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HomeMy WebLinkAboutPermit Septic Tank 1992-8-20 f REQUEST FOR: SEPTIC SYSTEM VERIFICATION . ~ TOWNSHIP 17 RANGE 0 2 T5~'4"1DDHA.Y DEN ."'"00 19 . 3' :'1"00 """"405 :II . ,. ,.. PARTITION LOT I PAlIICEL ROCK ..;. BRIDGE ROAD, SPRINGFIELD, OREGON IITRUCTUIlE8 NOW ON PR(lPERTY EXISTING SINGLE FAMILY DWELLING AND SHED 97L[77 PROPOSED USE SCPTlC WSTALUD PRIVATE USE WATEII "STALLED NO. 011 STORIES NO. 011 OlPLOYED COHITRut:TJQN COlJTlYAWI CESCRlI'TlOl4 OF PROP08EO WORK SEPTIC SYSTEM VERIFICATION NO. OF .E"iiiiiOOia DiRIECTIONS TO llJ{,....1l0ll COUATHOUBB HWY. 1LO TO MOHAWK, TURN LEFT TO MARCOLA, RIGHT TO 31sT STREET, LEFT TO HAYDEN BRIDGE ROAD, RIGHT TO SITE ABOVE. ....,.PUC...NT NAIIE .. AgORESS GORDON D. GREEN, PHO"'il. 741-2482 OWNEII8 NAMa;: .. AcDiiffi PHONI '"COiffiiiCTOA NAME oaR UCDlBI . PNONIi' SAME NA SAME AS THE ABOVE . FEES DUE: , 3501 GARDEN AVENUE, SPRINGFIELD, OREGON 97478 ADORERS ~"'~'r ~"'I,/ ~ 1111111. ........,.. .... ........':....:.,:'.: $ ~ DATE s;?-Zo -91" _ CALL FOR INSPECTIONS (SEE BACK OF FORM FOR 'vNSTRUCTIONS) 687-4065 SEPTIC permits sre good for one yeer. ALL other permits expIre sfter 180 dsys unless Inspections srs currsnt. ~ -' , . . , VIOLATIONS SIn'BACKS AND 01lII!R w........_..J OF APPROV ALMUST BB S11UClL Y OBSERVED. VIOLATION CAN RESULT IN REVOCATION OFnns PBRMrr. CITATIONS MAY DB ISSUFD UNDER nIB PROVISIONS OP LANE COUNTY'S INPRACIlON ORDINANCE AND/OR 01lII!R RBMEDIBS AlLOWED BY LAW. l A MINIMUM OF AT LEAST 24 HOURS AnV ANCE NOTICE MUST BE GIVEN FOR INSPECI10N REQUESTS Have the following infonnation ready when you call: 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 omClAL RIGIIT TO TRESPASS ON PRIVATE PROPERTY ORS ns.oso POWER TO BN'mR UPON LAND. TIm COMMISSION, AND ANY OF ITS MEMBFRS, OPFJCERS AND HMPLOYBS, IN nIB PERFORMANCE OP nmIRPUNCllONS, MAY mm:.R UPON ANY LAND A1<.'O MAKBEXAMINATIONS AND SURVEYS ANDPLACB AND MAINTAIN nm NOCESSARY MONUMENTS AND MARKERS THEREON. 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 INSPECTION: To be made after all ducting and gas piping has been installed and prior to being 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, fue blocking, bracing and roof are in place and all pipes. chimneys and vents are complete and the rough electrical. plumbing, and mechanical inspections have been made and approved. INSULATION INSPECTION: To be made after all insulation and vaperbarrie.. 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 fastene.. are taped and fmished. ADDITIONAL INSPECTIONS MAY BE REQUIRED. such as but not limited 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 electrical inspections have been made and approved. FINAL MECHANICAL INSPECTION: To be made just prior to the structure or remodeleq area being occupied and prior to operating any equipment FINAL PLUMBING INSPECTION: To be made just prior to the building. structure 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 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 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 occupancy. Tiedowns shall be installed pe~ enclosure. 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 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 WTI1I1N t80 DAYS, OR IF WORK IS ~wrr~D OR ABANDONED FOR MORE TIlAN 180 DAYS. SUSPENSION OR REVOCATION MAY OCCUR IF TIllS PERMIT WAS ISSUED owrnil 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 HA VE CAREFULLY EXAMINED THIS 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....~i as owner of record or authorized agent. I further certify that any and all work perfonned shall be done in accordance with the Ordinances of Lane County and tlte laws of the State of Oregon per- taining to the work described herein. I further certify that if I am not the owner of the l"-r--OJ' 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 sllbmitting the installation record form. An inspection will be made by a qualified sanitarian. If consbUction complies with all rules a certificate of completion will be issued to the permit holder. If consbUction does not comply with rules, the permit holder will be notified, and all corrections shall be made before a certificate of completion will be issued. Failure to meet satisfactory completion within 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 ~'"~-.i lines 10' Edge ofroad right-of-way 10' Building foundation 5' Wells or other water sources 50' DRAlNFIELD 10' 10' 10' 100' ......,......... .,.... ".. ..... ~(~;~iJ........ ::II~ . . , Please complete all lines Inside white boxes, If possible. GoR 7?z>N D. GRF-r;1II GRR Delv ~-fD-'7'2. "VUH I'IAMI: UAII: "5 'Fe, I YUUA' AUUHi:tfU RvE. 7J1f -;"iflj 2- "'"UNt: ?PIPINGFlcl-/) OR CITY ./ dl"i' IY! ~ OWNER OF PROPERTY (It not urn. .. abova) CJ?/f7 f' ZIP PI10Nt: OWNERS ADDRESS (It not ..,.. .. abo.,.) ZIP INlll'ALLktt I I:IU1LUl;.tI I ,"UNI HA" I Uti uu.,.. . , MAP, PARCEL NUMBER (Fourtd on Iu: map. In ..... ~nt . Tuatlon Dept.) /7 02 1'/.3./ 40S- ~ "lIiniI &lIeCllOn 114 &tcUon fu LOI TOWIIPlp 'ii:;"'" Section 1,. s.cUOn Ta: Lot I ownen., ~ UKllon 1/4 tlec:uon I U LOt \ ". . . . . .. .. .. .. ... . SITE ADDRESS~2- tl-7 ... Existing Buildings or Improvements on Property Is) House c::J Bam c::J Garage 9 Mobile. Home }Z9-Shed SEPTIC INSTALLED c::J Ves c::J No Water District ,~ .- Directions to site from nearest main Intersect/on Hwy J Z-b TD I'1",HRw)I. . 7P1Z1I/ L~prrc> I1I9RCO l.fl ~ Ruittr TlJ "3/:i!" 5rKEE r -' .. L t:'FT (z:> /Q,'r'IlEf.I 8R. ~ ffl? / };It; fiT , - .... ""'"1 \ IIrlPDEIr' 8RfD6;;&''''Lj' fOt( '::;;f?,f?ING EltE/'-/") /fIP , '? 7-IT? . MAIL PERMIT TO: G ~4?7l~ ...(Mt:. AUUHI:I;U. IIOIIT ZIP " , ' .. For Mobile Home Placement Only Brand Vear Size No. 01 Bedrms Weanse # , .' .- .. .. ....!~ ~/~t~~ce ;;0;" Home to: Land Management Dlv. staff can not be held responsible lor evaluations or recommendations based on lalse, Inaccurate or ,MIl ....2102 Incomplete Inlormatlon .........'.... . #.:~~.. ............................... ................. ....... ........ ..c...............,.......... .. ....... .... . .......... 1'114-68 02/92 Mobile Sewer/SeptIc j . . '. f)/i! fl (N FIEL-P c /-, T ~~ Il'). ~~ ~ ,~ ~ . &f?Tc 3~~7 / \., /ltfYPt::--1l/ {JRIDGE KV{Z'D / r 160 ./2.- F/~ ~ , -, tI I , . e . . e- e \~ e JII,!! I I,., i . _.1' . , . ,. e "- Ir. er.J Ii Q e. ii ~ I' e~~ .I",I.I.~ " . r; .~ ~ . . f:!,jih . .. . e .1 U~ . ..~ ;" I! -.~ . . rfl . . . ~F'F'~I~AN~ GREEN; GORDON LANE COUNTY D~b~RE~~4~GAA~b~~I~~ID~E2~a:;2SF'~~~~F~~~1{ TL~ 1702193100405 SUBDIV . LOT BLK NEW BLDG~YF'E USE R BDRMS 0 UNITS 001 STORIES ~BLDGS 001 F'HONE 741 2482 OWNER NME GREEN, GORDON ADDR 3247 HAYDEN BRIDGE RD.. SF'RINGF.IEL.. CODE AF'F'L NO ACTION DESCRIF'TION S~ FT UNIT COST VALUATION FEE ~: .BF' " ,II.J ~ BF' ^. BF' Bf' BF' \ . . 1'1'1'1 . DEF'OS IT ** . FT . 75.00 . , l'lfi , ., . ( 75.00 C'~ i .r il' ~ er . . . F'L ~FIX/BATH: MECH SUR F'CK LR LC 262792 SDSV " SWR: FT. WTR: MECHANICAL FEE STATE SURCHARGE F'LAN CHECK' FEE FT. RAIN: 5% ,257. . , "l ~ , ,: I. . ~ . CATG: F'LN SEQU: TAKEN BY RLH RA . SDS ELE PCK. ISS 1 2 EST. COMF'LETION DATE. / SI OTR . . jJ ~ ;? c~---/ -z.. . , : y . Co..-JP' e-:J - '\J//VI -1.-1 ,;: -62 /"T./J kyYd --v" Cl6 -- %3G / <.. !/d 11,.) hAt!-/( '1;d _,*/jF ~r -;C^re(f7r~;r, . ~