HomeMy WebLinkAboutPermit Septic Tank 1993-09-13fic,ke)UP CLC cA u nb r y*_{r .f6o rna.s
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FOR:
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I have carefully read BOTH sides this appli that all information is true and correct
PRhJT NA}'E DE
and hereby certi
READ CAREFULLYI Your Authorlzetlon tr Berd On Tho Followlng Condltlonr
APPROVED BY:FEES DUE: $DATE
CALL FOn NSPECTTONS (SEE oF FOnM FOA NSTPUCTTONS) 687-4065
SEPTIC permlts are good for one year. ALL other pormll, orplre alter 180 dayo unleas lnspectlons trc cufient.
LMD 040 Rev. 6/92
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VIOLATIONS
SETBACKS AND OTIIBR CONDrrIONS OF APPROVAL MUST BB STRICILY OBSERVED. YIOI,ATTON CAII REST'LT IN REVOCATION OP THIS PtsRMIT.
.. CITATIONS MAY EB ISST BD UNDER THB PROVIIIIONS OF IAI{E CICUNTY'S INRACTION OnDINANCts ANDiOn OTIIER RBMEDIES ALLOWBD BY LAW.
A MTMMUM OF AT LEAST 24 HOURS ADVANCE NOTTCE MUST BE GrVEN FOR TNSPECTTON REQUESTS
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llave the following information ready when you call: 6874065
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Permit number - Job address - Type of inspection required - . When'it wlllte ready . : ;
Your narne and phone npmbc - Any speciai airections to Ore sitb
powBR.roEMERUpoNLAND. ,r*""ffi*l?"3,T1ffi#3FllHilB'"ft:iH&*'*B'#[BH3iiil1lff*"***oFrHErRF,NcrroNs.MAy " '
ENTER rJpoN ANy LAND AND MAIG BXAMINATIoNs AND soRvEys AND?I.AcB AND MAnrTAnI Tfu r.nii:ess.mv rrroNr.ni;nrtrs *p ilo"rent t c**n. . i"REQr.IREDTNSPECITO.NS'',:',;]
FOLTNDATION INSPECTION: To be made after excav,atiorp foJ footings.are co'nplee and anylrequirqd r-einforging qtegl is in place. j
I.]NDERGRoI']NDPPINGINsPECTIoN:Tobemadgafterallundergroundpipinghasbeeninstalled'priortorinybackfi1l.
CONCRETE SLAB OR IJNDER-FLOORINSPEGTION: To be made aftef a[ in-slabsrundetfloorbuildturg serviceequipmeng conduit, pipihg
accessories and other ancillary equipme.nt items aiie iir place but before any concrete is placed or.floor sheathing installed, inclu$ing the subfloor,
ROUGH MECHANICAL INSPECTION: To b'e made after all ducting ana las piping has beeir h*tatea ailg pnbr to being covfred. ' .
RoUGHPLUMBING..INSPEGTIoN:Tobemadeaftprallplumbingrough:qrr{inplace,pdiortobeingcoi,ered.l.i
FRAMING INSPECTIQN: To be made after ttre all framing, fire blocking, bracing and roof are in flace and all pipes, chimneys and vents are complete
and the rough elec'trical, piumblng, and mechanical inspections have been made and approved. I i
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
plasteringisappIiedorbdfore,gypsumboardjointsandfaste[ersaretaped9dfinished.
ADDITIONALINSFECTIONSMAYREREQUIRED,suchhsbu(notlmiledto; ' " , i.i
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BLOCK WALL: To be made after reinforcing is in place, but before any grout is poured. The inspection is requted for each bond beam pour. There
will be no approval until the plumbing and electrical inspections have been made and approved.
FINAL MECHANICAL INSPECTION: To be made just prior to the structure or remodeled area being occupied and prior to operating any equipment.
EINAL PLUMBING INSPECTION: To be made just prior to the building, struchxre or remodeled area being occupied.
EINAL BLTILDING INSPECTION: To be ma&r after finish gading 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 an approved sewer or septic
system, prior to covering sewer or water lines, for setback requirernents, blocking, tiedowns and plumbing connections.
Footings and piers to comply with State formdation requirernents for mobile homes or as recommended by the manufacturer,
Minimum finished flodr elevation shall be certified.when required by F'loodplain Management I -..
Tiedowns, if required, shall be initalled and ready" for inspeciion within 30 days after occupancy. tieaowns snAi be installed per enclosure.
APPROYALREQUIRED : .
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
approv3l of.the butlding offi;fi. lSuch.approval inat U" given only after an inspection shall have been made of each successive step in the consrruction
as inilicated by each of the irspections required.
APPROVED PT.ANS MUST BE ON THE JOB SII'E AT ALL TMES DIJRING WORKING HOIJRS.
T}IIS PERMIT WILL EXPIRE IF WORK DOES NOT BEGIN WTITIIN 180 DAYS, OR IF WORK IS STOPPED OR ABANDONED FOR MORE TI{AN I8O DAYS.
SUSPENSION OR REVOCATION MAY OCCUR IF THIS PERMIT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS INFORMATION.
ANYONE PROCEEDING PAST THE POINT OF'REQT,IRED 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 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 described herein. I further certiff that il I am not the owner of the property, my registration with the Builders Board is in full forie
and effect as required by ORS 70I.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 subsruface construction is complete, the permit holder shall notify the County Land Management Division by submitting the installation record
form. An fuupection 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 holder will be notified, and all corrections shall be madsbefore a certificate of completion
will be issued. Faihne to meet satisfactory completion within the allotted time constitutes a violation of ORS 454.605 to 454.745 and this rule.
SUBSURT'ACE SEWAGE DISPOSAL SETBACKS SEPTIC TANK DRAINT'IELD
From: Interior property lines l0' 10'
Edge of road right-of-way 10' 10'
Building foundation 5' 10'
Wells or other water sources 50' 100'
ilGB A(-I
eme
x
Exlstlng Bullcllngs or
lmprovements on
Property
EEI Housel-r Barn
E Garagel-r ltr|ohile. Home
E Shed
SEPTIC INSTALLEDEl Yes
El No
V/FterDistrict- : tM,
Please complete all lines inside white boxes, if possible.
PHONEnot gna aaOWNEA OF P
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