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TRS, T (Job Location
ltitten Directions
( ) Aullding Permit
Acreage or Lot Size
-
Partitioning#--- ( )Completed( ) Pendin9 ,,
INFORMATION SHEET
( ) Site Feasibility Study for Septic Tank. Number of sites
Test h il
Subdivisi
-Or-"t1
Lot- Bloc
APPLICANT'S NAIVIE AND ADDRESS lq /^-l Phone
Phone
Phone
OWNER'S NAME AND ADDRESS, if different from applicant's
CONTRACTOR'S NAME AND ADDRESS
Mail permit or results of site feasibility study to ( ) Applicant ( ) Owner () Contractor( ) Prefer to pick up. Call (owner, etc. ) when ready
STRUCTURES NOW ON THE PROPE
il PROPERTY IS WITHIN ONE MILE OF CITY
Contractors O. S. #
# Bedrocrns
PROPOSED USE (this permit)
wATERsUPPLY(existingorproposedwell,etc.lfpublic.nameofsystem)
SEWAGE DISPOSAL {existing or proposed septic tank, etc.l S.l
PLUMBING BY Address
'*rlr*) oFFtcE usE oNLY BELOW THIS LtNE $****r*]r***
( ) New Address Necessary
ZON E
( ) Facility Permit Necessary
SETBACKS: Front
( ) Special Permit Area. Minimum Elevation
Side Facing Street
(FROM CENTERLINE OF HOAD)
lnterior Side Yard Rear
-
(FROM PROPEBTY LINES)
To: Planning/Building lnspector/Sanitarian/Surveyor.
This applicant appears to have a problem with
Your assistance will be appreciated.
By Permit Processing Section
Response
By
DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
Permit Processing Section
125 East 8th Avenue
687-4394css-12
lvrslon
rJf\l b-oc)/(
PERTVIIT #
TRS, TL JOB LOCATIO
lVlinimum Septic Tank Capacity (Gallons)
Drainfield Required - Lineal Feet
Maximum Depth
Date
LANE COUNTY PERMIT
Acreage or Lot Sizc Partitioning #) Completed
Contractor's O.S. #
OWNER'S NATVIE AND ADDRESS
CONTRACTOR'S NAtVlE AND ADDRESS
APPLICANT,S NAME AND ADDRESS , Phone-
Subd ivision
Lot- Block-
Phon p
Phone-
lVlail permitto ( )Applicant ( )Owner ( )Contractor. ( )Prefertopickup. Call-(owner,etc.) whenready
STRUCTURES NOW ON THE PROPERTY
THlsPERl\4lTlSFoR#BEDRooMs-#PLUlV]BlNGcoNNECTloNS-
WATER SUPPLY SEWAGE DISPOSAL s.t. #
THlSPRoPERTYlSWlTHlNoNElVllLEoFTHEClTYoF'PLUtVlBlNGBY
I hereby certify that the above statements are true and accurate. and that I have the following legal interest in the property:
-owner
oI record;
-contract
purchaser;
-
potential buyer;
-
realtor or agent. I further certify that (if not the owner) I am authorized to act for the owner ol
record, and that said owner is aware and approves of this action. I hereby agree to comply with all applicable Codes relating to this permit.
Fee Paid S-Signatu re Date
NEWADDRESS () FACILITY PERI\4IT TO TRANSPORTATION DEPT.- l SPECIA L PMT. AR EA. MIN.ELEVATION:-
SANITATION BU ILDING
Comments
By:
Type of Construction
Use Classification
Comments:
By
roup
Date
ire Zone
PLANNING REOUI REIVIENTS SATISFIED. Bv:Date Date lssued
ZONE SETBACKS: FRONT SIDE FACING STREET (FROIVI C/L) INT. SIDE YARD REAR (FROIVI P/L)
LANE COUNTY DEPARTIVIENT OF ENVIRONIVIENTAL IVIANAGEIVIENT, 125 EAST BTH AVE., EUGENE, OREGON 97401
POST THIS PERMIT ON MAIN BUILDING AT SITE
c55-13 BLDG.pERMTT-wHrrE; BUTLDTNG-GREEN; pLUMBTNG-GANARy; sANrrATroN-coLDENRoD; oFFrcEcoprr-wHtrE
PHONE:687-4394
(,
S ITE INSPECTION
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CONSTRUCTION PERMITS & !NSPECTIONS
S.B.C. SEC. 302(d} EXPIRATION
Every permit issued by the Building Official under the provisions of the Code shall expire by limitation and become null and void if the building or work
authorized by such permit is
'not commenced within 1 20 days from the date of such permit, or if the bu ild ing or work authorized by such permit is suspended or
abandoned for a period of 180 days at any time after the work is commenced. Before such work can be recommenced a new permit shall be f irst obtained to do
so, and the fee therefor shall be one-half the amount required for a new permit for such work, provided no changes have been made or will be made in the original
plans and specifications for such work; and provided, further, that such suspension or abandonment has not exceeded one year.
S.B.C. SEC. 302)e) SUSPENSION OR REVOGATION
The Building Official may, in writing, suspend or revoke a permit issued under provisions of the Code whenever the permit is issued in error or on the basis of
incorrect information supplied, or in violation of any ordinance or regulation or any of the provisions of this Code.
S.B.C. SEC. 304(d) REOUIRED INSPECTIONS (CALLED INSPECTIONS)
The Building Official, upon notification from the permit holder or his agent, shall make the following inspections (allow 1 to 3 working days) , and shalleither
approve that portion of the construction as completed or notify the permit holder or his agent wherein the same fails to comply with this Code.
(1) FOUNDATION INSPECTION: To be made after trenches are excavated, forms erected, and steel reinforcement is in place (if required) AND BEFORE ANY
CONCRETE IS POUBED.
(2) FRAME INSPECTION: To be made after the roof, all framing, fire blocking and braces are in place and all rough plumbing, rough electricaland fireplace,
chimneysandventsarecomplete. NO WORK SHALL BE COVERED UNTIL THIS INSPECTION HAS BEEN IVIADE AND AP-
PROVED. There will be no approval for cover untilthe plumbing and electrical inspections have been made and approved.
(3) LATH AND/OR WALLBOARD (SHEETROCK) INSPECTION: To be made after all lathing and/or wallboard, interior and exterior, is in place; but before
any plaster is applied or the wallboard joints and fasteners are taped and f inished.
(4) FINAL INSPECTION: To be made after the building is complete AND BEFORE OCCUPANCY.
OTHER INSPECTIONS: ln addition to the called inspections specified above. the Building Official may make or requird'any other inspections of any construc-
tion work to ascertain compliance with the provisions of this Code and other laws which are enforced by the Division of Construction Permits and lnspections.
BLOCK WALL INSPECTION: To be made after reinforcing is in place, but before any grout is poured. This inspection is required for each bond beam pour.
There will be no approval until the plumbing and electrical inspections have been made and approved.
FIREPLACE INSPECTION: To be made after the damper is installed. but before the chimney construction is started.
MOBILE HOME INSPECTIONS: An inspection is required after the mobile home is connected to an approved sewer or septic system for: setback requirements,
blocking, footing connection. tiedowns, skirting, and plumbing connections.
ANYONE PROCEEDING PAST THE PO!NT OF REOUIRED INSPECTIONS
W!LL DO SO AT HIS OWN RISK.
You may make your request for inspections between 8:00 a.m. and 5:00 p.m. Monday through Friday at the Department of Environmental Management, Public
Service Building, 125 East 8th Avenue, Eugene 97401, or call 687-4065. Outlying areas may call the following: Florence, 997-3461; Oakridge, 782-2258; Cottage
Grove,942-4493.
THEBU!LDINGPERMITMUSTBEPOSTEDANDAPPROVEDPLANSMUSTBEOT\ITHEJOBSITEATALLTIMESDURING REGULARWORKIT\G HOURS.
WATER POLLUTION CONTROL
OAR CHAPTER 340 Division 7 Subsurface and Alternative Sewage Disposal Subdivision Standards for Subsurface and Alternative Sewage and NonWater-carried
Waste Disposal.
71-015 (7) A permit issued pursuant to these rules shall be effective for a period of one year from the date of issuance.
71-O17 (1) Upon completing the construction for which a permit has been issued the permit holder shall notifythe Department. The Department shall inspect
the construction to determine if it complies with the rules contained in this division. lf the construction does comply with such rules, the Department shall issue
a certificate of satisfactory completion to the permit holder. lf theconstruction does not comply with such rules, the Department shall notify the permit holder
and shall require satisfactory completion before issuing the certificate. Failure to meet the requirements for satisfactory completion within a reasonable time con-
stitutes a violation of ORS 454.605 to 454.745 and this rule.
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INSPECTION SHEET
TYPE OF INSPECIION
DATE:
TIME:
CONT., PLMBR., INSTALLER, NAME:
TELEPHONE #:
PERMIT NAME:
ADDRESS:
B.P. #:
LOCATION:
COMMENTS:
c55-7L
RE.FUND OT FEE
Txe Llr.rg COUNTV DeplRruErur Or ETVIRoNHENTAL MGT. I HAvING REQUESTEo REFUND
OF TEE TO:.
OF
Nlue ADoRESS
Appt-TCATtON FOR BUILDING PERMIT DENIEDT AND No APPEAL Of SUCH DENIAL
HAV I NG BEEN MADE.
rI'
Appt-tcATloN FoR BUILDING PERMIT cANcELED.
AppLlcATloN FoR BUILDINc PERMlrr ovERPAYMENT.
_ ZoH tnc Per lr loN.
Appt-tcATtoN roR REsrluRANr Ltceruse.
Appt tcATloN'ron CrnrlFlcATE or SlNlrATloN.
AppttcATtoN roR Pnsutl,tlruaRv Stre lrusnEcTtot't.
Fon rxe FoLLowrNG REASoN:
AHO fxe AppLtCANT DESIRING THAT THE FEE BE REFUNDEDT^fxe .Dtnt
ruoAuolTlNGtsREQUEsTEDToREFUNDTHEAMoUNaoF$%,
NUMBER I N THE CASE OF APPL I CAT I ON FOR BU I LD I NG PERMI?
FEE CHARGED.
ctrn tr Ftruarqce
UNOER AFPL I CAT I ON
, wHlcH ls THE
(
)
Dere
v
55-029-12
TRS, T -o3-Job Location
INFORMATION SHEET
trtuilding Permit ( ) Site Feasibility Study for Septic Tank. Number of sites-( ) Would like to meet on site. Call
Acreage or Lot Size Test holes will be ready-
Partitioning #- ( )Completed Subdivisi( )Pending
APPLICANT'S NAME AND ADDRESS
OWNER'S NAME AND ADDRESS, if different from appl S
CONTRACTOR'S NAME AND ADDRESS
Mail permit or results of site feasibility study to ( ) Applicant ( ) Owner ( ) Contractor( ) Prefer to pick up. Call ( owner, etc. ) when ready
STRUCTURES NOW ON THE PROPER
678- zZ
(owner, etc.)
Lot Bloc
//'= a
p6onr746- da72
Phone
Phone
PROPOSED USE (this permit)vwATEBsUPPLY(existingorproposedwell.etc.lfpublic.nameofsystem)
SEWAGE DISPOSAL (existing or proposed septictank, etc.) S.l
PLUMBING B Address
() PROPERTY IS WITHIN ONE MILE OF CITY (
**r*r** oFFtcE usE oNLY BELOW THtS LtNE *l**********r
( ) New Address Necessary
ZON F
( ) Facility Permit Necessary
SETBACKS: Front Side Facing Street
(FROM CENTERLINE OF ROAD)
( ) Special Permit Area. Minimum Elevation
lnterior Side Yard
-
Rear
(FBOM PROPERTY LINESI
To: Planning/Building lnspector/Sanitarian/Surveyor.
This applicant appears to have a problem with
Your asristance will be appreciated.
By Permit Processing Section
Response:
c55-1 2
DivisionBy
DEPARTIVIENT OF ENVI RONMENTAL MANAGEIVIENT
Permit Processi ng Section
125 East 8th Avenue
687-4394
ugAL)
60.855 (2 )
ArZD rp &
LANE MANUAL
Variance
Change of Occupancy Inspectjcn Fee
0ther Requested Inspect'ions
Reinspection Fee Building
Rei nspecti on Fee P1 umbi ng
Resident'i al Mechani cal Fee
Wood Heater and F'irepl ace Stoves
Appeals Filing Fee
2-tr-96
60. B5s (2)
$to.
50.
$ts
$1s
$to
$1s
$:s
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Da^rh NE'Eb A uy fiiEm o
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BU r LDr trG PERt4rT lI--?53_9,
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a rESS
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ne
PRoPERTy ADDRESS 2936 Msqmu]vr RD
iBui I ding Valuatjon)BilH?t!!#b) Prior
ficorrecti on
Fee Recejved By
LANT COUNTY DEP
I(u*t. due
I lrefund
4,OO
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Signature of Applicant
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ARTI'iENT OF EI.IV i RONI'IE
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NTAL I'IANAGEI'IENT
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Frn R i9B0
Department of Veterans' Affairs
FARM AND HOME LOANS
15OO VALLEY RIVER DR. SUITE 1OO, EUGENE, OREGON 97401
February 6, 1980
Phll Stoven Schroder
3536 Bayvood
Eugene, OR 97h04
APPII - SCIIB0DER, PhlI Steven
The maxtmun loen rflrtch rre could considcr or1 tlris propcrtll is
$ lo5,5oo.0o.
A loan ln thls amount does not neet vith tlre terras of your
Earnest )toney Recelpt, and for thj-s reason, we are rrnable to
t:llie favorable aetlon orl your appllcati-on at thls tltae.
Any loan rsould be eubJect to thtc folloulrrg requlrcneuts:
1. You or the seller should deliver the enclose<l l{ood
Deetroying Organism Report to a structtrral pest control
opcrator llcensed by the State of Orc5r.on Dcpartment of
Agrictrlture and request that lt be conrpleted. Instruct the'
operator to return the re-port to you for your slgnature to
show your acknowledg emerrt of the contenta. Return the
conpleted re]rort to thls offlcg lnxnc.dlately. Thls offlce
ulll advlse lf corrective rneasurea are necessary. DO llOT
PROCEBD I,IITII CHIIIICAL fR[AT}fENi' OR RIIPAIR$ Ui:ITIL i']E ADVILIE
YOU TO DO SO.
2. Provlde a satlsfactory r.'flter potablllty and ar.senlc tcst
from the Lane County lnvironnental liea].th Dlvl.elon or aoy
State llcensed laboratory. l'hoevcr does the testlng must
collcct the sanple.
3. Provlde an lnstrlated, L6" on ceilter, stud ft'a:rc prrnrp
house, cotrstructed out. of exterior grade materials in a
rrorknanlllce manner for all nechanl"cal cotrponents of ttre
ptruping and pressure systen. If not constructeC on a curbed
slab floor, the urrderatructure rflrst be elther of pressurc
treated wood or have at least 6'clearancc betrleen any rrood
member and the soll by using concrete pier blocl:s.
4. Provide 6 punp test for the dornest-lc raater srrppll' system.
The eyatem mtret be capable of deliverlng a strstalncd flotr of
flve galloaa per minute. I{oldlng or storilge tanks are not
acceptable for nortgage loarr purposes. Aftcr the well ls
developed, I test of at least four hours dtrration shall be
conducted to determlrre the yleld snd uraxlmurn drau down' A
BiIILER (BArL TEST) IS tioT A.CCEPTABLB.
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SCIIRODBRT Phll Stcvcn
February 6, 1980
5. Furnlsh a eatLsfactory repart of lncpectlon of the
aafety of the electrlcal eystem by the Lene County clcctrlcal
lnspector. Correctlon of sorle or all of the deficl'encles reay
be requLred after revlevr of the rcport.
6. Furnlch a sstlefactory report of fnspectlort of the
furrctloalng of the plurablng systen by the Lane County pluroblng
lnspeetor. CoruectLon of solne or all of tlte deflelenclcs may
be requlred after revlew of the report.
7. install gpttcrs and clovnspouts corrnect,eC to clraln llnea
a6 lndlcatcd on the attachcd bullctln, VB'4-2 Ror:f i'Igter
Dlspoeal. Lecve all trc'neltea cPcn untll efter ELeSI-&g"
Treat and apply two coatB of pal'nt to etterlor and lnterlor
of guttcrs and olterlor of dounspouts'
B. Install a peruaBent type ccntral heatlng aysteo capable
of ualntatnlng a constant 68o daytfunc temperature.
TliI,S IS }IOT A COI.lilIT}I[t;T. YOU SIIOULD I{OT PROCESD i-JITH AI'IY
}iEPAI.RS TINTIL NOTIFIED I}I WRITI}'IG FRO}I TIIIS OFFICB.
If you are able to aceept a loan In thle errount, pleose
aubrrl.t a revlced Earnest ltoney Recelpt, and aCvlse this
offlce ehere the dlffercnce betsreen otrr loan and the purehaeo
prlce wlll be obtalneC.
If we do not receive thc nbove by February 2O, 1900 your
appllcatlon wll1 be canceled, effectLve oa that rlate.
Cencellatloc of yoi;r appllcatlon ln no uray af,fects your loau
rlght. llowever, should you urake appllcatlon at sogle future
date on thle or some ottrer property, lt Wlll tre neceeaary
ttlat you furoish all of the forms and lnforn.atlon requlred
to cocrplete a nen apPllcat,fon.
LOT.LY NOI{RIS
Loan Offteer
686-7654
Jr
IiFCT Hood Destroying Organlsn RePort
$cll Tegt Procedures
Valuatlon Buldettn 4-2
Courrtryman Reslty. Iuc.
Jean Tate Resl Estate
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