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Home My WebLink AboutPermit Septic Tank 1991-8-20 REQUEST FOR: SEPTIC SYSTEM VERIFICATION .. .. ~.""" .... T#'.1\.Ar-\ .'. .~_.:llitVJ:W _. .::...>.;.::.th~'C:" ': Lan4 '. .' ,". Dlylsiciri125..i:;. ~ TOWtGHlP 17 ""'G' 03 ."'"ON 2 2 :~.~ON TAll LOT 2300 IUltlylSlOtll1 (llAIITlTlON LOT/PARcn ~0Qt LOc;a. TWN AllORES. ,U HAYDEN BRIDGE WAY, SPRINGFIELD, OREGON 97477 STRUCTURES HOW ON PROPERTY EXISTING SINGLE FAMILY DWELLING, SHED PROPOSED VSE 8EPlIC "8TALLED PRIVATE USE WATEJIllNBTALUD NO,OfITORlIiB NO. Of EllPLOYlQ CQNITRUCTlOll C08TiVAWI Di:SClavrlON OF PROPOSED WOAK NO. OF IIWROOIIlI SEPTIC SYSTEM VERIFICATION CIRiellO".. TO"""'iffE ,.ROII COURTHOUSE CITY OF SPRINGFIELD, TO NORTH ON PIONEER PARKWAY TO END, GURARD RAIL, HOUSE HAS WHITE POURCH AND TRIM APPUCANT N.....E .. ADDRElII THEOLA GRIMSLEY, SAME AS THE JOB ADDRESS ABOVE SITE IS BEHIND PHONI 747-0137 OWHill8 N....... .. ADORID PHONI COI'HflACTOR HAME oaR UCD48e: . PHON. SAME NA. SAME AS THE ABOVE NA NA ~ MAIl. PERMIT TO: FRED GRIMSLEY, SAME AS THE JOB ADDRESS ABOVE ) NAMI ...ODAI88 I hava carafully raad BOTH sldas of this app~ and hareby c!'rJlfy that ey Information THEOLA GRIMSLEY ~ ~_ ~ '\ PRMN.u.lli --.. ., la true and correct ~-/~-<9/ DAlE CAREFULL VI Your Authorization Ie Based On Tha Following Conditione ~ FEES DUE: $ \ APPROVED BY: fl ~-- DA TE J ~ .2 O-'l( CALL FOR INSPECTIONS (SEE BACK OF FORM FOR IrlsfRUCTIONSj 687-4065 .' SEPTIC permlls are good for one year. ALL other permlls axplra after 180 days untess Inspections BrB current. ? - . - VIOLATIONS SarBACKS AND O'IHI!R ........OJ........... OF APPRQV ALMUST DB STRICTI.. Y OBSERvED. VlOLAnoN CAN RESULT IN RBVOCATlON OPlHIS PBRMrr. CITATIONS MAY DB ISSUPD UNDER nIB PROVISIONS OP LANB COUNTY'S INI'1tAcnoN ORDINANCB AND/OR. 011fER RBMEDIBS AlLOWED BY LAW. . A MlNIMUM OF AT LEAST 24 HOURS ADVANCE NOTICE MUST BE GIVEN FOR INSPECl10N REQUESTS Have the following infonnation ready when you calI: 687-4065 Permit number - Job address - Type of inspection required When it will be ready Your name and phone nwnber - . Any special directions to the site PUBLIC OFFICIAL RIGlITTO TRESPASS ON PRIVAn: PROPERTY ORS 115.010 pOWER ro BNJ'ER UPON LAND. nIB COMMISSION, AND ANY OP D'S MEMBERS, OFPICHRS AND EMPLOYES, IN nIB PBRJlORMANCB OPnIEIR PUNcnoNs, MAY BNJ'ER UPON ANYLAND AND MAKE EXAMINATIONS AND SURVBYS AND PLACB AND MAINTAIN nIB NBCBSSARY MONUMBNTS AND MARKRRS ..~..,. REQUIRED INSPECI10NS FOUNDATION INSPECI10N: To be made after excavations for foolings are complete and any required reinforcing steeI is in place. UNDERGROUND PIPING INSPECI10N: To be made after all underground piping has been installed. prior to any baekfill. CONCRETE SLAB OR UNDER-FLOOR INSPECI10N: To be made after all in-slab or under-f1",,~ building service equipmen~ eondui~ piping accessories and other ancillary equipment items are in place but before any concrete is placed or floor sheathing installed. including the subfloor. ROUGH MECHANICAL INSPECI10N: To be made after all dueling and gas piping has been installed and prior to being eovered. ROUGH PLUMBING INSPECI10N: To be made after all plumbing rough-in is in place, prior to being covered. FRAMING INSPECI10N: To be made after the all framing, frre blocking, bracing and roof are in place and all pipes, ehimneys and vents are complete and the rough elcctrical. plumbing. and mechanical inspections have been made and approved. INSULATION INSPECI10N: To be made after all insulation and vapor barrieIll are in place, prior to covering. LATH AND/OR GYPSUM BOARD INSPECI10N: To be made after all lathing and gypsum boafd, interior and exterior, is in place but before any plastering Is applied or before gypsum board joints and fasten"", are taped and fmished. ADDITIONAL INSPECTIONS MAY BE REQUIRED, sueh as but not1imited to; BloCK WALL: To be made after reinforcing is in place, but before any grout is poured. Th~ inspection is required for each bond beam pour. There will be no approvaI until the plumbing and electrieaI inspections have been made and approved. FINAL MECHANICAL INSPECI10N: To 1iemade just prior to the structure or remodeled area being occupied and prior to operaling any equipment FINAL PLUMBING INSPECI10N: To be made just prior to the building, slIUeture or remodeled area being occupied. FINAL BUILDING INSPECI10N: To be made after finish grading and the building, structure or remodeled area is completed and ready for occupaney. MOBILE/MANUFACI1JRED HOMES: An inspection is required after the mobile home is connected to an approved sewer or septie 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 recommended by the manufacturer. Minimum fmished floor elevation shall be certified when required by Floodplain Management Tiedowns, if required. shall be installed and ready for inspection within 30 days after oecupaney. Tiedowns shall be installed per enelosure. APPROVAL REQUIRED No work shall be done on any part of the building or struclW"e beyond the point indicated in each successive inspection without first 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 by each of the inspections required APPROVED PLANS MUST BE ON TIlE JOB SITE AT ALL TIMES DURING WORKING HOURS. TIllS PERMIT WILL EXPIRE IF WORK DOES NOT BEGIN WITHIN 180 DAYS, OR IF WORK IS STOPPED OR ABANDONED FOR MORE TIlAN 180 DAYS. SUSPENSION OR REVOCATION MAY OCCUR IF TIllS PERMIT WAS ISSUED ON TIlE BASIS OF INCOMPLETE OR ERRONEOUS INFORMATION. ANYONE PROCEEDING PAST THE POINT OF REQUIRED INSPEcTIONS WILL DO SO AT THEIR-OWN RISK. Your signature on the front of this form verifies the following: I HAVE CARERJLL Y EXAMINED TIllS COMPLETED APPUCA TION, and do hereby certify that all infonnation hereon is true and correct, and that I have a legal interest in the Y.~Y-.~J as owner of record or authorized 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 ifl am not the owner of the r--r-.-J" my registration with the Builders Board is in full force and effeet as required by ORS 701.055, and that if exempt the basis for the exemption is noted hereon, and that only subcontractoIll and employees who are in compliance with ORS 701.005 will be used on the job. SUBSURFACE & ALTERNATIVE SEW AGE DISPOSAL SYSTEMS: When subsurface construction is complete, the permit holder shall notify the County Land Management Division by submitting lhe installation record fonn. 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 pennit holder will be notified, and all corrections shall be made before a certificate of completion will be issued. Failure to meet satisfactory eompletion'within the allotted time constitutes a violation of ORS 454.605 to 454.745 and this rule. SUBSURFACE SEW AGE DISPOSAL SETBACKS SEPTIC TANK From: Interior y.vy...i lines 10' Edge of road right-of-way 10' Building foundation 5' Wells or other water sources 50' DRAINFIELD 10' 10' W 100' '. - i. . ..}~ '..))'. ...ii}).t)).} ....... <\R E(JUEST.fORA$SISTANCE Land ManagemeritDiy; 125 E. 8th Ave. Eugene, OR 97401 ...............~l =.lAHOMANACEMENT OlVlSlOlf"': . .. , Please complete all lines inside white boxes, if possible. -. , ... 00 Ho..y de... .6,...a!.9.... W"-y $;-/3-9/ DATE Existing Buildings or Improvements on Property ~ House c::J Barn c::J Garage c::J Mobile. Home ~ Shed ,l,,<.., SEPTIC INSTALLED ~Yes c::J No Water District --rA-e~1a... G r' n-.s/~" ,UUt'! NAMe 'UUH AUUHl:~::> 7</7-013 7 S Pr~"'q ~,,,,icL "HUNt:. O~ '17<177 z,p CITY F'r..,d (;;r.",,>S/...v OWNER OF PROPERTY (il not ..me as ebov.f ..HUNt:. 5,,-~ OWNERS ADDRESS (if nol "me' .. above) z,p t;UNlHAl.:IUH Licen,e, ., ( Directions to site " . ~ m Covrthouse ( - &.. '\, 0"-/C5 10 clTv c..,'^~\- 5"'1'f:' ") lownshlp ~::;eCllon 1/4::;eC:llon €.)(,r I'I\,,~~ O'^ lax Lot fo <o.r PIOH'4''<lo- /l&\)o-'(wC\1 To chd_ ~ 01.<':0'-<- 15 lo~h'''::ci 9Uci~J r >.lL I:iP ho..s,< h~s w!..,\'<. I-'O'-<H.!" ..+\-,,:.,.,. . MAP, PARCEL NUMBER (fOUn~n ta:a:3 1::;~uea.~1L.T.xat~~~_o ~ "ltiii'g'O ::iocuon 114 :;:;eC1l0n I.U Lot Town.hip ~ Section 114 Section T.x Lot , ,- SITE ADDRESS OtP No.y d",.., 6 J-oIe:i9 <e... we,,/ . ';.f'I'"''''1r...icl.,oe 97't'77 ~ lIP ~ ..-.; MAIL PERMIT TO: .,c"" y- ...... cR z,p For Mobile Home Placement .Only Brand Year Size No. of Tip-outs No. of Bedrm<' License # NAMt;. 0:....,......,5/..y AUUHt;.b:b: l..:l" , . -.. -. . . . ~ . ". . STAFF EVALUA TioN . Information Request (:jnly . c:::::J TRS Verified..c:::::JVes '}Noc:::::J Allowed Use '>=Ves' No = , . COMMENTS . FOLLOW:UP Partition I Subdivision Lot & Block . , IJiJ.Ct! ::'l..IIJlUl.l. j 1 I ) ~ Land Management Div. staff can ~ not be held responsible for evaluations or recommendations based on false, inaccurate or incomplete Information . .' , i , , ' .. ,"::, ";;i-.:' .;~ : . .i - J.. .'. , .. ; ,'. ~. \ ., . ;.." ~ .:..... ,. .,:<!::::ji~?~! f~,I~~;~~t'}~~:~.::. . .' ""l..,;." '...it,:, . :~:.,..~.::~r . . .},:'L:~' ,.&. :~:~:~/,;;,,;:, .,,~ ~......P- ".,.... t 7:t:tT~..::: . ..'~ .: . " ". '. ,. \. .:~-l.;:. ~ ~,:~. '~~.'.~ .,~. , . ..:-;:.~ .: ,.:(-. ./. ~.., ',:~ ",J';'; - '" ":t~.,, . ". ..:-~ .. , ..~ .' ,J-:. . *~~ 'C--:h r. ,": .... - ~ .,':,';'" .....: '- ""\ , , i , I I .. '-. . ",,-;"" .,.....:' ':c':,."'" . .....;.....- '-''';' .-'~.,.'- . .:.;.:..,-. 0 .... '" " f j" /~ -./ . / t?~ .' ?J '~';.~ t~..:.-,' -':'.' . ~.:--: ~ . .' :.-r .' .;.: (/I "" '.,J'; .. . ~ . . . . . " . Ii I ~ 1"\ ~ . .'. I~ It . .~ l c , . .1 . c 0 . .~ .. I'fl!l li~ ~ . . . .~ g . ! . .! . , j . .~ c . . W: 5 3 LANE COUNTY DEPT ENV MGT I,ECEIPT ~'245891 DATE 08139..1. . APPLICANT GF\IMSLEY, THEOLA ,~DDR ~>0 HAYDEN BIUDGE WY., SPRINGFIEL.D, [. TL.~' 170:~224402:50(~ SUBDIV LOT BLI<, , , rt~'NEW BLDG TYPE USE R BDRMS 0 UNITS 001 STORIES IBLDGS 001 PHONE 747 01311; . OWNEF( NME GF(IMSLEY, THEOLA t-lDDF( 50 i-[AYDEN BRIDGE WY.. SPFnNGFIELD, [. CODE APF"L NO ACTION DESCRIPTION . SQ FT UNIT COST VALUATION FEE DA":'S BP r e BP .It Br-' ~ BP ~ e BP .. I P[... . MECH SUR ~ I i 'PCK eLR 'U'FIX/F.<ATH: SI,jF( : FT. WTF(: MECHANICAL FEE ST A TE SURCHAf,GE PLAN CHECK FEE Fr. F(AIN: FT LC 24~'>B91 SDSV 75.00 , .~ I : J~ \ '. .. .~ ~ 5% 25% . . CATG: PLN . SE':QU: TAKEN BY RLH F(A SDS .1 EST. EL.E PCI< ISS I SI orR ., 7~5 . 00 CI< ; .-, ..:. COMPL.ETION DATE DEPOSIT H. e e~ \;'H e ,; <I \ ~ .