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SSPTIC INSTALLATION
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1.7 02 1.9 41 100 94-/):J -32 PARCEL 3
LOCATJall ADDRESS
3856 HAYDEN BRIDGE RD., SPRINGPIELD 97477
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STRUCTURESNON till PROPERTY
NONE
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SEPTCHSTAl.UD WATCRIt;!JTAUEO NO.OF&TORES NO.OFEMI't..OYEES
NO SEE SI~4-449 RAINBOW
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~QFPA:lPaiEDWCA(
INSTALL STANDARD SEWAGE DISPOSAL SYSTEM.
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0IRECTl0NS TO SITE FRCJoI NEAREST MAIN NnRSECTION
ONE BLOCK EAST OF HAYDEN BRIDGE ROAD & N. 36TH; NEXT TO 1854 HAYDEN
BRIDGE ROAD.
-APPUCIlNTNAMIi. a ADDRE88
DAVID AURAND, 2243 N.
C.
-CCHTAACTOR/NSTAUEW BUILDER NAME
EMERALD VALLEY CONSTRUCTION
) MAIL PERMIT TO:
EMERALD 'TA~LEY CONSTRUCTION, ~~43 N. 11TH ST., SPRINGPIELD 97477
) fwoll:. STREET CTY 71i'
I have carefully read BOTH sides of this appllcat~ and. hye~certlfy that JIll Information Is trua and correct
lJi.\\!Ir:> "URAND --/g~ ~~ /~ 3-/9- 96
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065066
'"'126-9485
'"'126-948~
'"'1~6-9485
11TH ST., SPRINGFIELD
97477
97477
CIWNl:RS NAME' ADDRESS
DAVID AURAND, ?~43 N. 11TH ST., SPRINGFIELD
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FEES DUE: $
APPROVED BY:
DATE
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CALL FOR INSPECTIONS (SEE BACK OF FORM FOR INSTRUCTIONS) 687.4065
SEPTIC permits are good for one year. ALL other permits expIre efter 180 days unless Inspecllons are current,
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LMD 040 Rev. 6192
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VIOLA nONS
. .;.. ~ \', $BTBACJtS AND OTHER CQNDmoNS OF APPROVAl. MUST HB SI'RIC'n. Y OBSERVED. VIOLATION CAN RESULTtN' RBVOCATION OPTIiIS PERMrr.
. .' CITATIONS MAY BE ISSUED UNDER nm PROVISIONS OPLANHCOUNTY'S INPRACI10N ORDINANC!AND/OROTHBRRBMEDIBS AlLOWED BYLAW,
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A MINIMUM OF AT LEAST 24 HOURS ADVANCE NOTICE MUST BE GIVEN FOR INSPECfION REQUESTS
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Have the following infonnation ready when you call: 687-4065
Permit number - Job address - Type'of uispection'required - When A will be ready
Your name and phone number - Any special directions to the site
PUBLIC omCIAL RIGHT TO TRItSPASS ON PIlIVATE PROPERTY ORS n!.olO
POWER TO BN'rnR UPON LAND. mE COMMISSION, AND ANY OP ITS MEMBERS, OFFICERS AND EMPLOYES, INnmPBRPORMANCB O~1HBIRFUNcnONS.MA y
BN'J'BR UPON ANY LAND AND MAXBBXAMINATIONS AND StJRYBYS AND PLACi AND MAINTAIN TIm NBCESSARY MONUMENTS AND MARKERS nmREON.
REQUIRED INSPECTIONS
FOUNDATION INSPECTION: To be made after excavations for footings are complete and any required reinforcing steel is in place.
UNDERGROUND PIPING INSPECTION: To be made after all underground piping has been installed. prior to any backfill,
CONCRETE SLAB OR UNDER-FLOOR INSPECTION: To be made after all in-slab or under-floor building service equipmen~ condui~ 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 INSPEcnON: To be made after all ducling and gas piping has been installed and prior to bemg covered,
ROUGH PLUMBING INSPECTION: To be made after all plumbing rough-in is in place, prior to being covered.
FRAMING INSPECTION: To be made after the all framing, frre blocking, bracing and roof are in place and all pipes, chimneys and vents are complete
and the rough elecuical, plumbing, and mechanical inspections have been made and approved.
INSULATION 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 fmished.
ADDITIONAL INSPECTIONS MAY BE REQUIRED, such as but notlirnited to;
BLOCK WALL: To be made after reinforcing is in place, but before any grout is poured. The inspection is required for each bond beam pour, There
will be no approval until the plumbing and elecuical inspections have been made and approved.
FlNAL'MECHANICAL'JNSPEcnON: To bO made just prior to the stniciuie or remodeled area being occupied and prior to operating any equipment
FINAL PLUMBING INSPEcnON: To be made just prior to the building, strucl11re or remodeled area being occupied. ..
FINAL BUILDING INSPECTION: To be made after finish grading and the building, structure or remodeled area is completed and ready for occupancy,
MOBILE/MANUFACTURED HOMES: An inspection is required after the mobile home is connected to an approved sewer or se)' c
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 manufac r.
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 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 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 indic,!!ed by each of the inspections required.
APPROVED PLANS MUST BE ON TIlE JOB SITE AT AIi TIMES DURlNG WORKING HOURS, ' . .
TIllS PERMIT WILL EXPIRE IF WORK DOES NOT BEGIN WITIDN ISO 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 PAS~ THE POINT OF REQUIRED INSPECTIONS,WJ:LLDO ~O AT THEIR OWN RISK,
Y our,signatl!re on the front of this fonn verifies the following: I HA VE CAREFULLY EXAMINED THIS COMPLETED APPUCA TION, and do
hereby certify that all information hereon is true and correct, and that I have a legal interest in the property as owner of record or authorized agent. I
further cenify that any and all work perfonned 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 funher certify that if I am not the owner of the r' -r--', , 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 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 the installation record
fonn. An inspection will be made by 8 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 completion ,,:ithin the alloned time constitutes a violation of ORS 454.605 to 454,745 and this rule.
SUBSURFACE SEW AGE DISPOSAL SETBACKS SEPTIC TANK
From: Interior t'....t'-~/ lines 10'
Edge of road right-<lf-way 10'
Building foundation 5'
Wells or other water sources 50'
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GAfiAGE
SEWAGE DISPOSAL ,
PLAN APPROVED
permit# R~I -.,~
DATE '+--/~~n.
BY -~~~l{2X
E~NMENTAL HEALTH SERVI~ES
, 125 EAST 8TH AVENUE
- - EUGENE, OR 97401
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,W: 3 LANE COUNTY DEPT ENV. MGT RECEIPT ;; B8196 DATE 03.9
APPLICANT AURAN~, DAVID AD DR ,2243 N. 11TH ST., SPRINGFIELD
TL;; 1702194100100 SUBDIV ,LOT 3 BLK
NEW BLDG TYPE USE R BDRMS 0 UNITS 001 STORIES ~BLDGS 001 PHONE 726 9.5
OWNER NME AURAND, DAVID ADDR 2243 N. 11TH ST,; SPRINGFIELD Jj
CODE, APPL NO ACTION DESCRIPTION SQ FT UNIT COST VALUATION FEE "D'A')!'
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REQ:Esf1;ORJ'i'SSZsfANCE
LAND MANAGEMENT D1VISION125~8THAVE,;EUGENE;OR 97,401 ,,','
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LMD staff can NOT be held
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. ExIstIng Buildings 01' Int-
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SEPTIC INSTALLED?
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Water District
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nearest main Intersection
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NO.
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DAT.
PARTITioN No. 94.02'28
tOR
TERRY HENDERSoN'
IN
NEII4 SECTioN 19, TI1S, R2W. W.M.
8PRINotIELO. lANE COUNTY;,', OREGON
MAP 11-0t.llI, TAlC LOT: 100
FILED tELlx SCOttel.LO, No. 82
AUO ls 1994 R09ERts SURVEYINo INC,
29 WEST 29 nl STREET
COUmCUrJ; EUGENE, OREGON 97405
1'1 Ld.'~~ PHONE 345-1112
JUNE 30, 1994
SCALE I' 60'
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APPRoVAls, '
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t,tt. & ~rWAGE DISPOSAL SI"FE EVALUATION
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Lot
Block
Job Location _..:-~ 7k-,A.,... )!,~~kAL
XWritten Directions ..1AL. ~ ~ d &~~ ~ .3 '-f~ ,J77 cI--
~~~.. . IlHL I-"-.::Puz-A/. ~e? ~&.or{, /U
/7 ~ ;j ,;' WATER SUPPLY -.L~/~ ~~r......- '
..h'A/;--r..'Y ~ ~z.'i J A/ ~(fJ, ../.:r .-.?/L Cf-/L Phon" 7U~9f{1':r
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~ PROPOSED USE ~F PROPERTY sJ; ~ .AncL..<-'
;1rRS, TL
Subdivision'
APPLICANT'S NAME AND ADDRESS
OWNER'S NAME AND ADDRES" .k-AA-.
r
STRUCTURES NOW ON THE PROPERTY ,
I hereby certify that the above statements are true and accurate. and that I have the following legal interest in the property: ^wner of record; x.. "ontract purchaser; "otential buyer:
A------reartor or agent. I ~urthe{ Je~lfy that (if not the owner) I am authonzed to act for the owner of record. and thayraJd oWQBr }/ aw~e and approves of t?? action. __
.ST HOLES READY i{)-{..U ~ Signature _~./h.-/ tI~~/- _ Da. '7 2-2 '7~
* * * * * * * . * . * * * * * * * . . * * * . * * . * * * * . * * OFFICE USE ONLY BELOW THIS LINE * .,,( * . . . * * * * . * * * * * * * . * * * * * . * * .-
THIS REPORT IS NOT A PERMIT FOR SEWAGE SYSTEM INSTAllATION
The area deswibed on t e .ttache
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ADDITIONAL COM ENTS: R'?I'~~ .~ /J..m~.
fJfL <:"1).'~ j)f~~~~"A. OJ'~-
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system. W
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for a
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ANOTE:
.f this report approves use of a sand filter or pressurized distribution
will be required with the installation permit application.
system, detailed construction design plans
O:P...... ~-/-?c..
cJD'Eo AUTHORIZED 1::' ~ ~TE
LANE COUNTY ENVIRONM TA1?';:;;;;LTH, 125 EAST 8TH AVENUE, EUGENE, OREGON 97401
C55-32
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
. .
. WARNING: .
. .
* This Site Evaluation is a technical report to determine if a on-site *
. system will function properly. It does not approve the proposed use of .
. the parcel. This Site Evaluation may be converted to a construction .
: permit only if the parcel and use meet land use regulations in effect at :
. the time of application. YOU ARE URGEO TO CONTACT YOUR LOCAL .
. PLANNING OFFICE FOR LAND USE REVIEW, .
. .
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * . * *
THIS IS A PRELIMINARY REPORT WHICH DOES NOT
ENSURE THE ISSUANCE OF A FUTURE BUILDING
PERMIT. ANY PLANS OR EXPENDITURES MADE IN
RELIANCE UPON THIS REPORT ARE AT YOUR OWN
RISK, IF SITE IS APPROVED, SEE REVERSE SIDE.
(687-4051)
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MEMO
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TO: APPLICANT
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FROM: tANE COUNTY ENVIRONMENTAL HEALTH
SUBJECT: CONDITIONS OF SITE APPROVAL
1. Any alteration of the natural conditions in the area approved for the on-site system or the placement of a well within
100 feet of the approved area may void this approval.
2, This approval IS given on t~e basis. t,hat the lot or parcel describe? above. wlil not be further partitioned or subdivided
and that conditions on subject or'adjacent properties have not been altenid in any manner which would prohibit
issuance of a permit in accordance with O,R.S, 454.605 through 454,755 and Administrative 'Rules 'of the"'Emiironmental
Quality Commission. Any such subdivision, partitioning or, alteration may void this report.
, . .. ,,,.oj.. . \"_'. . ." ...." .'. _"
3. This report" is valid until an on-site sewage system is installed pursuant to a construction ,permit obtained from Lane
County, or until earlier cancellation, pursuant to Commission rules, with written flatice thereof by..the Qepartment of
Enviromental Quality to the owners according to Department records or the' qou'nty tax records, Subject" to the
foregoing, this report runs with the land and will automatically benefit subsequent owners,
4. Only persons having a valid license issued by the Department of Environmental Quality under ORS 454,695 to install
subsurface sewage disposal systems 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 person other than the above
perform the installation,
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~EWAGE DISPOSAL
i: (J'i i', '.'-i APPROVED
A permit is required
prior :0 sfarting construction..
DATE _ _ ~
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W: 3 LANE COUNTY DEPT ENV MGT RECEIPT 0 940449 DATE 09229'
,'iPPUCANT,I"IENDEFU;QN, ,.JEr(I~Y ADDR :m20 HAYDEN BIUDGE RD., SPIUNGFIn.
TLO,1702190000100 SUBDIV .LOT BLK
NEW BLDG TYPE USE X BDRMS 0 UNITS 001 STORIES OBLDGS 001 PHONE 747 4324
OWNU:( Ni1E HEi.DEI'(SON, ,JERRY ,'iDDF( 3820 HAYDEN BfdDGE r~D., SprnNGF1n.
CODI:: AI::'F'L NO ACTION DESCrnPTION SQ FT UNIT COST VALUATION FEEe ,'JA,')i,1
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PRELIMINARY
MINOR PARTITION
IN
NE 1/4 SECTION 19, T17S,R2W
LANE COUNTY, OREGON
" MAP , 17-02-19 TAX LOT 100
FOR
TERRY HENDERSON
3B20 HAYDEN BRIDGE ROAD
SPRINGFIELO,ORE,97477
PHONE 747-4324
BY
ROBERTS SURVEYING INC,
29 WEST 29TH STREET
EUGENE, OREGON 97405
PHONE 345-1112
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FEB,5, 1994
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TAX LOT 100
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NOTES:
1) DOMESTIC WATER PROVIDED BY
RAINBOW WATER DISTRICT
2) ELECTRICITY PROVIDED BY
SPRINGFIELD UTILITY BOARD
3) SANITARY SEWER IS BY SEPTIC TANK
4) SOLAR CRITERIA - EXISTING PARCEL
CONFIGURATION DOES NOT ALLOW US
TO MEET SOLAR CRITERIA
5) ZONING - LDR/UF-l0
6) ON SIGHT STORM WATER TO BE
DESPDSED OF BY ENGINEERED DRYWELL
7) ELEVATION DATUM - LCCM RT-796 ,
A BRASS CAP IN CONCRETE LOCATED
ABOUT 5 FEET NORTH OF AC ON
HAYDEN BRIDGE ROAD AT A 90 DEGREE
CORNER TO THE SOUTH AS SHOWN ON
MAP, ELEVATION. 463,B99'
.
PROPERTY DESCIPTION:
nEGItmr~m ,\T A rc::::::r
ON T: IE CAST LIi~E
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on
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OF THE TRACT OF LAND OWNED BY W,I.
PATRICK, THE DEED OF WHlr.H _TRACT. IS _
"RECORDED IiI VOLUMEf255 ON PAGE 202,
LANE COUNTY RECORDS OF DEEDS; 'SAID POINT
BEING 2091,3 FEET NORTH AND 770,61 FEET
WEST OF THE SOUTHEAST CORNER OF SECTION
19, T17S, R2W, W,M.; FROM SAID POINT RUN
N B6'3B'W, 96,21 FEET TO A POINT ON THE
URBAN GROWTH BOUNDRY AND MARKING T,iE TRUE
POINT OF BEGINNING FOR THIS DESCRIBED
PROPERTY, THENCE CONTINUING N B6'3B'W,
lB9.23 FEET TO A POINT IN COUNTY ROAD
'661; THENCE NORTH 157,40 FEET ALONG
SAID COUNTY ROAD TO A POINT IN THE ANGLE
OF SAID ROAD: THENCE WEST 271,26 FEET
TO THE ,SOUTHWEST CORNER OF SAID PATRICK
TRACT; THENCE LEAVING SAID ROAD A~D RUN
N j'30'E, 350,00 FEET TO A 5/B" IRON PIN
LOCATED ON THE NORTH LINE OF THE URBAN
GROWTH 6DUNDRY: THENCE EAST, 460.00 FEET
ALONG SAID BDUNDRY TO A POINT WHICH IS
N l'30'E, 523.92 FEET MORE DR LESS FROM
THE TRUE POINT OF BEGINNING, THENCE
S l'30'W, 523,92 FEET TO THE POINT OF
BEGINNING; ALL IN LANE ,CoUNTY,OREGON AND
CONTAINING 4,33 ACRES MORE OR LESS,
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ATION-
:uth faco of Pacific Power
lcated north from Haydon
Ithen north on Hill Road
to McKenzio View Road
" south of sou Ih edgo of
.. thwost 0' south end of
11- "
. '0 of Pacific Power
~ I
'.: earth from Hayden
" ,. tho!l southwest on Hill ~
; Feet east of 88$1 edge 01
"~t' corn~r of bridge oyor
'M'MOH.41
Istand.rd disk 'tamped
.61 mila north from tho
; ldge oyer tho Willamotte
'ld.McKenzio River north-
I standard disk stamped
Route 5 Bridge near Jud-
~ridge oYor the Willamatte
I
IND. EWB/21987, located
'ass over private road on.
'orline of Franklin Boule-
\t by CH2M HILL. (CFW
I p.A.ped "RT.895,"
2.;wE'oast along Me-
~h Coburg Road.
~bova ground In tho south
[02 designated "GAK'9:'
lew ROld from its inter.
!
ie post stamped "RT 892
~oh~wk Road from Hey-
. end 25 feet west of the
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'e post stamped"RT 891
, Bridue. 50 ~eet west of
ohewk Road.
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AREA NOT INCLUDED
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APPLICATION # q Lj - L/ '-I q
LOC<TION Haydon $" <he ~ ~":';;:;~
NAME '
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ZIP CODE ~
The Lane County Building and Sanitation Division cannot proceed with processing your application because: ~
1. (?f
ADDRESS
Incomplete application (items deficient).
o Address and/or directions to application site,
Or Proposed number of bedrooms in dwelling.
~, Approvable plot plan (see attachment).
o Notification of date test holes will be ready.
2. 0 Verification of existing system required (see attachment).
3. 0 Two lest holes (2'x4'x5' deep) required for expansion or repair of existing sewage disposal
system in the area of the proposed drainfields.
4. 0 Other'
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If no response has been received in regards to this matter by
the application will be denied. '
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LANE COUNTY ENVIRONMENTAL HEALTH SERVICES ~
Courthouse. Public Service Bldg. /125 E. 8th Ave. / Eugene, OR 97401 / 687-4051