:'1'" ~ au~~ JK-"f4Jj1. ~ ' , ':-. .~.. ..."l ~i" ';',,'" ~ - . Ii --.,....""."~....---:-.-~' " i ,.. ,~ y ~ ","..:;i ~~ i ,~;~r~:~ 1 ~h~t, f t ,~:: :. WATER<;SWPlN; !?A1j.,Jez;uJ, IA/A-rd-li: PERM~~, I' ;}", -, ; ';'; ,;,S;: j' ; SEWAGE' DrSPOSAl;{. .iJ.iff?TJ(". 77-\7\/~, S I '~i\ ,ir:;;: ", '. . ',~,' ,:",,::',')." . . Jt. :.....:.: i'_ ~, '. . ..... ELECTRlc:/-$:ERVIC# ~.- ;,~WI:::?3 ZO~NG' ,,,:\,, '. i": t':'^"ifr-2..0" . ~;;ij:!L if:f.'\~~ J .e&~~-.....;-tti_ ~;> V:;.e~ -C<....p p , : l- I;;; 1'-~'.!;': 1: . .. DAT~i gtm~nTTErii ,',,-, ,:'io - 2. 4 ~77 ,v ,r~"~~ .: ~.l ' REC~Iy,~b BY:' ,"dec.( -_'_ ~,:,,__".~,-,' \'0,-, ~c~:.,,_, FEEfAJ;D:, -. HEj~~~- DATE:J : _:": ;': It - Il -l7 ~i:~~:;-:' ,fo: 4ffiC~'~';,~~e only ',~ ~'~ ~ " . ~e . v.' " ",," BY: i .; ,,' 'f ; :.j. .'. ~-. t. : 7 '.; .r :~:~r'. J. <" I t .; ;,,~ ,', ~ !~ . ~. ,.~ '>1 :;"" . " ,. Acting Gli~Hrnuiri" Land D~veiopmerlt;_~eview Cormnittee Date ,',/ :~ .' , , :~, '" "',~ ," . \1 --',_ l ''',,,!,, t. " J . ,":": \::i~, ';" ~~ ,(;J, I" ~~i;:1" vic:iniity ,~.~. ";~:" Jli~ap .1,f:," ": ~, ~' r..' , "-'\,'" ..,. "'-". , I j. . ,- beUZ,C>'X,'1=i r :)" , JJ! ,~ YOL-A-~D~ :, ,~~.:: ':'.,.. ", " F'fLi NO: M,~ 2 " ~-Jff!;: : ",8..f:. ~ ;~ !. .'1' :'(, . . ~ MAP PREPAlmD BY: ,.:.'i ; ~.. .:. ~ '1 . .' ., ',,~~' J~ ~. lpL~~NI~G bivislo~ / ENVI~ON;; ci4-15 - " -'. . 1 .' AL MANAGEMENt bi:PAfnMENT / 125 EAST AVE, / EUGENE, OR 97401 / PHONE (503) 687, Sheet 1 ( ~ .... "'.."'1. :~, ~ r' i ',",< ,," ,~--,,,",~,,,,-,,,,w'-li' .,':" -~.~--- .;. ',: ~ ~ ", :(~ ~\ : , , , , '. .,;" / /' , , I. i: r ' I , , ''''., . ,..-/ '. '.. ,. .I~f .!. ,t ""1;' ~ t.... , -:': __' ' ' :;;j ~~__ "; .~;..',,~ ::, >'" .Ji. >: '~~ /C)>. ,/ /~:J':' iL--J :i; , No/iTti ~ .,,' ~~"" Z. ____ . / / . .1 :SC,l1rL E x" ':'/~O; , /'?~. '~ ;/,/ ~, : "'~ -; . / / . I ",10 , ~: . .: ..., ;,", ;.<'~. '. 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'.. .ot1i~i-R: tiE-AN",.;kEl.F~:tbH~' ::;-)<, A$SE.sSOR '3 MAP &0. /7'03' 23 7"/1... /20 . '.' ., d'.' '" ';;':',.;1"1:, "; ".;;, ;I,,,..,,;; ;..'. ,: . DEVEI.C1P ER. t. 'V;!Jc.I<I("E~#AR.A . . , , ~i ~.,d : ~6. ~, oS r. '";;; . ;}jP'R !/VG,-li/E/. D, b.~. .~ :. r '1 /:i i :~ ., )44gg J :;~ ; ~ I x- -f '"" ~ ~- "... ~ '--v "- i lB. _ 1424 . QCrOe12R ;;z I, (977 tsCA l. E' / " . /00 ' -t. ORFlW/lvG PRij:j,qjU?D 8Y: . Bk):{;vCh' eNG/NEGR/NG 2,$-7'6 .N. /67"# srREE r Sj;>;i?INGF'/~1..0, OR.EGON 3 ~ ." . 1<';1. .~~....!; ..../~;<f. ~:~' ~,~Y~';;~~\~~:\~.:~.L : ~:,.~i",l;~>./i::'."} :-~:.i .. ;S't:r~xv..&e- D/.SIf'il::'.~G. ,", iJ:Gtf,riC. : rA/v..K, JVA',ra-.e ;,fV.....P~y i IlAI'NB6W . -W,freN PI; i,.}qIC r Ct Mbz8-l7 ~1J... . . ,",~-,.-",-~,""",.-~ ;;. ... 7<f[ - /;;f-7 ' # 1 T E S T L .E. # 2 T .> T H 0 L E . ~ PERCHED WATER PROFILE PREDICTED WATER PROFILE Inch Inch ; Predicted in. Predicted 'in. Observed in, Observed in. Date Date 12 _SCL ' 12 _cS:C!~, $ATURATED ZONE SATURATED ZONE Predicted in. 24- Predicted in 24 - Observed in. Observed, in Date Date 36 -; 36...; S~ Restrictive Layer ~n. Impervious Layer _in. Mottling ?J?fhL~Q.J_in, . SITE DOES .~ - ) Restrictive Layers;-'Y in, Impervious Layer in, . Mottling Yi.F4.- ~---:.in, 48- 48 - 60 6~ . . eury ~/ DOES NOT ~. MEET MINIMUM STANDARDS. ' . . . ADMINISTRATIVE RULES REQUIRE ~ MINIMUM DEPTH QF: o .36 inches to. an impermeable .layer ~ . 30 inches to' a. restrictive laye,r' o 60 inches .to a permanent water table o 24 inche OTHER REA ,PLOT PLAN: Stream '~ Drainage or pond ....~,.'......f.. Road .. ~... ..--- Test Hole cI) '\. % Slope Cut Bank' -;,/')' II -"'" Fence tK )( 'ON YOUR PROPERTY THE DEPTH WAS: inches inches inches )t s to a.temporarily perched water table inches . ~ONS ,FOR DENr - 4) Pff c?f./ F/ f= L f) r. ,m. f." 'r~l ,; ~= ; i . ; ; ! i n' I T ., TT "-'. If I i -' '~~~ ut .j/yr.! ! i : i 1 ... r , T J..,.. .; ~~~"!m~~ l ;~ ...... UUJ " r <.>/1],' crtr+. :;H; i C" " i;% ~ .'.;r. '1 .' I( i ,:= I i 'S" ~. ~ ;. , "'~~~ '. '. 0 HjJ'f~ ./ ,I? i ! I i . : I .~'I' I, I' 'I , ;. I 'Aj. , j 'r, 'Ii ! fm' ... I }' ; I.. o it !J 'j i ,... i T t.... ... ~r . I t ... . '.... .... i " em. 1.' : Ii ;/" ;.. . "'('r' ; ...... ,.: ....j .r , ! ;.... ..... ,..... .... i... . . : i..... i r " ' i ; ~ ',l , ..r ; i , I' I -. I ; -'.J' i --' ;...':+ .: : i ,T ! r ,.. ; ! n D)i: mllHt" " t!:Lj.:i.. .'1',1.1 /, LWW+1 ; .' ~ ~$ij~j}lt' I.. ejLtr ...... T .: i " j...... i .i...~.- .... j Ilf U,...' U 'TL I i i I I L.Rash.- '~ . 78'-/J7 .~ - ~/- -:,'" 1 ,p- . ;t ,,-. ;' '~""':, ,; - ,- - - SITE EVALUATION WORKSHEET' ,.:.," _- LOCAT;LON: TWP. J 7, RANGE .~ SECTION ;;;2.3 'IAX LOT # ~C)/ SIZE OF PROPERTY: .,- ~ROPOSED'~;JJ$E:~ FtfJ _' -,AMQUNTUSABLE'AREA: ~. ZONING: WATER SUPPLY: COMMUNITY fg) , PUBLIC. ,I~ . INDIVIDUkL ,lCZLI. ,- '" _..' IF SITE .MEJ;:TS STANDARDS FILL OUT: Type of structure '-and approximate sewag~ flow: - Sinf?le Family Multi-family 'gpd ,Iqdustr.ial - " , Commercial.______, gpdIns titutional "?-~ ~ ~. gpd gpd gpd MINI~MDESIGN REQUIREMENTS: Length of ,disposal trench required .' /150 gal. .' - ... .. . Distribut:Lo-n Met::J.1od: . "Curtain. drain requl.red.: Oihe r: Equa 1 LJ Yes LJ- "'.... ' -, SPECIAL SITE CONSIDERATIOrS OR VARIANCE OPtIONS OR .OTHER ALTERNATIVES: .. - } - . NAME : ~~--' t7 DATE OF EVALUATION: ,;2. -':'12 ~ 7'6 ,- . .C74 - 12 6