HomeMy WebLinkAboutPermit Miscellaneous 10/11/2007
Dave Collier
(541) 767-3087
P 1
Fax
Pacrlic Surveymg, Inc
oG~
~))TII~~
,
75505E1ooMullamSclmIIld Tel (541)767.m'JO
~ Gme, Qeg:m97424 Fax (541)767-3ffi7
TOl Lrnda Pauly
From: Dave Collier
Fax: (541) 726-3689
Pages: 8
P- (541) 726-4608
Date. 10111/07
Re:
Dove Estates
cc:
o Urgent
o For Review
o Please Comment 0 Please Reply
o Please Recycle
. Comments:
Linda
Here IS the well decommission papers from Casey Jones Well Dnlllng and the Crty of Spnngfield
paperwork saymg the sepbc tanks have been taken care of
Date Received
Planner AL
10;'/ h-tlD7
I
Dave CollIer
(541) 767-3087
p.2
~~ City of Springfield 10/1 0/2007
I 26 45PM
Bulldmg Permit & Inspection Summary Job #,
COM2007-01362
225 FIfth Street
541-726-3753 Phone Job Address 1057 ANDERSON LN Sprmgfield
541-726-3676 Fax Scope of Work Site Work Only
Project Status Issued DescnptlOn of Work DemolIsh house and abandon septic
Owner & Contractor(s)
Name Address CIty. State. ZIP Phone
CON BENSON DEVELOPMENT CO LLC 940 HWY 99N EUGENE OR 97402 541-688-8897
OWN BENSON VCRN 1057 ANDERSON LN SPRINGFIELD OR 97477
Valuation of ProJect
Date
Occupancy Con,tructlOn Type Cost Per So Ft So Ftl! ValuatIOn Calculated Staff
Fees PaId
DescriptIOn Amount PaId Date PaId ReceIpt #
DemolitIon $50 00 09/07/2007 1200700000000001168
Sanitary or Stann Sewer Cap $50 00 09/07/2007 1200700000000001168
+ 5% Technology Fee $500 09/07/2007 1200700000000001168
+ 8% State Surcharge $800 09/07/2007 1200700000000001168
+ ] 0% Admmlstratlve Fee $10 00 09/07/2007 1200700000000001168
Total Amount Pdld $123 00
Plans RevIewed
Depdrtment ReceIved Due Date Completed Resu It RevIewer Comments
Inspections Conducted
InspectIOns Comments Date Result Inspector
DemohtlOn
SeptiC Pumped and Filled Two tanks, receIpt on file 09/18/2007 OK SKG
,
1 of I
Date Received
Planner AL
jo/;/2fJD7
/ I
Dave Collier
(541) 767-3087
p.3
ST A rF' or OREGON
W.\.TI':R SlIPPLY WELL REPORT
(" I UJllllld /1", ou...' 'tl7 76~ & OAR 690~20~ 0210)
LANE 67850
09-20-2007
Page' of'
Wl!:LL LABEL # L I
START CARO# /10(22))
(l) LAND OWNeR OWI1l..1 \\L11 102 (9) LOCATIO'\' OF \VELL (legal descriptIOn)
rll,t "'J'1I1lt'VLr1l L I~t l'\"1.me Rt'llsun Count) I Rn~ Twp...l..1.i2Q....~I\./;:, RflngLJ.U1L~ EVvWM
l1l1llP1i1} Sec~~ 1/4 ot lhe ~ 1/4 Tax lot 101
Ad,lrl", (}40 I-h~y 1)9N T'lx M \p Number lot
C I) [lIeene State OR Zip 97407. Lat _o~_ 'm DMS or DD
(2) TYPE OF WORK 01\(':\\ WLll 0 D~epenmg o CnnV1:r~lOn lung _o...!L.-'_ .. or OMS or DO
o ~11<..I;:ltltlll (reI- m'rLLollrutlon) ~ AhandOnlnerlL ~ Street addre<;.<; ofwdl r Ne'lle<:.t addre5~
II 057 4rld~er<inn Lane Springfield I
\SJ DRILL METHOD
[{OIl]) <\.Ir OROI'1lvMud DCClblc OAuger Dr'\ble \1ud (10) ST....T1C WATER LEVEL
o I{L,\L1....l Rot.H) OOtlle! Orne &WI(p<:.l) + S\\L(Il)
(4) PROPOSeD llSE[ZlDomestlc Dlnl~"ltlOn DCommunlty IC"-lstmg IhdJ / Predeepenmg - 81 IR I
ICnmpletedWell I I
Q Im!u\ I!;II (ommLncml 0 Ll\L!,tock 0 De\\::itenng FlowlIlg Artesian' D Df\ [lole?O
DIIH..lmllDlllleeltOn o Other WATER SCARING 7.0'lE~ Depth \\..ttel ";1S fils! found
(5\ BORf~HOLE-GOi'lS1 RUe' 1-10'1 <;:'oecl'll qldnda~d DAt1ad1c'1?") S\\ L [)JI~ fro To r~t rlr... l,WI' 51' H
Depth ofColllpletcd Well 000 It
~ORC HOLE SEAL b.aI.J~ EE3
nil rmlll To MllLrl11 From ro Am' Ih,
I " ! [) ~Ir"m""' I 0 I~
(11) WELL LOG uroumi [le\aluln
Ho\\ \\1, sCII plJltd Method 0' 08 cg]c DO DE Matenal flam To
~(llhel 1m U')O 220 OQSO I
B.JLl..lillpIILLlI 110m _ n (0_ II V1atenal 1
I ill~1 pILI, lrom ftw It M<ltenal SIze
0''' - ,
F~pl(j""I\l"" Il~ul Type \mount ,
Irp C\SIi'\G/LINER
<l~lllg \ lllt.r Dr,l + 110m To G'loge ,,1 Plstc Wid 1 hrd
6~ 1 I~ ~
I
"'11m: Oll1~Hk DOu's'de OOLhcr LocatIon ofshne(~)
1 Ln,p L l'.mt, 0 Ye~ Dw Flom To
(7) PI:RFORA nONS/SCREENS I
PetioratlOns Method -I
~creen~ T)-pL M1tcllal I
I',tt.., l '", <'L ~,r SCln ....Iot Slnt . or Tele/ DntL Started (19 'JO_ ?om r'omplelt:J 0('-/0 7007
l.ILlll LIllLt Dla From To .....ldlh lenjlth I"Tl
I ~ i I -1 I I (unbonded) W Itcr Well ('f1l1~trudor Certlfilltmn
1 certIfy th:lt the I~ork 1 pl.1 lomlcd on the constluctlon clcqx.mng; a1\el>1tlOn 01
abandonment of this well I~ In comph lrlC~ wIth Oregon wafer ~\lpply IH.lI
l-on<;tructfOrJ ~tand!}/(l!' M.JtellJh u~erl ,md IntormatlOn rl..plJrtl!d abo\C ale true to
the be~t ormy koOvdt.dge 'lnd I;n:hel
(8) WELL TESTS Minimum te..tln~ time 1<; I hour llcen~eNumb...r ]R19 D..ltt.. 0920-'007
Ol'lImp 0811ILr @Al1 0 FIO\~ 109 Alte~J:]n Ekctronll:ally Filed
'rH.li,-Jltml11 Dr,lwdOlVn Dnll <:.lem Pum denth Durouon<hrl Signed MlrllAr! Ilfnl r FY(~_ld{rl\
I I I (bonded) Wnter Well Con..trul.lar CertificatIOn
I I I I accept re<;ponslbll1ty for the canst! ucllOn dccpl..mng n1temtlon or ah'mclonmellt
I 1 I "OIic perfom1ed on thIS wLlI dUlIn~ the wn\tl uC(JOn .hle.> repnrted nbove All work
ILlllpllJlllrl. or Lab analysIs Dyl.' By performed cl\\I111g thl~ tlmto': IS In complmnce wIth Oregon ....ufer supply well
\1/ It,! C]ualil\ L()l1LL01~'7 OYe~ (describe bclo\\) constructIOn ~LanJ lld<:. ThiS repolt I~ fruL 10 lht.. beit arm) kno....ledgc ..lnd belief
I l,nni I Tn I n,..,r"l,..nn I Amount 8 LlccnscNumlJCI 1"i41 Date 09_70 'Jom
ElectronIcally Filed
<:;Igned r'ASFY 'ONF~ lR IF filpc1)
Contact Info (opllonnl) r_ , CA''''.''.,O''
ORIGIJ,'AL ~ VvATER RESDI ReES DEPARTMeNT
nl'<;; RJ I>l)Rf "'JUST BE 'iUB\1ITIED TO THr \YATER R['iOURCEc; DCPART'vlE'lT wn HIl\)O DAY!;) 01 CQ\1PL!::TION or WORK
Date Received
Planner AL
Fonn VeNQn 0 qg
10/;;/200 '7
I /
Dave Collier
(541) 767-3087
p.4
Page I of I
S tartcard Data
Well Constructor: 1541
CASI<.. Y JONES JR, CASEY JONES WELL DRILLING
Start Card Number 1002233
Owner Information
Company
First IVERN
Name
Street! 1940 HWY 99 N
Street2 I
CIty !EUGENE
Last jSENSON
Name
State lOR Zip )97402
Home I
Phone
Workj
Phone
Type of Work
_Ece Re_qUlred CNew
L ConversIOn
o Deepenmg
No Fee DAlteratlOn
ReqUIred ~ Abandonment
Ongmal
Start Card#
Ongmal Well
Tag#
ConstructIOn
Proposed
Commenccment 9/1912007
Date
EXlstmg!
Proposed 50
Depth(ft)
Diameter
(mches) 5
Use
~ Domestic
o Thermal
o Momtonng
DCommumty
o InjectIOn
o Plel:ometer
o Industrial
o Livestock
o Dewatenng
o ImgatlOn
Other
Proposed Well LocatIon
1057 ANDERSON
Street
address
of well
LANE SPRINGFIELD, OREGON
QQ/Q NE
Taxlot 101
NE
Township 1700
- Lattltude
S
Range 3 00
LongItude
w
SectIOn 33
County Lane
OWNER PLEASE NOTE Thi.!lL'J not D wnler right apphcatlOn. Tbe owner is responluble forobtsln.mg a WJIkr nght through 1be Waler Resour'tCll Department, Ir
required Tbr Oregon He-aUh Drvl~on n:C)tllre:5 plaDs to be "ubmllt~ and approved pnor to conltructlOD trtbe wdl15 to be used as a publk syslem
http //apps2 wrd state or us/apps/gw/startcard-!,urchase/startcarddata aspx?sc_Id=149607 9/19/2007
Date Received /~)/7a07
Planner AL
Dave Colller
STATF OF OREGON
\\ , fER SUPPLY WELL REPORT
(", llqllllld in ORS 'H7 765 & OA.R (902050210)
(1) LAI\D OWNER
OwncrWel1lD
r, ,l f', inK \ cm
(ompllh
\d.1ll"\ 'J4() Hw\ lJ9N
(IIY LU':,~lk
L'l\!'\hmc Henson
~tate OR
(2) TYPC OF WORK O""lew V\oell 0 Deepenmg
o Alh.r,lllOn (rcpalr/rCCondltlon) ~Ab<lndonmenl
LANE 67849
09-20-2007
ZIp 97402
D CnmerslOn
CllDRILL METHOD
IZS) RotalY Air 0 Rotary Mud DCahle DAugel DC'lbk Mud
DRl\L'~l R~lllr) DOlhcl
(4) PROPOSeD US.C[8J Dome\T1C Dllll!~:<Itlon DCommumty
o ll1dll<;t1lal lommlnclnlD Llve<;lnck DDe\~alcrJng
C fhll1Thll DInJcctlon 0 Other
(5) BORE HOLE CONSTRUCTION
Depth orrolTlpleted \Vell 000 It
BORb HOLE
])1.1 from Tn M'll~ rlol
~iremen'
SplClll Standard
SEAL
from
(541l 767-3087
p.5
Page 1 of'
WELL LABEL # L I
ST ART CARD # 11002232
(9) LOCATION OF WELL (legal de'croptlOn)
County lnrl~ 1....p...11....QQ..-~N'S R<lnge~K-
See ...3.1...-- .b.E.....-- 1/4 cflhe ~ 1,4 TD.~ Lot 101
Tax Map l'o.urnber Lot
I t " "or
~a _~-D..--,_
Long_~_ or
(it Strcet "IddrLss of....ell
11057 Andscr<;on Lam.. Sprmgfidd
r NLJle~t <Iddr~..
I
DB
!>acb/
Tn AmI Ibs
~(ll)WELLLOG
[;gJc DO DE
1 lo\' \\ I' \lJI placed Method 0 A
~OlhL' Illl hl)() nil ()O(IO
R1llllllpllLLdlr(1m_ n to Fl Miltcnl!
Idl",'Pllllholl1 flto ~laterJaI
L,plo'IH., II~ld [JYe~ T\pc-
Amount
(G) CASI'IG/L1'1ER
'9~r
FlOm Tn
...."n... 0 In~11lt OOul~lde
lLml'''I'''lIlgDYe~ 01:1
DOthe,
110m
Location of~hoc(~)
To
(7) PERFORA TIONS/SCRECNS
PLrtontlOns \!ethod Holl... air p...rJoratar
Strr{..ll$ I ype Mdtuml
[lLlII.... { 1..1Il~/ "creen
C1U'I) LlflLl 01:1
From
"
To
"
SClTlI,lot
WJdth
'"
'"
,
(8) \\ ELL 1 CSTS i\lInlmum hosting: rime I" 1 hour
o PUI11)l 0 B,ller @ AIr 0
"ILld toll mIll Dr1.\\dnWll DIllJ ..tlm(PlJOln denth
I I
lClllpLrllur. "F L:lb:lnalys,<;Dyc~ By
\V"llLI 'i" rillY LllllCe1Tl<;' O'r...l,. (dc~clllw belo....)
IIllll1 I" n..,.~r"l'l"'"
I I L
11
SIZe
Gauge ')11 Pl'tc WId Thld
IU
,)Iot
Ico:o!th
#of TeleI
..lut~ Ilpe ~1Le
,on
GmundElc\ HlOn
Material
From
FIO\~lrIg Art\..l.l.:l1l
DunHlon f'nr)
, I
I
I
I,m""", E3
Date SloTted OQ 1 Cl ?007
Completed ()q_1 Q_,007
EWW'A
DMS or DO
OMS or DO
18
S\'o;L(lt)
11-:
~
To
l
(unbonded) Water \Vt.!l COrl'llrul.'tor CerhficatlOn
] certify Ih II the work I perlormed un the ('on<;lrtlcllClIl deepenmg 'lllunlHln or
ubandonment of thiS well 1<; In compliance wllh On.gan ....Iller suppl\ \~ell
Lomtrllctlon st<lndard~ Matenal~ u~ed <lllcl mformatlon reponed 'lbo~l 'lrl 1rUl to
the best of mv knov.kdge <lflU bt:lllf
Llc...n!.!,. Nurnb\..r I R,9 O'lte nQ 70_ 10n?
Elr;:ctrnmcally Fllcd
Signed MlrHAPl I H(1II FY iF f"rlf'nl
(bonded) Wntcr 'Veil Con~truclor Ccrtlfic.ltion
1 accept respon<;Ibllity for Ihe con<;tructl(\1) deepening aller;J.llon 01 jh mdUoOlLnt
....ork performed Oft thl~ well eluTing the con!.lructlOn rhle~ repoJ1cd 'lbovc All\>, OIl<
perfonned dUTlng [hIS lime IS In cnmpllnncl With Orq!,on ~\aler ..upply ~ ell
conslnJcllOn stanlhnJs ThiS l"Lpnr1I' trul 10 the be~t ofm) knowledge and belief
Llcen::.\.. 'lumbel I ~41 Date (lQ 10 '007
Clec:rronlc<ll1y Fded
SIgned rASJ:'V I()NFc:. m (F_tilt"ri)
Contact Info (op\Jonal) (' ,~,. UIA'I ,,",p.ll.. ,,1 '_01.1"'1 "1;'11
ORIGINAL WA.TER RESOURCES OfPART\fCNT
I HI" RI PORT \11 1ST HI::: SUL~MII-l Ll1 10 rHF WATER RI:SOURCES DEPARTMENT WITHIN 30 DAYS OFCOMPLETIOt\ or WORK
Fonn Vcr<;lof\ 088
Date Received
Planner AL
/(1 ):lJg{)7
Dave CollIer
(541) 767-3087
p.6
Page I of 1
Startcard Data
Well Constructor 1541
CASEY JONES JR, CASEY JONES WELL DRILLING
Start Card Number: 1002232
Owner Information
Company
First IVERN
Name'
Streetl!940 HWY 99 N
S treet2 I
CIty jEUGENE
Last [BENSON
Name
State ~ ZIp 197402
Workl
Phone
Home I
Phone'
Type of Work
Fee Required DNew
o ConversIOn
CDeepenmg
No Fee LJAlteratlOn
ReqUIred ~ Abandonment
OrIgmal
Start Card#
OngmaI Well
Tag#
Construction
Proposed
Commencement 9/1912007
Date
EXlstIng/
Proposed 50
Depth(ft)
Diameter
(Inches) 6
Use
o DomestIc
o Thermal
D MOnItOrIng
o Community
o lnJecllon
o PIezometer
o Industnal
[I LIvestock
o Dewatenng
DlrngatlOn
Other
Proposed Well Location
1057 ANDERSON LANE SPRINGFIELD, OREGON
Street
address
of well
QQ/Q NE
Taxlot 101
NE
Township 1700
Lattltude
s
Range 3 00
Longitude
w
Secllon 33
County Lane
O\VNER PLEASE NOTE Tb,," not II willer ngilt application. The owner t!I re!lpoDluble for obulIDmg a wlIter nghi fhrougb tbe Water QCSQUf"Ces Dcpa.rtmeut, .r
requuul The Oregon HClIUh DrvI'llOn requires plan! to be submItted Bod .pproved pnor to coo.druc:tICP Ir the weill" to be used DS a pubbe system
http //apps2 wrd state or us/apps/gw/startcard -PUfcbase/startcarddata aspx?sc _ld=149606
9/19/2007
Date Received.
Planner AL
/p/i/Zo07
, /
Dave Collier
LANE 67851
STATF OF OREGON
\\ nER SUPPL Y WELL REPORT
(I' lllllllnd h.,. OR" 5'\7 761;, & OAR 690-20:;-(210)
09-20-2007
(5411 767-3087
p.7
Page 1 of 1
WELL LABEL # L 1
STARTCARD# 110022J4
EWWM
(1) LAND OWNER
OwnLrv.,cll rD 3
L 'l~l N 1m!: Henson
III~ N JIlll \ (Ill
((JIllIlIllV
AddIL" ')40 Ih~\ ()l)'\I
(It\ ] \I!:~t1... Slate:: OR ZIp 97402
(2) f)' p~ or '''aRK DN~\\ Well 0 Deepenmg D Con'verslon
D \tlLlatlOll (lepmrl1el..\mdt\H)n) ~ \b'lndonml..nt
illUR1LL METHOD
l6J Rotal} All DRolJlY \r1ud DC'lbl<.. DAuger DCabk Mud
o RL\ e::r-,e Rolar\ 0 Other
(4) PROPOSED USEl:8JDomc~llc DlrngatlOn DCQmmumty
Dllln\l~11111/('llmmLllclal 0 L1\estock o De\\'lh_llng
01 III 1TI111 DlnJeclJon DOthl,.f
(5) BORE HOLE CONSTRlICTION
Special StJnwrn
D~plh orCol1lpleted Well
GORE HOLE
nIl rlom To r..-htefml
~Ir"n""
000
n
seAL
From
"
H{1\\ II I, 'L11Illlct'd Method D^ DB
cg]OtlKr pLI (190-220 0()50
HJllddlplllldlrum_ ft to ft Matulal
I Illll Pll,." hom It to ~1a(LfIl\I
Explu'I\"" ll~LJ D'l<" T\f.lt"-
Size
Amount
(6) CA~('1G/LlNER
Ca'dllt! Lllle, DI1 +
n~
ru
Gau!;,e Stl Phtc \\< Id Tnrd
In
FlOm
~hoe:: 0 In~ldl: DOulsldc
r"l11pl,J~m!;,D'yLs Dla
(7) PERI'ORATIO'lS/SCREENS
PerforatIOns Method
~lrC"'l1~ T\ pe
DOtl1eJ
From
Location ofshoe(s)
To
Mltt'rJ.l1
pMI.... (..I'dnl) 'lclu.n Scrn1o;.Jot Slot p. of TcleJ
m '''I '" I"" I ~'" ffi
(8) \VELL TESTS !\tllmmum testmg hml. I~ 1 hour
o Pllflll' 0 B.tilel @ All 0 FloWlOg ArteSian
Vldd _11 mill DnwdOl\n Dnll ~'ern't>umn denlh DuratIOn {hrl
I IT. I
i -r TI
i T T -,
T"ll\llll Hun
"F LabanulyslsDv.... By
DYes (descnbe bdow)
I Amount ~
WIlLI qlldttyconcems'
~~
I"
n"",."p""'''
(9) LOCATION OF WELL (legrll dC<LrIphon)
Range "'00 \N
Tux Lot 101
County 1,10" Twp~~N/S
Sec ~ ~ 1140fthc ~ 1/4
T.u:: Mlp'lllmlKI
Ldt _"'~'_"or
Long_"'~'_"or
(i Slreet4ddress of well
11057 And-:.ep..on (,lne Springfield
Lnt
DVltlol DD
D\1''IoIDD
r J'\eareq 'lddre\,
(10) STATIC WATER LEVEL
Datc
SWL(p.t)
81
flOWing ArteStan? D Df~ Hok? 0
WATER BCARING ZONEt; Depth ....'!ter WJS filSl: found
OAtlach copy) sv. L OJtL Fmm To SWl ~I
sncks!
To Amt Ibs
~(ll)WELLLOG
I2';]c Do Dc
xlstmg v,.cll / l'redeepe11111g
C'ompletedWell
,
Ground Ele\ollun
Mltlf1,l1
from
DJte St.Jlted oq_ 70 ?007
Completed 11970 ,om
~
+
l:iWL(ft)
"
~
To
(unbondE!d) W.lter" ell Con,truetor Cl..rtlfic.lllOn
ll.er11f\ th~1 IhL work I perfmmed on the construcllOn dlx.pl.nmg altLrlC10n Ot
abandonment of lhl~ ....ell l~ In cOInph'lnce Wllh Oft:J:,Orl water ,upplv wdl
con~tructlOn stmdnrds MatLrlllls u"cd !Ind mformatlon reporled ahovl. 1rc rruL 10
the best of m\ knO\"ledge and belief
Llcen~e Numbel I R1Q DalL ()t}?fl ?flrl7
EleclronlcallvFllcd
Slgfled MlrllARI r ~()II rv tr fillY!)
(bonlled) Water Well ConstrllclO( Certlfildhon
J accept respoo<;lblht) fOl the con'tructlOn JCLp~OlO~ [lIter-won 01 abandonment
work perlolmed on tht~ ....el1 dunnglhe con~trllcl,nn d'!te~ reported Jbo\e A II work
performed dUrlnb thiS tIme:: l~ III comphance w1th Oregon watcr ~upph w..11
conslructlOll ~t.Jmj:.m:i~ Thl~ report IS true 10 thL bl<.t of my knOl" ledge ,md heltcl
LIcense Number 1'141 DatLoq 7(\ 'l()fl7
Electronically I lIed
Signed ('A<o;fV rONF... rR IF filM)
Contact Info (optIOnal) r!'tc","v 1 n..,H..,,,. ".Ill 7.r} ?~n
ORIGf!\AL WATER RESOURCES DEPARTMeNT
I HI" RLPOI~l MI ~ I BE SUBMITTED TO THC \I;ATER RESOURCES DEPARTMENT WITHfN 30 DA YS OF COMPlrTION Of' \\ORK
Form VerSIOn (I ~~
Date Received
Planner AL
jo/t//2tJtJ7
I / .
Dave Collier
(541) 767-3087
Startcard Data
Well Constructor: 1541
CASEY JONES JR, CASEY JONES WELL DRILLING
Start Card Number: 1002234
Owner InformatIOn
Company
First IVERN
Name'
Street1 1940 HWY 99 N
Last ISENSON
Name
Streel2!
City jEUGENE
Home I
Phone'
State ~ Zip 197402
Work I
Phone
Type of Work
Fee ReqUired DNew
o ConversIOn
o DeepenIng
No Fee 0 Alteration
ReqUIred Q Ab d t
I-"J an onmen
OrigInal
Start Card#
OngInal Well
Tag#
ConstrUl_tlOn
Proposed
Commencement 9/19/2007
Date
EXlstIng/
Proposed 50
Depth (ft)
Diameter
(mches) 4
Use
~ Domestic
o Thermal
o Momtonng
o Industnal
DLlve~tock
o DewaterIng
o rrngatlon
Other
DCommumty
o InjectIOn
o PIezometer
Proposed Well LocatIOn
1057 ANDERSON
LANE SPRINGFIELD, OREGON
Street
dddress
of well
County Lane
Township 1700
Lattltude
S
Range 3 00
Longitude
QQ/Q NE
Taxlot 101
NE
w
SectIon 33
p.8
Page 1 of 1
OWNER PLEASE NOTE This 1<; not It water nghlll.pphcatJon The DWDer IS r~pon!llble for obtaining a wa,ler nght through tbe Waler Rcsourc~ Department, If
n.ql.llred The O~on Heallh DIvISIOn requlI''t$ plans to be submitted and approved pnor to construe bon If the well IS to be used UJI publiC syslem
http //apps2 wrd state or us/apps/gw/startcardyurchase/startcarddata aspx?sc_,d=149608
Date ~ecelved
Planner AL
9/19/2007
/01/2&177
, /
10/11/07 THU 09 45 FAX 5417263689
CITY OF SPRINGFIELD
~001
RECEPTION OK
TX/RX NO
CONNECTION TEL
CONNECTION ID
ST TIME
USAGE T
PGS
RESlILT
*********************
*** RX REPORT '*'
**************~*4*~**
8880
541 767 3087
10111 Oq 41
03'25
8
OK
Date Received
Planner AL
/O/;/~67
/ /