HomeMy WebLinkAboutPermit Septic Tank 1975-4-10
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V ::~R~~~:~~ER C RAWES
. SAMF.
LANE CC'" 'NTY
BUilDING ....J
rfll-J { 5. 7- 7~
BUILDING PERMIT OR MOBlr 'OME USE PERMIT
MH rnx PERMIT NO. MH 11]--7<;
MAILING ADDRESS PHONE
933 NORTH A STREET SPR I tlGF' t ELD OREGON 747-<;110
MAILING ADDRESS PHONE
PROPERTY LOCATION - INCLUDE POST OFFICE .*'
SOUTHERN EXTREMITY OF' rtL6ERT GROVE 2074 HARBOR DRIVE
PROPERTY LEGAL DESCRIPTION - METES, BOUNDS
rlL6ERT GROVE 5TH ADDITION
lOT' 48. BLOCK,
18
,
SECTION TAX LOT NO. CODE
11."z,,,.< # .3-..$.00
EXISTING STRUCTURES ON PROPERTY
CENSUS TRACT
TWP
RANGE
APPL.
NAME
&
LAURENCE C. RAYNES
Ml'u..r
LEGAL ACCESS TO PROPERTY
, . 2074 HARBOR' .(tft~
PROPERTY SIZE - FT.
q" NORTH A STREET
MAILING
ADDRESS SPRINGF'lELD OREGON
FOR MOBilE HOME PERMITS ONLY
No. of Bedrooms
WIDTH
DEPTH
AREA
,
Connect to Existing Sewage System D
TYPE CONSTRU~T]ON SQ. FT. :# BDRMS
2
New System D
VALUATION
STRUCTURES TO BE BUILT THIS,PERMIT
PACIK MOBILE HOME
INSTALL'StWAGE DISPOSAL SYSTEM.
SEWAGE DISPOSAL
PUBLIC OPR lOR SEPTIC TANK 0
BUILDING ~
WASTE DISPOSAL
PLUMBING
PLAN REVIEW
PARK TRAILER
PLUMBING INSTAllED BY
OTHERO
FEES
OWNER 0 OTHER: NAME
WATER SUPPLY
c;o . 00
.4.00
PUBLIC 0
o OTHER
TOTAL
$
":l0.00
- .04
84.04
COUNTY BUILDING & SANITATION SPECIFICATIONS
DRAIN FIELD REQUIRED
MIN. SEPTIC TANK CAPACITY
WITH 0151. BOX: GAl.
750
UN. FT
150 TRENCH WIDTH FT.
3 DE PTOR SQ. FT.
300
/'. TYPE OF STRUCTURE
OCCUPANCY
ZONE
PUBLIC .UTll. EASEMENT
MH I
BLDG. SETBA<;:KS__ FT. FROM OR. OF ROAD RIGHT OF WAY
USE ClASSIFICATION
FRONT
<;0'
REAR
'>'
SIDE INT. 1:)1 SIDE EXT.
AUTHORIZED SIGNATURE - DATE
/S/ J. E. Boss. BY C.HARBAUGH
JOHN SHOOK/SANITARIAN
DATE
4/1017<;
01 M
BLDG. PERMIT - WHITE
OFFICE COPY - WHITE
COUNTY TAX - PINK
PLUMBING - CANARY
BUlLDING - GREEN
SANITATION '- GOLDENROD
Call 687~4065 to schedule all required inspections. "All construc-
tion sholl comply with Uniform Buildirg Code, D.E.Q. standards
IMPORTANT: for subsurface sewage disposal and county regulations covering
plumbing. All buildings require a certificate of occupancy before
being .occupied. .
(See Details on Reverse Side)
F,ORM :;= C55 -13
(POST THIS PERMIT ON MAIN BLDG. AT SITE)
LANE COUNTY, DEPT. OF ENVIRONMENTAL MANAGEMENT
COURTHOUSE ANNEX, 135 EAST 6th, EUGENE, OREGON 97401
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APRO 3 1975
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. bAN'~G6UNfy
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'( \-~..c 1J . T_ '<:6 'R 6~ S II TAX LOT.
~\. . .1" SUBDIVISION:
NO. /; ..-:!'/3,?-7S-: LOT: BLOCK:
. ~ ' APPliCANT' fu\!M~
-DATE
BUILDING' SITE EVALUATION /
,
( )
( )
BUILDING PERMIT APPliCATION
SITE 'I NS.PECTI ON
1.
2,
3,
4,.
5..
-.\ Not
,App l.i'cab 1 e
Zon i ng Ord i nance Comp 1 i ance: Zonelfhtl-Mkl )
.Subdivision Ordinance Coop 1 iance . ( )
Requ i red Access . ( )
Building Site (Area, W.idth, 'Frontage) ()
Other (see comments) ( )
PLANNING DIVISION
COMMENTS:
No . Yes
T).~6,
( ) (v)
C) (t::-.
( ) ('7 '
( ) ( )
CK'D BY:~
Setbacks from ell
Front
. Side Exterior
Setbacks from interior
Side
Rear
1 j.nes:
s--
c;
7' -;J'-7.s-
of road:
~.
-
BUILDING INSPECTION DIVISION
PLANNING DIVISION ACTION PENDING: YESl ) NDl ) APPLlCATION/t
. Not
Appl icable
( )
(()
( )'
()
7, Plans Submitted
8, Soil Stability (footings)
9, Flood Plain .
10, Other (see comments)
\
COMMENTS:
(
"'
WATER POLUTION CONTROL
Not
Appl icable
()
( )
II,. Meets Department.of
Quality Standards,.
12, Other (see comments)
Environmental
COMMENTS :'
./
,
No Y~ t1 .,/ .
T).~/-.
( ) () -
( ) ( ).
( ) ( )
. . /d/}/~ -
CK'D BY,:{/.//Jt ..t./-r-'J&
, . A!E
No Yes
T)N
- ,
( ) ( ) : .
. ,
CK'D
.BY: ~,\~ L/hh~
r \. DATE .
\ "
"
TO APPLI CANT: ,
{o~ Building I ~ite Inspection:
;J?Q Can be approved.
..~ () Cannot be approved. at this time. as indicated on iKem.NO, above.
)L~~~ jC) Questions and further information on items I through 6 conta.ct the LANE-
"1~ ~~ COUNTY PLANNING DIVISION, Questions and furthe~ information on items 7
, through 12 contact the LANE COUNTY BUILDING AND SANITATION DIVISION. /.
( ) Will be held in this office unfil you can resolve the problems indicated.
( ) Is- be ing returned;
(. ) Your bui.1dinq permit apJ>1 ication fee is be'inS! returned under seRar~te cove,!.
_ "EPARTMENT OF ENV I RONMENTAL MANAGEMENT
135 Sixt~ Avenue East Eugene Or~gon 97401
, PHONE: 687-4065 .
" LANE COUNTY PLANNING 91VISlpN PHONE: 687-4186
C55-28
-I ".-~
. .
LANE cr. '''HY
BUilDING. L1
IOME USE PERMIT
PERMIT NO. ~
BUILDING PERMIT OR MOBIL
M H [[)l(
MAILING ADDRESS
9~~ ~~~1" A STREeT
MAILING ADDRESS
,
PROPERTY OWNER
LA~cr~~e C ~v~eo
CONTRACTOR
SAt::!
PROPERTY LOCATION - INCLUDE POST OffICE
S~ann t~TnE~ITY 0' rILO~RT G>1Cve 2014 H~oon OaIV~
PROPERTY LEGAL DESCRIPTION - METES, BOUNDS
!'.;p.nlf<t\'.....u'J
r'~OuBT ~1ova 5TH AOOITIOh
LOT W Gt.oat ~
TWP
RANGE
CENSUS TRACT
SECTION
TAX LOT NO.
CODE
18
1
11
APPl.
NAME
&
EXISTING STRUCTURES ON PROPERTY
LAURENCE C. RAYN20
1\,""'.....
LEGAL ACCESS TO PROPERTY
207~ HAoacn ~.~
PROPERTY SIZE - fT.
9~~ N~T" A STn~~T
MAILING
ADDRESS SPell ~a' I GLD OorrOON
FOR MOBilE HOME PERMITS ONLY
No. of Bedrooms
STRUCTURES TO BE BUILT THIS PERMIT
WIDTH
DEPTH
)Jtl (.j ,1.
~.
\.
.'
~~ 111.. 7'~
PHONE"-'
1'k>""DU 7/.7.<;111)
PHONE' -
"
AREA
PMl~ ~OtLa Moog
Connect to Existing Sewage System 0
TYPE CONSTRUCTION SQ. FT. :;; BDRMS
2
InsTALL S~AGE DIOPOSAL SY9T~
SEWAGE DISPOSAL
PIllon
PUBLIC D SEPTIC TANK D
BUILDING $
WASTE DISPOSAL
PLUMBING
PLAN REVIEW
PARK TRAILER
OTHERD
PLUMBING INSTALLED BY
OWNER D OTHER: NAME
WATER SUPPLY
FEES
c:;o .00
.lJ.OO
PUBLIC D
o OTHER
m.M
- .00
Bb.ch
COUNTY BUilDING & SANITATION SPECIFICATIONS
DRAIN FJELD REQUIRED
TOTAL
;
MIN. SEPTIC TANK CAPACITY
WITH DIST. BOX: GAl.
750
L1N. fT
IIJO TRENCH WIDTH FT
, OlCPTOR SQ. FT.
TYPE OF STRUCTURE
OCCUPANCY
ZONE
PUBLIC UTll. EASEMENT
t-Ol I
BLDG. SETBACKS _ FT. FROM CTR. OF ROAD RIGHT OF WAY
USE ClASSIFICATION
FRONT
'W'
REAR
"i'
SIDE INT. qt SIDE EXT.
AUTHORIZED SIGNATURE - DATE
I~I J. E. eooo ov c. HAQaAU~
JC'<lCJ 9HOC:t!t'1lt.l1't/lOI^,'
BLDG. PERMIT - WHITE
OFFICE COPY - WHITE
COUNTY TAX - PINK
PLUMBING - CANARY
BUILDING - GREEN
SANITATION - GOLDENROD
New System D
VALUATION
~oo
DATE
lJhnlm
-.
.-t' "'.'" t"l.
Call 687-4065 to schedule all required inspections. All construc-
tion shall comply with Uniform Building Code, D.E.Q, standards
IMPORTANT: for subsurface sewage disposal and county. regulations covering
plumbing. All buildings require a certificate of occupa!1cy before
being occupied.
(S~e Details on Reverse Side)
-.
FORM = C55-13
(POST THIS PERMIT ON MAIN BLDG. AT SITE)
<ANE COUNTY, DEPT. OF ENVIRONMENTAL MANAGEMENT
COURTHOUSE ANNEX, 135 EAST 6th, EUGENE, OREGON 97401
\,
SLAB FLOOR
PLUMBING GROUNDWORK
ApPROVED ;---y DISAPPROVED ~ DATE
REMARK 5
GAS PIPING GROUNDWORK
ApPROVED t / DISAPPROV[O ;---y DATE
REMARKS
ROUGH PLUMB.lNG.
'ApPROVED ~ DISAPPROVED ;---y DATE
REMARKS
ROUGH GAS PIP lNG'
ApPROVED ~. DISAPPROVED ~ DATE
REMARKS
INSPECTOR
INSPECTOR
INSPECTOR
INSPECTOR
FINAL PLUMBING
ApPROVEO !KJ DISAPPROVEO ~ DATE~-;;J +---J5' INSPECTOR ~ y/'
REMARKS
FINAL GAS PIPING
ApPROVED / / DISAPPROVED / / DATE
REMARK 5
.CERTIFICATE OF OCCUPANCY
I.
READY TO ISSUE ~ NOT READY TO ISSUE ;---y DATE
REMARKS
~
INSPECTOR
INSPECTOR
.....
.
.
LANE CI"".INTY
BUILDIN<L..'r
., .\.,
. . .,.\.
BUILDING PERMIT .OR
MH [JiJ:l:
MAILING ADDRESS
MOBW~IOME
\"../
USE PERMIT
PERMIT NO.
It.'~"'.
.
....'"
. -
PROPERTY OWNER
\';W-.fb;.(".E C ttlTBt.t1B
CONTRACTOR
::JA~.:l
PROPERTY LOCATION - INCLUDE POST OFFICE
'(.OH;~tl~" Eum:nan er E'11.6l:i:\'f
PROPERTY LEGAL DESCRIPTION - METES, BOUNDS
r 't .'t1i'1 G~~O'''/;l ')T;I JlDtltTtr;m
91~ :~tmTfl
MAILING ADDRESS
.
.
... STl'ICrr'l'
~"/!]'Unftl"L"
ldH t ';1.,.... ";...1
'PHONE''''
Ost:rot'tu 1t. ....:.-'r.';1 i'l
PHONE' ,
. -' ~ "
,.
GHQ1!<'t ?N4 H"'~Gr.i!l naA\;~
I
lG't ~tJ a..OIl.: ~
TWP
RANGE
SECTION
i.~
3
J'
..
TAX LOT NO.
.. )
CODE
,/ (:
EXISTING STRUCTURES ON PROPERTY
CENSUS TRACT
APPL
NAME
&
!.Ar"c:,z:t;CIt C. [?lItYN<:8
8,,,,,"u...
LEGAL ACCESS TO PROPERTY
2074 II!IItSOR ~
PROPERTY SI~E - FT.
'.H"l :to'i11 II nl'Rf'U
MAILING
ADDRESS ~DttHtG7urt..O O$iZ'cr.;~:.
FOR MOBILE HOME PERMITS ONLY
No. of Bedrooms,
STRUCTURES TO BE BUILT THIS PERMIT
WIDTH
DEPTH
AREA
Connect to Existing Sewage System D
TYPE CONSTRUCTION SQ. FT. :;; BDRMS
New System 0
VALUATION
t~::::~~ teo~ft,e ,:~
2
Ct'3ftlV<. $C'iIl'A<Ot I;H~plltl;fll.. S'1SUlil
SEWAGE DISPOSAL
F~.tI:[1'
PUBLIC 0 ,. ~. SEPTIC TANK 0
BUILDING, $
WASTE DI,SPOSAL
.PtUMBING
PLAN REVIEW
PARK TRAILER
FEES
PLUMBI~G INSTALLED BY
OWNER 0 OTHER: NAME
WATER SUPPLY
OTHERD
":.0.00
~.OO
PUBLIC 0
D OTHER
TOTAL
m.oo
.O~
t4.oll
COUNTY
BUILDING & SANITATION SPECIFICATIONS
$
MIN. SEPTIC TANK CAPACITY
WITH DISL BOX, GAl.
DRAIN FIELD REQUIRED
'f50
L1N. FT.
'50 TRENCH WIDTH FT.
1 D!i:ltl'OR SQ. FT.
~oo
, ,
.,
~C\'-~.I:.~~
/~I.J\,.i~ ",,,-,\--\ \,\
\
TYPE OF. STRUCTURE
::1
OCCUPANCY
ZONE
PUBLIC UTIL. EASEMENT
3
BLDG. SETBACKS _ FT. FROM CTR. OF ROAD RIGHT OF WAY
FRONT ~fl. 'SIDE INT. 51 SIDE EXT.
AUTHORIZED SIGNATURE - DATE
/J/ .'1. C. 6O~-ll- at c. liMWMH'.l.
USE ClASSIFICATION
REAR
")..
JOtlN lJf!\DOll/lII\H I-tAIUAt.l
DATE
,. hol1<;. c>, "
BLDG. PERMIT - WHITE
OFfiCE COPY - WHITE
COUNTY TAX - PINK
PLUMBING - CANARY
BUILDING- GREEN
SANITATION - GOLDENROD
.'
Call 687-4065 to schedule all required inspections. All construc~
tion shall comply with UniforfT! BuilsJing Code, D.E.Q. standards
for subsurface sewage disposcil.c;riCi;'Jclouhty regulations 'o~ering
plumbing. ,All buildings require a certificate of.o'ccupancy before
being occupied. ~
. ..... (See Details on Reverse. Side)
IMPORTANT:
FpRM :::; C55 -13
./
/
(POST THIS PERMIT ON MAIN BLDG, AT SITE)
LANE COUNTY, DEPT; OF ENVIRONM.ENTAL MANAGEMENT .
COURTHOUSE ANNEX, 135 EAST 6th, EUGENE, OREGON 97401
"
. ".
,
\,
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SITE I NSPECTI ON
ApPROVED.C1 DISAPPROVED I / DATE
INSPECTOR
REMARKS
FOUNDATION INSPECTION
ApPROVED I
I DISAPPROVED L-/ DATE
INSPECTOR
REMARKS
FRAMING INSPECTION
ApPROVED ;. /- DISAPPROVED II DATE
INSPECTOR
REMARKS
LATH OR SHEETROCK INSPECTION
APPROVED~! DISAPPROVED ~ DATE
INSPECTOR
REMARKS
FINAL INSPECTION
APPROVED' / /
REMARK 5
;1.14/
DISAPPROVED II DATE
,,';, fAJuJ~ ".")."~7r.lj ~
,
INSPECTOR
CERTIFICATE OF OCCUPANCY
READY-TO ISSUE / / NOT READY TO ISSUE II DATE
INSPECTOR
REMA.RKS
I1HmH~ 207"/ %~,1)...w
, .' /rf rJ}:J - J~cL~
!NSTALLER:
h:., .' l' '.
. _... '. PROP()S SEWAGEDISPOSA( SYSTEM. RECORD. ..." . .
.Comlll,ete.top.' part of' f'or:m to .sig,!ature and .submi.t'.both.cop,eswith application.
, , . PERMIT NO. . MHl'n-7'i
INSTALLER'S. NAME,... ~ p,ROPERTY. ADDRESS.. ._
.: l/2~f61LJ;,v ~~f~.:;z J .',.2<)74 r;IARBOR ,.',
No,. Living Units BedroomS'. Baths Basement. Water Supply.
.l "'- .'~ .. . .1 .Yes. No 'x Pub lic){ .Oth'er-L i st ..
Septic Tank: .,
Ft. from well". ... St.~..._~l 0::'.. Concrete 1)(1 No. COmpartments ' Gal;Cap~ci ty: .
. ~ . -'. J~ao .4A--/
.lnside.Dimensions; F.t. - ,Tile.Disposal Field.:. -" ..
LengthWfdth - Diameter_..D'epth :Di'stri'bution Box: . Yes'-.. 'No
OWNER. Other Distribution-Type
-NAME. .1 'A; 1';~~lr& (' :"OA v~,~ e " ,'_
JS
. b3~ N~~TH A STREET..
'-. :~~l. ~ ..
.SPR I NGF:' ELO OREGON
Length ,of Li'n.~s-Ft, :lT~e,~chl.
I, 2..3. 4.5. 6.. Width.,
'lot Plan lsee -Instructions):'
Feet from '
WEll ~t7c~~p7_ Foundation.
~~~n~ine II) I. '-Side;- {-:).. {: Rear /60 I
1Ft.. Betlj.een, .IFi 11'1ifjlfi ller Dept~/(IFIller~elow
LInes' /ty Tvpel?'2JAbove T-i Ie G:; inlTi Ie I!.. in.
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-ADDRESS
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Date. .' - .. ," . .. S 19nature
. . , ... ." . " CERTIFICATE OF .SATISFACTORY COMPLET.ION
. ~ . , - .. ~ .
For Sanitarian ~se'Only: . .
I n accordance w.ith 1973 Oregon Laws .Chapter 835vSect I. on 214 th is. cert if i cate
.as evidence .01' sa"dsfado~y completion of a subsur.face ..sewage disposal system
location.. .-- :.-:. .
&t.Appr.oved:' System I~stallatlon conforms to. current standards
t::i Disapproved; ,Does not conform to current standards '.
Remarks: - 'c..' '. .
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. .RE-CEIVED ..
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M AY 2~,'19_7.~.
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;', tA~E COUNTY .
" . ~VllWNMtNTAL., MGMT.
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IS Iss~l". ..
at the above
,.
JI\l\' .;
, . ~~s' 'signature . .
.L COUNTY -,
ENVIRONMENTAL QUA~ITY
"._-
.C55-U. -
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. .
STA!E ..OF OREGON DEPARTMENT OF
.""
,,; . -~
..
.PERMIT 1F1!j/l~/,j ?-J.)
BEEN. APPROVED ~
-NOTE:
NO PERMI'
'ILL BE ISSUED UNTIL THIS APPLI,
rON HAS.
APPLICATIONFOR:~
CONSTRUCTION .c====J.
MOBILE HOME [)tJ
'pLAN REVIEW c=:J
ClIANG~ OF OCCUPANCY 0
. . ~ .~ - - ' .. . .
~ OWNER~!<lI'f"f..MI/Nj.:C' . qq~ N. J~.~it-r-
. '. . Name. '.,'. Address,.
. .....- . 'J..:. .' .
c=J CONTRACTOR. ""-" .'
~p I~PIr;L1)' '
I City
'q7LJ./7
Zip
- i7tL7- 5;:/ I [)
fhoue
.,#IIIA
- Name
~".
,
.Address
City
,Zip.:,
Phone
0.$. REG, II
--
Twp. /~ Range-O'1, ..~ect~on j I
SUbdi:iSion ~l' ~EIl\ G-tr<~ STIt-~Lot t+ f
ACC~SS TO PROPERTY (Road Nam~) ~()rz4. 8ft/< M/2
Existing Structures on pro'perty:.. -pJOME'
Tax Lot
Gode
Censu~
Tr'act 3r..:-tt!JJO
, I .
Width~DePth~
" Blci~k-.3
Property Acreage
~;;<d)4
J-I,aP2ol? .DiiIE
DP I Vi"' ... . /
5,()( )17it:r'? ~l:;- )( Tlf'efYJ I Tf' v;P ('It KEPI r.:rL
., ,. ;/
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Sq. Ft. ilBedrooms/- Valuation
.:1- .-
/
/
.'
. Property Locat;op. - Address/Directions:
Below for_Office Use
~~~~.~.
, ,~ ..-:' ,j,;; .. ~ -.. ~
~.-4iV$
SEWAGE DISPOSAL; . JO.A~
Sit"e .Inspedtion fl. 'T." _'-.,.-V
WATER SUPPLY.:
Well
;:J rJ, () ()
,eif/
.,
!
Owner ~ O=:J .
r
/ :..
'"0
.New System Requued C:=J fre-
' -/~
., ~
.Community or Public System ~
.,.
.Spri~g"
E~i;ti~g Sewage Disp~sal System. ~
Public' ~.:
Communi"ty,. ~
Ot.her
c
:
.FEES:
PLUMBING: .
Installed 'by
Name
Bldg__.
Waste Disp.
Plumb'i!lg
'Plan Review
Mobile Home
1% ,Surchar.ge
5l),oo
1/: 0. 0
PLUMBING FEES:
Sewage '-- .
Connec tion . d' t..
,.
Water
. Connection .::2 ,
TQTAL
fi-l.f. () 'i" ..
.-'0 CASH'
.'I:~.'
PLANS FURNISHED FACILITY PERMIT
.tfJbo'r . .~'
~YES c=J NO ~ Y~S NO_
Signature of APp~icant~/"''''Lf/--:'' '~!:f-~v
FeeReceivedBy:Q.p~ . Date: k-? "/,\-
'I' 4<;' r
"
~in. Septic T.ank Capacity~ ~ L 1DGa'infield 'Required - Lineal Feet i 5L:::>
Maximum D~Pth'
-'2,
:.
Type of Construction
.IV! J.{ . G,~up
i
Ffre Zo"ne
,Use' Classificat~on"
. Bldg.Se~backs - from Center. of Ro~d Right of Way:
Fronf;:/-W'f;:.~(J) Side Int. :~.. Side Exterior
"
" .
Rear'
s-.
.Zone'
iT
.(/>(,.4.-/1.1 /4.
<;:55-1.2
:'
..4/;~~n;~ .., ._ ~~:Lj/717~j)4~"~ ~_D?~~j_
LANE. COUNTY ~~ENT OF ENVIRONMENTI' MANAGEMENI
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