HomeMy WebLinkAboutPermit Septic Tank 1987-02-194n'rP j'/ 2 >82
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Lane County Authori za,ttort fon
(b EP c &rrrs orj
FOR OFFICE USE ONLY
Application/
Permit #b f3.n 7
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FRCPOSED
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CI'IY
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CURR.ENTLY ON
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I.JATER SUPPL ProposedExisti
TELEPHONE NUMBER}JAME AND ADDRESS
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TELEPHONE NUMBERAND
I HAVE CAREFULLY EXAIiINED THE COMPLETED APPLICATION rOR PERMIT, ar'd drj herelJy certi,iy t-hat atl infomation hereon is true and correct' and tha! I
NAUE (pfease print)
a).- l0(;avt, Dow
f:rther
ntauthori zedl:COrr fa(:t aserrrch rtheoownerrecordf agepthehaveinteItreslnTlegafollowingpropertyT fo Statethe ofthw1ttlr)anceuOrdr fo Lane theand Laws Oreqonbeshal I 1ndone accordattr;i,CoutythataIlandworkformedcertiperIfyany .vlDi ston ur-Ircturetrtthowftir eut m1 osslon fIbeIomadefpc the Bui ldinghereinthatandOCCUPANCYnniNOtoworkthesdecribedrtaining bathe forIctre17005that exenptifeI1Stn1f ul-orcet eitnd fe a5 byf xemPtrBoardquired
ANDREADIHAVEonusedth,S ecttf.w1 701ORS 1I be ProlarewhonIconplianceildemployees
ther cerlify that registration with the Builde
is noted hereon, and that only subcontractors
CIIECKED THIS APPLICATION THOROUGHLI.
zone partition # Parcer *- Parcer Size-
Date:
rnstallation Record rssuetl? fl Y"= fl n"
UseATII pr,ans
COMT1ENTS:
F
COM}1ENTS
Date
Date
t
B. P. #SANITATION: s. I- *
YOUR AUTHORIZATION IIAS BEEN BASED ON THE FOLLOWI NG CONDITIONS:
re arin te ri or
cor'!\lEtlTs
READ THIS SECTION CAREFULLY
fl pr,alurnc,zzoNrNG:
l4aximum DePth
of TrenchesLineal Feet
of Drainf,ieldrnstarlation Gallon
Specificaeions:
-Tank
c .-f, qr deMinimum setbacks, "", ,ton
Jtn-f7
DATE
OFF ORS 80s (r
ENT OF PUBLIC WORKS LAND MANAGEMENT DIVI
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
J LANECOU
f* l"-" ue
SEE REVERSE FOR INSPECTION INI'ORMATION
sloN, 687-4061,
ct4-25 R*
D
n
Type Group
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SETBaTCKS AND OTIIDR CO:iDI?IoNS OF APPROVAL MUST BE STRICTLY OBSERVED, VIOLATION CAN RESULT IN REVO-
cnTIo:t oF tttrs PER|lii, crT;Tro:; UNDSR PirovlSioNs oi LAr-E a3u);TY'|:l I\FRACTIoN oRDI:;ANCS, AND/OR OTHER
REIIEDIES ALLOHED BY LAW.
'iHEN
RE.\DY FOR If,'SPDC,TION, CALL 687-.i065. i1 }1INI}IU:.l OF ,i'i LEAST 2t IIOURS ADVAI;CE NOTICE FOR INSPEC-
TIoN REQUf:STS l.lLrST Btr GIVEN. IIa'/e Lhe following iniornation ready: permit number, lob address, Lypsof inspeccion, when i,t wiII be reaCy, your name and phonc nunber, and any special- Circctions to Site.
BUILDTNG DTVTSTON:
REQUIRED I:.SPECTIONS :
L. Poundation rnspectron: To'be made after trenches are excavated and forms erect€d and when aI1naterials for the founCation are delivered on the job. iihere concreto from d central mixingplant (comonly termed, "transit nrxed") .is to be used, naterials need noL be on the job.
2. Conclete Slab or t-Jnder-aLoor Inspection: To be maie after all in-slab or under-floor buildingEilvirefl-ipm*t,-qAult, piping-EEE6ssories, and other anciltarl, equipment ilems are in
. place but before any concrete is poured or floor sheathing installed. including the subfloor.
3. IEI+S & Insulalion In:!!!-- trene, . To be made af ter the roof , .ill f raning, f ire blocking, andbracing are 1n ?face ano all pi.pes, fireplaces, chimneys, and vents are complete and ali roughelectrical and plunbing are apploved. At1 ualL insulation anC vapor barriei are in place.
4- Lalh 1!g/9r Gypsum 99gl !I:!l:!!19t, To be made aiter al-l lathing and gypsun board, interiorand e\.erior, is rn-pEce-b-u-befu-re any pLastering is appliec an6 beio;a'gypsm board jointsald fasteners are taped and fj-nrshed.
5. Final rnspecticn: To be nade after the buirding is conplete ana uetore occupancy.
APPRoVAL REOUrRED. :Jo work sharr be done on any-parL of:he builciog or structure beyond the pointj.ndj'cated in each successive iispection without firsr obtalrrng tne i.opiovaL of tire b;ildin! o?ilciarsuch aDproval shal-l' be given cnry after an inspection shalr have beel'iade of each urcc"ssi,ie =i"pin the constructj.on as indicared by each of thi inspecticns requiieJ.
NorE: AIl building Pernits reguire inspections for the work authori-zed, such as but not limited to:A' Bl-ock l^Ia1l: To be.nace-after reinforcing is in place, but before any grout is poured. ThisInsprctlm is required for each bond beari oour. There will be no approval untiL the plumb1ngand electricaL inspectlons have been nade ind approved.
B. l.Iood Srove: To be made after completion of nasonri- (if applicable) and when instal,larion iscoqplete' rnstallation sha.rr be i^ u..o.Jun." uith ar appiovea, nationalry recognized testingagency and the manufacturer's instaflaLion fnstructions.
c' Mobj're Home: An inspectlon is requrred after the mobile hone is connected to an approvediEwE?-ofseptic sl,stlm for.setbacl., requiiements, blockj-ng, footing connection, tiedowns,skirt j.ng, and plmbing connect.ions.
1' Footings and piers to comply uith state foundation requiremencs for mobile homes or asrecomended by the manufacturer-
2' Mobire home hinimum finish floor elevation shall be certified when required by a frood-plain management IeELer.
3' ilobire hone tiedowns, when required, and skirting shall be instarl,ed and ready for.insoec-tion within at least 30 days ifter occupancl,, Tiedowns and skirting shaLl. be instalLeiper enclosure.
D. ###rT+ir=lii?Xo?r.u. when sreel is io place and before concrere j.s poured. Above srade
APPROVED PLC'NS 51UST BE ON TIIE JOB SITE AT ALL TIMES DURING WORKING HOURS. THIS PERMIT I'ILI, EXPIRErF h'oRx DoEs Nor BEGIN wrrHr*- 160 DAYS, on ir wonr rs suspEr-DED oR ABAN;oNED FoR IroRE THAN r.go DAys.i$i:".il,i+?i":" RtrvocArroN l-LqY occu. rF iHrs prn'rii was rssuDD oN rHe aisii oF rNColrpLErE oR ERRoNEous
ANYONE PROCEEDING P.\ST THE POIi,:T O' REQUIRED INSPECTIo^-S WILL Do So AT THEIR owN nIsK.
SUBSURFACE AND AL?ERI\ATIVE SEI{AGE DISPOSAL SYSTE}IS:
I. permits shall be effective for one year from the Cate of issuance.2' upon conpl'eLing Lhe construction for uhich a pernit has been issued, the permit hol.der sharlnotify the Lane county DePartflent or llanning-and community o.".iopr.^t by submittj.ng theinstalration.ecorc forn. The Deparmeni
"nirr inspect irrl."r.iiI.aron ro detcrmi.ne j.f itcomplies with the rul-es contained'i;1;i; iiri.io..' ri ai;;;;;;;;;cr1on does compry with suchrules' the Department sharr issue o "uriiri.ut" of satisfactoiv-"o.pr"a.on to the permitr.horder.rr rhe consrrucrlon.roes nor compr!'"il;-;;;;-;ri;.,-;;"^;;;;;'*IXi.n"r,. notiry rhe permitholder and shalr requrre satr=r!ctory -.oiit.rion n.r".- i..rifr ih'e certiricate. Failure tomeet the requi'rements for sar-isfacto.lr.o.irotro.
"i;;i;;-;;;;lnu'ilr" ti.. consri.rutes a vio_Larion of oRs 4s4.60i ro 154.74s i.J-inii i:rt"
Setbacks - Subsurface Sewa!lc Disosal
Iiterio! properti, lines
ECge oi' road rrght-of-way
Burldinq founCation
lieLIs, other uater sources
.ScpLic T3nk
10'
10'
50'
4\
Drainfield
t0'
10,
100,
(D:m,, ACT|V|TY tNFORttIATtON SHEET
Please complete all ltems above dotted line
'eI3.H:i':,H,y*s::i-
FILLING ouT * LINES wILL GET You INFoBMATIoN oNLY
-
x DATE _ l___l__
*PERSON
MAI(ING
REOUEST
ACTUAL
PROPERTY
OWNE
CITY
,0
ADDR ECC 0
CITY STA I .),TE , _ZrP_
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ATE_ZrP_
TELEPHONE (BUS) ,. , (HoME)_TELEPHONE
*pnOpeRTY ADDRES
OR
MAP & PARCEL NUMBER (round on tax maps in the Assessment & Taxation Dept.)
t1
STAFF WILL DETERMINE
-
Zoned Flood Plain
Zoned Flood Plain
Zoned Flood Plain
Townshlp Range Sectlon Tax Lot
Townshlp Range Section Tax Lot
Township Range Section Tax Lot
TOTAL CONTIGUOUS PROPERTY lN SAME OWNERSHIP: ACRES
*REQUESTlaescribe what you want to d /.tttrr
Directions to site ll
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a.rf ,arar.trarrutf ,, staff use onlyttt.rrr., f .ar.rr.rra
Com ments:
Land Management Division, Public Works Department E.Ave., Eugene, OR 97401 phone 6874061
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