HomeMy WebLinkAboutPermit Correspondence 1994-12-13,CITY OF OREGOIU
St ^rCFlt L O
P Lt 3 L I C r4'O,qh S 9EPA Frl"rg^'r
Decenrber 13. 1994
Roger Oberg Construction
3006 \\'illakerrzie Road
Eugene OR 97401
SUB.IECT: AVAILABLESANIT.A'RYSERVICE
Dear \{r. Oberg.
Sanjtan' se\\'er js not availab,le for ihe Ono Street prop'rsnl' that 1'ou are co:rsidering for
der,elopr:rent. The Citl' has lenlalivel)' included tile construction of a sanitatl' se\\'er in our
Capital Improver:rents Plarr forthe fiscai 1'ear'95-96. Lane Countl'u'ill be co:rstructing 19th
Street rhat )'ear and rhe construcrjon of sanitaq: 5g\\'€rs u'ill be included u'ith their u'ork. rather
than a separale project.
The lgth Srreet se\\:er ri'iJl be a tru::]; io corurect local sen'ice lines for adjacent areas . Propenies
ihen ri'ill be able ro corutect to the seu;er if tiiey'1reet the necessar)r requiret:rents in force at rhat
tirne. No oiher projecls are planned ar this time.
If 1'ou have an;'questions. please call me at126-36i1.
Sincerely.
4r .-,.- ,. ,, :. -,1- .'
'i il/-"_-z"J+72 -'t
George \\ralker
^ ,,. .. -.. :
oaBfseR-
PERMIT #37"{{-1r
REAUEST
FOR:SEPTIC SYSTM4 INSTALLATICA]
RES. NO CITYoEscnFnclrGp EDltoBK - -----ilo.oF-BED-B6rs------ --
INSTALLATIOI{ OF SEI^IAGE DISPOSAL SYSTEM
HB=9PE@-RD----@-9140L
-
-345:11!2---omensruenTaeooffi-EiiZABE"TH-Mtllgn, 2320 N. 19TH sr., seRTNGFTELD 97477 PHNE
STRUCTURES NOW OII PROPERW
SEPTE NSTALI,IO r.to. oF sToRrEs collsTRt,cTtottr ooSTATALUE
DrREcIoNs ro srEFRo,t NEAREST MAIN NrE
SCXJTI{ ACROSS BIKE PATI{ & EWEB EASEMENT.
CONTRACTOR /II'ISTALLE& STJ'LDEB NAME
OBERG COT{STRUCTIO$J 89944 34s-3107
NO\IE
PROPOSEO USE NO, OF EMPLOYEES
PHONE
cr8t PHONE
r^6TAU!0
OTTO ST., SPRINGFfELD 97477
N. 19TH ST WEST ON CITO
APPLICAIT NA'IIE & AOOR€SS
3006 WILLAKENZIE RD.401-OBERG ot{INC
OTY DP
on andI have carefully read BOTH sides of this a
PRIT{T
that all inlormation is co
READ CAREFULL r Authorizatlon ls lng CondltlonsOn The Fol
FEES DUE: $APPROVED BY DATE
CALL FOR INSPECT|ONS rSEE BACK OF FOBM FOB TNSTBUCTTONS) 687-4065
SEPTIC permlts are good lor one year. ALL other permits expire after 180 days unless inspections are current.
LMD 040 Rev. 6/92
VIOLATIONS
SBTBACKSANDOTHBRCONDMONSOPAPPROVALMUSTBBSTRICI,YOBsERVBD. VIOI"ATTONCAI{N,ESI.'LTTNRBVOCATIONOFTHISPtsRMIT.
CITATIONS MAY BE ISSI,BD I,NDBN, THB PROYISIOIIS OF III{B COUNTY'! INIAACTION oRDINA}TCts AI{D,ON, OTHER RBMEDIES ALLO}IIBD EY LAw'
A MINIMLTM OF AT LEAST 24 HOURS ADVAT.ICE NOTTCE MUST BE GIVEN FOR INSPECTION REQIJESTS
Have the following information ready when you call: 687-4M5
Permit number - Job address - Typ" of inspection required - When it will be ready
Your name and phone number - Any special directioru to the site
powERroBN'BRUpoNLAND. *"""ffi,!l?"i1ffi#3Fl{Hffiff:H#1,'1ffi1ffi[3${3lif;'*?*-t**.FrHBIRFtNcrIoNs.MAy
ENTER TJPON ANY LAND AND MAXE EXAMINIITIONS A!{D SURVEYS AND T'I.,ACB AND MAINTAIN THE NECBSSARY MONI.'MBtr{TS AND MARXERS TIIERBON.
REQUIRED INSPECTIONS
FOUNDATION INSPECTION: To be made after excavations for footings are complete and any required reinforcing steel is in place.
LTNDERGROLIND PIPING INSPECTION: To be made after dl underground piping has been installed, prior to any backfill.
CONCRETE SLAB OR LTNDER-FLOOR INSPECTION: To be made after all in-slab or under-floor building service equipmeng conduit, piping
accessories and other ancillary equipment items are in place but before any concrete is placed or floor sheathing installd, including the subfloor.
ROUGH MECHANICAL INSPECTION: To be made after all ducting and gas piping has been installed and prior to being covered.
ROUGH PLUMBING INSPECTION: To be made after all plumbing rough-in is in place, prior to being covered.
FRAMING INSPECTION: To be made after the all framing, fire blocking, bracing and roof are in place and all pipes, chimneys and vents are complete
and the rough electical, plumbing, and mechanical inspections have been made and app,roved.
INSULATION INSPECTION: To be made after all insulation and vapor barriers are in place, prior to covering.
LATH AND/OR GYPSUM BOARD INSPECTION: To be made after all lathing and gypsum board, interior and exterior, is in place but before any
plastering is applied or before gypsum board joints and fasteners are taped md finished.
ADDITIONAL INSPECTIONS MAY BE REQLIIRED, such as but not limited to;
BLOCK WALL: To be made after reinforcing is in place, but before my grout is porned. The inspection is required for each bond beam pour. There
will be no approval until the plumbing and electrical inspections have been made and app,roved.
FINAL MECHANICAL INSPECTION: To be made just priu to the structure or remodeled area being occupied and prior to operating any equipment.
FINAL PLUMBING INSPECTION: To be made just prior to the building, struchre or remodeled uea being occupied.
FINAL BLIILDING INSPECTION: To be mader after finish grading and the building, structure or remodeled area is completed and ready for occupancy.
MOBILEA,IANUFACTURED HOMES: An inspection is rcquired after the mobile home is connected to an approved sewer or septic
system, prior to covering sewer or water lines, fu setback requirements, blocking, tiedowns and plumbing connections.
Footings and piers to comply with State formdation requiremens for mobile homes or as recornmended by the manufacturer,
Minimum finished floor elevation shall be certified when required by Floodplain Management
Tiedowrs, if required, shall be installed and ready for inspection within 30 days after occupancy. Tiedowns shall be installed per enclosure.
APPROYAL REQTITREI)
No work shall be done on any part of the building or structrre 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 inspection shall have been made of each successive step in the construction
as indicated by each of the inspections required.
APPROVED PLANS MUST BB ON T}IE JOB SME AT ALL TMES DURING WORKING HOURS.
THIS PERMIT WILL EXPIRE IF WORK DOES NOT BEGIN WTTI{IN I8O DAYS, OR IF WORK IS STOPPED OR ABANDONED FOR MORE THAN 180 DAYS.
SUSPENSION OR REVOCATION MAY OCCUR IF THIS PERMIT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS INFORMATION,
ANYONE PROCEEDING PAST THE POINT OT'REQUIRED INSPECTIONS WILL DO SO AT THEIR OWN RISK.
Your signature on the front of this form verifies the following: I HAVE CAREFULLY EXAMINED THIS COMPLETED APPUCATION, and do
hereby certify that all information hereon is true and correct, and that I have a legal interest in the property as owner of record or authorized agent. I
further certify thalalV.anf all work performed shall be done in accordance with the Ordinances of Lane County and rhe laws of the State of Gegon per-
taining to the wgglaafrjted hqfi. I turther cAgglfy tlnt if { am not the owner of the property, my regisuation with the Builders Board is in tull forie
and effect as redrftiltqifqfr51,Sffi:glr"ixf,15#ry for the exemption is noted hereon, and that only subcontractors and employees who
are in compliance with OI
SUBSURFACE & ALTERNATIA OWNTTbMOSAL SYSTEMS:
When subsurface construction is compl&e, ihJft.f,,il nota"r shall notify the County Land Management Division by submitting the installation record
fory. .t1- inspection will be made by a qualified sanitarian. If construction complies with all rules a certificate of Completion ivil be issued to the permit
holder. If construction does not comply with rules, the pumit holder will be notified, and all corrections shall be made before a certificate of compietionwill be issued. Failure !o meet satisfactory completion within the allotted time constitutes a violation of ORS 454.605 to 454.745 and this rule.
SUBSURF'ACE SEWAGE DISPOSAL SETBACKS SEPTIC TANK DRAINF'IELDFrom: Interior property lines l0' l0'
Edge of road righr-of-way l0' 10,
Building foundation 5' l0'
Wellsorotherwatersources 50' 100'
Permit *". V7(5-?f*^"
Standard Systemf(qq11s
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M BE IN BLACK
Range
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Section L"t l?fftt
Lot Block
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FOR INSTALLER'S USE:
Tank Capacity lO@ .(Iqt
Measured Distance f romYWell
DT
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Below Tile 6"
Total Length of Lines
(Model No.)- Pump
have been installed with this sewage installation
.:
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liench Depth
Man
to Tank d
COMPLETE THE FOLLOWING IF A PUMP WAS USED ON THIS INSTALLATION
I (installer's name)certify that a (Mfg.)
and Mercury Float Switch (Mfg. and No.)
Signature Date
2.5c tL
$ousa
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otr.o 5r
rrected Date
Date
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CiCl@(r!FOR SANITARIAN'S USE ONLY:Approved tr System Disapproved X tteeOs Correction
COMMENTS:
System Capacity gal./day Signature
INSTALLATION RECOFD & CERTIFICATE OF SATISFACTORY COMPLETION When signed by the County Sanitarian. this certificate is evi-
dence as per ORS 454.665 ol satisfactory completion of a subsurface sewage disposal system at the above location.
To request inspection, return all three (3) copies of this form to: Lane County Environmental Health Services. located in the basement of the
Public Service Building, 125 E. 8th Avenue, Eugene. OR 97401.
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lane county
HOLID SI.IP
FrNAL TNSTALLATToN RE.oRD F,R pERMrr * j 7 5' ry
Li ^/b,rbrnut notfitTALLER
l1-fu c,40 )L'-,d ADDRESS
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Your Certificate of Sat'isfactory Completion for the above referencedinstallation cannot be approved until the following corrections are made:
I. INCOMPLETE FORM / INADEQUATE PLOT PLAN
Township, range, section and tax lot description
Address or street, road, etc.
AppTiqant' s name/mai I ing address
Instal}-er's signature
Distances from tank & drainfield to well
Pump & switch specification statement on plot plan
Vicinity map
Additional measurerents needed
I. IllegibleJ. Forn must be filled out in BLACK INK.K. 0ther
3. CONSTRUCTION
Water level d-box
Grout box(es) (inside and out)
Non-approved materials used in effluent sewer
Trenches covered
Incorrect grade on trench bottom and/or drainline
Incorrect trench depth
0ther
If the necessary corrections are not made within days, theCertificate of Satisfactory Completion will be denie
c.c Appl icant Date
8:00 - 9:00 A.M.
hlater Pollution Control Division / Environmental Management Department
125 East 8th Avenue / Public Service Building / Eugene, Oregon 97401
( s03 ) 687 -4061 / wat.s L i ne I -800- 4sT-ffi19
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JUL I
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REQUEST FOR WRTTTEN APPROVAL TO USE CONSTRUCTTON METHODS N6Try4,.t,.
INCLUDED IN OREGON ADMTNISTRATIVE RULES 69O_2OO THROUGH 69O_240
Before request can be considered, the following must be answered.
Requests shall be submitted to the WeLl Construction Specialist,water Resources Department, 3850 portland Road'NE, sarem, oR973LO. Requests may also be considered by the appropriate Regional
Manager.
Date of request:
Bonded WelI Constructor (or permitted Iand owner):
(1) Locati n f t^Ie1l: l/4 l/4 of Section 'l-d.\
rownship / 75 , Ranse O]_k/-,County.
Address at well site:+/,
(2) Name and Address of Land Owner:
(3) The distance to the nearest well, septic tank or drainfield:
(4) The unusual conditions existing at the site:
(5) The proposed construction methods that the werlbelieves will be adequate for this well.constructor
), //aA.-.1o ,, --ro /
Check No.
START CARD
NOTICE OF BEGINNING OF WELL CONSTRUCTION
(as required bv ORS 537.762)
This form must be completed, signed by both the owner (or authorized agqnj) and.c_onstructor, and the original mailed or
delivered to the Water'Resourcei Depirtment, 158 12th St. NE, Salem, OR 97310, no later than the day construction,
alteration, conversion or abandonment work begins. A $75 fee shall accompany all notices for new well construction or
conversion of an existing hole not previously used to obtain water (make checks payable to the Water Resources
Department). Notices meeting this requirement but received without the required fee will not be accepted a-l proPerly
and timely filed. In addition,-the consiructor shall provide the "Watermaster Copy" of this notice to the office of the
district watermaster within which the well is being constructed, altered, converted or abandoned using one of the
following options: (a) by regular mail no later than- three (3) calendar days (72 hours) prior to commencement of
work; or, (6) by hand detivery, during regular office hours, no later than the day work is commencedl or, (9) by FAX no
later than the diy work is commenced. If this method is used, the original "Watermaster copy" of this notice shall also
be mailed u.-delivered to inebffice of the district watermaster no later than the day work is commenced. The Water
Resources Commission has authority to impose civil penalties for failure to submit the required $75 fee with the start
card and for failure to submit cards prior to beginning any construction, alteration, conversion or abandonment work.
Owner's name and mailing address:
.1
Check type of work: Required
New construction
Conversion
Fee IE A Alteration @epair/Recondition)
E i;mrx"*&11ffi,#Required
Proposed Commencement Date ;, -f ',.;f Existing or Proposed Well Depth ,.. i Diameter , .
'
I Public System (Community) f] Industrial ! Irrigation ! Monitoring
Check Use: I Domestic
I Thermal I Injection f] Other
Township (N o S) Range .': r -r @ or W) Section ---
U4 of i U4 of abve sectionl.
3. Tax lot number of well location i ) :' ..- r')r")
4. Attach map with location identified.
See reverse of this form for approved maps.
5. Show well location within 1/4, 1/4 of section grid at left
I hereby certify that the information provided herein is accurate and the well is being properly located from septic tanks,
septic drain fields and other hazzrds. (See#2 on back)
,' i .t /: - ". r''.-4 License No.
Bonded WaterMcinitor Well Construc-to{
Company
NOTE: This is not a water right application. The owner is responsible for obtaining a water right through the
Water Resources Departmenf if required. Public Systems require plans to be submitted to and appnoved by the
Oregon Health Division prior to construction.
No Fee
Prooosed Well Location: Countv Owner's Well Id. No.
2. Street address of well location - ir', .o-
STATE OFOREGON
WATER SUPPLY WELL REPORT
(as rcquircd by ORS 537.765)
th is are of this form.
1) OWNER:WeIl Numbcr
Name
(2) TY
E New Well E Deepening E Alteration (rcpair/recondition) lUdbandonmenr
(3) DRILLMETHOD:
!RoraryAir [RouryMud ECable lArg"t
Other
!Community IIndustrial !Irrigation
Thermal [Injection
HOLE CONSTR
Special Construction approval Q/f". ! No Dcpth of Complered Wcll
-ft.
Explosivesused flYes ENo Typ.- Amount
(START CARD) #
(9) LOCATION OFWELL by legal description:
County
NorS Range
Longiurde_
E or W. WM.
Section
Tax lot _Lot_ Block
Street Address of Well (or nearest address)
U4_ U4
Subdivision
Size of gravel
To Gauge Steel Plastic Weldcd Thrcaded
Number Diamctcr
Material
Telc/pipe
size
-- i C* ft. below land surface.
Anesian pressurc
( 1l)
Depth at which water was firsr found
From To Esrimated Flow Rate SWL
'/ tt
t fr(t ,tf,r,,J?) a t-
(12) wELL LOG:
Ground Elevarion
I)ate starled
Marerial From To SWL
/' 1.b,.. i*. ,h o -L
i" i^.) ^--. I .f ^,1 .'ti'.ti -,^ -\-
-v7-
- -
lb. per square inch.
Date
Date
HOLE
Diameter From To
SEAL
Materlal From To Sacks or pounds#
#
How was seal placed: Method A B
E other
Backfill placed
CDDEE
fi. to
ft. ro
ft.
ft.
Material
Gravel placed frorn
ER:
FromDiamcter
Casi
Liner:
Final location of shoe(s)
7)A'
! Perforations
I Screens
From To
Slot
size
Method
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tr
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Type
(8) WELLTESTS: Minimum testing time is I hour
f]Pump lBailer [air
Yicld ll stcm at
Flowing
I Anesian
Time
(unbondcd) Water/Certification:
I hr.
I ccnify that the work I performed on the construction, alteration, or abandonment
of this well is in compliance with Oregon water supply well construction standards.
Materials used and information reported above are true to the bcst of my knowledge
and bclief.
WWC Numbcr
DateSigned
Temperature DepthAncsian Flow Found :(bonded) ll'ater Wcll Constructor Ccrtilication:
Was a walcr analysis done? ! Yes By whom
Did any strara contain war.er not suitable for intended use? ! 'lbo l.ittle
!Satry !Uuaay lOaor lColored !Orher
Dcpth of strata
of water
.\ /..,--.
ORICINAL & FIRST COPY.WATER RESOURCES DEPARTMENT SECOND COPY-CONSTRUCTOR THIR
(r0) S lAl lU wAl l,R LEv r-L|
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Please complete all lines inslde white boxes, lt possible tulthg B.ilrdhtgl t h*
prouementsolUp W
House
Bam
Garage
Mobile Home
Shed
SEPTIC INSTALLED?
7Yes
No
Water District
Dlrcctlons to sfte lrom
aearest maln lntercectlon
fu/L p/rrt *^,>
o
T En*
+1^
TTAP, PARCEL NUMBER
(Fomd on trr lllrp. h tr. 4.....mril & T.r.lbn D.pal
15ffip @- -Edon tiaEdon
IofiilIp Tnry -Salm- tEEalm--
Trrlot
Tlr Lot
Site Address
Brand
Year
Size
No. of
x-
starts with X)
Home
Only
hom
to:
Water
Ll[D staff can ]lOT be held
responslble for evatuatlons or
recommendatlons based on
lalse, lnaccurate or lncom-plete lnformatlon.
LCPW r40 - UC'
Your Addr6s
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Phgl6
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fdwriHp RDg. S.cdon tra S.cto.t fu Lot
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HOLID StIP
Lane
Countgilt r--
-APPLICATION
LOCATIO
E
ZIP CODE
The Lane County Building and Sanitation Division cannot proceed with
1. tr lncomplete application (items deficient).
Address and/or directions to application site.
Proposed number of bedrooms in dwelling.
Approvable plot plan (see attachment).
tr Notification of date test holes will be ready.
tr Verification of existing system required (see attachment).
Two test holes (2'x4'x5'deep) required for expansion or
system in the area of the proposed drainfields.
tl other
g
-$tS.
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ng your application because
sewage disposal
2.
3.
4.
SIGNATURE
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Eol!
DATE
fromto to
OFFICE HOURS PHONE
lf no response has been received in regards to this matter
the application will be denied.
LANE COUNTY ENVIRONMENTAL HEALTH SERVICES
Courthouse-Public Service Bldg. / 125 E. 8th Ave. / Eugene, OR 97401 I 697-4051
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APPLICATION i 74-(rb
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ZIP CODE
The Lane County Building and Sanitation Division cannot proceed with processing your application because:
E.lncomplete application (items deficient).
tr Address and/or directions to application site.
tr Proposed number of bedrooms in dwellinq.
tr Approvabte ptot ptan fsee a*aamerrtl-_l&7 ouL,
I Notification of date test holes wilt be ready.
Verification of existing system required (see attachment).
Twg tesl holes (2'x4'x5'deep) required for expansion or repair of existing sewage disposal
system in the area of the proposed drainfields.
1
3.
2.
4.
2
/(-9
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SIGNATURE
OFFICE HOURS
to ffiz-
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PHONE
., lf no response has been received in regards to this matterthe application wi[ be denied.
LANE COUNTY ENVIRONMENTAL HEALTH SERVICEScourthouse-pubric service eHg. l izt'E. etn n
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