HomeMy WebLinkAboutPermit Septic Tank 1992-10-0630a=-9?PERMIT #
REQUEST
FOR:
I have certlry that all lnformatlon lt true and correct
#"Lla,tu
BOTH sldes of thls appllcatlon and
READ CAREFULLYT Your Authorlzatlon ls Based On The Fol Condltlons
APPBOVED BY:FEES DUE: $DATE o ?Z=
CALL FOB TNSPECTTONS (SEE BACK OF FORM FOR TNSTRUCTTONS) 687-4065
SEPTIC permlts are good tor one year. ALL other permlts expire atter 180 days unless inspections are current,
VIOLATIONS
SETBACKSAIDOTHBRCONDMONSOPAPPROVALMUSTBESTRICTLYOBSRVBD. VIOI.ATIONCANREST'LTNNAVOCATIONOFTHISPEBMIT.
CMATIONS MAY BB UISUBD ['NDER THB PROVBTONS OF LANE COI'NTY'S INFRACTION ORDINA}ICE ANDy'OR, OTHR RBMBDIES ALLOWED BY LAW,
A MIMMUM OF AT LEAST 24 HOURS ADVANCE NOTICE MUST BE GIVEN FOR INSPECTION REQUESTS
Ilave the following information ready when you call: 6874M5
Permitnumber - Job address - Type of inspection required - When it will be ready
Your name and phone number - Any special directions to the site
powERroBNrERr,,poNLA!.'D.,r**ffi,.'1,""i11ffi^1[j3ffi'3Hffift:3$&1"iffiffiTH?Hil'*Tr*r**oF'Ir{EIRpt,NcnoNs,MAy
ENTER I,'PON ANY LAND AND MAKE EXAMINATIONS AND SI,]RVEYS AND PLACB AND MAINTAIN THB NBCBSSARY T,IOI{T'MENTS AND MARKBRS THERTON.
REQI.IIRED INSPECTIONS .
FOLTNDATION INSPECTION: To be made after elr.cavations for footings arc complete and any required reinforcing ste6l is inplace. l
LJNDERGROTIND PIPING INSPECTION: To be made after all underground piping has been irutalled, paor to any backfill.
CONCRETE SLAB OR LINDER-FLOOR INSPECfiON: To be made after all in-slab or under-floor building service equipmen! conduit, piping
accessories and other ancillary equipment items ale in place but before any concrete is placeil 6r floor shea0ring hstaUed, including the subfloor.
ROUGH MECHANICAL II.ISPECTION: To be made after all ducting And gas piping has been irrstalled and prior to being covered.
ROUGH PLUMBING INSPECTION: To be maderafter all plumbing rough-in is in place, prior to being covered. .. I ' . ' i
FRAMING INSPECTION: To be rnade after the all framing, fire blocking, braging and roof are in place and all pipes, chimneys and vents re complete
and *re rough electrical, flumbing, and mechanical inspections have been made and approved
INSULATION INSPECTION: To be made after all insulation and vapor barriers are in place, prior !o covering.
LATH AND/OR GYPSITM BOARD INSPECTION: To be made after all lathing and g1pzum board, interior and exterior, is in place but before any
plastering is applied or before gypsrlm board joints ur{ fasteners arq t{ped and finished.
ADDITIONALINSPECTIONS MAY BE REQUIRED, such as but not limited to;
BLOCK WALL: To be made afterreinforcing is in place, but before any grout is poured. The inspection is rcquired for each bond beam pour. There
will be no approval unqil the plumbing and electrical inspoctions have been made and 4pproved
FINAL MBCI'IAMCAL INSPECTION: To be made just prior to the structure or reniodeled area being occupied and prior to qieiating airy eq[ipneor
FINAL PLUIVIBING INSPECTION: To be made just prior to the building, strucure or remodeled area being occupied"
FINAL BUILDING INSPECTION: To be made after finish gading and the building, structure or remodeled rea is completed md ready for occupancy.
MOBILEMANITFACTURED HOMES: An inspection is required after the mobile home is connected to ur alryroved sewer or septic
system, prior to covering sewer or water lines, for setback requirements, blocking, tiedowns and plumbing connections.
Footings and piers to comply with State fomdation requirernens for mobile homes or as recommended by the manufacturer,
Minimum finished floor elevation shall be certified when required by Floodplain Management
Tiedowns, if required, shall be installed and ready for inspection within 30 days after pccupancy. -Tiedpwns shall be inptalled per e,nolosure.
APPROYAL REQI.IIRED )
No work shall be done on any part of the building or structure beyond the point indicated in each successive inspection without first obtaining the
approval of the building official. Such approval shall be given only after an iupection shall have been made of each successive step in the construction
as indicated by each of the irspections required.
APPROVED PI"A.NS MUST BE ON THE JOB SITE AT ALL TMES DURING WORKING HOURS.
THIS PERMT WILL H(PIRE IF WORK DOES NOT BEGIN WTTI{IN I8O DAYS, OR IF WORK IS STOPPED OR ABANDONED FOR MORE TI{AN I8O DAYS.
SUSPENSION OR REVOCAfiON MAY OCCUR IF THIS PERMIT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS INFORMATION.
ANYONE PROCEEDING PAST THE POINT OF REQTIIRED INSPECTIONS WILL DO SO AT THEIR OWN RISK.
Your signanire on the fr,ont of this form verifies the following: I HAYE CAREFULLY EXAMINED THIS COMPLETED APPLICATION md do
hereby certify that all information hereon is true and correct, and that I have a legal interest in the property ,rs owner of record or authorized agent. I
fur0rer certify that any and all work performed shall be done in accordance wi0r the Ordinances of Lane County and the laws of the State of Oregon per-
taining to the work described herein. I further certiff that if I am not the owner of the property, my registration with the Builders Board is in full force
and effect as required by ORS 701.055, and that if exempt the basis for the exemption is noted hereon, and that only subontractors and employees who
are in compliance with ORS 701.005 will be used on the job.
SUBSURFACE & ALTERNATIYE SEWAGE DISPOSAL SYSTEMS:
When subsurface construction is complete, the permit holder shall notify the County Land Management Division by sr.bmitting the installation record
form. A1 inspection will be made by a qualified sanitarian. If construction complies with all rules a certificate of completion will be issued to the permit
holder. If corutruction does not comply with rules, the permit holder will be notified, and all corrections shall be made before a cerrificate of compietion
will be issued. Failure to meet satisfactory completion within the alloBed time constitutes a violation of ORS 454.@5 to 4Y.745 and this rule.
SUBSURFACE SEWAGE DISPOSAL SETBACKS SEPTIC TANK DRAINT'IELD
From: Interior property lines 10' 10'
Edge ofroadright-of-way l0' l0'
Building foundation 5' 10'
Wells or other water sources 50' 100'
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SEPTIC INSTALLED
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Please complete all lines instde whlte boxes, if possible.
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For Moblle Home
Placement Only
No. ol Bedrms
License *-
Brand
Year
Size?tbz
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Dlstance lrom Moblle
Home to:
Water Sewer/Septrc
Land ManaEement Div. staff can
not be held responsible for
evaluations or recommsndations
based on false, inaccuratg or
incomplete intormati119 - 282
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