HomeMy WebLinkAboutPermit Septic Tank 1985-08-13d--5
L C th t for,
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FOR OPFICE USE ONLY
333*i:";'""'At73-tr{
FANGE a SECTION,/73,OF
BLOCK
PROPOSED USE OF PROPERTY
ffnesidential tr rndustrial
PubIicCc,runerc ia I
DECLY 9 VALUE
I Prooosed
!,exiit:-"q
I HAVE CAFXFULLY EXAMINED ?HE COMPLETED APPLIC+TIoN FoR PERMIT, arrd do hereby certify that all j.nfomation hereon is true and correct, and that I
have the following 1e9a1 interest in the property,[*6*n"r of record; f contracE ptrrchaser;[authorized agent with evidence of authority attached.
I f:rther certify that any ild aI1 work perfomedz6fraf) Ue done in accordance witlr the ordaDances of lane Cowty and the Laws of the State of Oregon
pertaining to the work described herein, and that NO OCCUPANCY will be made of anj'strrrcture without the pemission of the Building Division. I fur-
ther certify that registsration with the Builder's Board is in ful1 force and effect as required by ORS 701.055, that if exehpt the basj.s for exempti
is noted hereon, ild that only subcontractors ad employees who are in compliance with oRs 7ol-.055 will be used on this Project. I HAVE READ AND
APPLICATION THOROUGHLY
SIGNATURX
CHECKED
t,
DATE
Specifications: _ Tank
Date
COM}IENTS:
Date:
cL
x Installation Ga1lon
COMI'IENTS
UseNA
SANITATION: s. I. #B. P. *
fl p ryp.- Grorp-
ZATION I]AS BEEN BASED ON THE FOLLOWING CONDITIONS !READ THIS SECTION CAREFULLY
I pmt':Nruc,zzoNrNG:
Minimum setbacks
cot'$1ENTS
rnstallation Record rssued? f] xu" fl N"
Date:
Lineal Feet
of Drainfi
ln ar
Parcel *Parcel Si
Baximun Depth
of Trenches
Partition #
cL,
r-+471 .4u--K,S
LANE COUNTY DEPAHTMENTOF PUBLIC WORKS LAND MANAGvtzsEAST 8TH AVENUE, EUGENE, oREGoN
EMENT D]VISION, 687
97401
SEE REVERSE FOR INSPECTION INFORMATION
DATE
4061,
cl4-2s R*
SETBnCXS AND OTiIER CO:iDlTla::S OF APPROVAL I1UST BE STRIC?L! OESER!'ED- \ITOLATION CAr* RESULT IN REVO-
C;'?ION OF lllIS liRIlIT, CIT,iTIO:,i Ur'DER PROVISIONS OF LAI;E:OUi:TI'.1 INFR.ICTION ORDI:i.\NCE, AND,/OR OTHER
RE}IEDIES ALI,OWED BY LAW.
wHEN RE)DY FOR IIISIjDCTION, C,\l.L 631-1065. A IlIr*ItlUil OP AT LaAST 24 IIOURS ADVAIICE NOTICE FOR INSPEC-
fiaif-TEECEST-:.aST-8! cIVs::- i-ijvi- tne followin-r in:c.:rtion re3dy: Fermrt nufiber, job address, type
of inspec!!on, when it wrLl be reaCy, your name and phoic nun5er, anC any special Cirections to site.
BUILDING DIVlSION:
REQUIRED I:iSPECTIONS :
I. Foundatj.on Inspection: To be made after trenches are excavated and forms erected and when all
n-tE;l=Tiliol' rIa fNn(lrtion are delivered or) the job. i{here concrete from a central mixing
planL (comonLy Lermed "transit nixed") is to be used. naterials need not be on Lhe job.
2. ConcreLe.:Irb or Lnder-:LDor InslFCtfrI: To be r3ie after aII rn-slab or under-floor buiLdrng
EEivTlie,l-;fpnmt, coruut, prpin,l;ZaEssories, and other anclllarl,'equipment items are in
place but betore any concrete is poured or floor sheathing installed, including the subfloor.
3. Franing & lnsulaLion Inspectionsi To be made after the roof, all framing, fire bloiki.ng, and
bracing ale in place ard all- pipes, fireplaces, chinneys, and vents are complete and alI rough
electrical and plumbing are apploved. AII ual-l insulacion and vapor barrier are in place.
1. Lath and/or C)psum Board lnspection: To be made a!ter all lathing and qypsun board, interior
aiE-ext-erl6r,lE--In-plrce-bu:--5*=-ue any plastering is applieC and befole gypsm board joints
and fasteners ale Laped and finished.
5. Final Inspection: To be made after the building is complete and before occupancy.
APPROVAL REQUIRED. No work shaLI be done on any part of tl-.e building or sCructure beyond the point
indicated in each successive inspection without first obtaining the approval of the bui.lding official
Such approval sha1l be given cnl.y after an inspection shall have been made of each successive step
in the constructj.on as indicated by each of the inspectlons requi.reC.
NOTE: A1I bui.ldin9 permj.ts require j-nspecLions for the uork authorized, such as buL not Iinited to:
A. BIoc\ l,lall: To be Eaie aftcr reinforcing is in place, but before any grout is poured. This
Ii'-sprcIi;E is required for each bond beam pour. There will be no approval until the plumbing
and electrical inspections have been made and approved.
B. hrood SLove: to be made afler compLetion of masonry (if applicable) and when instaLlation is
compled- Instaliataon shall be in accordance Hith an approved, nationally recognj.zed Eestlng
agency and t'he manufacturer's installation instructj.ons.
C. Hobile Home: An inspection is required after the mobile home is connected to an approved
wi-G6ptic system for selback requirements, blocki,ng, footing connection, tiedowns,
skirting, and pfmbrng connections.
I. Footings and piers to comply with State foundaEion requirements for mobiLe homes or as
recomended by the manufacburer.
2. Mobile home minj.num finish fl-oor elevation sha11 be certified when required by a flood-
plain management letter.
. 3. Mobile home tiedowns, when required, and skirting shall be installed and rady for inspec-
tion within at least 30 days after occupancy. Tiedouns aod skj.rtj.ng shall be instalLed
Per enclosure.
Swimrnq PooI: BeLow qrade when steel is in place and before concrete is poured. Above grade
ilhen oool is installed-
I
I
D
APPROVED PLANS MUST BE ON THE JOB SITE AT ALL TIMES DURIN-G WORKING HOURS. THIS PERMTT WrLL EXPIRE
IF I,iORK DOES NOT BEGIN WITIIIN 130 DAYS, OR IF WORK IS SUSPENDED OR ABANDONED FOR }IORE THAN I8O DAYS.
SUSPENSION OR REVOCATION i'1AY OCCUR IF TI{IS PEfuUIT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS
INFORMATION.
ANYONE PROCEEDING PAgT THE POII{T OT REOUIRED INSPECTIO:]S VIILL DO SO AT THEIR OWN RISK.
SUBSUREACE AND ALTERNATIVE SEWAGE DISPOSAL SYSTEMS:
I. Permits shalL be eff€rctive for one year from the Cate of issuance.
2, Upon completing the construction for which a pernit has been issued, the permj.t hol.der shall
notify the Lane CounLy Department of Planning and Comunity Development by submitLing the
installaLion record form. The Departrent shall inspect the construction to determi.ne if it
compLies wi-th the rules contained in this division. If the construction does comply uith such
rules, lhe Departsent shaLL issue a certificate of satisfactory conpletion to the permiti holder
If the construction does not comply Hith such rules, the Department slral.l. notify the permit
holder .nd shall require satisfactory completion before issuing the certificate. Failure to
meet the requirements for satj-sfactory completion wrthin a reasonable time constiLutes a vj-o-
lat.ron of oRS 454.605 to 454.745 and this ruIe.
Setbacks - Subsurface Sewage Disposal
Dra i nf ie Ld
Iiterior prope!ty lincs
Edge of road rlqht-of-uay
Burlciinq foundation
Ne116, other uater sourc@s
Scptic Tank
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ACTIVITY INFORMATION SHEET
COMPLETE THIS SECTION. INCOMPLETE FORMS hIILL BE REJECTEDT
** FoR STAFF USE oNLY **
_zqNE/LAIU_!$E i
BY: _ DATE:_ TIME IN:_ 0UT:_
NUMBER
DATE
lo I5 EIJ D IC
T
D 3j5t L/o,,tt TEDLLa
IL MAILING ADDRESSIp7tr
m
2 PROPERTY ADDRESS
2!:_7Q2.'? |At -Z=s7 _ z47q2z-
HOME TELEPHONE # BUSINESS TELEPHONE # HOME TELEPHONE #
( TF DIFFERENT TnO
3 rvrae B PAFIeEL NuMBEFI
( REQUTREp rNF0RI4ATr0N)
l.l
MIN-SE-IP
(from tax maps in Department of Assessment and Taxation
or from tax statement)ov t1.7,1 ry- /a/QmGEmTm ffi ZONING
t)MilNSETP MNGE SEET-IOII ffi ZONING
TOMI-STIP NANE SEETMN
TOTAL C0NTIGU0US PR0PERTY IN SAME OI^INERSHIP:
ffi ZONING
yae ACRES
O ,rrr*ON ( if appl icable)LOT BLOCK
5 REQUEST (s;tate exact'ly what you plan to do) /)€Z> €-C ptZ ' '<?ECttn")
V LO
6 DIRECTIONS T0 SITE: 0F
a
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LAND I''IANAGEMENT DIVISIoN / 125 E. 8th AVE., EUGENE, 0R 97401 / 687-4061
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