HomeMy WebLinkAboutPermit Septic Tank 1991-07-27:766 - {erto.
/?zrarPERMIT #
SEPTIC SYSTEI.l VERIFICATIONREOUEST
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HA, ZLItt ttLtt STREET, sPRINGFIELD, oREG0l,l a"7Li77
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have careful read BOTH sldes ol thls certlly that al! lnformatlon ls
READ CAREFULLYI Your Authorlzatlon lc Baced On The Followl Condltlon3
FEES DUE: $APPEOVED BY:DATE
oALL FOR INSPECTiONS (SEE BACK OF FORM FOR INSTRUCTIONS) 687-4065
SEPTTC permtts are good tor one year. ALL other permlts explre atter 180 days unless lnspectlons ate cufient.
. UOLATIONS
SETBACIs AND OTHBR CONDMONS OP APPROVAL MUST BB STRICTLY OBSBVD. VIOLATION CAT\' RASULT IN RBVOCATTON OF TIIIS PBB'N.
CITATIONS MAY B8 ISSI,ED UNDER, THB PIIOVISIONS OP LAT{E COT,NTY.S INFRACTION ORDINANCB AND,ON, OTHER RBMBDIBS ALLOWBD BY I.AW.
A MTNTMUM OF AT LEAST 24 HOURS ADVANCE NOTTCE MUST BE GMN FOR INSPECTTON REQUESTS
Ilave the following information ready when you call: 6874C65
Permit number - Job address - Type of inspection required - When it will be ready
Your name and phone number - Any special directions to the site
powERroBNrER,poNLAND. "*""ffi""1i.i,T1ffi#3FfllHilffik:3#eYiffit#lBffiBHft#***r *oFrHBrRF,NcnoNs,MAy
BNTETI I'PON ANY LAND AND MAIG EXAMINATIONS AND SURVBYS AND PI"ACB AND MAINTAIN THB NBCBSSARY MONI'MEVTS AND MANXBRII THBRBON.
REQT.IIRED INSPECTIONS
FOLJNDATION INSPECTION: To be made after excavations for footings are complete and any requied reinforcing steel is in place.
LTNDERGROLTND PIPING INSPECTION: To be made after all underground piping has been installed, prior to any backfill.
CONCRETE SLAB OR T NDER-FLOOR INSPECTION: To be made after all in-slab or under-floor building service equipmeng conduit, piping
accessories and other ancillary equipment items are in place but before any concrete is placed or floor sheathing instaUe4 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 are complete
and the rough electrical, plumbing, and mechanical inspections have been made and approved.
INSULATION INSPECUONI To be made after dl insulation and vapor barriers arre in place, prior to covering.
LATH AND/OR GYPSUM BOARD INSPECTION: To be made after all lathing and gypzum board, interior and exterior, is in place but beforc any
plastering is applied or before gypsum board joints and fasteners are taped md finished.
ADDITIONAL INSPECTIONS MAY BE REQIIIRED, 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 requied for each bond beam pour. There
will be no approval until the plumbing and electrical inspection:r}ave been made and approved.
FINAL MECHANICAL INSPECTION: To be made just prid to the strwhre or remodeled area being occupied and pior o operating ory equipnenr
FINAL PLUMBING INSPECTION: To be made just prior to the building, struchre or remodeled uea being occupied"
FINAL BLJILDING INSPECTION: To be made after finish grading and the building, struc[lre or remodeled area is completed md ready for occupancy
MOBILEA{ANLJFACTURED HOMES: An inspection is required after the mobile home is connected to an ryproved 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 formdation requirenrene for mobile homes or as recommended by the mmufacturer.
Minimum finished floor elevation shall be certified when required by Floodplain Management
Tiedowru, if required, shall be installed and ready for inspection within 30 days after occupancy. Tiedowns shall be installed per enclosure.
APPROYAL REQTIIRED
No work shall be done on any part of Ore building or structure beyond the point indicated in each successive inspection without ftst obtaining the
approval of the building official. Such approval shall be given only after an inspection shall have been made of each successive step in the construction
as indicated by each of the irspectiors required.
APPR,OVED PI.ANS MUST BE ON THE JOB SITE AT ALL TIMFS DURING WORKING HOI.JRS.
THIS PERMIT WILL E)(PIRE IF WORK DOES NOT BEGIN WTII{IN I8O DAYS, OR IF WORK IS STOPPED OR ABANDONED FOR MORX THAN IEO DAYS.
SUSPENSION OR REVOCATION MAY OCCUR IF 1IIIS PERMIT WAS ISSUED ON TTIE BASIS OF INCOMPLETE OR ERRONEOUS INFORMATION.
ANYONE PROCEEDING PAST THE POINT OF REQTIIRED INSPECTIONS WILL DO SO AT THEIR OWN RISK.
Your siSnature on the front of this form verifies the following: I HAVE CAREFULLY EXAMINED TttrS COMPLETED APPUCATION and do
hereby certify that all information hereon is true and corect, and that I have a legal interest in the property as owner of record or authorized agent. I
further certify thal any and all work perlormed shall be done in accordance with the Ordinmces of Lane County and the laws of the State of degon per-
taining to the work described herein. I further certiff that if I am not the owner of the propery, my registration with the Builders Board is in fulifo;
and.effect as required by ORS 701.055, 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.
SUBSURI'ACE & ALTERNATIVE SEWAGE DISPOSAL SYSTEMS:
When subswface construction is complete, the permit holder shall notify the County Land Management Division by submitting the installation recordform. An irspection will be made by a qualified sanitarian. If construction complies with all rules a certificate of completiol iill b" issued to the permitholder. If construction does not comply with rules, the permit holder will be notified, and all corrections shall be made before a certificate of *-pietionwill be issued. Failure to meet satisfactory completion within the alloned time constitutes a violation of ORS 454.ffi5 to 454.745 and this rule.
SUBSURFACE SEWAGE DISPOSAL SETBACKS SEPTIC TANK DRAINFIELDFrom: Interior properry lines l0' l0'
Edge ofroadright-of-way 10' 10'
Building foundation 5' 10,
Wells or other water sources 50' 100,
Exlstlng Buildtngs orlmprovemenB onProperty
ft6 Hors.
t----'I Barn
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F--l firlobito. Homel-1 Shed
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For llobile Home
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Land lJanagement Div. staff cannot be held responsible forovaluatlons or recommendations
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Partition / Su bdivislon
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REAL PROP RCCCIUNT SUTIMARY
199A. ASSESBMENT YERR'4/ t7 /91 13:54 : 1O
RES NEIGH 4AOEIX COM NEIGH
a4-14-g@ trtrNTROL 6ROUp e4
LEVY EODE I9.A3 TAX RATE
TRX CERTIFIED:
AD VALOREI{ TAX:
SPECIAL flSSMTB;
I99O YERR TAX:
TAX DUE I99A YEAR:
TAX DUE PRIBR YEARS;
INTEREST AS BF A4.T7-91
TOTAL BALANCE DUEI
CILDEBT DELINEUENT YEAR
19413
96.456e
l,4e6.51
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COUNTY: LANEn 1743e733097AA ACtrT X YRA LE 9A
ACCT ST T, SADJ, pAYBR, pOBT
PRCIP DESCR: 17 03 e7 33-A97ArCl
LE6AL:
PRUP ADDRIYRIA 90 YRLA 9A LRST AtrTIVITY
PROP CLASS lel STAT CLASS l4ClACRES CYELE 4 ZT]NE
TRUE CASH ASSESSEDLAND B, 6raa B,6AAIMpS 45,3eA 45,3EO
TIMBER
NAME RDDR: LUNDBLAD ROY WILLIAM
STEINER GERALD t^I
1444 VERA DR
SPRINBFIELD BR
RPTR ' REAL' pROp t]CIpR INFtrRI{ATION , 4/ 17/91 13154:83ACCT: E3EB66 1994 ASSESSMENT YERR CtrUNTYr LflNE
INDEX r F flCCT EB gErlG€'eSEg66 YRA LT 91 LEV X
AEET STAT: MDAT, SADJ, PRYER, POSTVOUCHER TYPE DATE OF LAST fltrTIVITY C'4-14-9fr
flmP 17 Crs e7 33-A970qr trODE 19-€13 pRop ELS lel STAT CLS l4al
FULL OCIFR PART OBPR MRKING DATE..g'3-19-86
97477
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SpRINBFIELD, tlRE 97477
RIDTL RERL PRflp IMpROVEMENT ASSESSMENT DETAIL { 4/17/gLACCT: PBEB66 199O ASBESBIvIENT YERR CBUNTYT LANE
INDEXT F ACCT EG EAlAaP3e866 YRA LT 91 LEV X
AtrET STRT: MDAT, SADJ, PAYOR, PCISTVOUCHER TYPE REASBN
lvlAp 17 raS P7 33-Ar97Cr0 APPRAISRL DIST 4 IHp* 1
YEAR r 1.9?CI CICIpR A NON-oCIpR 45, se0 HOMESTEAD
LEVY r l9-Et3 tlCIpR A NON-CIOpR 45, 3eO NBNHCII,IESTEADBCRES; Q.@0 LRST AtrTIVITY; A4-14-9A
APPR INT DATE YRIA PROP STAT EUA FER YEAR COND PRCT FOUNNO. INSP INSP trLAS CLAS RDJ COM BUILT EOOD DATN4e9 N A9-eA-89 9[r lel 146 -5 lAA :53 I A 74, CO
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(EE*,C^NCELLATION
REFUND AUTHORIZATION PERMITf
NAME
PRTiT
ADDRESS tr APPLIcAIIT tr oW\,lER tr coNTHAcToR
REASON FOR CANCELLATION
SIGNATURE DATE
Fees paid for waste disposal systsms (site lnspeclions andor applications to install the septic tank and drainficld) are ordinarily
nonrefundable. Relund may be on building, planning, or plumbing portions to the amount of the permiUapplication processed.
FEES PAID %REFUND.
o/o Flood Plaln Fee
To Bulldlng Permlt Feeo/o Moblte Home Fee
o/o Plumblng Permlt Fee
To Mechanlca! Permlt Fee
o/o Plan Check Fee
o/o State Surcharge
Septlc Dlsposal Fee
Slte lnspectlon Fee
DEQ Surcharge
o/o
o/o
o/o
o/o Land Use Apptlcatlono/o Plannlng Dlrectoro/o Recordlng Feeso/o Partltlons% Coptes & Ordlnanceg
oh surveyors
Less Processlng Fee
$
$
$
$
$
$
$
$
$
$-2 5.00
TOTAL AMOUNT TO BE REFUNDED $------_
Signatu Date
TO DEPARTMENT OF FINANCE:
Building Permit Refund
State Surcharge Refund
Septic Disposal Refund
DEQ Surcharge
Site lnspection Refund
Land Use Application
Planning Director
Recording Fees
Partitions
Copies & Ordinances
TOTALAil/OUNTREFUNDED S
PLEASE MAKE CHECK PAYASLE TO:
020
020
240
240
240
24
24
24
24
24
24
24
24
$
$
$
$
$
s
0674/Acct .42120lProg
0674/Acct .42123lProg
04271 Accl.42133lProg
0427lAcct.42123lProg
04271 Accl.42134lProg
067 4lAccl.46202lProg
0674/Acct .4215OlProg
1 87O/Acct .46211/Prog
Receipt#__Receipt#__Receipt#__Receipt#--_Receipt#__
Receipt#_Receipt#__Receipt#--_
Receipt#_
Receipt#_
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.110
$
24 -067 4 I 4cc1.46202/ Pro g. 0 1 0
-1 870/Acc1.44419/Prog.1 1 0
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