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HomeMy WebLinkAboutPermit Septic Tank 1994-11-28SEWAGE DISPOSAL SITE EVALUATION s.l #fl-gto .5b Ct*-''A V E4-o #Job Written Directions + Subdivision:Po l',lr'to,.. -".8 7_Brock-WATER SUPPLY U APPLICANT'S NAME AND ADD OWNER'S NAME AND STRUCTURES NOWON THE Nc.,r^'e-PROPOSED USE OF PROPERTY Phon e 12Q -132L Ptrone-?YG:1-83? E-- !- I herebv certifu that the ts ieartorLragent. above statements are true and accurate, and that I have the following legal interest in the property: -owner of record;-contract purchaser; -potential buyer; I further certify that (if not the owner) I am authorized to act for the owner of record, and that said owner is approves of this action. -EST HOLES q Signat .. i * rtr *r*** * * * * **r******i *** * **** t***** * * *i*r***.* * oFFlcE usE oNLY BELOWTHIS SITE MEETS STATE STANDARDS Standard System Sand Filter 1 Foot Capping Fill NO tr tr n YESNO n n tr YESXn u Low Pressure Distribution Holding Tank Other LAND USE COMPLIANCE Zoning Acreage or Lot Size CIOTAL) Partitioning #-Parcel ) Completed ) Pending COMMENTS: FLOODPLAI N I NFORMATI ON THIS IS A PREL]MINARY REPORT WHICH DOES NOT ENSURE THE ISSUANCE OF A FUTURE BUILDING PERMIT. ANY PLANS OR EXPENDITURES MADE IN RELIANCE UPON THIS REPORT AR RI tr Approximate Study Area tr Detailed Study Area tr Floodway All or part of this site may be in a flood hazard area for which 100 year flood levels have not been established. Extra precautions may be appropriate to assure that the building site will be reasonably safe from flooding. All or part of this site may be in a flood hazard area for which '100 year flood levels have been established. A building elevation above the 100 year flood level may be required. All or part of this site may be in a flood hazard area in which a floodway has been designated. Building may be prohibited subject to demonstration that the cumulative effect of proposed development will not increase the 100 year flood level at any point. E IS APPROVED, SEE REVERSE SIDE. ,rk/r/-----r--Fm LANE COUNTY c55-32 ENVIRoNMENTAL HEALTH, 125 EAST 8TH AVENUE, EUGENE, oREGoN 9740t (687-4051) TRS ,.- l L* oate-Xe-y'Ja /-9-Y(\ta*lltttlttttt**tttlattttttttl*ltltttattttttttllta tr tr tr t ,rg' t Gr-,\/v L)t)t tr,,!r lr) e,o \ o .4 5 A LbJ u 3 FJ IL L) Nf{ St) \., A \ l-l ( I IJJ ; 4 2t6l \9 ?l dl (. Ilir-lJ I{la-l SI L$l >l UI Al $ s ,- 5 Lr- l f So,o oo ll l 5 <t o V) 3\rl afi VE{?* tt)\] J I L : a2 Kt4 { L ft. z 6(\ti: E,u J? osq- b I \ $ 1 6,t5t *^!;;:;l ,f sr qd' so z a<tsAi ,OL /tJ N'" aSl\3,',_ zoa q \ /33 EA' ErnLur O e erq t'?l b 0 \x ?3.?? rn st?{ <(' s t3i' l{ 'i] fJ -l: r.J ,'y231 B? 3,f -2)/ 1l t 7 g 3. Yq ,ll'tt:: - -i__-:_I'i ,la"o @ /zt o o d ,L'306 o o a lL'3oo 1€ ,li $n "l L' \d s 30? q Zt.fr,o )oL ftc _tr $? 1?- ptl -€;'tprf .ia? 2/ u r.i t -4 "n9 K /O 41'l 34G c 6L qrs& 0 @ 73.ft, 1.9 9o.b Y ou^zoA tt)- ,,1,f,vt t It I I I @ @ c I at TI fl fl lrj :3 LANE: I$UNTY IIHFI'EINV 1461'ltti*trll-'T * ?4t1510 DATE AI}F,I*]:CANT F.ISI-]-E, TIH ADSR 319$ LOI'{T}ND, SI.'RINGTIHLN 1'L+ { ?03?40t}00?CI? sutrDlv t-ilT $ Nt-"1, Erl-DG TYl:j,la USH lt E(DttMS 0 UNI:1'S 001 S'f0ftIH5' *HLD[$ 00{ l-'l{0NE 7;:? flLJtlEIt NHH LIAftTIIN$II:, DIHNIS AD$f( NA, rfiDI. AI}PI-. N$ AITI$N DHS{:}IIF'T'ICIN SIl T:T UNI'I' {:$"qT VALUAT'IfiN F EH BP BF. FF trF' I+F F'J' " It A l: i.i t! ,it:tS " tt0 ,: ".. f.l 1.1 {{t$9.d iiJt- l( J' II,rir ii & T I ll.-lrl I ,.! L-r rt ,.! l. j' Ul:u ,ii'f' I X/llAf i'l i-fi ?401:;1 t:t I: I txlit: iiLJIl : [rJ'" i,J'l'Il : i-iHill'lili'l :t {:Al- f:'H[: ,11'A 1'[:: ;tt.J]':il l{AHG E: l:lL..r\N {:l{tifii'; F [itr 1 f,I tr/ -t tn ,1t: b,, - tjr|l'li: $:'LN S il.tllj : 'IAK.i:.'r.{ LrY i.ll-f, (t'ir) i. !:tA SDS F"t-[:: l]ilK l:ii$ ,r ,$ I t r-sT . L:tiHF l-ti.]'1.flN'tlATtl tlTrr $tj.Ii}:.;.::tT *r(1?40 " O(r [:K i l::