Loading...
HomeMy WebLinkAboutPermit Plumbing 1983-10-5 I '0. (J I -?; iVl"-\'::1-g, i1J a-.-"l> g S ~! 2" ... IN (b '" ~. IA ~ ~ f-iy: ! ~ .~ ......0.'" ,~ l\ ~o. ~ '" ~_ m ........ ~ () g: Gt/~ 9>! i { CL' .-o~ \J ~~ .~~ o ll> a; ~ ! (Dr=! ~o 0" ~ " '" '" I~Q, "," -g. " '" 0 <0 " () Z 0 >> '"c IN \:t ~~ ~ ~ ~f~~ "i ~ ~ V; , o Il.. ll> a; -r> " '" g, ~ I gv ~ " 'i. ~ ~ ~ 'i ~ ~ ~ VICINITY MAP ~ N' . :;- '" g, ro a. a '< o :;; " '" T ..... '-'l I ~ J..I~de_ l?"d~e ~I R04d z C> ~ ~ \!l --I. UCr6 ~pp60 MUST BE IN BLACK INK 'DIm c55-11 Permit No. J /,/Z - <f:J _ Twnshp. 17 Range _rJ:J' Section 2f':' f-I Tax Lot I:?L Standard System ~ Alternative System 0 (Spe.cify lype) _ ._ /.' ~ Job Location (Street Address) 7..t.c.'S ~~.R~~ ~ . Supdivision/Partition # Paitel Lot 7 _/F' ck DETAIL SYSTEM PLOT PLAN AS CONSTRUCTED /J13- I.{ '/e,v 13... Id9.:' Scale = {<'t!> ,4. ,I :1 D.,(}-(' l, ( Lu~'1 \ \ ) " ~ :z f'e... So-v.s/ /., ...zNSI7''''/1N ~ e :Ii 'IS ~-. ;:r A ,H..utJ A eo,... (' ,4A.J d t:J e-V'f';.' -I'r 7"/,....:t ,""" (]o,v-f;v~s 7", Th<::. R.../es 6 f C,.Q R ,s> If 0 D/~'S I(",,,?I "? ~[3~ 9 -tS--9,S -<"3 - ~s , " (Ve..u .' f 1 ,..JJ:n.,.). I:;"-~<'_ - -e"i.;r;::'., ";517 J)." ~ VI''' """-0" .., - 30 /- _ ~o' .' .1 I:. " USE BLACK INK ONLY .- FOR INSTALLER'S USE: Trench Depth .::; q Gravel Depth Below Tile t::~ I Tank Capacity /JIhO~ Manufactur"! l/h'/,1.",,~ t~ S'17""~ Measured Distance from Well to Tank <3 A7-y_ From Drainfield ,,..,.rfe_ Total Length of Lines~ 0 COMPLETE THE FOLLOWING IF A PUMP WAS USED ON THIS INSTALLATION: I (installer's name) certify that a (Mfg.) (Model No.) Pump and Mercury Float Switch (Mfg. and No.) have been installed with this sewage installation. Signatur" Datp FOR SANITARIAN'S USE ~NLY:~~~~m Approved /70 Syslllm Dis)1pproved _p Nee9s Corr~xtion COMMENTS' ~ (Il6..l..h: q _... ~q.v_ . ..YA&tl.P~_ _ ~ _~_~~~ ......"rt7-"7'.j;...~, ::._~ ou 1#A?JU' ~ ~~;:1.Cc;;rected Datp System Capacity ----.1"'"'rrl gal./day Signature _ --'><7 ~~ Date, ,(0 _ ~ ~P.-7 INSTALLATION RECORD & CERTIFICATE OF SATISFACTORY COMPLETION When sigKd by the County Sanitarian, this certificate is evi- dence as per OAS 454.665 of satisfactory completion of a subsurface sewage disposal system at the above location. To request inspection. return all three (3) copies of this form to; lane County Environmental Health Services. located in the basement of the Public Service Building. 125 E. 6th Avenue, Eugene, OR 97401.