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Home My WebLink AboutPermit Septic Tank 1974-01-28'II.D!NG PERMIT OR MOBITE HOfV.IANE COUNIY PERMIT TYPE - BUILDING MOBILE HOME OSC REG. # J5E APPLICATION PERMTT #'7 PROPERTY OWNER ADDRESS2l MAILING ADDRESS o 6 PROPERTY,,TION _UDE POSI OFFIC PROPERTY LEGAI. DESCRIPTION LOT_BLOCK_SUBDIV. TWP RANGE Iharrn d L L*{METES&BOUNDSEYES ATTACHED NO SEC.TAX LOT CODE CENSUS TRACT ,)3 2? DESC RtflE EXtSTtNG STRUCTURES ON pROpERTy tr ANY horse-Mock - APPTICANT NAME AND MAII.ING ADDRESS TEGAT TO PRO ROAD NAME OR # t€- PROPERTY DEPTH AREAff tao FOR MOBILE HOME PERMIT ONLY Number of Bedrooms STRUCTU TO BE BUITT IS PERM TYPE CONSTRUCTION SQ. FT # BEDRooMS VALUATION SEWAGE DISPOSAL PI.UMBING INSTAI.TED BY PUBUC tr SEPTIC TANK OTHER OWNER OTH ER NAME PIANS FURNISHED FACILITY PERMIT BI-DG. WASTE DIS. PTUMBING PtAN REVIEW PARK TR[R. TOTAI- FEES WATER SUPPTY PUBI.IC OTH ER YES YES N PTUMBING FEES - FIXTURES S FEE DATECASH E R CHECK N FEE PUBLIC WATER CONNECTION FEE t- #32.- COUNTY BUILDING & SANITATION SPECIFICATIONS DRAIN FIELD REQUIREDMIN. SEPTIC TANK CAPACITY WITH DIST. BOX, GA[.oo h"1,,r*- TRENCH WIDTH FT OR SQUARE FEET o/ tIN. FT 2_ )f,//" -a< TYPE OF STRUCTURE OCCUPANCY ZONE REAR YARD PUBTIC UTII.. EASEMENT USE CLASSIFICATIONBTDG. SETBACKS _ FT. FROM CTR. OF ROAD RIGHT OF WAY FRONT SIDE INT. SIDE EXT. rections to Find Property _ OFFICE_ JOURNAL - AUDIT COPY I COPY 2 COPY 3 Dqte PIANNING DqtE BIDG. INSP..7 REAR Form # css-t2 Connecl to Existing Sewoge System f or New System R.q. n TANE COUN BUTLDTNG E BUIIDING PERMIT OR MOBIIE Ho,vlE USE PERMIT MH E PERMTT NO. PROPERTY OWNER MAITING ADDRESS PHONE CONTRACTOR MAILING ADDRESS PHONE PROPERTY LOCATION - INCLUDE POST OFFICE PROPERTY TEGAT DESCRIPTION -METES, BOUNDS RANG E SECTION TAX LOT NO CODE CENSUS TRACT EXISTING STRUCTURES ON PROPERTYAPPT. NAME & MAITING ADDRESS TEGAT ACCESS TO PROPERTY PROPERTY SIZE - FT. WIDTH DEPTH AREA FOR MOBILE HOME PERMITS ONLY No. of Bedrooms Connect to Existing Sewoge System ! New Syslem I STRUCTURES TO BE BUILT THIS PERMIT TYPE CONSTRUCTION SQ. FT. # BDRMS VALUATION SEWAGE DISPOSAT PUBTIC N SEPTIC TANK tr OTHERE PLUMBING INSTALTED BY OWNER ! OTHER: NAlv{E BUII,DING WASTE DISPOSAT PI-UMBING PI.AN REVIEW PARK TRAII,ER F EES WATER SUPPLY PUBUC f]tr OTHER TOTAL COUNTY BUILDING & SANITATION SPECIFICATIONS MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GAI.. DRAIN TIEID REQUIRED I.IN, FT TRENCH WIDTH FT.OR SQ. FT. TYPE OF STRUCTURE OCCUPANCY ZONE PUBI.IC UTIt. EASEMENT BI.DG, SETBACKS FRONT FT. FROM CTR. OF ROAD RIGHT OF WAY SIDE INT. SIDE EXT, USE CTASSIFICATION REAR AUTHORIZED SIGNATURE - DATE DATE BTDG. PERMIT _ WHITE OFFICE COPY _ WHITE COUNTY TAX - PINK PTUMBING _ CANARY BUITDING - GREEN SANITATION - GOTDENROD Construction to comply with uniform building covering plumbing ond sewoge disposol. All of occuponcy before being occupied. code ond county regulotions buildings require o cerlificote (See Stotement on Reverse Side) (posT THts pERMtT oN MAIN BrDG. AT S!TE) LANE COUNTY, B[DG. & SAN. DIV., COURT HOUSE, EUGENE, OREGON 9740I ronu #655-13 BUILDING S ITE EVALUATION Building Permit Appl ication No. S i te lnspect ion Pre-Permit lnvest igat ion rs /(,H.g/,#,;,s 22 rAx Lor- l€- cg 8=6 X -7 e APPL I CANT: Nr\1.1E ADDRESS ( () PHONE OATE LANE COUNTY PLANNING DEPARTMENT NOT NO YES NAl"lE DATE app! iqable()(,) () () ) () ( ( () () ) 2 Zoning 0rdinance Compl iance(zone_) Subdivision 0rdinance Compl iance 3. Requ i red Access 4. Bu i ld ing S ite (Rrea, I./idth, Frontage, Setback) 5. Other (see comments) ( CO},IMENTS: BUILDING INSPECTION SECTION NOT NO YES le - NAI'iE DATE 6. Plans Submitted 7. Soi I Stab i I ity (foot ings) 8. Flood Pl ain 9. 0ther (see Corrnents) COMHENTS: () () ( ( ( () ()) )() () () ()/ -Lv -7f --F. SAN ITAT ION SECT ION Sewage Disposal Usable Area Water Supply 0ther (see Comments) aool icable--O (() () () () NOT NO YES NAI.lE DATE ) )) -a10. ll. 12. 13. () () () () TO APPLICANT: v?ggf {} Your Building Permit / Site lnspection: Can be approved Cannot be approved at this time as indicated on item NO.-above. Questions and further information on items I through 5 contact the Lane-- COUNTY PLANNING DEPARTMENT. Questions and further information on items 5 through I J contact the Lan e County Buildftrg and Sanitation Div . Wil I be he ld in this off ice gnaft- you can iesolve the problems indicated. !s being returned. Your building permit appl ication fee is being returned under separate cover. () () () LANE COUNTY PLANNING DEPARTI4ENT 135 S ixth Avenr]e East, Eugene, 0regon 97401 'HoNE: 342-l3ll ExT. 231 LANE COUNTY EUILDING 6 SANITATION DIVISION 135 Sixth Avenue East, Eugene, 0regon 97401 PHONE: 342-l 3l I EXT. 4l I 28 COH}lENTS: SLAB FLOOR PLUMBING GROUND/ORK Ap pnov r o REulnx s Dare I rusprcron GAS PIPING GROUND'ORK AP PRov E D Rruanx s D DrsaepnovEo D DArE I ruspecron ROUGH PLUMB I NG A ppnov e o Rruanx s D DrsappRovro D Dare I rusprcron ROUGH GAS Ae pRov E o Reunnr s PIPING Dr sAPPRovEo Dar r I Hspecton F I NAL PLUMB I NG AppRov e o RE uanx s Dr sappRoveo Dart /'77-7 4 tNspEcron FINAL GAS PIPING Ap pnov e o REuanr s Drsappnovro Date I Nspecron CERTIFICATE OF OCCUPANCY Rraov ro lssuE RrulRx s DarE I NSPEcToR D Drsappnoveo D D D Nor Reaoy ro tssuE D - IANE COUN'. .BUILDING -PF$;T OR MOBILE H(USE PERMIT PERMIT NO. PROPERTY OWNER BUILDING MH MAILING ADDRESS PHONE CONTRACTOR MAITING ADDRESS D PHONE PROPERTY TOCATION _ INCTUDE POST OFFICE PROPERTY LEGAT DESCRIPTION -METES, BOUNDS RANG E SECTION TAX LOT NO CODE CENSUS TRACT EXISTING STRUCTURES ON PROPERTYAPPL. NAME & MAITING ADDRESS LEGAL ACCESS TO PROPERTY PROPERIY SIZE - FT. WIDTH DEPTH AREA FOR MOBILE HOME PERMITS ONLY No. of Bedrooms Connecl to Existing Sewoge System New System !STRUCTURES TO BE BUILT THIS PERMIT TYPE CONSTRUCTION SQ. FT, # BDRMS VALUATION SEWAGE DISPOSAI. PUBLTC tr SEPTTC TANK n OTHERE PIUMBING INSTALTED BY OWNER D OTHERT NAME BUITDING WASTE DISPOSAT PI.UMBING PTAN REVIEW PARK TRAITER F EES WATER SUPPI.Y PUBUC tl N OTHER TOT,AT $ COUNTY BUILDING & SANITATION SPECIFICATIONS MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GA[. DRAIN FIETD REQUIRED tIN. FT TRENCH WIDTH FT OR SQ. FT TYPE OF STRUCTURE OCCUPANCY ZONE PUBTIC UTIL. EASEMENT BI.DG. SETBACKS FRONT FT. FROM CTR. OF ROAD RIGHT OF WAY SIDE INT. SIDE EXT. USE CI.ASSIFICATION REAR AUTHORIZED SIGNATURE _ DATE DATE BLDG. PERMIT _ WHITE OFFICE COPY _ WHITE COUNTY TAX - PINK PTUAABING _ CANARY BUILDING _ GREEN SANITATION _ GOLDENROD construction to comply with uniform building code ond county regulotionscovering plumbing ond sewoge disposol. elf buildings require o certificoteof occuponcy before being occupied. (See Stotement on Reverse Side) (posT THts pERMtT ON MAIN BLDG. AT S|TE) I.ANE COUNTY, B[DG. & SAN. DIV., COURT HOUSE, EUGENE, OREGON 9740I ronu Jt 955- 13 I I I.ANE COUN1 BUTLDTNG E 3UIIDING PERMTT OR MOBITE HC MHI USE PERMIT PERMIT NO. PROPERTY OWNER MAII.ING ADDRESS PHONE CONTRACTOR MAII.ING ADDRESS PHONE PROPERTY TOCATION _ INCTUDE POST OFFICE PROPERTY tEGAt DESCRIPTION - METES, BOUNDS RANG E SECTION TAX LOT NO.CODE CENSUS TRACT EXISTING STRUCTURES ON PROPERTYAPPt. NAME & MAITING ADDRESS LEGAT ACCESS TO PROPERTY PROPERTY SIZE _ FT. WIDTH DEPTH AREA FOR MOBILE HOME PERMITS ONLY No. of Bedrooms Connect to Existing Sewoge System ! New TYPE CONSTRUCTION se. FT BDRMS VALUATION m STRUCTURES TO BE BUILT THIS PERMIT SEWAGE DISPOSAT PUBTTC [] SEPTTC TANK l-l oTHER! PTUMBING INSTAII.ED BY OWNER N OTHER: NAME BUII.DING WASTE DISPOSAL PTUMBING PI,AN REVIEW PARK TRAITER TOTAT FEES WATER SUPPTY PUBUC n fI OTHER COUNTY BUILDING & SANITATION SPECIFICATIONS MIN. SEPTIC TANK CAP.ACITY WITH DIST. BOX: GAT. DRAIN FIETD REQUIRED LIN. FT TRENCH WIDTH FT OR SQ. FT TYPE OF STRUCTURE OCCUPANCY ZONE PUBTIC UTIT. EASEMENT BI.DG. SETBACKS FRONT FT. FROM CTR. OF ROAD RIGHT OF WAY SIDE INT. SIDE EXT. USE CIASSIFICATION REAR DATE BLDG. PERMIT _ WHITE OFFICE COPY - WHITE COUNTY TAX - PINK PTUMBING _ CANARY BUII.DING _ GREEN SANITATION - GOLDENROD Construction to comply with uniform building code ond county regulotions covering plumbing ond sewoge disposol. All buildings require o certificoteof occuponcy before being occupied. (See Stotement on Reverse Side) (POST THIS PERMTT ON MAIN BrDG. AT S!TE) I,ANE COUNTY, BTDG. & SAN. DIV., COURT HOUSE, EUGENE, OREGON 9740I ronu1f655-13 AUTHORIZED SIGNATURE _ DATE - I Darr SITE INSPECTION Ap pRov g o Rruanxs Dr sappRoveo I NSPEcToR FOUNDATION INSPECTION APPROVED ReuaRxs DrsAPPRovEo Dare I Hspecton FRAMI NG APPRovEo Re uanx s I NSPTCT I ON Dr sAPPRovEo Drr r I NsPEcroR LATH OR SHEETROCK Appnoveo RexaRx s FINAL INSPECTION I NSPECT I ON DrsappRoveo f7 Dare D I SAPPRovED Dnr r I NspEcron Ap pRov E o Rrua nx s Ir.rsptcroR CERTIFICATE OF OCCUPANCY ReaoY To lssuE Rru rRx s D Nor Rraov ro lssuE D DarE l rusprcron Z\ NSTALLER: L<.mplete rug; part of f orm to signaturc and subnrit both coPies with appl ication. PERMIT NO. INSTALLER.S NAI'IE PROPIRTY AUDRESS 96-74--- N -Aartrs -Blfttila1fleflngd-Ir&ter Supply Yes No Public 0ther-List s{qioflbrrk: Ft. from wel I rrlff/r{!{] xx No. Compartments Feet WEII Gal . Capaci ty No Foundat i on 1000 grl. er Be ou., ile in ,I Conc rete xx lnside Dimensions: Ft. Len th width OWNER XAHE MAILING AODRESS o 6 e sPosa F D i ameter 0e rh Distribution Box: Yes 5 0t er stri ut i on-PE XT Lot L Front rom ne S ide Rea r Le l. tng 4 l) tn. Filler Tvpe lf iller Depth lAbove Tile\./idth rench Sq.Tota I Fr. Ft. Between Lines(bn 6&e 5Brstructions t: :I t? (-.\IC.\)(/\\c, *"*se- Da te S i gnature CERTIFICATE OF SATISFACTORY COMPLETION For Sanitarian Use 0nly:Date:1-st- t Iln accordance with 1973 Oregon Laws Chapter 835, Section 214 this certificate is issued as evidence of sat.isfactory cornpletion of a subsurface sewage disposal system at the above I ocat i on Approved: System lnstal lation conforms to current standards Disapproved: Does not conform to current standards Remarks: tureantarans LANE COUNTY . STATF OF ORFGON DEPARTMENT OF ENVIRONMENTAL OUALITY c ,f-g PROP' ID SUBSURFACE SEWAGE DISPOSAL S**TEM fnst. 1er: Complete top part of forn. ) sLgnature and subml.t both copi,es wl.th appX.icatLon. B {rn fnstallerrs Name No. Septic I h e)tNo. I Permit No -7 PubIic /=otnut- r ty List Bedrooms 3 Baths I Yes- No.)l Basement ER (#,,8,.ru !bFt. Lengt:h /lt Applicant Name Mailing Address I Date weLl Dimens : Ft. wtdth O / Dianeter 6 Gal. Ie DLsposal Fle Depth 5 Dlstribution Box: Yes Other Distributlon - Tlpe Feet frour Foundation Iot LLne Signature )S "o- Ft 5 of 3 '1 4 ,Total sq.tt. ctil Ft. between LLnes 16 c Filter. / rur" l'L in. ,ons :t lL iF. ,l (il I7/ I lrt n I l..h) G I r I T I I +- ) 1 I l I I .-l \.f I \'. I .(r I l -,l t j I r Iu\ F I 8o9,.{anltarian use only:lY Approved: System Installation Conforms to DEQ Rules for Subsurface Sewgge Disposal Ef Disapproved: Does not Conform to DEQ Rules for Subsurface serf,age Disposal Date: /-30'7{ Remarks: - , SanitarianrsState of Oregon Departnrent of EnvLronmental Quallty Interim Forrn #2 I I I I i I 2 3 4 5 6 7 8 PI,OT PLAN MUST INCLUDE: IJegaI description (Bottom of page) Property dimensions Direction of North All roads (existing and proposed) Driveways (existing and proposed) Location of structure(s) on,property Location of water source Direction of slope PLOT PI.AI\I GUIDE For Preparation of Exhibit {lI o 11. L2. 13. 14. 15. Iocation of trees Proposed location of septic tank and drainfield and replacement area Dimensions and spacing of leach lines Distance from system to property lines Location of test holes Draw to scale Iocation of wells on adjacent lots ( ,7, L0 P/L \ F tll IIJ q l-. V) il o 0t nu ,,rt(l ol -rl,l P/L o o ? F ?\ ,g It_ IoFA/NF, ELD " REPLAC€MF^I 7 ,{ t_--1 ,?84 T- tL__ I .t7E.s'r Pt7 .'ero' L o Dt 57P.t.UT|ON BoX TF?EF q DR)VEWAY GAL <E C 7AN lpo r WELL ON IDJ4C€N'T LDT t4 Vl N N /_r,t.., 10 ('c WE LL t 9-I./ND6N LANA'../( rnoeos e a) PHOPOSE BDM PL,4N SCA (E /"= bo' Section 2 T. :r.=s Tax Lot or Account No. z-roo Interim Form #5 R.zW, W.tr,l .