HomeMy WebLinkAboutPermit Septic Tank 1996-6-27
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PERMIT #
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AUTHORIZATION FORM
~and lIlanagement Division 12$ E. eth Ave. Eugene, OR 97401
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STRUCJU?ES NOW ON PROPERTY
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PROPOSED USE SEPTIC NSTAL1..E.D
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MAIL PERMIT TO
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applI~~nd hereby certify that all Information
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'PLANiIlNGIZONING < READ CAREFULL VI Your Authorization Is Based On The Following Conditions .,.
/,IINIMUM
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r. ~ ~'t"f" P v ~A~PROVEo- PLot PLAN DAne- 7 CL7
O r~e: SYSUM APPSAFlS TO U WORKING ~
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( ..... CALL FOR'iiisPEc"iioNS (SEE"BACK OF FORM FOR INsTRuCrioNs) 687-4065
SEPTIC permlfs are good for one yeer ALL other permits expire alter 180 days unless Inspections are currenf
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LMD 040 Rev 6/92
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VIOLA nONS
SHTBACKS AND 01HBR ............. .......... OF APPROV ALMUST BB STRlCIL Y OBSERVED VIOLATION CAN RBSm. T IN REVOCATION OPnIIS PERMIT
CITATIONS :MAY DB ISSUFD UNDER TIlE PROVISIONS OF LANE COUNTY S INFRACTION ORDINANCE AND"oR OTIIERREMEDIBS ALLOWED BY LAW
A MINIMUM OF AT LEAST 24 HOURS ADVANCE NOTICE MUST BE GIVEN FOR INSPECTION REQUESTS
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Have the followmg mfonnauon ready when you call 687-4065
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Pernut number - lob address - Type of mspecuon requIred When ,t W111 be ready
Your name and phone nwnber - Any weC1al drrectlons to the SIte
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PUBLIC OWlClAL RIGIITTO TRESPASS ON PRIVATE PROPERTYORS 2150SO ' , I
POWER TO ENTER UPON LAND nIB COMMISSION AND ANY OP ITS MEMBERS OPFICERS AND EMPLOYES INTImPRRFORMANCEOPlHBIRFI..,................ MAY
ENTER UPON ANYLAND AND MAKE EXAMINATIONS AND SURVBYS AND PLACB AND MAINTAIN TIlE NECESSARY MONUMENTS AND MARKERS nmRBON
REQUIRED INSPECTIONS
FOUNDATION INSPECTION To be made after excavatIons for footmgs are complete and any requIred remforcmg steel IS In place
UNDERGROUND PIPING INSPECTION To be made affer all underground p'pmg has been lJ1Stalled, pnor to any backfill
CONCRETE SLAB OR UNDER,FLQOR INSPECTION, To be made afrer all m-slab or under,floor bUlldmg semce eqUlpmen~ condu,~'p,pmg
accessones and other ancillary eqUIpment Items are m place but before any concrete 15 placed or floor sheathmg mstalled. lJlcludmg the subfloor
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ROUGH MECHANICAL INSPECTION To be made after all ductmg and gas p'pmg has been lJ1Stalled and pnor to bemg covered '
ROUGH PLUMBING INSPECTION To be made after all plumbmg rough-m 18 m place, pnor to bemg covered
FRAMING INSPECTION To be made afler the all frammg, fIre blockmg, bracmg and roof are m place and all p1pe!, chunneys and vents are complete
and the rough electncal, plurnbmg, and mechamcal mspeCl10ns have'been made and approved .... ' J" ..
INSULATION INSPECTION To be made after alllJ1SUlallon and vapor bomers are m place, pnor to covenng
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LATH AND/OR GYPSUM BOARD INSPECTION To be made after alllatlung and gypsum board, mlenor and extenor, IS m place but before any
plastermg 18 applIed or before gypsum board JOmts and fas1eners are taped and fImshed
ADDITIONAL INSPECTIONS MAY BE REQUIRED, such as but oot lumted to,
BLOCK WALL To be made after remforcmg 1S m place, bU1 before any grout 18 poured The lJ1SpectlOn 18 reqUIred for each bond beam pour There
will be no approval until the plumbmg and electncalmspectlons have been made and approved
FINAL MECHANICAL INSPECTION To be made Just pnor to the structure or remodeled area bemg OCCUp1ed and pnor to operatmg anyequ1pmenL
FINAL PLUMBING INSPECTION To be made lust pnor to the bu1ldmg, structure or remodeled area bemg occupIed
FINAL BUILDING INSPECTION To be mad, afler fuush gradmg and the buudmg, structure or remodeled area 18 completed and ready for occupancy
MOBILE/MANUFACfURED HOMES An mspectlOn 1S requIred after the mobue home IS connected to an approved sewer or sepUc
system, pnor to covenng sewer or water lmes. for setback requrrements, blockmg, uedowns and plumbmg connectIons
Footmgs and piers to comply WIth State foundatIOn requlfements for mobtle homes or as recommended by the manufacturer
Muumum fInlShed floor elevauon shall be cerl1fied when reqwred by Floodplam Management
Tiedowns, If reqUired, shall be lIlStalled and ready for mspectlon Wlthm 30 days after occupancy Tledowns shall be mstalled per enclosure
APPROVAL REQUIRED
No work shall be done on any part of the bUlldmg or structure beyond the pomt mdlcated m each succeSSIve mspeCbon WithOut tIrst obtammg the
approval of the buildmg offICial Such approval shall be given only after an mspectIon shall have been made of each succesSIve step m the construction
as mdIcated by ~ach of the mspecnons requrred
APPROVED PLANS MUST BE ON TIlE JOB SITE AT ALL TIMES DURING WORKING HOURS
TIllS PERMIT WILL EXPIRE IF WORK DOES NOT BEGIN WTI1IlN 180 DAYS, OR IF WORK IS STOPPED OR ABANI)ONED FOR MORE TIlAN 180 DAYS
SUSPENSION OR REVOCA nON MAY OCCUR IF TIllS PERMIT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS INFORMA nON
ANYONE PROCEEDING PAST THE POINT OF REQUIRED INSPECTIONS WILL DO SO AT THEIR OWN RISK.
Your SIgnature on the front of tlus form venfies the followmg I HA VB CAREFULLY EXAMINED THIS COMPLETED APPLICATION, and do
hereby certIfy that all InformatIon hereon IS true and correct, and that I have a legal mterest m the property as owner of record or authonzed agent I
further certify that any and all work performed shall be done m accordance W1th the Ordmances of Lane County and the laws of the State of Oregon per,
tammg to the work described herem I further certIfy that If I am not the owner of the t"~....t""'~'J' my regIStratiOn WIth the Builders Board IS In full force
and effect as reqwred by ORS 701 055, and tha11f exempt the baslS for the exempbOn 18 noted hereon, and that only subcontractors and employees who
are 10 complIance w,th ORS 701 005 will be used on the Job
SUBSURFACE & ALTERNATIVE SEW AGE DISPOSAL SYSTEMS'
When subsurface constructIon IS complete, the pernut holder shall notIfy the County Land Management DIVISion by subnuttmg the mstallatlon record
form An mspectJon will be made by a qualIfied samtanan If constructJ.on complIes With all rules a certIfIcate of completIon will be ISsued to the permit
holder If construction does not comply WIth rules, the penmt holder will be notlfied, and all correctlons shall be madejffore a cemflcate of completion
WIll be ISSUed FaIlure to meet satIsfactory completion WIthm the allotted tune constitutes a VIolation of ORS 454t605 U!-54"745 and tlus rule
SUBSURFACE SEW AGE DISPOSAL SETBACKS SEPTIC TANK
From Intenor property Imes 10'
Edge ofroad ngh1-of,way 10'
Buudmg foundanon 5'
Wells or other water sources 50'
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ENVIRONM~L HEALTH SERVICES
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C(llJN1"Y DEPT E~NV MGT RECEIPT :~ 137496 DATE 043096
'ADDR 3~58 1~(INGRIDG[ I)R.. SF)R!N~FIELD, OR
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UNITS 001 S"rORIES #BLDGS 001 PJ'~ONE 747 285"7;"1
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SQ r"I' lJNIT tOST VALUA1"ION FEE DAYS
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OWNER NME ~OLANE, LARRY
COD1~ APP!_ N() A(:~TION IDESCRIPTION
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APPLICATION .11
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/ LOCATION .6'8 c-/8
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The Lane County BUilding and Sanitation DIvIsion cannot proceed with processing your application because
1 ~lncomPlete application (Items deflc;ent)
D Address and/or directions to appllcallon site
D Proposed number of bedrooms In dwelling ...
,~ Approvable plot plan (see atta.;;,..".,,,;) f?c7 (jUJ
-, D Notification of date test holes will be ready
2 0 Venflcallon of eXisting system reqUired (see attachment)
3 0 Two test holes (2'x4'x5' deep) reqUIred for expansion or repair of eXlsllng sewage disposal
system In the area of the proposed dralnflelds
4 0 Other
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SIGNATURE . f DATE '
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OFFICE HOURS
PHONE
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If no response has been received In regards to this matter b1l
the application will be denied
LANE COUNTY ENVIRONMENTAL HEALTH SERVICES
Courthouse-Public Service Bldg /125 E 8th Ave / Eugene, OR 97401 /687-4051
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APPLICATION #
/37V-rC
3358 L(!itJ? fZ I ce.(-
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The Lane County BUilding and Sanitation DIvIsion cannot proceed with processing your appliCation because r
1 ~ Incomplete application (Items deficient)
D Address and/or directions to application site
D Proposed number of bedrooms In dwelling
... <.. ,.)tI Approvable plot plan (see attachment) !3?c-cQ1..(/
~, " D Notification of date test holes will be ready
2 D Verification of eXisting system reqUired (see attachment)
.(' D Two test holes (2'x4'x5' deep) reqUired for expansion or repair of eXisting sewage disposal
system In the area of the proposed dralnflelds
c;{ U/1 /1 c( /t:E /IJlO(0~ LOCATION
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ZIP CODE
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LANE COUNTY ENVIRONMENTAL HEALTH SERVICES
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