HomeMy WebLinkAboutPermit Septic Tank 1990-5-2
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Lane County Authorization for:
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APPlicationJ '1/lJ"l_O/)
Perm~t i a<l'Jf.J /u
TOW;;SH; '7 I RANGE 0 2-
S~BDrvISION/PARTITION (if applicable)
SECTION
/0
4/
j TAX LOT DOUT OF
CJo9tW
I LOT/PARCE~ r BLOCK
CITY
PROPOSED USE OF PROPERTY
.gf Residential 0 Industrial
o Commercial 0 Public,
LOCATION ADDRESS STREET
~q<b.o YAY?> eN
STRUCTURES CURRENTLY' ON PR PERTt
NovE::.
DIRECTIONS To SITE
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ZIP
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C'::>NTRACTOR'S NAME AND OSR #
(4Et-1O<A'L. )
P.:;RNIT TO BE MAILeD TO' \NAME AND ADDRESS)
C try CJ 1= SIJA7/~?ltdlJ
~LARED ~ VALUE
/2. 7,C?O 0
'gl Proposed
(IExisting
TELEPHONE NUMBER
74(0 -1-3~!5
TELEPHONE NUMBER
TELEPHONE NUMBER
12~-3 '~3
I HAVE CAREFULLY EXAMINED THE COMPLETED APPLICATION FOR PERMIT, and Jo herouy cert.ify t.hat all infonnatiOIl hereon is true and correct, and that I
have the following legal interest in the property: Downer of record; 0 cOlltrdc:t- purcha~er; Oauthorized agent.
I f:.:.rther certify that any and all work performed shall be dOne in accordanr;(, wi th tte Ordinances of Lane County and the Laws of the State of Oregon
pertaining to the work described herein, and that NO OCCUPANCY will ~ made of ar,~. structure without the permission of the Building Division. I fur-
ther certify that registration with the Builder's Board is in full force Olnd effect as rec;uired by ORS 701.055, that if'exempt the basis for exel1lption
is noted hereon, and that only subcontractors and employees who are in compliance with ORS 701.055 will be used on this project. I HAVE READ AND
CHECKED THIS APPLICATION THOROUGHLY.
NAME (please print)
SIGNATURE
DATE
READ THIS SECTION CAREFULLY. YOUR AUTHORIZATION gAS BEEN BASED ON THE FOLLOWING CONDITIONS!
[] PLANNING/ZONING:
Zone
Parti tion #I
Parcel #I
Parcel Size
CL, front eL, side
-y?.fi- r.4.A/.-?L.7' d~/~ g~~
, - /Da~, 4--23-7>0
[] SANITATION: 5, 1. # fOJ-O ?-::Lr a, p, #
Installation le9Ull'. Gallon /;::-t7\
specificationsoh.f"Dll.d6s,,'J Tank ~ U
COMNENTS,. ~ _"<:;Q,~ ~/I.r
&-r. flu, ra,.....k 4..", K.
Minimum Setbacks:
interior
rear
CQM.\IENTS :
~
0-r4-
p~.r
, J ,
6'",....". ern
Installation
Lineal Feet .,;2.. .JI
of Drainfield ~ '
/JI-.. ~R;J
11 4.s-
Record Issued? 0 Yes 0 No
Maximum Depth
of Trenches "\.
~ k i 'fGt./f)
Date:
11
[] PLANS EXAMINATION: Type
GrOUD
Use
COMHENTS:
Date:
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/' - :2 111~ 2'
__ PERMIT APPROVED BY BUILDING OFFICIAL/DESIGNEE (oer ORS 456.805 (l)) /DATE
~P:, 1M LANE COUNTY DEPARTMENT OF PUBLIC WORKS LAND MANAGEMENT DIVISION, 687-4061,
-ta ~ 125 EAST 8TH AVENUE, EUGENE, OREGON 97401
N~S' , ~'fO ~ SEE REVERSE FOR INSPECTION INFORMATION
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SETB1,CKS 1\:-:0 OTHER CO,:OITI0:,S OF APPRO'/AL ~lUST BE STRICTLY OBSERVED. VIOLATlON C,,~ RESULT IN REVQ-
C';:'IO:l Of iHIS PERmi, CITATlO:l UNDSR PROVISIONS OF LANE COU::T..'.') INfRACTION OROl,:ANCE, AND/OR OTHER
RE~EDIES ALLOWED BY LAW.
\o;HEN READY FOR r:,SPCCTION. CALl. 687--\065. A mNHlU:4 OF AT LEAST 24 HOURS ADV;\,::CE NOTICE FOR INSPEC-
T~v, lU".....""',:) ~,t.."'. tic ':'l11El.. Have t.he ~ollowing in:o::-::1at.ion :-eady: permit. number, job address, type
of inspection. when it will be ready. your name and phor.c number, and any special cirections tasite,"
BUILDING DIVISION;
REQUIRED INSPECTIONS:
1.
Foundation Inspection; To be made after trenches arc exca~ated and forms erected and when all
materlalS :or i.ne foundation are delivered on the job. h'here concrete {rom a central mixing
plant (commonly termed "transit mixed") is to be used, materials need not be on the job.
2,
Concrete Slab or Under-rloor Insnection: To be made after all in-slab or under-floor building
servl~e e~uipment, condult, plplng accessories, and other ancillary equipment items are in
place but before any concrete is poured or floor sheathing installe?, including the subfloor.
3.
~raminq , Insulation Inspections: To be made after the roof, all framing, fire blocking, and
raClng are 1n piace and all plpes, fireplaces, chimneys, and vents are complete and all rough
electrical and plumbing are approved. All wall insulation and vapor barrier arc in place.
4.
Lath and/or Gvpsum Board Inspection: To be made after all lathing and gypsum board, ;,nterior
anc-e~rIOr, lS 1n place but betore any plastering is applied and before gypsum board joints
and fasteners are taped and finished.
5. Final Inspection: To be made after the building is complete and before o~cupancy.
APPROVAL REQUIRED. ~o 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 indicated by each of the inspections required.
NOTE: All building permits require inspections for the work authorized, such as but not limited to:
A. BlOck Wall: To be made after reinforcing is in place, but before any grout is poured. This
1nspecrron is required for each bond beam pour. There will be no approval until the plumbing
and electrical inspections have been made and approved.
B. Wood~: To be cade after completion of masonry (if applicable) and when installation is
complete. Installa tion shall be in accordance wi th an approved, nationally recogni zed testing
agency and the manufacturer's installation instructions.
C. Mobile Home: An inspection is required after the mobile home is connected to an approved
sewcr-or-5eptic system for setbaCK requirements, blocking, footing connection, tiedowns,
skirting, and plumbing connections.
1. footings and piers to comply with State foundation requirements for mobile homes or as
recommended by the manufacturer.
2. ~obile home minimum finish floor elevation shall be certified when required by a flood-
plain management letter.
3. Mobile home tiedowns, when required, and skirting shall be installed and ready for inspec-
tion within at least 30 days after occupancy. Tiedowns and skirting shall be installed
per enclosure.
D. Swimffiinq Pool: Below grade when steel is in place and before concrete is poured. Above grade
wncn pool-rs-installed.
,\PPROVED PLA~S ~lUST BE ON THE JOB SITE AT ALL TIMES DURING WORKING !lOURS. THIS PERMIT WILL EXPIRE
If WORK DOES NOT BEGIN WITHIN laO DAYS, OR If WORK IS SUSPENDED OR ABANDONED fOR ~ORE THAN 180 DAYS.
SUSPENSION OR REVOCATION }~Y OCCUR If THIS PE~~IT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS
INFORHATlON.
ANYONE PROCEEDING P,\ST THE POll,,!, or REQUIRED INSPECTIONS WILL DO SO AT TllEIR OWN RISK.
SUBSURFACE ~ ALTERNATIVE ~ DISPOSAL ~:
1. Permits shall be effective for one year from the date of issuance.
2. Upon completing the construction for which a permit has been issued, the permit holder shall
notify t.he Lano County Department of Planning and Community Development by submitting the
installation record form. The Department shall inspect the construction to determine if it
complies with the rules contained in this division. If the construction does comply with such
rules, the Department shall issue a certificate of satisfactory completion to the permit: holder.
If the construction docs not comply with such rules, the Department shall notify the permit
holder and shall require satisfactory completion before issuing the certificate. Failure to
meet the requirements for satisfactory completion within a reasonable time constitutes a vio-
lation of ORS 454.605 to 4S4.745 and this rule.
SetbaCKS - Subsurface
F:"o:n:
Interior property lines
Edge ot road riGht-oC-way
BUildinq founda~ion
"ells, other ~ater sources
S>:lwa<]c Disposal
Scptic Tank
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The Invert Elevation of the Perforated Under-Drain Piping Must Be
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A Thirty, (30),Mil. (Minimum Thickness) PVC Sheet Membrane Liner or
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CONCRETE SAND FILTER
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1500 GAL SEPTIC TANK WITH BAFFLE
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1500 GAL SC:PTIC TANK WITH BAFFLE
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GENERAL NOTES:
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O('~~ro e...u. ASTY AI"
GRAOE fiO . I, . &0,000 "'I
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$f1'l[Hc;TH AT 18 OAT T(ST.
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4, A CAlJl..O[I'l C I T. COU"'L[fIl. Of'l [0J0l( l"""lL
I[ Sl,..P"LI[,D 1I'ITH [ACH 'C./'l[D\JU 40 ..... flTT'NO,
5. Tt1S SY51(w CO~"lr[S w.TH ()A[~ 0 [, Q ST~O'
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I~ GA.l. stPTIC T.A.N( 'fr1TH IAFf1.C
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WILLAMETTE GRAYSTONE
p. o. 101C 78IS
EUGENE. OREGON '1401
721-16615
BH'!J ENGINEERING
a SURVEYING
IlOS s.t eol,l'"
'1117]..01 I!:OSUUfIlG M ,7419
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'::"'_-' ,"~ , SEWAGE pIS~OSAL SITE EVALU~:rION .>' ,"<: :'~, fr - 0;;2.:21'
TRS,TI/7-{)2~19V/ /.F:;7t:?t1 Job Location ,/~7:PEft .L;5~6E /':;;;;;/:?/ ':V;6"'-..cc-~
. ":.., Written Directions' ~/~/~..# ~ /.c7;--/vi~rP'c/Y' 8.P~hE
. ~Jrb;b.4r~/W/ >:';':;:'?//.r-s.h2?~~/~~
, " ., .. - --:;?' .
, . Lot' 'Bloc~ ' ,_ i " //" i \ ".-<- ~TERSUPPLy_..,<:::-?#~jCb/:::% /'<'-7/ " _
APPLICANT'S NAME AND ADDRESS /...@!;'1/)"k' L / d''?(....J df/~ :.;/ 4/7- ,T, [;0/ ~.;:? ':77 P"'.P? ' Phone -;7-f/.:? ~y~-
OWNER'S NAME AND ADDRESS~"y /3~/::JZ!',t)c' //..f d '//YA';1(T/,J;?; C4-k7/h/''':Z7~ /;?.e~ ~hon" /f",?"- ?6~
. STRUCTURES NOW ONIH~~,~OPERT~~~ ~?"""-"'.-?&' ";, ~ROPOSED USE O.F ~R,!),p'~~T~J.:zv.c7?~ E'
_ I hereby certify that the above statem, ants are true and accurate, and that I have the following legal Interest in the property: ,_owryer of record; -:----~n 'act purchase, r; ~t,ential
buyer; '.
_realtorOrag9nt.lfurtherc~rtify}hat..Qf~ott eowner)la authorized to act for U)8 owner of record. and that said owner IS! Y!'jlreandappr<;txeeoft I t'.~o !.'.'.: 1..~. ..) ~
" '/,'/712 Ii _ h' ( , "0) 'Ie... ' , ' I "",. /2.. .r" I,Oe'
TEST HOLES READY ,.i~, ,-~~ ,/te.-~/-" Signaturo)( ~~\/, " Dat"X /::::> a/
* * *. * * * * * * * * * * * * * * ** ** * *~** ** * * * * * * * * * ** * ** * * * * *. * * OFFICE USE ONLY BELOW THIS LINE......* *...... .......... ... .*..i ........... * ........
Subdivision: ,
:'
SITE MEETS STATE STANDARD~ . " YE!)" NO
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, ':, " '," 0 ,'. ,0 Low Pressure Distribution
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" ~,!~l\V{i:}~';:;;J~ j".: :,.~h~ j -:~; 0 '. ll"~:\" HoldinglTank
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YES
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NO,
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Standard System
Sand Filter "
1 Foot Capping Fill
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COMMENTS: " /) <".-,,1'..<....,;,,1'\- ,ple,~,,, I'.-<i
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FLOODPLAIN 'INFORMATION
'i:-.;", .,
. 0 Approximate
Study Area
All or part of this site may be In a flood hazard
area for which 100 year flood levels have not
. been established. Extra precautions may be
appropriate to assure that the building site will
be reasonably safe from flooding.
All or part of this site may be In a flood hazard
area for which 100 year flood levels have been
established. A building elevation above the 100
year flood level may be required.
All or part of this site may be In a flood hazard
area In which a f100dway has been designated.
Building may be prohibited subject to
.' I demonstration that the cumulative effect of
. proposed development will not increase the
; 1 00 ye.a~ n~ l!Wel at any ~Int.
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Study Area .
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. )F SITE IS AI;'PROVED, SEE REVERSE SIDE.
.' .': .' ,',: . .... t. . .,. . .
y..<":7 'J'~~~' 1 ' .;;2 -,2 7,("'/
'--' AUTHORIZEDSljlf>!ATURE ' DATE
.' ,
LANE COUNTY ENVIRONMENTAL 'HEALTH, 125 EAST 8TH AVENUE, EUGENE, OREGON 97401 (6L7-4051)
J ' '
055-32 .. , ..
GJ;loodway
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