HomeMy WebLinkAboutPermit Septic Tank 1978-8-14
TRS, TL
17-03-24
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Job Location
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7t'-?t:;6:r
HAYDEN BRIDGE DRIVE
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Written Directions
Subdivision: CHURCH SUB: PHI
2 I
Lot Block l '
SITE FEASIBILITY REPORT FOR SUBSURFACE AND ALTERNATIVE SEWAGE DISPOSAL
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APPLICANT'S NAME AND ADDRESS JACK LOY 14'.66 HAYDEN BRIDGE RD SPRINGFI ELD OREGON
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Phone 746-3589
OWNER'S NAME AND ADDRESS
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Mail report to' ;(X) Applicant () Owner
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STRUCTURES NOW ON THE PROPERTY
SAME
) Prefer to pick up. Call
NONE
Phone
(owner, etc,) when ready.
P- ''\POSED USE OF PROPERTY . ,NEW DWELLI ~G SITE
WATER SUPPLY , I' PUBLI C WATER E Ml LE OF THE CITY,OF NA (NO)
-'.hereby certif~. that the above statements are true and accura:te, and that I have th ollowing I,tgalinterest in the property: XX owner of record;
contract purchaser;.' potential buyer;, realtor or agent. I fur er certify thatj(jf not the owner) I am authorized to act for the ,owner of
record, and that said owner is aware and approves of this ~tion. " t . ' ..'
NO~I f . JACK LOY 8/8/78
1 Signature'" Date
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TEST HOLES READY
._ * * * * * "* * * * * * * *.* "* * * "* * * * * * "* * * * OFFICE USE ONLY BELOW THIS LINE * * * * * * * * * ; * * * * * * * * * * * * *. * * * *
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".SFlE rn'MEETS STATESTANDARDS 0 DOES NOT MEET STATE STANDARDS,
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Zoninc
Acreage or Lot Siz~ 16.000 so
Partit'ioning # NA
Parce I #
LAND USE COMPLIANCE
RA '
ft: (TOTAL)
(,J Completed
( ) Pending
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THIS IS A PRELIMINARY REPORT WHICH DOES NOT ENSURE THE ISSUANCE OF A FUTURE BUILDING p;ERMIT. ANY PLANS OR EXPENDI,
TURES MADE IN RELIANCE UPON THIS REPORT ARE AT YOUR OWN RISK. IF SITE IS APPROVED, SEE REVERSE SIDE,
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AUTHORIZED StGNAT.URE
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Division 'of Water Pollution Control
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DATE ;'
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DONNALEE MElts
8/17/78
AUiHORtZED SIGNATURE
DATE
LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
C55-32 .
Permit Processing Section
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125 EAST 8TH AVENUE,.EUGENE, OREG'ON 97401
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687,4061
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OAR Chapter 340, Division 7, Section 72,020(6): This report shall remain in effect until issuance of a
permit to constru'ct, unless in the meantime conditions on this or adjacent properties have been altered in
any manner which would prohibit issuance of a permit, in which case this evaluation report shall be con,
sidered null and void. Technical'rule cn'anges will not invalidate any evaluation report issued pursuant to
this section. ,
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Before constructionis'.started bring this .form to 'the .Department of Environmental Management and apply'
for a building permit, Exact specifications for the sewage disposal system will appear on',thepermit. ,', ., '
'. . If the property is only a ~o.r~~on of a ta.x Ieit,. a partitionin~:orJsubdiv,ision m~.st. be approved before the'
permit will be issued. ,,' '.
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Only persons having a valid license issued by th~ Departm'ent of EnvironmenUI Quality under OR$' 454.695'
to install subsurface' Sewage disposal systems or a~ owner or contract purchaser or his regular employees
may ,install subsur:face sewage disposal systems. A certificate of satisfactory completion will not be issued
if persons other than the above perform the installation,
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PRatt PDsn..,
Subdivision C.~, ( t - "-..-\;""
Lot--==-\.~::2. Block
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Vicinity Map
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Job Location (Address)
Permit ulip-, b~ln For"',~ -,.-\""
Permit U For
Permit U' For
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SITE EVALUATION WORKSHEET
LOCATION:
17
_/ <-/ TAX LOT #
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TWP.
RANGE
(9'7., SECTION
ZONING:
PROPOSED USE:
SIZE OF PROPERTY:'
AMOUNT USABLE AREA: /L~-b
PUBLIC 0 INDIVIDUAL I " I
WATER SUPPLY: COMMUNITY IKL-
SUBDIVISION/PARTITION
LOT
BLOCK
PARCEL
IF SITE MEETS STANDARDS FILL OUT:
Type of structure and approximate sewage flow:
'J<ro
Single Family
Industrial
Multi-family
gpd
gpd
Institutional
Commercial
MINIMUM DESIGN REQUIREMENTS:
Length of disposal trench required
1&0 l.~
. serialJO .
No [Rl..
Distribution Method:
Curtain drain required:
Other:
Equal [@--
Yes 0
SPECIAL SITE. CONSIDERATIONS OR VARIANCE OPTIONS OR OTHER ALTERNATIVES:
NAME:
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DATE OF EVALUATION:
C74-l26
gpd
gpd
gpd
/150 gal.
S1# / f' - ref'.
#'1 TEST HO
PERCHED WATER
Predicted
Observed
Date
in.
in.
PROFILE
Inch
# 2 T E S H 0 L E
PREDICTED WATER PROFILE
Predicted in. Inch
Observed in.
Date
SATURATED ZONE
12 -
~IC(
L(J ft<,.-
12 -
SATURATED ZONE
Predicted
Observed
Date
in,
in.
24-
Predicted
Observed
Date
in
in
24 -
Restrictive Layer~
Impervious Layer- . in.
Mottling vvt1u.Q. ~n.
36 _
if. .1
1Q'
'me
48 -
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36 -
Restrictive Layer
Impervious Layer
Mottling
in
in
in
48 -
FS' 4 fJ,
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SLOPE -#,,-h/
SITE DOES .0tJ DOES NOT
ADMINISTRATIVE RULES
60_
SLOPE ~
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60 -
o t;1EET MINIMUM STANDARDS.
REOUIRE ~ MINIMUM DEPTH OF:
ON YOUR PROPERTY ~ DEPTH
~:
0 36 inches to an impermeable layer
0 30 inches to a restrictive layer
0 60 inches to a permanent ~ater table
0 24 inches to a temporarily perched water table
OTHER REASONS FOR DENIAL
inches
inches
inches
inches
jllli++L++'11 ,"I: I :_=::1-1-; III: 'I:: I +H-J I :' ,11_'f-': l'll'-:.-:-~
PLOT PLAN: ,,+;j+H-+c.l-4. .rl rrtT +' I U I I II 'I I' : i
Stream I : ' , ! I-t Lt-, ~J= .::'- = +.:::: ~ .::t:_t-L, -H- -i+!- - T:~=l= -1- --;-i-- -I t 1:::::1:: ~='::::J:t ~
Drainage or [111 :-, -~I I t[. -:::Fr,=--'tttrtLtt'l ,:..!1tLl~+ .l~. ~r::!=2=t-HtI
Pond rr-' H...L11 1 i rj-- +I'+t:-::1'1tl:j;i~ II, I , I: 'rTt ,--H-H-; , I ; , ,
I ' +1-:1 ' ..Ll_'+ 1<'-~e;P~ 0~ I r _...L I I II I I ,
~~::"..,...." #I:::t = +~I::l"1-: (#~~tJ=,i' ~ : J8i=L t7r1 :r rH R-:: +"- = + l- t tt:1: -, H-t
I I ll~ ++- J: I I -!,...I I I I I I I I I I
----:., I'!IIIIIII'::'::-'-,., -'-'---'--'-111 I-I, I~ 1'-1--
Test Hole QD :'I!I::- H--=H11 J~j==+j:t:::,--i-:III_ __11,'~1 +-L ,+' I _J i 1 -+~I ='::'::=_1 =:
, 1 "" I r + I .++ I ' _, I II I I I I
, "q I ++_...L-!-' II ..-- II I' J II ,+ ' 1,--1
~ % Slope Hf+-I; j'--i-i--'J-c:-=:rr:1----' .-f-J- ' ~ '+, T' -H-~- 111-1
1-:, il__p.::"== . -~.:::::~::H:r.::~=:------'--t=:=.:::t ,- II '':::;:-, 1
Cut Bank H'i : I 'I==~::::=-+I-':_L== ::tt-4:J--:'-j1::' - -I'i. "-1- '~=-,-II ! __=1+_..1 I ~~Fl
; i ; , I , i+l I I I l-L -L--' -+-.1 _ + _ _ __.
~e~ce' , II i ! , -===-, ,_'_ II '+I?=='_: ,- , - _I_'l. __~I::=- _..I ' i :.. i-i 1'-
I' ; I' I -I TfTTT-, "--- -- 1---. I tj i! I I --'IT-----t--
~-K-)f ~!,t---'===t=~ t1=l=-, ,--;-- -::-::j::j::Cf,-,-'-!~=Ml-.::=.::-, '----1 ,=::
::!t:-----I+r-::::j::Ll++I--i..:--,- '-I '1111 II, ;.!' ~++ II I
::1 I I i I :-++1-,-' t!::t:t=l::tji:::~..I--: I ! II . I : : . :=+=1 ! : j :- - -::1 : : I U. I
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LANE COI "'TY DEPARTMENT OF ENVIRO'NMEr-JTtI,L MANAGEMENT
I:L ..:AST 8TH AV~ENUE. EUGENE,OREC ,97401
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Current Zonlng ~ fEE
[]pending [JCompletcd
PLAN~lNG 'DIVISION~
AVERAGE PROCESSING
TIHE
Partitioning ._
Parcel No.
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Partitioninq Required
Other!
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c=J- WATE~ POL~UTION EO~TROL
~Site Inspection (sr:--~
SOS Con~truction LJ New [J
Number ot Bedrooms I
S1t(2)
s
s
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t' ot.
Repair -
Commercial/Industrial -
Other'i.
, .ot- Employ~e8
C'll '6/
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0,. :CONSTRUCTION PER."IITS AND INSPECTION
(See above tor I ~~ bedrooms/I of employees)
tj ~~bile ~ome:
o Permanent
o Temporary
, 0 Renewa 1
Stru<;:ture
L
FEE
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Sq. Ft.
Valuation
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S S
S Each S
\ I:ach S
Subtota 1 . S
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S
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~otal V-,lu,"ltion
_____ Plumbing fixtures at
Scwe~/Wiiter Conn. ",t"
., State Surcharge
Pl'ans Check Fee
Change ot Occup~~cy
TOTAL BUILDING PERMIT FEE
s .
"Minimum. structural, eetbacks:
From ,centerlineot street: Front
Exterior Side
Address
from interl~r lot lin~5:'
o Co~',1.plan5 sheet to
Sidc______ R~ar.
appli'cilnt. 0 Curb cut to <'Ipplicant.
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PUBLIC IJdWS D Address 0 Nin'imum Elcv.'tion
PUBLIC WORKS. 0 .f/'lCill'<t:~~t";I) ()_
EINIRO~j:-O.L:lT/'\.L IIEAL~~("
Chec, I \oL\('~ncC'd i,y~ ,~, \.O~^I.
IMini~um Elevation
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Ca.llh
AFf'IDA'JIT:. If'-.-this permit is.'for an agricultural building, I hereby.declare that" this buildln-q
will be ..t.r~ricultural, purposes as .1Ho....ell by zoning and/or the State Building Code. .'and
for no her purpal. I further certify that the statements and other informa,tion submitted on
this IIp 1 .'n are "true a'nd'accurate, and that I have the following legal. interest in tlie
propcrt : wne' f record'; c('mtr:1c,t purch,lSerj l(~s$ce; holder of <'In exclusive option'
ta purch, e; y authorizQa-lo act.for "" person whohasth\.l. fOllowing leqal intercst:
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, . '; or th.'l,t the o"'TIcs..- f :~e~ 15 kno....} ~c,lblc of th1S
~~p~~~~,'m f:\Q ownec-r furth.e a'Jecc to c mp1'b h ,<1"r ','.''''0 codcs eclatlnq
Dote -/ ~IIIS IS~:D:C:::~:P::"~::~::ES ~ 'PE-~:'mON TO BL/
FOR INFOR..~ THE PROGRESS OF YOUR APPLIC^TIO~l. CALr. PERMIT CONTROL, 687-4357 (687-HELP)
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Vicinity Map
C74-150
Job Location (Address) ,
Permit II\{PyB,l.olo For~A-<e.
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