HomeMy WebLinkAboutPermit Septic Tank 1992-11-16PERMIT #e/5t ,qZ
SEPTIC SYSTE14 VERIFICATIONBEOUEST
FOR:
60a3
SPRINGFIELD,
Ll2 MILE,
ABOV E .
701 RAYNER
57
PHONE
'T63
L ARRY HAYES I
orvGRs NAi,lE E ADDBESS L475 K I EV STREET,
ON
WATEFSEPTP
ED&CINDY REEVES,
NAIIEBUILDER
RINGFIELDI
S
MAIN
5
LEFT ON RAI"1B LING DRI VE TO SITE
H APPROX.
TE SERI
BLING DRIVETR AI.1
AND SHEDGARAGED!'JELLINGTNGLE FAM I LYISTING SIEX
TRoPosEo LEE
STEM VEREPTIC SY
TH, NORTTO NORTH
747"6965TFFlrcmruue e STREET, SP
7t4
ccB,
OREGON
O\.INER
OREGONSPRINGFIELDI
OREGON
IFlCATION
5"0964
EUGENE,i461 OTY
STREET
oR EGoN 9740iOAK STREET,,WWand here ce that all inlorm ation I
PR[.{T NAI,IE
sides ol thls a pplI have carelully read B
LARRY HAYES
DATEFEES DUE: $APPROVED BY
CALL FOB |NS2ECT|ONS (SEE BACK OF FORM FOR TIoNS) 687-4065
days unless inspectlons are cltrrcnt,sEPTlc permits are good for one year. ALL other permits expire after lg0
LMD O4O Rev.6/92
READ CAREFULLY!ConditionsTheOnBasedlsAuthorizationYour
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[Iave the folfowing information ready when you call: 6g74065
Permitnumber - Job dg:, _ Type of inspectionrequired _ When it will bereadyyour name and phone numbei _ Any special directions to the site
PowERToBMERuPoNLAND'
"**ffi*l?,i5ff^1{'ff}::#-ffif;Heyiffiffiffigl*fi'*fr****oFrHBrRp,Nc,.oNs.MAyBNTBR TJPON ANY LAND AND MATG EXAI\,IINATIONS AND SI'RVEYS AND PI.ACB AND MAINTAIN TIIB NECFJSARY MONUMENTS AND MARKERS TITEREON.
FouNDATIoN INSPECTI.N: ro be made *,* "::1'-l:: ti?ffir?q::ffi,3f. any required reinrorcing steer is in prace.UNDERGRoI-IND PIPING INSPECTIoN: To bemadeafter ar unaerSuno piping has u"", i*rili"a pnor to any backfill.CoNCRETE SLAB oR UNDER-FLooR INSPECTION: To be made it",
"u i*rr"t o, urra"r-noo, irm1r,.s service equipme.ng conduit, pipingaccessories and other ancillary equipment items are in place tu, u"r.r" *y """*r" is placed or floor sheathing installed, including the subfloor.RoUGH MECHANICAL ['rsPECiIoN: To be made-afte, dr orctirrg-;d; piping has b""r, ir";; and prior to being covered.ROUGH PLUMBING INSPECTIoN: To be madeafter
"u
pt *b;;;;;;L is in prace, prior to being covered.
*#HffiffiS*fi,trTifff:ruruX;';f:Xlfff:ffi##:;;;H*oa,,pipes'chimnevsandvenrsarecomp,e,eINSULATIoN INSPECTToN' ro u" made after all insulation *a ,rupo. tui"r, are in place, prior ro covering.
i,i{{ffi1?.}f.!it[,:?#,',"T#ffi:X:nm*"t',m#--,;;ffi'*il,',io,-o,a"*,erior,isinp,acebu,beroreanyADDTTIoNAL TNSPECTTONS MAr BE itrqurnru, such as uut not timitea to;BLocK WALL: To be made after reinforcing is-in ptace, but b"f.." .ny;ut is pqwea rhe inspection is required for each bond treasr pour. Therewill be no approval until the plumbing and ete-ctrica inspections trave ueeimua" una app-rr"a. r ri requ'ed tor each bond
FINAL MECHANICAL INsPECnou: To be made just prior to a" rt *no" or r"-oa"to area being occupied and pnor to operating any eg'ipnenrFINAL PLUMBING INSpECIION:Jo be made jusrprior to the buildingl srr"n r. or remodeled area being oocupied.EINAL BI'ILDING INSPECTT0N: To be made
"?t"J
h"itr, gadins *a ir" iriloi"g, struch*e * .*roa"u area is compreed and ready fc oe,pncy.MoBILEA'IANUFACTURED HoMES: An inspection it t quited-^ftu, the mobite home is connected to an apprroved sewer or septicsystem' Prior to covering sewer or water lines, foi setback requirernents, blocking, tiedowns and plumbing connections.Footings and piers to comply with state foundation requirem€nb for mobile homes or is recommended by the marufacturer.Minimum finished floor elevation shall be certified when required by Floodplain ManagemenrTiedowns, if required, shall be installed and ready for inqpeciion witirin:o d"y, rft* ";;;;;y. Tiedowns shall be installedper enclosure.
APPROVAL REQUIRED
No work shall be done on any part of the building orstructure beyord the point indicated in each successive inspection without first obtaining theapproval of the building official. Such approval shall be given only aner an inspection shall have been made of each successive step in the corutructionas indicated by each of the inspections required.
rHIs PERMIT wr* *r*' " *&1i1%H',o1?lH"WiliiltT#i"^'f3.3ffi$f.?ffi#STf L"^ffi$if?ffi M'RE rrrAN ,80 DAys.susPENsIoN oR REvocATIoN MAY occuR IF TIIIS PERMIT wAs IssuEb oN TIIE-BASIs or nrcor"rpirrB-oi ERRitr.EdIi E{F6RMATT911,
AI\YONE PROCEEDING PAST THE PoFIIT oF REQI.IIRED INSPECTIoNS WILL Do so AT THEIR owN,BIsK.
Your sigriature on the front of this form verifies the following: I HAVE€.{REFULLY EXAMINED THIS coMpLETED APPLICATIoN, and do
hereby certify that all information hereon is true and correct" and that I have a legal interest in ttre property as owner of record or authorized ag;. 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 degon per-
taining to the wofk described huein. I further certify that if I am not the owner of the poperty, my registration wittr the Builders Board i" in t u toti"
and gffeCt as fequifed by ORS 701.055, and that if exempt the basis for the exemption is noted hereon, and that orrly subcontractors and emplovees who
ue in complianie with ORS 701'005 will be used on tre job'
$s
suBsuRrAcEs,wAcEDrsposAls,*ftr":*Irii#""'$*"-*[:'
t,;,[rliius"***o "o'
1oo
Exlstlng Bulldlngs or
lmprovemenls on
Property
House
Bam
Garage
lrttcbile. Horne
Shed
SEPTIC INSTALLED
Yes
Nlo
del-Icr
d
ilFE
Weler District '
Please complete all llnes inslde whlte boxes, if possible.
MAP, PARCEL NUMBER
(Found on tu m.p3 ln th. A.B3nanl I Turtlon Dapt)11 oS ?{ 2-l 03600ffi- TfiF EiIm-- rIrGiiEF -rrri-
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TF6[_OWNER OF PnOPEBTY (ll not m. r rbovr/
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OWNEFS ADDREa3 (f nol ..n ...boy.,
ztP
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l41f Ktcu
llrqes
Lca
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0cU Orqo't
10/ e 7{t-b ft,t-
Dlrectlons to slte lrom
nearest maln lntersectlon
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tl ( Mola"tL 6ur)
Le{t 0n lZa^ll,a-1
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Norl./,',( l/u rn,/i
srrE ADDRES"
I bS t Ra.nl I rn Drlde -/tctd Q'l.r{17
MAIL PERMTT TO:Moblle Home/4q€s ent Only
( 04t- fuul Size.oM 0re 0/1 q x(ol No. ol
License
STAFF EVALUATION from
Inlormation Req
TBS Verilied
Allowed Use
Land Managemenl Div. stalf can
not be held responsible lor
evaluataons or recommendations
based on lalse, inaccurate or
LMo 14e- 2a2 incomplete inrormstio
ril4-68 02/92
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