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HomeMy WebLinkAboutPermit Septic Tank 2000-8-9 \. . . SEPTIC INSTALLATION PERMIT SP007232 (a:an. _'0'_'. Dunty - Parcels: 17-03-24-31-01500 Site: HAYDEN BRIDGE TO N 17TH PL TO 2535 GRAND VISTA DR SPR Applicant: HYLAND SHAWN LARRY R WELLING MD PC COMB 323 N 72ND PL SPRINGFIELD OR 97478 Owner: PROTYPE PLAN 2541 GRAND VISTA SPRINGFIELD OR 97477 Site Inspection Number: 91-316 Work Description: INSTALL SEPTIC SYSTEM for 2535 Grand Vista Dr. SPR System Type: INSTALL, STD Applied Date: 07/10/2000 Approved Date: 08/09/2000 Issued Date: 08/09/2000 Expiration Date: 08/09/2001 INSTALLATION REOUlREMENTS: Projected Daily Flow: 450 gallons Drainfield Size: 225 feet Special Conditions: See attached effluent sewer drop requirements. Install as per OAR 340-71-220 Septic Tank Size: 1000 gallons Maximum Depth of Drainfield: 30 in. Sand filter Replacement. SANITATION SETBACK REOUlREMENTS: From drainfield to property lines and structures: 10 feet From drainfield to well: 100 feet From septic tank to property lines and structures: 5 feet From septic tank to well:' 50 feet C:-;?~:#k. .~? /Adthori"zed DEQ Agent 08/09/2000 This nermit will exnire after one year unless the system has been insoected. To obtain an inspection, make a drawing of the system as installed on the form provided. Submit the complete form to this office and the inspection will be scheduled. Final insnection for sewa\!e systems cannot be reouested bv telenhone. LANE COUNTY ON-SiTE-SEWAGE OFFICE 125 E 8TH Avenue, Eugene OR 97401. PH: (541) 682-3754. Fax: (541) 682-3947 -, !..':".=: :::..= .. " "" '., .,_: ,.. ,.:,,:~: ;,.::.' , eu04d818l841 :SI9N) 'JS1U8:J 841 oUlne::! .,: ....-. ....', . - -' --.,. , . .. _' . , '.,' " ~~1~~~6:~~~i~~~.~1;;ii~~;:~~~:~;'.'" .. 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' ' .. . ~ " 'u /.' ~, / /. f 6'~t-.:bvt'iTA Of' \ " - "---- ~Vll:::e ~fI.& VUi''''~ ~~'O peJ'OIT'1 * "5P~~e\.O ,:::~ - '-' , . . I \ . t:::E.;~ /etJ'LO LAr-l~e \, I' - ('\'\ e!it; LAS) III ~" =- ,'_ ~ I , NO!l."~ Pl.-PoN "'. W::rrr ...~ ~ ~tt?/-?~w:?, --.J1;rl~j2Y d/!tPC7-72..?L REdrJEST FOR ASSISTAWCE. ~.~ LAND MANAGEMENT DIVISION 125 E. 8'" AVE., EUGENE, OR 97401 ~,l~ /~~l~' Public \\brks Please complete all lines inside white boxes. (Incomplete requests will be rejected.) Existing Buildings or Improvements on the property: House ~ Barn ' Jl.o7"'Je- Garage (/' , Mobile orne Shed Industrial Building(s) Commercial Bldg Religious Building Public Building Other: >-.. 'y.,.o..v..^ \~\^ N\ ~,L\ \- O~S'1 Owner of Property V Phone ~"},S N, ~ '>_ t>L 5'1f11 0\ {'-{ 7 ~ Owner Address t Zip Your Name Phone Your Address Zip SEPTIC INSTALLED Yes BP/SP# -L No SI# Water District Well _ Yes No , --:)0 \,., ^ ~A e-- '> (,0/\ vi' Contractor/lnstaller/Bul er'),jame 1..\6071 7J.b~<iI<9~I_ ceB license # Phone Proposed work: _T^v\" \1\ S-..-0,)'- ----,\"",,1.-::" Sy<..A~ />/'~ /I...... - ;{'::r--~-.,:,ff u P' ~ . , Valuation of proposed work: \ 7 (') <, '),1.>- Township Range Section ~\ 0\50D Y.Section Taxlot Mail Permit TO, \ , ~'^.\\^^ ~\i\"",.>. Name ~h.~ tV _ 71^> \>'\. Address S--.. C \> tOR. ctlyk~te I ~Y7ln X- ZIp rvi- ~ ~ I ~ MAP/PARCEL NUMBER: (Found on tax maps in the Assessment & Taxation Department.) Township Range Section Yo Section T axlot ~ ~ I~ 1 .J Site Address: 2J..i' J ~7//b ~?o / ,O~/ J fl ;:::- ,::7 For ~blle Home Placement On/y~ Brand: ~ Year: ~ Size (L&W): ~ooms: Lice~startswit~ Distance in feet ~ from MH to: Water: Septic/Sewer: Directs to site from nearest major intersection: \~"Y).J?^ g.,n'L.Y, -\- 0 tJ. \/-fl., ?' -\,., Vo \r-,,^~.. UO";" ~ \ '--"/>0-.. -l':> , b-~\}.'<J~ f)1'. The signature authorizes the applicable programs to review this application and assess fees asdetemninedby Lane Code. The signature also signifies that this dOeS not mean th~tanappliC!ltion'h~sb13en made until all Lane County programs and applicable state divisi()ns' ha"13 reliiew13d the s~bmitlal.Theabove infomnation is al,so certified as !rlJea,ndac::cur8te. I realize,thatfalse information submitted is grounds to 'deny the application. 2L'~ Signature /- Date: '7/1() / /)r) LMDstaff'caniNOT,betiEild, ,. re~p~nsiblefo"ivaj'~lI~cfnS"based:On false; Inaccurate'or'lncompletEi' Infonnation. ' Completed request accepted by: Date: LCPWI49 .~~.~ ~ /~l~" PubUc. Works , . LANE COUNTY RECEIPT RECEIPT NUMBER: R00003197 PERMIT #: Sanitation--perrnit 2535 GRAND VISTA DR SPR 17-03-24-31-01500 HYLAND SHAWN 323 N 72ND PL SPRINGFIELD OR 97478 741-0259 TYPE: SITE ADDRESS: PARCEL: APPLICANT: . POSTED ON: 07/10/2000 SP007232 SUB-TYPE: INSTALL LCPWRLH Type Method Description Amount Payment ------------ ------------ ------------------------------ ------------- 566.00 2000 2100 3065 4010 4100 Check Description New Technology Fee Administrative Fee Long Range Planning Surc DEQ Surcharge sanitation-Permit Review Current pymt 10.00 64.50 21.50 40.00 430_00