HomeMy WebLinkAboutPermit Building 1979-08-23POST THIS PERMIT ON MAIN BUILDING AT SITE
tbe eooRess' t /Jo rJo,n coNsrRucrroN pERMrr #
ins, tL, subdivision:
This permit for the re'erenced propertY is hereby ' setbacks and other conditions of approval must be strictly observed. violation canresult in revocation of this permit, citation under prcvisions of Lane county's lnfraction orainance. analiioit Ji i"-r-J.,-""
"rro*"a oy r"*.
Applicant/Address:
Owner/Address:
Contractor/Address
Contractor's OS +Total Construction Value
Construction roved by this permit:
Telephone: '' '' -'' .' ^
Telephone:
Telephone:
Water Su
PLANNING DIVISION
WATER POLLUTION
CONTROL DIVISION
Zoning: Partitioning +
lVlinimum required structural setbacks, from: ce
side exterior: ; interior property lines:
Special lnstructions:
For information call 687-4394
+ Bedrooms:+r Plumbing Fixtures:
Parcel +
nterline of road, front:
;rear property line:
Parcel Size- ; centerline of road,
gal. min. septic tank capacity;
+ Employees:
Site lnspection + lnstallation specif ications:
lineal feet of drainfield required; max. depth of trenches
Special lnstructions:
ECAG'}
(
Setbacksr-eiior property lines
;e of road right-of-way
Building foundation
Wells, other water sources
CONSTRUCTION
PERMITS/INSPECTION
DIVISION
10'
5',
Type of Construction:
lnstructions:
Group
between 8:00 - 9:00 a.m.
Septic Tank---lo-Drainf ield--lo-
10'
10'
1 00'
I
50
Fire Zone Use Classification
For plans information call
For ins
By:
and 5:00 p.mons (see back of this
between 8:00 a.m. and g:00 a.m.
rmit) call 687-4065 between 8:00 a.m.
Directions to Site:
Date lssued:
lane county
DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
COURTHOUSE / PUBLIC SERVICE BUILDING
125 EAST 8TH AVENUE, EUGENE, OREGON 97401 .
(
For information call
SITE INSPECTION
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FOUNDATION INSPECTION
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FRAMING INSPECTION
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CERTIFICATE OF OCCUPANCY
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HOI,D SLIP ffi!'
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APPLICATION #
Name
Address
Z ip Code
The Lane county !{ater porution contror Divisfon cannot proceedwith processing your application because:l. Incomplete appl ication ( items deficient).
Address and/or directions to application site.
Proposed Number of bedrooms in dwelling.
Approvable plot plan (see attachment).
Notification of date test hores wiil be ready.
?. Verif-ication of existing system required (memorandumexplain'ing this proceduie ittach"di: -- \'rrY'| rvr v
3. Two test hores (ztx4'x5'deep) required for expansionor repair of ex'isting sewage disposal system in the
area of the proposed drainfields.
4. Other:
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I,t74-lBl
hIATER POLLUTION CONTROL DiVISIONr25 EAST Bth AVENUE / PUBLiC SERVICE BUILD
II NG
ENVIRONMENTAL MANAGEMENT DEPARTMENT.
/ EUGENE, 0REG0t'l 97401 b6/ -4uo I
I
lane courrty
HOLID SLIP
APPLICATION #
Name
Address
p e
The Lane County Water Pollution Control Division cannot proceed
with processing your application because:
I . Incomplete appl ication ( items deficient).
Address and/or directions to application site.
Proposed Number of bedrooms in dwel 1 ing.
Approvable p'lot plan (see attachment).
Notification of date test holes will be ready.
2. Verification of existing system required (memorandum
explaining this procedure attached).
3. Two test holes (2'X4'X5'deep) required for expansion
or repair of existing sewage disposal system 'in the
area of the proposed dra'infields.
4. Other:
M74 - i81
WATER POLLUTION CONTROL DIVISION _1 ENVIRONMENTAL MANAGEMENTr25 EAST Bth-AvENUE ) -- i;[sirc SrnvicE BUTLDTNG / EUGENE, gREGgN eT40r
rtotE]I[M1
lane countyHOLI} SLIP 6l!'
-Z
w'ith
APPLICATION #
Name
Address
Zip Code
The Lane County Water Pollution Control Division cannot proceed
processing your appl ication because:
I . Incomplete appl ication ( items deficient).
Address and/or directions to applicatjon site.
Proposed Number of bedrooms in dwe11ing.
Approvable plot plan (see attachment).
Notification of date test holes will be ready.
Verificat'ion of exist'ing system required (memorandum
explaining this procedure attached).
Two test holes (2'X4'X5'deep) required for expansion
or repair of existing sewage disposal system in the
area of the proposed drainfjelds.
0the r:
aL
3
4
M74 - 181
WATER P0LLUTi0N C0NTR0L DIVISION _1 ENVIRONI4ENTAL T,|ANAGEMENT125 EAST stt-AvLNuE / -- p[errc SEnvicE BUTLDTNG / EUGENE, oREGoN e740t,,otE]I[U[.r
lone county
HOTID SLIP
fufN z,r-.-tb.fu-za-"-
0!'--APPLICATION #
Name
Addres s
Zi p Code
The above appfication is being held by the Permit Processing Sect'ion for the following
reasons:
Di vi s'ion :
Signature DateALr"
---=:----4
on:
Si gnature:
Thi s appl j cat'ion wil I be hel d unt'il
required above has not been furnishe
Fees paid for waste disposal systemsthe septic tank and drainfield) are
bui I ding and pl umb'ing portion of you
v at date your app
Date
If the information
ation will be cancelled.
appl i cati ons to i nstal I
d ma.y be made on the
ion is necessary.
csite inspections and/or
nonrefundable. Some refunr application if cancellat
In the event a Plannilg or some other lgn_g. term problem exists over which you haveno control we w'ill hold the permit untit the problem is resolved and we ieteive-wordfrom you as to whether to prbceea with permit issuance or process a cancellat.ion.
PERMIT PROCESSING SECTION - 687-4394
c74-t39
?el-o
v
TO
PERI.lIT PROCESSING
PLAi'IN ING
PUBLiC hIORKS
FLOOD PLAIN MANAGEMENT
Departrnent of Publ ic Works
I 25 East Bth Avenue
Eugene, 0regon
687-4] 95
PERMIT NUMBER
PARTITION NUMBER
SUBDIVISION
OTHER
SITE ADDRESS
PERMIT VALUE IS A SUBSTAI{TIAL IMPROVEMENT.YES NO
SITE IN FLOOD HAZARD AREA YES NO
SITE LOCATION IS WITHIN A FLOOD HAZARD APPROXIMATE STUDY AREA, EXTRA
PRECAUTIONS MAY BE APPROPRIATE TO ASSURE THAT THE BUILDING SITE l^liLL
BE REASONABLY SAFE FROM FLOODING. MOBILE HOME TIE DOl^lNS REQUIRED.
SITE LOCATION iS WITHIN A FLOOD HAZARD DETAIL STUDY AREA.
MINIMUM FIRST FLOOR ELEVATION OF
MINIMUM FOUNDATION ELEVATION OF
RECOMMENDATiONS:
I
2
3
(M.s.L. ) REQUTRED.
(M.S.L. ) REQUTRED.
MOBILE HOME TIE DOI.'NS REQUIRED IF GROUND ELEVATION THAT MOBILE HOI4E
WILL BE PLACED ON IS BELOW THE REQUIRED MINIMUM FIRST FLOOR ELEVATION.
4. SITE LOCATED I^JITHIN A DESIGNATED FLOODI^IAY CHANNEL, BUILDING PROHIBITED.
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DATE
c99-2t
BY
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JOB ADDRESS:Avenue
TRS, TL Lt-o3-z2.I,t & Z Qoo
POST THIS PERMIT ON MAIN BUILDING AT SITE
CONSTRUCTION PERMIT +
Subdivision: [berneo Grove, Lot l
LC-L651-79
This permit for the referenced property is hereby approved' Setbacks and other conditions of approval must be strictly observedresult in revocation of this permit, citation under provisions of Lane County's lnfraction Ordinance, and/oi other remedies allowed by law.
Violation can
Applicant/Address: Benrry Gilnore, 211 North llth Sprlngfleld, Oregon 97477
Owner/Address: sare
Contractor/Address: aaae
Contractor's OS + 2622800 Total Construction Value: $691939.00
Construction approved by this permit
Water Supply: Ralnbow Water
Telephone
Telephone
Telephone
14?-tt*t1aa[e
same
Ih.rplex: Main @ 2O2l aq ft1 Z-garagea G 588 eq ft each celllng heat, wood etove; see
supplenent 86 and lnstaI1 wood stove.
Stnrcturea not' oo property: none
+ Bedrooms 1 41 2 eac\Plumbi ng Fixtures' 14 * Employees: oa
PLANNING DIVISION Zoning: Partitioning + Ea Parcel +r na parcel Size: 1Or80O aq ft
Minimum required structural setbacks, from: centerline of road, front: 19t**; centerline of road,
side exterior: 56t*rtfinterior property lines: 5t ;rear property line: 6r PIIE
Special lnstructions: ** Front setback 1s also: '45f ltiln and Klrk Street, sl.de setback Le also; 45r uain
and Nona Street.
For information call 687-4394, Doanalee l{elgs
WATER POLLUTION
CONTROL DIVISION
Site lnspection + 79-92 lnstallation specifications: 2000 gal. min. septic tank capacity;300 lineal feet of drainf ield required; max. depth of trenches: 24"
Special lnstructions: Install an equal dlatrlbutlou redrmdant eyeteo of 300r each syeteo
Setbacks
I nterior property lines
Edge of road right-of-way
Building foundation
Wells, other water sources
Septic Tank
-T0-10,
5',
50'
OUU ffiontheattachedp1otp1aaapprovedltag22,L979.(copyattached)
DrainfieEf there ls a well La the ehed or thls property lt ls to be properly abandoaded.
-TO'-I-f for sore reaeon thls system cannot be lnetalled exactly as shonn, this pemlt
10' 1111 uot be vall.d. Malntaln 10Ot setback frou aoy wel1.
10'100' For information call 687-3960 between 8:00 - 9:00 a.m., Kathl. I{lderhold
CONSTRUCTION
PERMITS/INSPECTION
DIVISION
IJ,?,.',:1,:;I*'HEE.Ia,.3II "r.u. Tp$,-rt-?", ,5dll38E'io"i."troouse crassirication IhrpLex
For plans information cal
For inspections (see back
I OAfltdT between 8:00 a.m. and 9:00 a.m., r{nof this permit) call 687-4065 between 8:00 a.m. and 5:1D
L@bp.m.
Directions to Site
Date lssued:
c55-1 3
i _ -^ o8tor 18t street to rlght to Klrk Street,
O1;1.3gf6 Earlow Rd, dorn GaEe I bne county
DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
COURTHOUSE / PUBLIC SERVICE BUILDING
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
By Roger L.il!'
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POST THIS PERMIT ON MAIN BUILDING AT SITE
JOB ADDRESS: a. /Jo l.)oli CONSTRUCTTON pER[4tT #
TRS, TL: Subdivision:
This permit for the referenced property is hereby ' Setbacks and other conditions of approval must be strictly observed. Violation can
result in revocation of this permit, citation under provisions of Lane County's lnfraction Ordinance, and/or other remedies allowed by law.
ApplicanvAddress: Telephone:Owner/Addr6s: Telephone:Contractor/Address: Telephone:
Contractor's OS # Total Construction Value:
Construction approved by this permit:l'ritl!}Brlm Hri* S ffxll'{ frt tr... srtoa 0 SSs rtr ft ech tirllts* h.rs, md-r stara8
Water
PLANNING DIVISION
+t Bedrooms:+ Plumbi +
Zoning: Partitioning + Parcel + Parcel Size:
Minimum required structural setbacks, from: centerline of road, front: ; centerline of road,
side exterior: ; interior property lines: ;rear property line:
Special lnstructions:
For information call 687
tr{w* $tm*tr
WATER POLLUTION
CONTROL DIVlSION
-4394
Site lnspection + lnstallation specifications: gal. min. septic tank capacity;
lineal feet of drainfield required; max. depth of trenches:
lnstructions
&strl *s
fnal!. !r fryill df#qrfi, uefi.ts .,pa€F gf 3t$t ruh ryrrtgm t$r rtrl3ftd plot ptr.m ryfq* tilrg 22, l,*fiI" (copy ErtrGhcri)
Setbacks
hterior property lines
Edge of road right-of-way
Building foundation
Septic Tank
10'
10'
5',
50'
Drainfield
-T0'
thprr Ir e '!s th 6d sB thlt prop.rt' !.t lr to bc froP:el, sb.odta{tGdfr,r rrr rtilEtr,thle aElctm aaM ta tstrlls& {ilrctly an r&m* tft{lc pcmr.t
10'
10'
1 00'
rlll cot hc rrf&io HltoEllll IOot -r!brc&. tror rIIy E Il.
Well other water sources
CONSTRUCTION
PERIVIITS/INSPECTION
DIVISION
F on call between 8:00 - 9:00
Fire Zone: Use Classification:IhrpIGType of Construction:Group:
lnstructions fisc tsnsrao rldo of p*d,t for rc4elred f,nrfmt ffio,
For plans information call between 8:00 a.m. and 9:00 a.m.,
For inspections (see back of this permit) call 687-406b between 8:00 a.m. and S:00 p.m.
mrdf E*lEs Ed, dm 6re .rrril" lit rttrcG E rtsht gE rlIk, strrat,lane countyDirections to Site:
Date lssued:By
DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
COURTHOUSE / PUBLIC SERVICE BUILDING
125 EAST 8TH AVENUE, EUGENE, OREGON 97401c55-1 3
Iktrs Lr Fffieklnlly 6l!'
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€1*B FLOOR
PLUMBING GROUND/ORK
Apeiroveo E DrsrppnovEo
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Dar e NSPECTOR fuL
GAS PIPING GROUNU/ORK
Ap pRov r o
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DrsrppRovro Darr.I Nsprcroh
ROUGH PLUMBING
Appnovro E Drsappnove, D DarE.
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rruspecron n 21
ROUGH GAS PIPING
AP PRoVE D
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Dt sappRovro Dar r I rusprctoa
F I NAL PLUMB I NG
I ruspecron ftLAppnov r o
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FINAL GAS PIPING
AppRoveo
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DrsappRoveo Drr e I usprcton
CERTITICATE OF OCCUPANCY
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TRS, TL: 1?{}3-3?
This permit for the referenced property is hereby appme'I'
Construction approved by this permit:
POST THIS PERMIT ON MAIN BUILDING AT SITE
CONSTRUCTION PE RIVI IT +IS-1651-19
Subdivision:
Setbacks and other conditions of approval must be strictly observed. Violation can
result in revocation of this permit, citation under provisions of Lane County's lnfraction Ordinance, andlor other remedies allowed by law.
Applicant/Address:
Owner/Address:
Contractor/Address:
Contractor's OS + Total Construction Value:
Telephone:
Telephone:
Telephone:
."t o''/ l'{,a-
3H
+ Bedroonrsi # Plumbing Fixtures:+t Employees:Water Su
PLANNING DIVISION
IArtor
Zoning: Partitioning + Parcel +* Parcel Size:
lVlinimum required structural setbacks, from: centerline of road, front: ;centerline of road,
side exterior: ; interior property lines: ;rear property line:
Special lnstructions: *t p1'5sxt a&trrctr l"n a1.mc 45t itflln and H1l* Str*at , ddr l:b.ct, tr rLer ll5f min
and flrprr Stfont.
ol
WATER POLLUTION
CONTROL DIVISION
For information call 687-4394,
Site lnspection + lnstallation specifications: gal. min. septic tank capacity;
lineal feet of drainfield required; max. depth of trenches:
500
Special lnstructions:
Setbacks
nter tor property lines
Septic Tank
-10-10'
5',
50'
Edge of road right-of-way
Building foundation
Wells, other water sources
DrainfieEf timra is s ft}l la ttro shfrd oq thl,s prlrperty tt ls t& bs proBarly abs*drm.l*d,1,'n--T0-lg for em r€esn thr,s stgt@ f;a'$tsfit be LnatellGrt *lractly es atrena, lhi.a parnlt \.."-J10' wll-l nnq he valld. HalaBela 1tX)f nathack frrm Rty lcrll.
10'
1 00'For information call between B:00 - 9:00 a.m.,
CONSTRUCTION
PERI\4ITS/INSPECTION
DIVISION
Type of Construction: Group: Fire Zone: Use Classification:
I nstructions:Sor rc*urm atdo of Ftrdt far romlm{ &*:nrctlmrr
For plans information call
For inspections (see back of this perm
between 8:00 a.m. and 9:00 a.m.,
it) call 687-4065 between 8:00 a.m. anA dhtffih
lane countyDirections to Site
Date lssued:
c55-1 3
q-lfff eln trdr dffi Oil .f$rr lrt rtmc to rtgbc ED lr-t* rtrrrt"
DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
COURTHOUSE / PUBLIC SERVICE BUILDING
125 EAST 8TH AVENUE. EUGENE, OREGON 97401
By:Asgar L* I*nolclt*/ly o
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Wattr Pollution
Control Division
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Lane County)
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Subdivision lh tot 7 BlockYICINITY MAP
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FOR SANITARTAN'S USE ONLY: Edstem Approved fl System Disapproved
COMMENTS
Si re Date:
FOR INSTALLER'S USE: Trench DePth Filler De Tile
Tank Capacity lgoc Manufacturer
Mleasured distance to well from tank from drainfield
PLOT PLAN
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INSTALLATION RECORD AND CERTIFICATE OF SATISFACTOR
When signed by the County Sanitarian, this certificate is evidence as per OR
isfactory completion of a subsurface sewage disposal system at the above locat
Return this forirr to: Permit Processing Section, Department of Environmental lVlanagement,
Public Service Building, 125 East 8th Avenue, Eugene 97401N ."y4r
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TO:
PERI,IIT PROCE
PLAi'IN ING
PUBLIC WORKS
'I NG
FLOOD PLAIN MANAGEMENT
Department of Public trllorks
I 25 East Bth Avenue
Eugene, Oregon
687-41 95
PERMIT NUMBER
PARTITION NUMBER
SUBDIVISION
OTHER
SITE ADDRESS K /,,,:. .<TI
PERMIT VALUE IS A SUBSTANTIAL IMPROVEMENT.
SITE IN FLOOD HAZARD AREA YES
YES NO
NO
SITE LOCATION IS I^JITHIN A FLOOD HAZARD APPROXIMATE STUDY AREA, EXTRA
PRECAUTiONS MAY BE APPROPRIATE TO ASSURE THAT THE BUILDING SITE l^llLL
BE REASONABLY SAFE FROM FLOODING. MOBILE HOME TIE DOWNS REQUIRED.
SITE LOCATION IS WITHIN A FLOOD HAZARD DETAIL STUDY AREA.
I. MINIMUM FIRST FLOOR ELEVATION OF
2. I'4INIMUFI FOUNDATION ELEVATION OF
(M.S.L. ) REQUIRED.
(M.S.L. ) REQUTRED.
3. M0BILE H0ME TIE Dot'tNS REQUIRED iF GRoUND ELEVATIoN THAT M0BILE H0l4E
IiJILL BE PLACED ON IS BELOI,.I THE REQUIRED MINIMUT'{ FIRST FLOOR ELEVATION.
4. SITE LOCATED I,JITHIN A DESIGNATED FLOODWAY CHANNEL, BUILDING PROHIBITED.
RECOMMENDATIONS:
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N 9\,* - DE'ART'iENT oF ENVTR.NT4ENTAL T,IANAGEMENT
NU corut 4,{ l1,rk /
PSB, I25 EAST BTH AVENUE
EUGEI.IE, ORECON 97401
lUcrVa-
Appl ication #
Add res s City
ship, Range, Section, Tax Lot
'lvlslon
Structures now on the property
Proposed use of property: /l Residentjal /_7 Commercial l7 Industrial /-/ Publtc
Lot .- Block
Affidavi t: I,
If this application is f
Lane County Code Chapter. owner of record;-----du ly authori zed
ease pr ntoranacul tural bu lding it vrill be usedl0 (zoning) and for no other purpose. I have the following legal interest in the prope
con tract pu rcha ser ;lessee;holder of an exclusive option to pu
to act for the owner, who is lni-wl edgeabl e o th s appl ication.
(zip)
hereby certify that this information is true and accurate
for purposes allowed by the State Building Code and
rty:
rchase;
S i gna tu relAdd res s
Te1 ephone or Date
l^lhen permit is ready notify: , Applicant
Owner
/-/ Owner /_/ Contractor !X
(zip)
l-/ mail /_/ pnone
Contractor (zip)
Phone
Phone
Con tractor' s 0SR#Plumbing by
If Commercial: # of stories
Residential: # of bedrooms
SI test holes ready
DO NOT WRITE BELOW THIS LINE
# of employees # of units
SDS: /_/ Existing, BP #
/J Proposed, SI #
Fee
Code Description Valuation Fee
$
$
$
$
Total Valuation:
P1 umbi ng f i xtures at
Sewer/water conn, at
4% State surcharge
Plans check fee
Change of 0ccupancy
$ i eacn$
,!, .$
Subtota l $
$
$
$
TOTAL
$$
// Cash
L( ,Check #
Received by
l,Jater Suppl y
Proposed _
Year Installed $
PERI,4IT PROCESSING Zone
l"li nimum setbacks: t, f ront
Part. #Parce l #Parcel Si ze
q
', rea r;t side ; int
Comments
To be typed on permit
By Da te
ft. of drainfielci; max. depth of trenches
WATER POLLUTION CONTROL
Instal I ation speci fications
3-g't
2()00
To be typed on permit
Te1 ep
'l . tank;
I
te *%4-
Di recti ons to site
Plans to CP&I
l^JPC
set(s)
set(s)
Hold 51 ip
to PCC
Da te
Comp 1 e ted
Da te
Requ i red
Date to
PCC/ / stF1
/_/ cP&l
/-/ YiPc
! Plannjng
/_t PuOlic l.lorks
, Elevation /*/ n/a
/ / Address
/_l Fac: I i ty Permit
/_/ Znutronmental Heal th
lx rnsta,&d
\gx/h4.k &"^
an&mttt*,
uru!./V'h/. )a!,(/yL* urril nnY fu uahd - f14a,k'w/zlh-
FOR INFORIIATI0N about progress of your application call Pennit Control Center 687-HELP G87-4357)
/a'
\.ip
Assigned Numbers
,1
Appl ication for
Sq. Ft. or
# of Sites
Unit
Cost
Exi sti ng
Job Address
Appl ication for
Structures now on the pr0per
::t $nd,.'.,tts#:l:ii i:i*tsFt#+$t'i M
Affidavit: I,..daan,t d/;,1/tn o ,.
1
DEPARTI1ENT OF ENVIRONI4ENTAL I,IANAGEMENT
PSB, I25 EAST 8TH AVENUE
EUGENE, OREGON 9740I
rlqilrt,tii
:{t:I:oetk:
tYoq e
i* ,liiflffiI#|i /_7 r$.ffie#rilitr e-r:::* u$il#.i*iil , rffi't#iii
t{_
.itt$i.S,rIEaii.i}|rlnr8sitntr.
_, hereby certify that this information is true and accurate
q4V hlLLA1,Z
ication is for an agricultural building
App I ican
'/&
Phone
Plumbing by
If it wi'll be used for purposes allowed by the State Building Code and
(zoning) and for no other purpo se. I have the following Iegal interest in the property:
older of an exclusive option to purchase;unty Code Chapter 10
of record;contract purchaser;
au thori zed act the owne ls
Si gnature/Address
Tel e
l,,lhen -perm it is ready notify
0wner
ntrac tor
Contractor's
'lessee;
[nowleZ!'eab1e o f-TEr-s app I i cati on
h z z1
or Da te
/_/ Owner l7 Contractor !Y: l-/ nail
z1
z'l
P
Phone
If Conunercial
Residential:'*5uffi -- ai'!Ylk-'t4/---7]7 existins
/-/
Tota l Va.l ua ti on
Va l uati onr,:EeA,.,
tqF€
SI test holes ready
ik$rfil:ptif ili
Ans{F SES
/_t Ba..ua.-
ffiiiiiifitiiirid-i iffit#i
,#r,fi.tl.i.$it+s,,. .$$ti Fee
t$
--<-\
at
at
$
$
Subtota l
each $
each $
$
$
$
Received by
Water S
Proposed _
Year Instal led
t, front
Conrme
To be typed on Permi
Group
Part. # _4
4% State surcharge
Plans check fee
Change of 0ccupancy
Parcel #
$
Exi st i ng
TOTAL $
lze
, side
Fire Zone
{yt4g.rr.;,-jnt.
U-O C>-crv
L)
Use Classification
rea r
By Da te
CP&I Type
To be typed on permit
By Da te
P
Da te
Compl eted
Date to
PCC
For plans information calI (area i ctor)
tions to siteD
l/ stro Plans to:
{ccar2( uec
/7 Planning
/-/ Public l^lorks
& Elevation /-/ n/a
( nooress
/ / Facility Permit
tt Ju;ronmental Heal th
CP& I
t^lPC
set
set
(s)
(s)
Da te
quire
Ho ld s]
to PC
p
Re C
b//b
FOR INFOP.MTION about progress of your application cal1
c74-L7L
permit Control Center 687-HELP (687-4357\
PERMIT PROCESS.ING
Minimum setbacks:
TqS,
Subd ivision I4OSSMAN
11-03-22.'1"*'"qN s.l. #
Job Location Novl Sr. lNo KrRE AvE., EueEruE
Written Directions 0rr or Hlnuow Rol ltro oowr.r Glr.,rE FlnM 8olo. 1sr. sTREET To RlcHT.
Lo -7t B lock
SITE FEASIBILITY REPORT FOR SUBSURFACE AND ALTERNATIVE SEWAGE DISPOSAL
APPLICANT'S NAME AND ADDRESS Ber.rr.rv C. G r ruuonE 2112 N. 11rn Sr. , SeR tNGF tELE, 91\77
OWNER'S NAME AND ADDRESS Si6M E
Phone -1 515
Phone-
t\t
Mail report to kX) Applicant ( ) Owner
STRUCTURES NOW ON THE PROPERTY
I
( ) Prefer to pick up. Call (owner, etc.) when ready.
2 uerlu BU I Lo I NGS A ND PUMPHOUSE TO BE REMOVED.
PROPOSED USE OF PROPERTY ResroENttet
WATER SUPPLY 2 WITHIN ONE MILE OF THE CITY OF IIII (NO)-
I heJeby certily that the above statementi are true and accurato, and that I have the lollowing logal interest in tho propsrty:
-owrler
oI record;
xX contract purchaser; potential buyer; realtor or
record, and that said owner is aware and approves of this action.
t further certify that (if not the owner) I am authorized to act for the owner of
TEST HOLES READY 2/?5/19 Signature /s/grNr,ry c. c rLL MORF oatez/za/lg
* * i oFFlcE usE oNLY BELOW THIS LINE * * *
SITE: F-I/IEETS STATE STANDARDS E DOES NOT/VI
3/r-- 4* ca* .&* ?rud
EET STATE STANDARDS
A^-Zoning
LAND USE COIVIPLIANCE
RA
Acreage or Lot Size
Partitioning NA
Parcel #NA
JEAN OFSTHUN
AUTHOBIZED SIGNATURE
Permit Processing Section
tu a_
"*tr-fr*-
J
DATE
Division Y *u,"r, Pollution Control
LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
css-32 q1L
^^4
4*
aA!A-/
(TOTAL)
) Completed
) Pending
%'"/,nbAJ4
THIS IS A PBELIMINARY REPORT WHICH DOES NOT ENSURE THE ISSUANCE OF A FUTURE BUILDING PERMIT. ANY PLANS OR EXPENDI-
TURES MADE IN RELIANCE UPON THIS REPORT ARE AT YOUR OWN RISK. IF SITE IS APPROVED, SEE REVEFSE SIDE.
3/19,/79
DATE
125 EAST BTH AVENUE, EUGENE, OREGON 97401 687-4061
T ?J.
ft"-
3-t7--)1
OAR Chapter 340, Division 7, Section 72-020{61: This report shall remain in effect until issuance of a
permit to construct, 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 changes will not invalidate any evaluation report issued pursuant to
this section.
Before construction is 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 the permit.
lf the property is only a portion of a tax lot, a partitioning or subdivision must be approved before the
permit will be issued.
Only persons having a valid license issued by the Department of Environmental Ouality under ORS 454.695
to install subsurface sewage disposal systems or an owner or contract purchaser or his regular employees
may install subsurface sewage disposal systems. A certificate of satisfactory completion will not be issued
if persons other than the above perform the installation.
.tl
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Aff idavi
DTPARTIIE NT OF EIIV I RONI.IT NTAL IIANAGEMF}II.
PSB, I25 EASI BTH AVENUE
EUGENE, ORECON 9740I
.Job Address 4
Io*nshlp. Rangc,tlon, Irr lot 7-"3 -L Cl ty
Subd{vlslon
Appl lcatlon for 81 ocl
tructures now on the prope
rr,ropor.d usG of property: & R"rtdcnttrl /*t rclal /-/ lndustrlrl
hereby certlfy
f;a seIf this application ls for an agricul turil bu lding lt will be used for purposes aLane County Code Chapter nd for no other purpose. I have the fol I owloxner of record;act purchaser;duly authorired
l0 (roning) aX contrt6-aiITo'r the
./
77 pubrt
that thls informa
'I lowed by the Sta
ng legal tnterestr of an exclusive
tlon.
tlon 'ls true and accurrte.
te Bulldlng Code andln the prope rty:
rcha se ioptlon to pu
t: I
p
Ies
IF6ilEd!'eab
see;holde
r.t C
Slgna t.ure,/Address
Hhen pennit
Tel
s ready notify:
Contrac tor
Contractor's OSRi
I f Cornnerc ia'l : I ol rtorlcr
Res{dential: I ol bcdros
owner ls le of-TI1i-f[pt ica
ZI
0r Da te
Appl lcant fl Wner ./_l Contractor [r fl mtl
z1
Pl unblng by
f of employees .--..-_*-_
e-.
phone
Phonc 2i1?.A-l)-
Phone -)s)2F
SI test holes ready S--
3q, Ft. orI qr!&1
i of unltr
S0S: /_/ Exlsttng, Bp I
/jj Proposed, SI I
Foc
Us S'e*{hlrerf va]lt-e"!-e!.Fee
$
I
Iotal Valuatton:
Plu-,6ing flrturer at
Sener/rater cono. at
each
each
Subtota I
$$
t
$
/_o\o $_
$--.
$
(
,
llece i ved by
PTRMIT PROCTSSlNG ne
l"l'ininrum setbacks, t front
Part. I
[, rid.
4X State surcharge
Plans check fee
Change of 0ccupancy
Pa rcel
TOTAL
Parcel Size ('Q-
lnt.-.-.-i rear
0a
t
P\cr-rr\Connents
lo be typed on permit
CP&l Type Grouo
To be typed on permi t
Fire Zone Use Classif'lcatlon
\-. )F--\I
8y , oatelr,r lrlons infornro 0n
tions to si
'-./ slro
r'
'/
CPt I
Plans to
lanning
/7 Public Horks
/l tlevation ll nla
fl Address
/-/ f acfiity Permit
[/ Environnental Hea] th
rea inspector)
Da te
Requ i red
Hold Sl ipto PCC
hone
0a te
Compl eted
0ate to
PCC
(:
tCP&l _ set(s)
llJPC _ set(s )
c74-17 |
*' ---,
_
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.{t
Or,vrre r
44?zt
4
-
sI# L( 7 f-r z-
#Z jST HOLE#T TEST OLE
PROFILE PROFILE
Inch Inch
Sc-c5(L
68
;
e$Is
244
36 -l
48-
60-
t2-
fo 5c,
PERCHED WATER
SATURATED ZONE
Restrict,i u" l,^y"rf 4*,
rmpervious Layer
-irr,
1fl r
]-fI r
]-fl r
SLOPE
1n
fakr
1II rMottling?()
Predicted
Observed
Date
Predicted
Observed
Date
36-
48-
L2-
24-
60
PREDICTED WATER
SATURATED ZONE
strictive Layer Mnious Layer _ln
1n
1n
SLOPE o/
].fl o
l-fl o
ttling
te
erved
cted
3a IN
Predicted
Observed
Date
(SITE DOES
Drainage or
pond
la ..la qla a.. aaa I a
Road
--E--
Tesc Hole @
\ % SloPe
Cut Bank
aT7777-
Fence
sl- X-X
DOES NOT MEET M]N]MI]M STANDARDS.
AD}fINISTRATIVE RULES REOUIRE A MINIMIJM DEPTH OF:
36 inches to an impermeable layer
30 inches to a restrictive layer
60 inches to a permanent water table
24 inches to a temporarily perched wat,er table
OTHER REASONS FOR DEN]AL
ON YOUR PROPERTY THE DEPTH
I{AS:
inches
inches
inches
inches
PLOT PI,AN:
Stream
--rh/\.lb
4*'nP
U
tr
€*
t{Lo- 77f>
SITE EVAIUATION WORKSHEET
LOCATION:rwe. ll RANGE o ) sEGTroN Z Z- TAx Lor #
ZONING:PROPOSED USE:
SIZE OF PROPERTY:AMOIJNT US$LE AREA:
WATER SUPPLY:COMMI]NITY PUBLIG INDIVIDUAL IC
SUBD I VI S I ON/ PART IT I ON LOT BLOCK PARCEL
IF SITE MEETS STANDARDS FILL OUT:
Type of structure and approximate sewage flow:Single Family
Industrial
-a-o cpd
gpd
8pd
Mr l ti-f ami ly
Conrnercial
MINIMUM DESIGN REQUIREMENTS :
Length of disposal trench required
cpd
gpd Ins titutional
/L5O gal.
Distribution Method:
Curtain drain required:
Other:
Equal EI SeriaI
NoYes E
SPECIAL SITE CONSIDERATIONS OR VARIA}TGE OPTIONS OR OTHER ALTERNATIVES:
NAME:J- zr*=
c74-L26
U DATE OF EVATUATTON, J -7- 7 7
,rL $ L---a---:=(.-J Job Locatlon (Addres
Pertrtt //
Permlt il
Permlt
,
f For
For
For
Permlt #
Permit
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CORRECTION NOTICE
This buildin,
os noted be
LANE COUNIY DEPT. OF ENVIRONMENTAT A'IANAGEMENT
Conslruclion Permits & lnspections Division
EUGENE, OREGON
or slructure does not conform to Lone County building regulolions, ordinonces or codesg
,lo
L ,, o,q,
oot<s.
5,
/4 t/rH
I nspectorcss-73 RE-!N IRED
Building t#
a
o"r"7-7.t*77
.',,:_rANE COUNTY, OREGON. DEPT. OF ENVIRONMENTAL MA' SEMENT
CONSTFIUCTION PERMITS
A INSPECTION DIV.
DATE
-/'I ,b GCIFIFIECTIGIN IVGITICE w
t)JOB ADDRESS
TO
NOTE:
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d
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BLDG. PERMIT
a
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r
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DEPT. OF ENVIRONMENTAL MAI
JOB ADDRESS
CONSTRUCTION PERMITS
S INSPECTION DIV.]EMENT
CGIFIFIECTICIN NGITICE
DATE
TO BLDG. PERIVIT
NOTE
c55-73 FIE.INSPECTION FlEEUIFIEE,
Phone eiaT-4o6,g5 FoFl aP],FlovAL INSPECTOR
/0
U,qNT COUNTY, OREGO
DEPT. OF ENVIRONME
ot)
.]EMENT
CGIFIFIECTIGIN NGITICE
CONSTRUCTION PERMITS
A INSPECTION DIV.
a o
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DATE z-/
BLDG. PERIMIT /L-f/*1A
JOB ADDRESS
TO
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NOOO 5 70
c55-73
EIE.INstPECTIClN FIEGIUIFIEO
Phone Ei87-4flCi5 FCIFI APPErovaL
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ild Val uati on )Revi sed (
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refund
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Pl umb.
Plan R.
3%sur.
TOTAL amt.du e. pai
,il n\
ff,.ril
,lt
Signature of App I i cant
Fee Received1 [ ]chec k
c74-tl9
LANE COUNTY DEP
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Date