HomeMy WebLinkAboutPermit Septic Tank 1988-10-11&g /04
Lane County Authori zattott for'
SEPTIC INSPECTION FOR LOAN REVIEI{
FOR OFFICE USE ONLY
i\Cwi\*SH I P
t7
RANGE
03
SECTION
2334
TAX LOT
1r03 [our oF
SJBDIVISIoN/PARTITION (if applicable)I,OT,/PARCEL
PRCPOSED USE OF PROPERTY
W Residential [-l rndustriar
Commercial Public
!,CCATION ADDRESS STIT-EET
655 Rowan Avenue . Springfield, OR 97 47 7-3558
C]ITY ZIP
Rowantor
DiscRIPrIoN oF pRoPosED woRK - BE SPEcIFIcSEpTIC INSpECTI6N FgR LSAN REVIE1n1
Proposed
Existing
WATER SUPPLY
Rainbow03t
TELEPHONE NUMBER
7 46-0435Leland & Martha Cheever (site address)
ADDRNSS
TELEPHONE NUMBERCONTRACTORS NAME AND OSR
Leland & Martha Cheever (site address)
I IIAVE CAREFULLY EXAMTNED THE COMpLETED APPLICATION F.OR PERMIT, arrd,lo hercLy certiiy that all inforaation hereon is true and correct, and that r
Lo/ 4/88CheeverDT
DATE
zeaauthori agentrdtCOIIplrrchase rofrecord uownertheDrestinteINrtyathehavepropelegalfollowing of S!atethe oftheand Ore9onLawsthetliofo rCr nance 9 CowtyLileaCcO!dan(jebeshal.1 rndoneaIIandworkrf omedce rti:rther that pefyany f ur-.vlDi slon IssfonmaforlqwithoutureBui ldingthebeofnadestrpetheNOwlOCCUPANCYaiiI1hereincribedandthattoworkthede tirtainingpebastheforfIthatefe xemp1ASred70oRstr>mptanforcedffectbyasBoardfulIrequrINthWIBuitheldersthattrationI5rthere9 ANDREADcertifyects.HAVEI1IusedbethlsonWIORSth05s701Prolananceawhoarecomplildemployee
off
is noted hereon, and that only subcontractors
CBECKED THIS APPLICATION THOROUGHLY.
and & I,lartha
Parcel SizeParcel *
Yes
COMI1ENTS:
Date
NoDt1
Use
PLANS
Date
or re'
rnfPffiIltrt-TffiG-ncr
ar
S Ibtmnrvrrr*to ED
of Drai ie ldTank
COMI'IENTS
zone Partition #
inte ricL,ON REQUISPECORL!"eriTt'-*to"*
7"B. P. #
speci ficati
YOUR AUTHORIZATION :tAS BEEN BASED ON THE FOLLOWING CONDITIONS:
READ THIS SECTION CAREFULLY.
Install-ati-on Record Issued?
Lineal Eeet
COI',L\ENTS
Installation Gallon
s. r. *Maximum DePth
of Trenches
fl plauurtlc,zZoNrNG:
Minimum setbacks:
1-0-
SIGNEE Der ORS 456
OF PUBLIC WORKS LAN D MANAGEMENT DIVISION, 6874061'
125 EAST 8TH AVENU E, EUGENE, OREGON 97401
BY ILDING
LANE COUNTY
SEE REVERSE FOR I NSPECTION INFORMATION ct4-2s R*
S/K
!zl'^;i"i*g?9*(F
fl slurterrou,
/
Group
n
r;
SETBACKS AND OTHER CONDITIONS OF APPROVAL MUST BE STRICTLY OBSERVED. VIOLATION CAN RESULT IN REVO-
CATION OF THIS PERMIT, CITATION UNDER PROVISIONS OF LAIiE COUNTY'S INFRACTION ORDINANCE, AND/OR OTHER
CALL 6 8 ?-4065.
. H;ve-TEE-o
A MINIMU}I OF AT LEAST 24 HOURS ADVANCE NOTICE FOR INSPEC-
Il"owing information ready: permit number, job address, type
RETIEDIES ALLOWED BY LAW.
W!iEN READY FOR INSPDCTION,
@ENof inspection, uhen it ulII be ready
BUILDING DIVISION:
REQUI RED I NS PECTI ONS
your name and phone number, and any special directions to site
L. Foundation Inspection: To be made after trenches are excavated and forms erected and when aLlmaterj.als for the foundation are delivered on the job. lrhere concrete fron a central mixingPlant (comonly termed "transit mixed") is to be uied, materials need not be on the job.
2' -:=:9^=!*=-u^9::=ll?"t rnspection: ro be made af rer all in-slab or under-f loor buirdingservlce equrpment, condurt, prplng accessorj.es, and other ancillary equipmenL items are inplace but before any concrete is poured or floor sheathing in.t"iiia,'inlfrainq t;" "uUfi""..3' Framinq 6 rnsuratio l!:egg*:e!:, To.be made after the roof, alr framing, fire btocking, andEreln, tr;--miIa-@ fia-fillFes, riiepiace., chimneys, and vents are complete and aLl rougherectricar and plunbing are approved. ail wali insulaiion a"a v"por barriei are in p:.ice.-
4-
=+^:IqJgi
Gypsum,Bg?fd l::egs!]en: ro be made.after all larhing and gypsun board, i.nreriorand exterlor, is j.n prace bnE lerq-re any prastering j.s applied ird l"r"i6'typ"".-i"i.a"iIint"and fasteners are taped and finished.
5' Finar' rnspecti.on: To be made after the buir.ding is conplete and before occupancy.
APPRoVAL REoUTRED' No work sharl be done on anv-part of the building or structure beyond the pointindicated in each successive inspection riir,ort'ri."t obtaining the ipproval of the buiLdinc officiar.such approvar shal1 be qiven onry afcer an insjection shall have reen'maoe of each ..a""".ir1a .lapin the consrrucEion as indicated by each of ttr!-inspection",.qrf."il .--"
NOTE: Al,1 building permits require inspections for the work authorized, such as bu! not limited to?A. Block walt: To be made after reinforcioq is in place, but before any grout is poured. Thisirspecrron is required f.;;;.;-;;;;-;;;;;"".. -There wirr r..o ipp.or"l until rhe plumbingand eLectrical inspections have been nade lnd approved.
B. Hood stove: To be made after completion of masonry (if applicable) ano when installation is*I::;-il ll:'illi:::t":3:lf 3;.tr;ti::::;U:.::!: i;'.;5:;;:;;'ll,,onur:v .""oq.i".i-,."ii.e
c' Mobile Home: An inspection is. required after the mobile home is connected to an approved:;ff:':;,":iStE.iIilil::L:::?:;:.'esuirements' ulockins;-ioolinl-.o.n".tion, tied-wns,
::::H:;.33tri':;: ::":?l::L3::' state foundaeion requiremenrs for mobile homes or as
XiSii'**ff.il:li'il.::::'" rLoor elevation sharr be certiried when required by a rrood-
Mobi'le hone tiedowns, when required, and skirting shalL be instarled and ready for insDec-;::t"x:i::1.:t least 30 davs irt..6.""p"i.i."'ii.uo,"' and skirrj.ns shal.L be insrallei
D. swj.minq poor: Berow_grade when steel is in pr.ace and before conc:tEs-po61-l=-instalred] *o rn place and before concrete is poured. Above grade
APPROVED PLANS MUsr u" oY-:l! JoB srrE AT ALL TrMEs DURrN-c woRKrNG HouRs. THrs pER-rtrrr rdrll ExprRErF,oRK D.ES Nor BEGrN wrr,.rN-1eo oovi,-'on"ii 16"*..r, suspEND;;-;R iiiooiio*ro FoR r,ioRE ,HAN r.8o aAys.;H:Bxffii?ir:" REvocArroN MAy occuR ir-ixiJ nu*ir ro, rsiuib-or,r iir'r";il;; oF rNcoMpLErE oR ERRoNEous
ANYONE PROCEEDTNG PAST THE POIIIT OT REOUTRED TNSPEC?IONS WILL DO SO AT THETR OWN RISX.
SUBSURFACE AND ALTERNAT]VE SEWAGE DISPOSAL SYSTEMS:
I. permits shall be effective for one;;;.o* rhe date of issuance.2' N5:lr;"Tf,:'::l: :::,:;^;:;::H31.':; xij;1,. permir has been issued, the.permir hor.der sharlinsrairario; iu."ia r6'..' "h"-;;p;;;:;r':l:ri'i^:;Hi'i;l ::x:l:x::l:,"i"":!T:iiil!^*:r.
;lqii'!,:';1,:ti"::i":,,:il.lis:"j;Jlii,i:ii:,:i::.it.i::.::F:rx"5.e1 ao."."o.fiy-,iin-i..nrf the construction does n"t ""iirf iiin'^ii.r, rures, rhe o"ou.-*".JP19tion to ttre-plrniijhoraerhor'der and shall requlre .u.'.r!"ro'v-"oiiL..ion ;;r;;; i;I;i;;'';;"':::lr??:jll..iF"iii1:4..T::i":n:,.3H!'[;T:l;; ::.,;i:;;l;:j3,t,:#jiji;; ;:i;i; j"ixi13"".l," .i^"_.".,ri.,t!i^"".ii"_
Setbacks - Subsurface Sewage Disposal
1.
2.
3.
From:Int.erjor property fines
:dg:.gf road rrqir-of_wayBuildi.ng foundationWeIls, other water sources
Septic Tank
50 |
Drainfi.eld
1.0 |
10,
10,
100 |
OR MOBIIE HOr, , USE PERMIT
PERMTT Nb. ?0ut!_DING MH
MAITING ADDRESS
r&li
OWNER PHONE:ir Bffistlrhl P,O.BoxD{
MAITING ADDRESSrarrlq Cri*rl frtenetles} lruf $rre
s'r,QtFAftf,LO oneagt
$rure
l+i*.
TRACTOR ". !PHONE
PROPERTY TOCATION _"INCtUDE POST OFFICE
r-or.3 *r*r\':.,,r in"Hri,.r*i
PROPERTY TEGAT DESCRIPIION.i-METES,,BO
t'.i it ''.'
Dlr r.,, :',. :r. 11 I -st. )'. ...:.':.-:i$s'ir
n,:.r i?...r*^:i\3\"'*i h,\$$qUNIi(J\i'ct S.
RANGE SECTION TAX T NO.coDE CENSUS TRACT
&;8"
EXISTING STRUCTURES ON PROPERTY
' lthtlt
, LEGAL ACCESS TO PROPERTY \.
,Fbh'rr.8tnr}
RTY SIZE
Jo Existing e tem ! New
co UCTION-
Fet
FOR MOBILE HOME PERMITS ONLY'
No.otiBSdroo-s'\ '.:it ','. '! -
STRUCTURES TO E}E BUILT THIS PE RMIT,
I Fa; fr*BORMS VALUATION
[r*ci u r
SEWAGE, DISPOSAI
I t*:fi et.8o
[-cf,, e 5.3O g; l!1"tig-,i
I
..\: rl .r
firlt$IO$ AFfi :^. . j :p . . ...1. . ,
owNER E .OTHER: NAME
i.,PUBLIC SEPIIC TANK OTHE
.(I) tEEsBUII.DING. ] :
WASTE DISPOSAT
PTUMBING
itaN nrvr
50 a
WATER SUPPI.Y
PUBIIC OTHERI
PARK TRAIIERi7,trr:lCriAijE
COUNTY BUILD
TANK CAPACITY
WITH DIST. BOX;GAt.
DRAIN F
-.!
I.IN. FT
IEI.D REQUIRED Sgrrn
'TRENCH
\ \ $i. tr..''.-
TYPE OF STRUCTURE
5r{ ', ''.. , ,
OCCUPANCY
l.+."t ZONE PUBLIC UTlt. EASEiIENT .L
BI.DG. SETBACKS --
,*o*ri,, Io:FT. FROM CTR. OF ROAD RIGHT OF WAY
SIDE INT.
PIJ slDE Exr
USE CTASSIFICATIONI
REAR Tt .,, ,i. , . AUTHORTZED SIGNATURE _ DATE;tt/ J+ f. Boag EY c, t*reglucx .JoxN Sxoo-r,/sl ;" I tl* ;r.H
DATE
. BLDG. PERMIT _ WHITE "'
, OTFICE COPY _ WH ITE
couNTy rAx - ptNK j
.PI-UMBING._ CANARY
BUII,DING _ GREEN :..I
, SAN]TATION _ GOTDENROD
,1 nhjl
coll-bgz-1065 to'tchedule oil required in ions. Alltion sholl com ply wirh Unifo rm Buildin s
rspect
Code D.E.Q.IMPORTANT:fec
Plu
beirng occupied.
buildi .ngs require arcerlificole of -occupon
..subsurfqce
rhbins..- All
.sewo ge'iJisposol ond counly regulotions
:(Sei'obioii! "p., R"r"'("'
(POST THIS PERMTT ON MAIN BIDG. AT slTE)
LANE COUNTY, DEPT. OF ENV|RON,IiENTA!IAANAGEMENT
\
con slrui-
stondords
covering
cy before'
COURTHOUSE ANNEX, I35 EAST 6Ih, EUGENE, OREGON 97,(OI
Side) r
I
.-t
TANE COUNT sUITDING I
I
'il oR
r
oR 97401,
Exlstlng Bulldlngs or
lmprovements onProperty _-? )tF-f-iouse '2' uEI Barn iEI Garase 1
El lvtobile. Home
E Shed
SEPTIC INSTALLEDEYes
trl No
're/
Please complete all lines inside white boxes, if possibte.
TEONEnot {ma a3
ztP
Ltccn3c,
E
ztP
nol
l1f-er:
7^t#-o us<
07+**
Dlrectlons to slte
from Courthouse
C-r., 6 nt 0 Eltil tt "r{
>(
)
MAP, PARCEL NUMBER
(Fopnd on ttr mrp. ln th. A.mtmml LJurtlon D.PL)&Ra=,#-,#/{i
-owmhip Rrne. Sclion l/t S.ction Tu Lol
Toffiffi Ti;F. 5."ii6i- rIiEffi -lifEt-
r)tr,
ztP
Q 7l 77,=PQt N G-Fr ELnDFESS-d: yo( t)srr,A/1/ Al),
For Moblle Home
Placement OnlY
Brand
No. ol Tip-outs
-
No. ol Bedrms
License #
Year
Size
MAIL PERMIT TO:
AI'DB ES3
ztPCIII
Land Management DIv. stall can
not be held resPonslblE lor
evaluatlons or recommsndatlons
based on false, lnaccurate or
lncomplote lnlormatlon
.ts--Lt
LANE COU
BUTLDTNG I
H .E USE PERMIT
PERMIT NO.
N BUILDING PERMIT OR MOBIIE
ER
MH
MAILING ADDRESS PHONE
Klnsr Bencsur
CONTRACTOR
P. O. Box D
MAILING ADDRESS
Saue
Spn r xcr r ELD OnEeot
PHONE
PROPERTY TOCATION _ INCI.UDE POST OFFICE
PROPERTY LEGAL - METES, BOUNDS
0^f-<-*'-:
tl
RANG E SECTION TAX LOT NO CODE CENSUS TRACT
Klnsr Bencsxa
EXISTING STRUCTURES ON PROPERTYAPPt.
NAME
&
MAITING
ADDRESS
LEGAL ACCESS TO PROPERTY
Rorrn Srnret
Spntusrteto OneooN
PROPERTY SIZE - FT,
WIDTH DEPTH AREA
FOR MOBILE HOME PERMITS ONLY
No. of Bedrooms
STRUCTURES TO BE BUILT THIS PERM
Connecl to Existi
TYPE CONSTRUCTION
m New m
se. FT BDRMS ON
Dralr t pe t5r
tot e I.3o
PLUMBING INSTATTED BYSEWAGE DISPOSAL D
PUBI-IC SE
F EES
OWNER OTHER: NAME
WATER SUPPIY
PUBTIC N N OTHER
BUILDING
WASTE DISPOSAL
PTUMBING
PI-AN REVIEW
PARK TRAII.ER
l ftisuncxrnce
TOTAI.$_-
COUNTY BUILDING & SANITATION SPECIFICATIONS
MIN. SEPTIC TANK CAPACITY
WITH DIST. BOX: GA[.
DRAIN FIETD REQUIRED
uN. FT ' 'r TRENCH WIDTH TT,OR SQ. FT.
De prn
TYPE OF STRUCTURE OCCUPANCY ZONE PUBTIC UTI[. EASEMENT
t&.J
BLDG. SETBACKS FT. FROM CTR- OF ROAD RIGHT OF WAY
FRONT , SIDE INT, SIDE EXT.REAR
USE CLASSIFICATION
AUTHORIZED SIGNATURE - DATE
JoN x Sxoo*^/e,ANrrARrAH
DATE
/zs,/tl+ otn
BI,DG. PERMIT _ WHITE
OFFICE COPY _ WHITE
COUNTY TAX - PINK
PTUMBING _ CANARY
BUII.DING _ GREEN
SANTTATION - GOTDENROD
Coll 687-4065 to schedule oll required inspeclions. ,All conslruc-
tion sholl comply with Uniform Iiuilding Code, D.E.Q. stondords
IMPORIANT: for subsurfoce'slwoge disposol ond counly regulolions covering
plumbing. All buildings require o cerlificote of occuponcy before
being occupied.
(See Detoils on Reverse Side)
(POsT THIS PERMIT ON MAIN BLDG. AT SITE)
IANE COUNTY, DEPT. OF ENVIRON,\AENTAI MANAGEMENT
COURTHOUSE ANNEX, I35 EAST 6Ih, EUGENE, OREGON 9740I
ronu 3c55-13
PROPERTY
TANK brndnn
BUr L0 tqts rI.E _EwtLUAIl !N
I-\T R
SUBDIV,.ON:
APPL I CANT
DATE
3 TAX LOT3 7
))-)i
O BUILDING PERHIT APPLICAT!ON NO
()SITE INSPECTION
PLANNING DIVISION
Zon i ng 0rd i nance Cornp I iance: Zone
COI{I{ENTS:
L
7€('
A
Not
I icable
I
2
3
4
5
No Yesf) I7l' 6.
ilfi
CKID BY:
Setbacks rom c
Front
Side Exteri Or-
Subdivision 0rdinance Compl iance
Requi red Access
Building Site (Area, Width, Frontage)
0ther (see comments)
()
()
()
()Setbacks from interior I ines:Side 5Rear T
PLTNNTNG DIVIS APPTTEATTOffi
BU ILD ING I NS.PECT ION D IV IS I ON
7. Plans Submitted
8. Soil Stability (footings)
9. Flood Plain
O. 0ther (see connnents)
Not
Aool i cabl e
( l)(l)
(u
No Yesr) ?Q'( )'( )() ()
() ()cKo ev:er
COMMENTS:
UATER POLUT ION CONTROL
ll. l{eets Department of Environmental
Qual ity Standards.
12 . Other (see cornments )
Not
Appl icable Nor)TT
()()r CKID B
E
COH}.tENTS:
TO APPLICANT:
4J
Jour Building / Site lnspection:
M C"n be approved.
{) C"nnot be approved at this time
Questions and further informati
COUNTY PLANNING DtVlSlON" Ques
as indicated on item N0" above.
on on i tems I through 6 contact the LANE-
tions and further information on items 7^lP\v 6 he LANEthrough l2 contact t
( ) |Ji I I be held in this( ) ls being returned.
BUILDING AND SANITA s l0N.
ems n i cated.ce unt you can reso vet Pr
rmi t a I ication
ktftirtft#t
40r
-41 86
c55-28
Your bui ldin
135 Sixth Avenue East Eugene Oregon 97
PHONE: 687-4o65
LANE COUNTY PLANNING DlVlSlON PH0NE: 587
)
I.ANE COUI\BUILDING PERMTT OR MOBTLE HrMHIBUILDING
: USE PERMIT
PERMIT NO.PROPERTY OWNER
CONTRACTOR
MAITING ADDRESS
MAII.ING ADDRESS
PHONE
PHONE
PROPERTY TOC ATION _ INCTUDE POST OFFICE
PROPERTY LEGA t DESCRIPTION -METES, BOUNDS
APPI..
NAME
&
MAITING
ADDRESS
RANGE SECTION TAX LOT NO,CODE CENSUS TRACT
EXISTING STRUCTURES ON PROPERTY
TEGAT ACCESS TO PROPERTY
PROPERTY SIZE-FT.
WIDTH DEPTH AREAFOR MOBILE
No. of Bedrooms
HOME PERMITS ONLY
STR UCTU RES TO BE BUILT THIS PERMIT
Connect to Existin Sewoge 'stem
TYPE CONSTRUCTION SQ. FT
New
BDR MS VALUATION
SEWAGE DISPOSAL PTUMBING INSTAI-I.ED BY
PUBI.IC
BUILDING
WASTE DISPOSAT
PTUMBING
PI,AN REVIEW
PARK TRAIIER
SEPTIC TANK OWNER
WATER SUPPI.Y
PUBLIC
OTHER: NAME
FEES
tr OTHER
TOTAT
COUNTY BUILDING & SANITATION SPECIFICA TIONS
MIN. SEPTIC TANK CAPACITY
WITH DIST. BOX: GAL.
DRAIN FIEI.D REQUIRED
tIN. FT TRENCH WIDTH FT,OR SQ. FT,
TYPE OF STRUCTURE OCCUPANCY ZONE PUBTIC UTII.. EASEMENT
BIDG. SETBACKS
FRONT
FT. TROM CTR. OF ROAD RIGHT OF WAY
SIDE INT, SIDE EXT.
USE CLASSIFICAIION
REAR
AUTHORIZED SIGNATURE _ DATE DATE
BLDG. PERMIT _ WHITE
OFFICE COPY - WHITE
COUNTY TAX _ PINK
PIUMBING _ CANARY
BUITDING _ GREEN
SANITATION _ GOTDENROD
Coll 687-4065 to schedule oll required inspeclions. All construc-
tion sholl comply with Uniform Building Code, D.E.Q. stondqrds
IMPORTANT: for subsurfoce sewoge disposol ond county regulotions covering
plumbing. All buildings require o ceilificote of occuponcy before
being occupied.
(See Detoils on Reverse Side)
(POST rHlS PERMIT ON MAIN BIDG. AT SlrE)
I.ANE COUNTY, DEPT. OF ENVIRONMENTAL MANAGEMENT
COURIHOUSE ANNEX, I35 EAST 6Th, EUGENE, OREGON 9740I
ronu f 655- 13
SLAB FLOOR
PLUMB I NG GROUNU^/ORK
AppRovEo f--7 Dtsappnoveo / I Dar e I Nsprcron
ReMlnr s
GAS P IP I NG GROUNDI'ORK
DATE I HspecroRAppnoveoD r SAPPRovED
REuaRxs
ROUGH PLUMBING
APPRov ED
ReuaRx s
DrsnpeRovroK Dar I ttsp
ROUGH GAS PIPING
Dar r I ws pE cron
AP PROV E D
Reuanx s
F I NAL PLUMB I NG
N D I SAPPROVED D oarl?' ra'21/I HspEctonAPPROV E D
RE uanr s
FINAL GAS PIPING
AP PRov E o
Reul nr s
DrsappRoveo DarE I Ns PE croR
CERTIFICATE OF OCCUPANCY
Reaov ro lssuE
Rr pta nx s
Nor ReaOV TO ISSUE Darr I Hsprcron
DrsAPPRovEo D
D D
IANE COUN}.
BUTLDtNG I
BUITDING PERMIT OR MOBITE HC ;
MHtr
UsE PERMIT
PERMIT NO.
PROPERTY OWNER MAILING ADDRESS PHONE
CONTRACTOR MAILING ADDRESS
,
PHONE
PROPERTY LOCATION - INCTUDE POST OIFICE
PROPERTY LEGAL DESCRIPTION.-BOUNDS
RANGE SECTION TAX LOT NO CODE CENSUS TRACT
EXISTING STRUCTURES ON PROPERTYAPPt.
NAME
&
MAILING
ADDRESS
TEGAT ACCESS TO PROPERTY
PRO?ERTY SIZE - FT.
FOR MOBILE HOME PERMITS ONLY
No. of Bedrooms
WIDTH
Connect to Existing Sewoge System ! New System !
STRUCTURES TO BE BUILT THIS PERMIT TYPE CONSTRUCTION se. FT. f BDRMS VALUATIoN
\\
SEWAGE DISPOSAT
PUBLIC tr SEPTIC TANK tr OTHERE
PLUMBING INSTALTED BY
OWNER N OTHER: NAME
BU ITDING
WASTE DISPOSAI
PLUMBING
PtAN REVIEW
PARK TRAII.ER
$FEES WATER SUPPTY
PUBLIC OTHER
TOTAT
COUNTY BUILDING & SANITATION SPECIFICATIONS
MIN. SEPTIC TANK CAPACITY
WITH DIST. BOX: GA[.
DRAIN FIETD REQUIRED
I.IN. FT TRENCH WIDTH FT.OR SQ. FT.
l"\
glr,,.\$,)t
TYPE OF STRUCTURE OCCUPANCY ZONE PUBTIC UTIT. EASEMENT
BLDG. SETBACKS FT. FROM CTR. OF ROAD. RIGHT OF WAY
FRONT SIDE INT. SIDE EXT.
USE CTASSIFICATION
REAR
AUTHORIZED SIGNATURE _ DATE DATE
BTDG. PERMIT _ WHITE
OFFICE COPY - WHITE
COUNTY TAX _ PINK
PTUMBING _ CANARY
BUILDING _ GREEN
SANITATION _ GOLDENROD
IMPORTANT:
(posT THls PERMIT ON MAIN BLDG. AT SITE)
LANE COUNTY, DEPT, OF ENVIRONMENTAL MANAGEMENI
COURTHOUSE ANNEX, I35 EAST 6Ih. EUGENE, OREGON 9740I
Coll 687-4065 to schedule oll required inspeclions. All construc'
tion sholl comply with Uniform Building Code, D.E.Q. stondords
for subsurfoce sewoge disposol ond counly regulotions covering
plumbing. AII buildings require o certificole of occuponcy before
being occupied.
(See Detoil's on Reverse Side)
roau f 655-13
AREA
<-
SITI INS
AppRov r o
Reuanx s
REt'tlRx
PECT ON
, D r snppnoveo
Dr sappRoveo
Dar r
Darr
I NspEct
"4 lP
FOUNDATION INSPECTION
AppRov E o 7,5',*rrr*
/,
FRAMI NG
AppRov e o
Re pteRx s
I NSPECT I ON
Dr sappnovro Dar E I Hsprcton
t**- 2 6'4
LATH OR SHEETROCK INSPECTION
Ap pnov r o
REuaRx s
ru' DrsappRovE o f--J oort 2- I Y' 7{ tNsPEcro ro
FINAL INSPICTION
AppRov r o
RE S
Drsrp , i L-tL'?d rruspEcrED
,
a'
CERTIFICATE OF OCCUPANCY
Rerov ro I ssuE
Rruanx s
Nor Rraov ro lssue
t{ 77" 7r 4tt
Darr l nspecron
PRT
INSTALLER: Complete top part oi
SED SET/AGE DISPOSAL SYSTEH RECO
orm to signature and submit both copies with
PERI,I IT
appl i catlon..
2487-74
C \-t
n9
\
L o rJs
n ts rooms at
Rowan Street
sementYes No /P
No.v
Sept c
Ft
ater S
ubl ic her-L i st
v3
from wel I Steel tr Concrete No. CornpartmentsOygGal . Capacity IOO6lM
n5
NA}'TE
}IAILING
AODRESS
e0 s ons:t
n th },idth
ER
'2 Di er oth Distribution
t r
sPosa e
str ut on-
Yes 1/No
Foundat I on
e
Karst Ber sma
P 0 Box D
Feet frorn
}JEI I
Lot ne
S n fi d r ront Side /O
L nes-Ft.
4 6
Date
For Sanitarian Use 0nly:
ln accordance with 1973 Oregon Laws Chapter 835, Section 214 this certificate
as evidence of satisfactory completion of a subsurface sewage disposal system at the above
I ocat i on.
EA Approved: System lnstal letion conforms to current standardsI-t Oisapproved: Does not conform to current standards
Remarks:
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er6 ov,
?:'?:#l+'7J
Trench
uJ i dtro-
Sq.
oo
TotalFt,3 Ft. Between
Lines /O
ert 'tn
er ept
Tile
'lot Plan see instructions
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9
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an s
COUNTY
QUAL ITY
c55-I1
STATE OF OREGON DEPARTI.IENT OF ENVIRONH
gnature
Pm'{rr/t 2t87-7
IAI{E CC[,]NIY Building
DEPARIMEM OF E}WIROIS,IM\TIAL }4ANAGEvIMM }bbilc HCNrC
APPLIC,ATION FOR zuIIDNG PERMIT OR I.{OBILE HC},IE USE
I\o permj-t will be issued intil this application has been approved.NOTE:
PLEA^SE PRINI
PROPERIY I,OCATTON .f
4(7/
Tt^lP lf RA}GE 3 sEC TAX IOT tt CODE CM{SUS TRACT
I,Crr iw. _2 BrrcK SIJBDNIISION
ACCESS r0 PR0PERIYjAa2AiO 5 *re-e e {_wrru{ 8o',n.1 ' OR ACREAGE
DESCRTBE D(ISTT}G STRUCTT]RES ON ITIE PROPERIY
,lAPPLIC,AIVI
MME
NAI'{E
ADDRESS PrrCI\rE 2{6- n87 ,
PrroNE v!* ?r a?
ttres to t
.30
frb ZLFP.ou
E>cis ting semage disposal systen il or ne\^r systsr required DSite krspection 1t
WA ter Dwpry:l-l District Nane welt []Spring lll ocherhrblic
Brdg.
Waste Dis.
Plunbing
Plan Revier^l
Ttailer
17. sr.nrcharge
@ Fees
Pltlrbi:rg Installed by 0r,uner 0ther Nare
Pltrnbing Fees Ser,'rer corurcction
ts\ /l of fixAres Dir:rspection fee
ter connec
ainspection fee
[] Cash
I Check
Plans fur'nished Facilin w PennitilroK
TOIAL
d;atl
te
Min. Septic tank capacity _with dist. box: Gallons aDO o"pth_-L_or Sq. Fr.36 O
,,tl"?
TYpe o-S trrrctrrrqlM_OE-npancy ffiFiie-Zone- Us ffi
c55-12
fr
S
te
2-o7
te
BIgd.
Front
setbacks-40 Rear -1 zooe Ia* t
/
Fo rt ls/ o.tA
a
Ttench
Yes
Signatwe of
Fee received