HomeMy WebLinkAboutPermit Septic Tank 1991-09-200 68'- SPzrr,6Fce74
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SEPTIC SYSTEM VERIFICATIONREAUEST
FOR:
EXcEL REALTy) 1461 onK srREET, EUGENE,0REGoN 97ti01
have carefully
JIM VfEESE
and correct?/read OTH ofsldes 3rhl althat nformatlon lsappllcatlcertlfyhereby
READ CAREFULLYI Your Authorlzatlon Is Based On.The Fo Condltlons
FEES DUE: $APPROVED BY:DATE 7- s-o -?t
GALL FOR TNSPECTTONS (SEE BACK OF FORM FOB TBUCTTONS) 687-4065
PSE Ttc ate onetor LA oL ther 180 da unless current,arepermltsgoodyear,permlts expire ,y9 inspections
'3Tlit"'F'fi"rnsnur BLVD., spRrNGFrELD, oREGoN
COEURG ROAD NORTHI TO RIGHT ON HARLOW ROAD, GO EAST TO PHEASANT BLVD., TURN
TH0t4PS0N, SAtJiE AS THE J0B ADDRESS AB0VE
L7 ?2.c5 800
xo. s sToBtB XO. q ilPLOYEE9
APPLISAXT NAUE I APDEESE '"""'545-67 89JIM \,,'EESEI
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ooa.aleuctK)il coS7vaLuEdSIALUD
IVA E USE
NANA
VIFUSIUiES iOW S Pf,9FEETYEXISTING SINGLE FAi,iILY DI'JELLINGI SHED
PROPOSED USE SEPIIC NSTALLEO
LEFT (ItONTH) TO SITE ABOVE.
SEPTIC SYSTEM VERIFCATION
"o'= 5 gr -gr 46
VIOLATIONS
SETBACKSANDOTHBRCONDMONSOFAPPR.OVAI.MUSTBBSTRJCTLYOBSERVBD. VIOLATIONCANREST'LTINREVOCATIONOFTHISPtsRMIT.
CTTATIONS MAY BE ISSUBD I'NDER THE PROVISIONS OF LANE COI,'NTY'S INFR,ACTION ORDINANCE ANDr'OR, OT}IER REMEDIES AIIOWED BY LAW.
A MINIMTIM OF AT LEAST 24 HOURS ADVANCE NOTICE MUST BE GTVEN FOR INSPECTION REQI]ESTS
Ilave the following information ready when you call: 6874M5
Pernrit number - Job address - Type of inspection required - When it will be ready
Your name and phone number - Any special directiors to the site
powERroENrERU,.NLAND. "*"oi$,"'l?"?Tffi^XYS}IlHffirit::H&!'iffi-#[8ffi?HfiH?*-r**oFrHErRFUNcnoNs,MAyENTER I,JPON ANY LAND AND MAKB EXAMINATIONS A}.ID STJRVEYS AND PT"ACE AND MAINTAIN THE NBCtsSSARY MONT'MEI{1'Si AND MARKERS TTIERBON.
REQI.IIRED INSPECTIONS
FOLJNDATION INSPECTION: To be made after excavations for footings are complete and any required reinforcing steel is in place.
UNDERGROUND PIPING INSPECTION: To be made after all underground piping has been installed, prior to any backfill.
CONCRETE SLAB OR LJNDER-FLOOR INSPECTION: To be made after all in-slab or under-flocr buildhg service equipmeng conduit, piping
accessories and other ancillary equipment items are in place but before any concrete is placed or floor sheathing futstalle4 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 ue complete
and the rough electrical, plumbing, and mechanical inspections have been made and approved.
INSULATION INSPECIION: To be made after all insulation and vapor barrien 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 btrt boforc any
plastering is applied or before gypsum boardjoints and fasteners are taped and finished.
ADDITIONAL INSPECTIONS MAY BE REQIJIRED, such as but not limited to;
BLOCK WALL: To be made after reinforcing is in place, but before ury grout is poured The inspection is required for each bond beam pour. There
will be no approval until the plumbing and electrical inspections have been made and approved.
EINAL MECHANICAL INSPECTION: To be made just prior to the strucnre or remodelbd area being occupied and prior to operating any equipnenr
FINAL PLUMBING INSPECTION: To be made just prior to the building, struchre or remodeled rea being occupied"
FINAL BT ILDING INSPECTION: To be made after finish grading and the building, structure or remodeled area is completed and ready for occupancy.
MOBILEMANUFACTURED HOMES: An inspection is required after the mobile home is connected to m approved 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 formdation requirements 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 occupancy. Tiedowns shall be installed per enclozure.
APPROVAL REQTIIRED
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 inspection 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 TIIE JOB SITE AT ALL TMES DURING WORKING HOLJRS.
THIS PERMIT WILL E)(PIRE IF WORK DOES NOT BEGIN WIfiIIN I8O DAYS, OR IF WORK IS STOPPED OR ABANDONED FOR MORE THAN I8O DAYS.
SUSPENSION OR REVOCATION MAY OCCIJR IF THIS PERMIT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS INFORMATION.
AT{YONE PROCEEDING PAST THE POINT OF REQUIRED INSPECTIONS WILL DO SO AT THEIR OWN RISK.
Your signature on the front of this form verifies the following: I HAYE CAREFT LLY EXAMINED TItrS COMPLETED APPLICATION 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 that any and all work performed shall be done in accordance with the Ordinances of Lane County and the laws of the State of Oregon per-
taining to the work desctibed herein. I further certify 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 subcontractors and employees who
are in compliance with ORS 701.005 will be used on the job.
SUBSURFACE & ALTERNATIVE SEWAGE DISPOSAL SYSTEMS:
When subsurface construction is complete, the permit holder shall notify the County Land Management Division by submitting the installation record
form. An 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 construction does not comply with rules, the permit hotder will be notiflred, and all corrections shall be made before a certificate of compietion
will be issued. Failure to meet satisfactory completion within the allotted time constitutes a violation of ORS 454.605 to 454.745 and rhis rule.
SUBSURFACE SEWAGE DISPOSAL SETBACKS SEPTIC TANK DRAINFIELD
From: Interior property lines 10' l0'
Edge ofroadrighrof-way l0' 10'
Building foundation 5' l0'
Wells or other water sources 50' 100'
Please complete all lines inside white boxes, if possible.Exlstlng Bulldlngs or
lmprovements on
Property
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