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Home My WebLink AboutPermit Septic Tank 1987-6-23 fa. G G '-(0_ .. '. n f1 11"1\ r ,-, __, II '-1.1 ~~ Ir '\ I. I II ) /"J. I CH ECKED .JU~J ~ ~ "'~"'" Lane County Authorization for: SEPTIC INSPECTION FOR LOAN REVIEW , ,. , . FOR OFFICE USE ONLY ApplJ,ca t~on/ Perm~t if I r 'l-7~?7 , . ~'NWl\s'i;'ip- "..AANG'b5''"''''.' ,.. ,.,,,. . ...~5~.~~'., SJBDIVISION/PARTITION (~f appl~cable) 17 .n., "--'T2~oEOUT I LOT/PARceL BLOCK 'OF - ...'" PROPOSED USE OF PROPERTY o Res~dent~al 0 Industr~al o Commer'c~al D Publ~c LOCATIO"l ADDRESS ~TREET' ~ 8 CI1Y () . ,,~~ff~9~mdAi.~l0 ~ 0 Qlc1.. T "(fjo~::~) t::ldr-R ffl (j~., IN'DIf- .'''~ON ~~.,~ SEPTIC INSPECTION FOR LOAN REVIEW 0~'77 '- '--\ DECLARED $ VALUE !=~vJO.~ '# OF~ '# nE~, r1f;)L\~cJ'nMtu ~~~;~,;__,,_J ill; ;'"t?"" AD:~n ~.~r. f0r/;{ f1Je-., ~LuM./n.:yM. ""'PNO", NOM",R_ COR' oN '~o -t() a :t 'J- '--I ".. -I.{ <-V.f "',,"PNON,"U"" J:1Z~,,"~A~ l14.. 1\f:u'} t)L~N2f;Yb I HAVE CAREFULLY EXAMINED THE COMPLETED APPLICATION }OR PERMIT, and <10 herel.iy c tt fy that all 1n~atlOn here~ true and correct, and that I -have the follow~ng legal ~nterest .l.n the property Downer of reco~d 0 contrat t purchaser ~uthorl;ed agent I f_rlher certl.fy that any and all work performed shdll be done 1n aLLo1danr f' W1 th the! Ord1nanceb of Lane County and the Laws of the State of Oregon 'perta~n1ng to the work descr1bed here1n, and that NO OCCUPANCY w111 be made of a~l s>ructure N1thout the perrn1ss1on of the Bu,ld,ng D1v1s~on I fur- ther cert~fy that reg~strat1on w1th the BU11der's Board 1S 1n full force and effect as rcsu1red by ORS 701 055, that 1f exempt the bas1s for exernpt1on. ',S noted hereon, and that only subcontractors and employees who are 1n comp11ance w1th ORS 701 055 w~ll be used on th1S proJect I HAVE READ AND CHECKED THIS APPLICATION THOROUGHLY 5J?or\ '" Wo..l'<.er ",~4 11n~.- / ---- ,- SIGNATURE 'n'"'''' '."/'" "" II .~",.r., I , ,... fo--JIJ61 NAME (please pr~nt) DATE . I..... I.~i..~ ...,1,;,.".... .:..... READ THIS SECTION CAREFULLY YOUR AUTHORIZATION qAS BEEN BASED ON THE FOLLOWING CONDITIONS! [] PLANNING/ZONING Zone Part~t~on # Parcel # Parcel S~ze M~n~mum Setbacks CL, front CL, slde ~nter~or rear COMl'IENTS SEPTIC INSPECTION FOR LOAN REVIEW, NO SPECIAL PLANNING ACTION REQUIRED 6- r1-P7 Date .~. Installat~on Spec~f~cat~ons Gallon Tank L~neal Feet of Dra~nf~eld Installat~on Record Issued? DYes D No Max~mum Depth of Trenches o SANITATION S I # B P # COMl'IENTS \.~ ~~ <D~ ~ )b, ~; ~ ~~~ 4~UJ :b~.. /J/~~ff oA'L. /4-avJr/dt~ Date (/;:,-f2::3:-jJ7 _Jij7, o PLANS EXAMINATION Type Group Use COMl'IENTS Date D ~ _'/;1CJ '~R_~.\' . ~OVED BY~BUILDING OFFI~~/DESIGNEE (oer'ORS 456 805(1)) DATP LANE COUNTY DEPARTMI{tff OF PUBLIC WORKS LAND MANAGEMENT DIVISION, 687-4061, ~ ely -?7 f 125 EAST 8TH AVENUE, EUGENE, OREGON 97401 SEE REVERSE FOR INSPECTION INFORMATION r.1L.._?, QRA.. SETB"ChS ,,~D OT'ICR CO~DITIO~S OF APPROVAL 'lUST BE STRIC-L' OPSERVED VIOLATIO"- CA'1 ReSULT IN REVO- Cr.....IO\J OF '"'IUS PERl-tIT, CITriTIO J L"JDER PROVISIO~S OF LA"'C COL\ T\ 'J I"JFRACTIO"J ORDI'\A"JCE, A....O/OR OTHER RENEDIES ALLOWED BY LAW "HE'1 RE;DY FOR I'1SPCCTIO'1 CALL 687-4065 A 'II'1I'IU I OF AT L:AST 24 1I0LRS ADVA :::E ,,-O-ICE FOR INSPEC- TIO"J REQLE.ST.:, ILST ur: GrJc'J~a Ie the following lnforma tlon ready perml t number I Job address, type of inspectlon, when it Will be ready, jour name and ohare nu~ber and any special directions to site BUILDING DIVISION REQUIRED I"-SPECTIO~S Foundation Inspection To be made after trenches are excavated and forms erected and when all naterials for t~e toundatlon are delivered on the Job \1here concrete from a central mixing plant (commonly termed 'transit mixed') 15 to be used, materials need not be on the Job Concrete Slab or Under-~loor Inspection To be made after all In-slab or under-floor bU1ldlng serVl~e e~Ulpment, conou1t, p1plng accessor1es, and other anc1llary equ1pment 1tems are 1n place but betore any concrete lS poured or floor Eheath1ng 1nstalled, lnclud1ng the subfloor Framlng & Insulat10n Inspect10ns To be made after the roof, all fram1ng f1re blocklng, and brac1~g are 1n ~ldce a~d all p1pes, flreplaces, cr1mneys, and vents are complete and all rough electrlcal ana plumblng are approved All wall lrsulat10n and vapor barrler are 1n place Lath and/or G\psum Board Inspectlon TO be made after all lathlng and gypsum board, nterlor a~d e^ter1or', lS in place but betore any plaster1rg lS appl1ed and berore gypsum board J01nts ana fasteners are taped and flnlshed Flnal Insoect1on To be made after the bU1ldlng lS complete and before occuoancy APPROVAL REQuIRED '10 work shall be done on any part of t,e bU11d1ng or Structure beyond the p01nt lndlcated 1n each succeSSlve 1nspect1on wlthout flrst oct31n1ng the approval of the bU1ld1ng off~c1al Such aeproval shall be glven only after an 1nspect1o~ srall have been made of each succeSSlve step 1n the co~struct1on as lnd1cated by each of the 1nsoectlons requ1red NOTE All bUlld1ng oermlts requ1re 1nspect1ons for the work author1zed, such as but not Ilmlted to A Block Wall To be made after relnforclng lS 1~ place but before any grout 1S poured Th1S 1nspectiOn lS requ1red tor each bond beam pour There w1ll be no approval unt11 the plumb1ng and electrlcal lnspect10ns have been made and approved B Wood Stove To be made after co~plet1o~ of masonry (If appl~cable) and when ~nstallat1on 1S complete Installatlon shall be In accordance Wltn an approved, nat1o~ally recogn1zed test1ng agency and the manufacturer's ~nstallat1on 1nstruct~ons C Mob1le Home An 1nspect1on lS requ1red after the mob1le home ~s connected to an approved sewer or septlc system for setback requlrements, block1ng, foot1ng connect~on tledowns, s~lrt1ng, and plumblng connect1ons 1 Foot1ngs and p1ers to comply w1th State foundat1on requ1rements for mob1le homes or as recommended by the manufacturer ~oblle home m~n1mum f1nlsh floor elevat10n shall be cert1f1ed when requIred by a flood- plaln management letter 'toblle home t~edowns, when requ1red, and sKlrt1ng shall be 1nstalled and ready for 1nspec- t10n wlth1n at least 30 days after occupancy T1edowns and s~lrt1ng shall be ~nstalled per enclosure D SWlmm1ng Pool Below grade when steel 15 ~n place and before concrete 1S poured Above grade when pool-rs-lnstalled APPROVED PLA~S ~UST BE O~ THE JOB SITE AT ALL TIMES DURING WORKING HOURS THIS PE~~IT WILL EXPIRE IF "ORK DOES NOT BEGIN WITHIN lBO DAYS, OR IF WORK IS SLSPENDED OR ABANDONED FOR MORE THAN 180 DAYS SUSPENSION OR REVOCATION 1AY OCCUR IF THIS PERMIT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS INFORMATION ANYO~E PROCEEDING PAST THE POINT or REQUIRED INSPECTIO'1S WILL DO SO AT THEIR OWN RISK SUBSURFACE AND ALTER'1ATIVE SEI,AGE DISPOSAL SYSTE11S Permlts shall be effect1ve for one year from the date of lssuance Upon completlng the constructlon for wh1ch a perm1t has been lssued, the pcrm1t holder shall notIfy the Lane County Department of Plann1ng and Co~~un1ty Development by subm1tt1ng the 1nstallat1on record form The Department shall lnspect the construct1on to determ1ne 1f lt compIles w1th the rules conta1ned 1n th1S dlv1slon If the constructlon does comply w1th such rules, the Department shall lssue a cert1f1cate of sat1sfactory complet~on to the permlt, ~older If t~e construct1on aoes not comply w1th suc~ rules, the Department shall notlfy the permIt holder and shall requlre sat1sfactory completlon before lssu~ng the cert1flc~te Fallure to meet the requ1rements for satlsfactory complet1on wlth1n a reasonable tlme const1tutes a V10- lat.on of ORS 454 605 to 454 745 and th1s rule Setbacks - Subsurface Sewaqe DIsposal f-ro'1\ r,terlor propertJ Ilncs Edge at road rlqnt-of-way BUllalnq foundatlon hells other ~ater sOurces Scpt1C Tanh. 10 ' 10' 5 ' 50' Dr<:unf1eld 10 ' 10 ' 10' 100' .. . ~ Ia:~~~ty ACTIVITY INFORMA TION SHEET PNllJ LAND M^N,.rrMrNT nrvr"'{)fIf 00'-" In...."' , f ,..... V"...... Please complete all Items above dotted line FILLING OUT * LINES WILL GET YOU INFORMATION ONLY ~ *DATEjn / " / ~7 * PERSON ACTUAL ~~la~ST SV~ lAJ{L( ~t?r- b~O:EE:TY H u]) ADDRESS 1/ I..f (}Of1(J S~56- u.JCU1 ADDRESS 6,;zo suJ CITY 6..J4eAf!- STATLY ZIP 'qjl{O) CITY Porf-flAncL. TELEPHONE '(BUS)31lf -qOY h (HOMEI TELEPHONE (BUS) *PROPERTY ADDRESS /80(0 men /0 I r.i OR""""" ) MAP & PARCEL NUMB~i~FaUnd an tax maps In the Assessment & TaxatIOn Dept) l 0) STAFF WILL DETERMINE /1 - D3-- 28' 0 - O.2fcD J/' T9wnshlp (Range Section oZ.~- 40) t.o~ AJ~ sTATE,Dr. zlpQ72,OY (HOME) ScYJ, C1-{@ leL q 7'( 7 7 ~ ..-/ Tax Lot Zoned Flood Plain Township Range Section Tax Lot Zoned Flood Plain TownshIp Range Section Tax Lot Zoned Flood Plain TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP. ACRES * R E QUE 51 (describe what you want to do) -kv- Seph'L- In Cb r;:::x?CI\ lY\ " loon r-e..J\' Q~ Directions to site I .J) <-..f.. Qe{\+er\; ell f-...Jor-U 0.'\ ) 01\ ~e.nLO L'f' Q<;'(??Jt " ,/ -- -- ....................Staff Use On~.................... Comments: Land Management Division, Public Works Department 125 E 8th Ave, Eugene, OR 97401 phone 687-4061 ~-~/~ h"0~ r<\ eA \ c> --~<- -' ~e('-- \ ( S4~.s e..- I Lr. l- w \ <3 I C; /1'9-17 ACTIVITY INFORMATION SHEET @ COMPLETE THIS SECTION INCOMPLETE FORMS WILL BE REJECTEDI _.,_~.. ~ .... _ ~_. ...... ._.. "~ ~ ;". _. ._~',y'.:', ,_ '.':". ..'."\ ::'-:A':."-"_ ,,_'."~:- :' "' ." ... ,- "' '" ..,....,... .. ........ ., ..." ,..~.. ~ , PERSON MAKING REQUEST PROPERTY OWNER MAILING ADDRESS MAILING ADDRESS CITY STATE ZIP CODE CITY STATE ZIP CODE BUSINESS TELEPHONE # HOME TELEPHONE # BUSINESS TELEPHONE # HOME TELEPHONE # : 2 PROPERTY ADDRESS (IF DIFFERENT FROM MAILING ADDRESS) ; 3 MAP &. PARCEL NUMBER (REQUIRED INFORMATION) (from tax maps ln Department of Assessment and Taxatlon or frbm tax statement) TOWNSHIP RANGE SECTION TAX LOT(S) OR PARCEL # ZONING TOWNSHIP RANGE SECTION TAX LOT(S) OR PARCEL # ZONING TOWNSHIP RANGE SECTION I TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP: : 4 SUBDIVISION (If appllcable) · 5 REQUEST ((,tate exactly what you plan to do)1 TAX LOT(S) OR PARCEL # ZONING ACRES LOT BLOCK , . j 6 DI RECTIONS TO SITE: I '. ,.......,.,.,..., 0-. .~.._,.......,". . ,."_ ._.. ",_ o. .'_,_.... .. . . _ . . ,_..... ., _ . ** FOR STAFF USE ONLY ** " .,.,,,,,.,., ."._,_.,_" ,tiJ ZONE/LAND USE: .. 14-33 LAND MANAGEMENT DIVISION / 125 E 8th AVE., EUGtl'lE, OR 97401 / 687-4061 I