HomeMy WebLinkAboutPermit Septic Tank 1995-7-6
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· REQUEST
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The Following Condition.
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FEES DUE: APPROVED BY: DA TE
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(CALL FOR INSPECTIONS (SEE BACK OF FORM FOR INSTRUCTIONS) 687-4065 J
SEPTIC permits are good for one year, ALL other permits expire efter 180 days unless Inspections are current.
lMD 040 Rev. 6/92
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VIOLATIONS
SHI'BACKS AND onmR CONDmONS OF APPROVAL MUST DB S11UCIL Y OBSERVBD. vroumN CAN RBStn..TIN RBVOCA110N OFTIilS PERMIT.
. "" CrrATlONS-m Y BE ISSUED UNDBR nIB PROVISIONS OF LANE COUNTY'S INPRACI10N ORDINANCB AND/OR onmR RBMBDIRS AlLOWED BY LAW.
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A MINIMUM OF AT LEAST 24 HOURS AnV ANCE NOTICE MUST BE GIVEN FOR INSPECTION REQUESTS
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Have the following infonnation ready when you call: 687-4065 /
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Permilnumber - Job address - Typeofinspectionrequired_J Whenil,will be,!,iIdy)
( . Q\~; Yournaffi. andPho'n.rimnber <:0' 1i.ny ~a1direciions to lIi.si.hj(, 1\-,' /)
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PUBLIC omClAL RIGIITTOTRESPASS ON PRIVATE PROPERTY oas DS.OIO C) n ,- 1/'/
POWER TO BNI'ER UPON LAND. nm COMMISSION, AND ANY OF rrs MBMBERS, OPPlCERS AND EMPLOYES, IN nIB PERPORMANCE OP1HBIRFUNcnONS,MA Y ~
BN'TER UPON ANY LAND AND MAKE BXAMINATlONS AND SURVEYS AND PLACl AND MAINTtJN.:nm NBCBSSARY MONUMENTS AND MARKERS TIIEREON..] ()}' _) (
REQUIRED IN~PECn<)NS / ,. ( , ( -'. - . .
FOUNDATION n{SPECTION: To be mad. after .xcavations for foo!!ngs:~~irPll~ F~yjhu~e:d}'~~~.irig 1~1 is in P!."F~! f)/ U,. I;
UNDERG~Q..U\IDrr.~IN,G II'!:~Pf.crrO!,;, 1:0 ~ \'lade. af~r\~I,'!'Id?,'~~ piP,ing,~~~~ iIJstall~prior,t?,"J'r'~"Y.ill.. .J LJ( ~ 1. --
CONCRETE SLAB OR UNDER-FLOOR'INS~ECTION: To.be mad. afterlalliin,sl.b,or.ulid~l100r,buildijlg servic..quipm.n~-conQui~ piping I
.cc.ssori.s and~oth.r "";i1lary diuipmehi:iteins ':"'in plac. bu~befcir'8nY cOncrete,is placedor-flolir sh..thing installed{mcl~ilingth~ sUbri"".. J
ROUGH MECHANiCAl! iNSp,ECTION: To be'';'adeafter all dutting and gai'plping'has bed" iAslalled andp,;';; to bl,ing C{J'vrdad~' I 'J"
RouqH,~~UMBING,n:f~rECTION:l1f h4'l1)ad,b ~"!.~ IJIWTJbi",g ~o{gh'y is ij11~~~iJrWt?j>e~'g fo';~' /,J.'!/iJJ)/ i III j, ..
FRAMING INSPECTION:r To be mad. lifter th.alI framing; flTe/blocking, brilcingand roof .rein plac. and all pipes, chimn.ys and venlS,ar. compl.t.
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and th,e lO,ugh electrical, pUJllbing, an~ rrl!'ChllJ!ic'J1 ~pee!i?"" h,v"b'!en 'J'~ "F ~veO!,,..) 0 . _\ -,I I ) I. ~
IN.SP\;A-ryql:i ~~IlEmON: To be m.de after all ~a;>on 'F v.por bamers are m place, pnor to covenng. CJt.1 "I i ,~/l, r -
LATH AND/OR GYPSUM BOARD INSPECTION,'-To'be'made after all lathing and gypsum boanl. interior and .xterior, is in place bUt before any
plasteringis.ppli~or~o!"gypsum!>pardjqjn!sapdfas,tenersarel~andrmis~~: /1 ,-', I' >~ "_ f ~., ' -, I
ADDlTIONALIN~Pl,lqI'I.o!'lSMAy,BEREQUIRED.,suchtasbuln'ollliiiitedto,;'u,,-, r~J ~(t:... 7' I !ll IJ ,.':){" '/11/ '.j(
BLOCK WALL: To b. m.de aft.r r.inforcing is in1pla\:.. but before any ~ut is poured. Th. ins~tion is required for .ach bond beam pour. There
will be no .pproval until the plumbing and .lectrical inspections h.v. been mad. and .pproved.
FINAL MECHANICAL INSPECTION: To be made just prior to th. structur. or remod.lad are. being occupiad and prior to operating any equipment
FINAL PLUMBING INSPECTION: To be mad. jusl prior to th. building, structure or remodeled area being occupied. '
FINAL BUILDING INSPECTION: To be mad. after finish grading and th. building, structur. or remod.lad ar.. is compl.ted and ready for occupancy.
MOBILE/MANUFACfURED HOMES: An inspection is required after th. mobil. home is connected to an approved s.wer 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 foundation requirements for mobile homes or as reconunended by the manufacturer.
Minimum finished floor elevation shall be certified when required by Floodplain Management
Tiedowns, if requir.d, shall be installed and ready for inspection within 30 days after occupancy. Tiedowns shall be installed per enclosure.
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APPROVAL REQUIRED
No work shall be done on any part of the building or structure beyond the point indicated in each successive inspection without flIst 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 ~ ....h.~f th. inspections required. ~'
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\ ", APPROVEDP SMUSTBEONTIlEJ6BSITEATAB.TIMESDURlNGWORKINGHOURS.,~:...,~ - '"
THIS PERMIT WILL EXPIRE IF WORK DOES NOT BEGIN WTIl!IN 180 DAYS, OR IF WORK IS S wrrw OR ABANDONED FOR MORE TIlAN 180 DAYS.
SUSPENSION OR REVOCATION MAY OCCUR IF TIIIS PERMIT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS INFORMATION.
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ANYONE PROCEEDING PAST THE POINT. OF REQUIRED INSPECI'IONS WILL DO SO AT THEIR OWN RISK,
Your siin~IUre';n.ih. front of this form verifi.s the ~ll~';'~g: I HA'~E'CARERlLL Y EXAMINED TillS COMPLETED APPLICATION, and do
hereby certify that~l information hereon is true and COrTect. and that I have a legal interest in the property as owner of record or authorized agent. I .
further c.nify that any and .ll work performed shall be done in .ccordanc. with the Ordinances of Lane County and th.l.ws of th. State of Or.gon per-
taining to th. work described her.in. I further certify that ifl am not th. owner of th. "'.Y'_'/' my registration with th. Builders Board is in full force
and effect as required by ORS 701.055, and that if .xempt the basis for th. ex.mption is noted hereon. fIld that only subcontractors and .mployees who
are in complianc. with ORS 701.005 will be used on th. job. ~ ~ ~
SUBSURFACE & ALTERNATIVE SEWAGE DISPOSAL SYSTEMS: -~. ~~' "\iI:I~~ o.Q,~
When subsurface construction is complete, the permit holder shall notify the County Lan~Mktra~ent Divisio~.b)'.t'-~ini~g'1he ~ion record
form. An inspection will be m.d. by . qualified sanitarian. If construction complies with all n\fes . cenificat. o~11fjIIm~iIl ~Jis;a.~ to th. permit
holder. If construction does not comply with rules, the pennit holder will be notified, and all corrections shall be m!4e,before a certificate of completion
will be issued. Failure to meet satisfactory completion within the allotted time constitutes a violation of ORS 454.605'~o~ and this rule.
SUBSURFACE SEW AGE DISPOSAL SETBACKS SEPTIC TANK
From: Interior y"y__, lines 10'
Edg. of road righl-of-w.y 10'
Building found.tion 5'
Wells or other water sources 50'
DRAlNFIELD
10'
10'
10'
100'
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SEW AGE DISPOSAL'
PLOT PLAN APPROVED
, A permit i. reqIJired
prior to starting ~truction.
DATE. 7-G::~,
IV CC ~~
ENVIRONMENTAL HEALTH SERVICES
128 "EA:BT 8TH AVENUE
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CITY OF SPRINGFIELD. C~EGON
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LANE COUNTY DEPT ENV MGT RECEIPT ~ 212395 DATE 07059.
rl~lAPPLICANT KELLEY, JOHN ADDR 2198 LOMOND, SPRINGFIELD j~.
TL~ 1703240000713 SUBDIV . LOT BLK',
. NEW BLDG TYPE USE R BDRMS '0 UNITS 001 STORIES ~BLDGS 001 PHONE 729 7326e
OWNER NME NOLTE, TIM ADDR 2198 LOMOND, SPRINGFIELD
. CODE APPL NO ACTION DESCRIPTION SQ FT, UNIT COST VALUATION
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MECHANICAL FEE
STATE SURCHARGE, 5%
PLAN CHECK FEE 25%
LC 212395 SDSS
FEE SDSS
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PLN, RA SDS ELE PCK ISS I SI OTR
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BY MLC EST. CClMPLETION DATE DEPOSIT ** 0..00
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