HomeMy WebLinkAboutPermit Septic Tank 1991-05-29PERMIT #,G74-7/
SEPTIC SYSTEI'I VER IFICATIOI,IREAUEST
FOB:
."f5t ^'di'tie DALE STREET, sPR I NGF I ELD, oREGcN
grRuctunEa ]aow oa{ PraOPEitY-'EXi'Sfi'ttG"5'Iltelr FAMILY DIT,ELLING AND GARAGE
ROADT EAST TO PHEASANTI NORTH CN PHEASAi:T TO PINEDALE
T'i^t'-itlEiT"d:'"i461 oAK SrREEr, EUGENE, oREGoN E7401
LOT / PABCEL ILCX
ito. of SroetEg coa€tBtErxral coar/YALUEIIO. OF EIPLOYEEAWAIEF I{STALLEDPNOPOSED USE
PRIVATE
xo. oF aEDR@UADE3CmmON OF PAOPOSEO Wof,l(
OIRECTIONA TO SITE FiOT COUBTHOUSE
OWNERS NAIIE I ADDAESS
oaa ucENgE,COt{TBACTOi I{AME NANA
SEPIIC N IALLED
USE
SEPTIC SYSTEM VERIFICATION
COBURG ROAD TO HARLOW
STREET, TO R I GHT, EAST CUL-DE-SAC
3t+5-6789
746"0i66SAME AS THE JOB ADDRESS ABOVEKEN DICKEIIS0NT
NA
LEER, P.O. BOX iI11()-q, EUGENET OREGON 9i4t+()( nirru r coLLEEN
I have carefully read BOTH sldes ol thls
.,IM I,JEESE
s true and correct
#t'*o,
hereby that all lnformatlon I
READ CAREFULLYI Your Authorlzatlon !s Based On The Fo Condltlons
FEES DUE: 9 APPROVED BY:DATE -
CALL FOB TNSPECTTONS (SEE PACK OF FORM FOB
SEPTIC permlts are good for one year. ALL other permits expire atter 180 days unless inspections are current.
687-4065
VIOLATIONS
SBTBACKS AND OTHBR CONDMONS OF APPROVAL MUST BE STHCTLY OBSBVED. VIOLATION CAN REST'LT IN NtsVOCATION OF THIS PBRMIT'
cniilolls urv sB lssueD LTNDER. TrB pRovlsloNs oF LA}IB cot,NTY's INFRAcnoN oRDINANcts Al.lDr'oR oTIm. RBMEDIES ALLoUTBD BY LAw.
A MINIMUM OF AT LEAST 24 HOURS ADVANCE NOTICE MUST BE GI\TEN FOR INSPECTION REQUESTS
Ilave the following information ready when you call: 6874M5
Permitnumber - Job address - Typeofinspectionreqqired - Whenitwillbeready
Your name and phone number - Any special directions to the site
PUALIC OFFICIAL IIGIIT TO TBESPASS ON PBIVATE TIOPEITY OIS AS.OTII*ffi ffi xffffi ffi ffi :ffi'H"trtr:l#ffi Hffi ffi ffi'ffi-Hffi ff ffi [ffi ffi #"
REQI.'IRED INSPECTIONS
FOLJNDATION INSPECTION: To be made after excavations for footings ale complete and any required reinforcing steel is inplace.
I'TNDERGROLJND PIPING INSPECTION: To be made after dl undergrormd piping has been irutalle4 pnor to any backfill. -
CONCRETE SLAB OR UNDER-FLOOR INSPECTION: To be made after all in-slab or under-flocr building service equipment, conduit, piping
accessories and other ancillary equipment items are in place butbefore any concrete is placed or floor sheathing installed, 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 re complete
and the rough electrical, plumbing, and mechanical inspections have been made and app,roved.
INSULATION INSPECTION: To be made after dl insulation and vapor bariers are in place, prior to covering.
LATI{ AND/CR 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 gylxum bord joints and fasteners are tryed and finished.
ADDITIONAI, INSPECTIONS MAY BE REQIJIRED, zuch as bur not lirnited ro;
BLOCK WALL: To be made after rcinforcing is in place, but before any grout is poured The inspection is roquired 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 pric to the structure *r*rod"l"d area being occupied and prior to operating any eqgipnecrr
FINAL PLLJMBING INSPECTION: To be made jrst prior to the building, stmchne oi remodeled rea beint occupied.
FINAL BLIILDING INSPECTION: To be made after finish grading and the building, stnrcu:re or renrodeled area is completed and ready for occupancy.
MOBILEA'IANUFACTURED 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, fo setback requirements, blocking, tiedowns and plumbing connections.
Footings md piers to comply with State formdation requirernents for mobile homes or as re@mmended by the manufacturer.
Minimum finished floor elevation strall be certified when requircd by Floodplain Management
Tiedowns, if required, shall be installed ant ready for inspection within 30 days after occupancy. Tiedowns shall be installed per enclosure.
APPROVAL REQI.IIRED
No work shall be done on any part of the building or stnrcure beyond the point indicated in each successive inspection without first obtaining the
aproval of the building official. Such rygroval shall be given only after an inspection shell have been made of each successive step in tlrc construction
as indicated by each of the irupectioru required
APPROVED PI.ANS MUST BE ON THE JOB SITE AT ALL TIMES DURING WORKING HOURS.
THIS PERMIT WILL E)(PIRE IF WORK DOES NOT BEGIN WTruIN I8O DAYS, OR IF WORK IS STOPPED OR ABANDONED FOR MORE THAN IEO DAYS.
SUSPENSION OR REVOCAfiON MAY OCCUR IF TIIIS PERMIT WAS BSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS INFORMAfiON.
AT{YONE PROCEEDING PAST THE POINT OF REQTIIRED INSPECTIONS WILL DO SO AT THEIR OWN RISK.
Your signature on the front of this form verifies tlre following: I HAYE CAREFULLY EXAMINED TltrS 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
frirther 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 certiS 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 ttrat if exempt the basis for the exemption is noted hereon, and tlut only subcontracrors 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 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 holder will be notified, and all corrections shall be made before a cerrificate of completion
will be issued. Faih:re to meet satisfactory completion ivithin the allotted time constitutes a violation of ORS 454.605 to 4y.745 ard this rule.
SUBSURT'ACE SEWAGE DISPOSAL SETBACKS SEPTIC TANK DRAINFIELD
From: Interior property lines 10' 10'
Edge ofroadright-of-way l0' 10'
Building foundation 5' 10'
Wells or other water sources 50' 100'
Exlstlng Bulldlngs or
lmprovements on
Property
SHouseEIf Barn
dGarage[f, lrilohfle. Hom€l-t Shed
.SEPTIC INSTALLED
Fvesl-1 No
Water District
Please complete all lines inside white boxes, if possible.
PHONE
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from Courthouse
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For Mobile Home
Placement Only
Brand
No. of Tip-outs _
License #
Year
Size
nd Management Div. stalf cannot be held responsibte forevaluatlons or recommendations
based on false, Inaccurale orIncomplete lnformatlon
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