HomeMy WebLinkAboutPermit Septic Tank 1994-04-257+o 4so
?PERMIT #
REAUEST
FOR:
BOTH sldes ol thls
s or/3 trus and correctHkl?l-that all lnformatlon Ireadly()I have careful
DATt rn
READ CAREFULLYI Your Authorlzatlon ls Based On The Foflowtn Condltlons
FEES DUE: S APPROVED BY:DATE r-
year.
FORCALL INSPECTIONS BAE OFCK FORFORM(sE 065687-4UCTlous)
SEP Tlc are for neo other after 80permltsgood unless areI tcutrenpermltsexpiredaysinspactlonALL
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SBTBACKSANDOTHERCONDMONSOFAPPROVALMUSTBESTRICTLYOBSERVED. VIOLATIONCANRFST'LTINRBVOCATIONOFTTIISPBRMIT.
CTTATIONS MAY BB ISSUED T'NDER. THB PROVISIONS OF LANE COTJNTY'S INPR,ACTION ORDINANCB ANDr'OR, OTHER REMEDIBS ALLOWED BY LAW.
A MINIMUM OF AT LEAST 24 HOURS ADVANCE NOTICE MUST BE GIVENFOR INSPECTION REQI]ESTS
Ilave the following information ready when you call: 6874M5
Permit numb€f - Job address - Type of inspection required - Wheh it will be ready
' 'Your name and phone number - Any special directions [o the site
powERroEN,ERUpoNLAND. ,*""ffi*1!.R1ffi#3Fllffiffirft::H&!'iffi'#[B$I,Bli'fi'*1L-t**ornunnrri:noxs,urv
ENTER I.JPON ANY LAND AI{D MAXB EXAMINATTONS AND STJRVEYS AND E.ACE AND MAINTAIN TIIE NFTESSARY MONI'MEITITS AND MARIGRS TIIEREON.
REQI.NRED INSPECTIONS "
FOLTNDATION INSPECTION: To be made after excavations for footings are complete and any required reinfori:ing steel isin place.'
UNDERGROLJND PIPING INSPECIION: To be made after all underground piprnS has been installed, pnor to any backfill
CONCRETE SLAB OR UNDER-FLOOR INSPECTION: To be made after'all in-slab or under-floor building sewice equipmeng conduit, piping
accessories and other ancillary equipment items are in place but before ary concrete is placed or.floor sheathing installed, including the subfloor. . .
ROUGH MECHANICAL INSPECTION: To be made after all ducting and gas pipiag has been installed and prior to being covered.
ROUGH PLUMBING-INSPECTION: To be made after all plumbing rough-in is in place, lrior to beiirg covei6d. ' ! - '. '
FRAMING INSPECTION: To be made after the all framing, fire blocking, bracing and roof are in place and all pipes, chimneys and vents are complete
and the rough electrical, plumbing, and mechanical inspections have been made and approved
INSULATION INSPECTION: 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 but before any
plastering is applied 6r before gypsum boaril joints adjastengn are tap6d 1dlfinished. \ ., r
AIIDITIONAL INSPECTIONS MAY BE REQTIIRED, such as but not limited to;
BLOCK WALL: To be made after reinforcing is in place, but before any 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 apprcved.
FINAL MECHANICAL INSPECTION: To be made just prior to the struchre or remodeled area being occupied and prior to operating any equipmenf
FINAL PLUMBING INSPECTION: To be made just prior to the building, stnrchre or remodeled area being occupied"
FINAL B[IILDING INSPECTION: To be made 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 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 fomdation requirements for mobile homes or as recommended by the manufacturer.
Minimum finished floor elevation shall be certified when required by Floodplain Management
Tiedowrs, if required, shall be installed and ready for inspection within 30 days after occupancy. Tiedowns shall be installed per enclosure.
APPROYAL REQUIRED
No work shall be done on any part of the building or structure beyond the point indicated in each successive inspection without flust obtaining the
approval of the building official. Such ap'p'roval shall be given only after an irupection shall have been ma& of each successive step in the construction
as indicated by each of the irupectioru required.
APPROVED PLANS MUST BE ON TIIE JOB SITE AT ALL TMES DI,JRING WORKING HOIJRS.
THIS PERMT WILL E)(PIRE IF WORK DOES NOT BEGIN WTTHIN I8O DAYS, OR IF WORK IS STOPPED OR ABANDONED FOR MORE THAN I8O DAYS.
SUSPENSION OR REVOCATION MAY OCCI,JR IF TTIIS PERMIT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS INFORMATION.
ANYONE PROCEEDING PAST THE POINT OF REQITIRED INSPECTTONS WILL DO SO AT THEIR OWN RISK.
Your signature on the front of this form verifies the following: I HAVE CAREFIrLLY EXAMINED THIS COMPLETED APPLICATION, and do
hereby certify Orat 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 ttrat any and all work performed shall be done in accordance with the Ordinances of Lane County and the lawg of t!: State of Oregon per-
taining to the work described herein. I further certify that if I am not the owner of the properyrgny regisurfln 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 notddl*rgqrt,4r*Ut only srltrcontractors and emjloyees who
areincompliancewithORST0l.005willbeusedonthejob. .r,- ,Fnil& .ftfft|d W*X,
SUBSURFACE & ALTERNATIVE sEwAGE DISPoSAL SYSTEMS: '-,1} T \, q-}.Li,,.A," SiO
When subsurface construction is complete, the permit holder shall notify the County Land Management Division bf slbmitting the installation record
form. An inspertion will be made by a qualified sanitarian. If constnrction complies with all rules a certificate of co{$o1ryil,pe issued to the permit
holder. If construction does not comply with rules, the permit holder will be notified, and all corrections shall be made bdf{lf 4ftiScate of comPletion
will be issued. Failure to meet satisfactory completion within the allotted time constitutes a violation of ORS 454.605 to 45Ellt5 dn! this rule.
SUBSURF'ACE SEWAGE DISPOSAL SETBACKS SEPTIC TANK DRAINFIELD
From: Interior property lines 10' l0'
Edge ofroadright-of-way 10' 10'
Building foundation 5' 10'
Wellsorotherwatersources 50' 100'
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APPLICANT'S NAME AND
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SITE MEETS STATE STANDARDS
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Holding Tank
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. COMMENTS:
FLOODPLAT N I NFORMATI ON
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E Approximate
Study Area
All or part of this site may be in a flood hazard
area for which 100 year flood levels have nol
been established. Extra precautions may b€
appropriat6 to assur€ that the building site will
be reasonably safe from llooding.
All or part of this site may be in a llood hazard
area for which 100 year flood levels have been
established. A building elevation above the 100
year flood level may be required.
All or part of this site may be in a flood hazard
area in which a floodway has been designated.
Building may be prohibited subject to
demonstration that the cumulative ettect of
proposed development will not increase the
100 year flood level at any Point.
tr Detailed
Study Area
TH]S IS A PBELIMINARY REPORT WHICH DOES NOT ENSURE THE ISSUANCE OF A FUTURE
BUILDING PERMIT. ANY PLANS OR EXPENDITURES MADE IN RELIANCE UPON THIS REPORT
ARE ATYOUR OWN RISK. IF SITE 1S APPROVED, SEE REVERSE SIDE.
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OATE
E COUNTY ENVIRONMENTAL HEALTH,
c5$32
125 EAST 8TH AVENUE, EUGENE, oREGoN 9740t (687-4051)
Subdivision:
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statem0nts are true and accurate, and that I have the
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the property: /owner olrecord; contract
not the owner)I am authorized to act lor the owner of record, and that said aware and approves of action.
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