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HomeMy WebLinkAboutPermit Building 1981-11-17FOR OFFICf, USE ONLY CONSTRUCTIU LACEMENT PERM IT COIIPLETE THIS BLOCK. PLEASE USE BLACK TNK AND PRINT. PLANNING ZONING z zone Applicatio :flts!fre-Copj,es of Pfans fl Tro Copies of Plot Plans f] l.lechan j-ca1 Checklist frlumning Chec]:1ist Plan Check Info Sheet Partrticn i Parcel #Parcel size 7 tt4,Z LorlPAR'EL G< BLOCXI5 E3e sidenr-i al n tndustrial flnuuricCommercia foF -/,l--l Proposed frg.i.t:."e NU}'{3ER THE COMPLETED APFLICATION FOR PERI'IIT, and do hcrcbT,rottifi'thot aIl inf.)rmation hcrcon is trrrc and correct rrtd I flrrtl)cr I performed shall be done in accordance with the Ordilralcos of Lane County and the l,ans of thc SL.rr_e of Or?(l.rn I,,_.ftair)in,land that No oCCUPANCY uill be nade of any structure without the permission of the Building Divislon. 1 furth{rr c:r rtity rilder's Board is in fulf force and effect as required by ORS 701.055. that if exenpt the basis for cxenption is not..d .ractors and emPloyees who are in compliance with ORS 701,055 will be used on this project. I HAr,rE READ AND CIIEC],.ED THIS d-,l or,.e, SIGIJATURE fl es..t <^ 2-E(qontrac*-o: NA-["IE (p]ease print) L//t r" .AREFULL, EXAMTNED /c{tity that any and all work /o *e work described herein, that. registration with the Bu hereon, and that only subcont APPLICATION AHOROUGHLY. Iulinimum Se lnstal]ation Specifications: Colunents: C L,C L t idc.interior re ar tr PLAIN: I nunal ADDRESSING: CRID COORDINATE N I samrtATroN: s. r { In flood hazard aruaz Ff lto I ves, see attactled sheet Date: Date: Date:E B. P. #lnstallation Record Issued? [ v.= f] no Maximum Depth of 1'.rerrche!l GalIon Tank Lineal Feet of Drainfield Date: {r"*l ,rn" V -Al ",",n ?-trirl-l ,,"V€z,]tilllZAt-EXAMINATION: Conunents : xed Uni-t C Fee/ ostfr Floodplain Fee Subsurface Fees Building Fee FEES PATD BY By: Date 3-@$ ) $ $ $ fun%-Seweg/Storm Drain/Water $/. rr*iT{Q,-$,'""1& H::T::{?,ry"*/ state surcharge 4lZ rorAl PIIE 99.54 $43,/ TOTAL VALUATION $fl cas.Fe Do€-tf 74.?g PERMIT APPROVED BY BUILDING OFFICIAL/DESIGNEE (per ORs 456 (1) )DATE LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT / 125 EAST EIGHTH AVENUE, EUGENE, OREGON 9740L c74-t94 SEE REVERSE ^"'22 PROTOSUI] USL OF PROPERTY tr tr ,? ) \ \, i-;,{ SETBACKS AND OTHER CONDITIONS OF FIrPROVAL MUST BE STRICTLY OBSERVED. VIOLATION CAN RESULT IN REVOCATION OF THIS PERMTT; CITATION UNDER PROVISIONS OF LANE COUNTY'S INFRACTION ORDINANCE, AND/OR OTHER REMEDIES ALLOI,IED BY LAt.l. WHEN READY FOR INSPECTION CALL.687-4065. A MINIMUM OF AT LEAST 24 HOUR ADVANCE NOTICE FOR INSPECTION REQUEST MUST BE GMN. Have the following information ready: Permit numberi job address, type of inspection, when it will be ready, your name and phone number, and any special directions to site. BUILDING DIVISION: REQUIRED IIISPECTIONS f) F0UNDATI0N INSPECTI0N: To be made after trenches are excavated and forms erected and when all materials for the foundation ffiob.Whereconcretefromacentra.lmixingplant(common1ytermed..transitmixed..).istobeused, materiais need not be on the Job. 2) CoNCRETE SLAB 0R UNDER-FL00R INSPECTIoN: To be made after all in-slab or under-floor building service equipment, EonEult, piping atcessories and other ancillary equipment items are in place but before any concrete is poured or floor sheath,inq, instal led, including the subfloor. 3)FRAMING & INSULATION.INSPECTIOf{S: To be made after the roof, al'l fram'ing, fire blocking and bracing are in place and sandventsarecomp1eteanda.llroughe1ectrica.landp1umbingareapproved. walI irr"ulation and vapor barrier are in place. 4) LATH AND/oR GYPSUM BoARD INSPECTI0N: To be made after all lathing and gypsum board, interior and exterior, is but before any plastering is app'lied or before gypsum board joints and fasteners are taped and finished. 5) FI!!! !tlSP!Cl!0lI: To be made after the building is complete and before occupancy. All in piace APPR0VAL REQUIRED. No work shall be done on any part of the building or structure beyond the point indicated in each successive inspection without first obtaining the approval of the building offic'ial. Such approval shall be given on'ly after an inspection shall have been made of each successive step in the construction as indicated by each of the inspections requ i red. N0TE: Al1 building permits require inspections for the work authorized, such as but not'limited to: A. BL0CK WALL: To be made after reinforcing is in p1ace, but before any grout is poured. This inspection is required for each bond beam pour. There will be no approval until the plumbing and electrical inspections have been made and approved. B. W00D ST0VE: To be made after completion of masonry (if applicable) and when instal'lation is comolete. Installation shall be in accordance with an approved nationally recognized testrng agency and the manu- facturer's instal lation instructions. C. l,l0BILE HOME: An inspection is required after the mobile home is connected to an approved sewer or septic system for: setback requirements, blocking, footing connection, tiedowns, skirting, and plumbing connecti ons. (f) Footings and piers to compiy with State foundation requirements for mobile homes or as recommended by the manufacturer.(2) Mobile home minimum finish floor elevation sha'll be certified when required by a floodplain management Ietter.(3) l4obile home tiedowns, when required, and skirting shall be installed and ready for inspection within at least 30 days after occupancy. Tiedolvns and skirting shalI be installed per enclosure. D. SWIMMING P00L: Beiow grade when steel is in place and before concrete is poured. Above grade when pool is instal led. APPROVED PLANS MUST BE ON THE JOB SITE AT ALL TIMES DURING I,IORKING HOURS. THIS PERMIT WILL EXPIRE IF I'IORK DOES NOT BEGIN I,IITHIN I8O OAYS, OR IF I^IORK IS SUSPENDED OR ABANDONED FOR MORE THAN]8O DAYS. SUSPENSION OR REVOCATION MAY OCCUR IF THIS PERTIIT I^JAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS INFORMATION. ANYONE PROCEEDING PAST THE POiNT OF REQUIRED INSPECTIONS I,JILL DO SO AT HIS OI'IN RISK SUBSURFACE AND ALTERNATIVE SEWAGE DISPOSAL SYSTEMS Permits shall be effective for one year from the date of issuance. Upon completing the construction for which a permit has been issued the permit holder shal'l notify.the Dipartmeht by submitting the installation recbrd form. The Department shall inspect the construction to delennine if-it compliei with the rules cqntained in, this division. If the construction does comply vtith such rules, the DepirAnen?bfiatl,issue a iertift.eate.of satisfactbrycompletion to the perm'it holder. If ther construction does hot comply with such rules, the Department shal'l notify the permit holder and sha'I1 require satisfactory completion before issuing the certificate. Failure to meet the requirements for satisfactory completion wittrtn a reasonable time constitutes a violation of ORS 454.605 to 454.745 and this rule. (r ) (2) Setbacks - Subsu From:Interior property l$*=:..,.,*.r.* P:- Edge of road qight-of--vlay-' ' ' - l0': - -"' Bui]ding foundat'ion 5' Wel I s ,. ,other ,water sources 50' '10, '100' Drai nfi el dlTo-]-- lane county6l!'\- CHECKLIST PIUM BI NG / TUIEC HAN ICAI Y"Laa"oLq LJ APPLI CANT INFORIvIATION : OI rm-ease PLT]MBING CONTRASTOR MECHTqNI CAL CONTRACTOR C.-c,-o Yes Firm Address tr No n 1ng Se r.r- SS r o Cont. OSR#)O - ty? FB 6 Self Firm Cont. OSR# 2U IY Address fl Nofl serr PLIJMBING OFFICIAL USE ONLY App1i./ Permit #zw Tlpe of Fixture Number of Each Fee On Each Total Sink $ s.o0LavatoryAS1ns. 00 Tub (with or without shower )5. 00 Showcr, separate 5. 00aterosettoI s.00Disposer t e r s. 00 )b s. 00 40.oo _Sewer--lst 50ft.15.0 eaEh additional 100 ft.10. Water Service--1st 100 ft.15. 00 each additional 100 ft.1 Storm and Rain Drain--1st 100 ft.15. each additional 100 ft.1 Special Wqqte Connection s .00'ejector 5.00rl) Other c1 STorlnotTAnr Y,tox f+ SIIB-TOTAI (Minimum $10. 00) TOTAT FEE MEGIANICAT Type of Equipment l{umber of Each Fee on Each Total Mechanical Permit Base Fee $ 10. 00 Furnace up to 100,000 BTU/H I $ 6.00 /P Furnace over 100,000 BTU/H 7. s0 Qlothes Dryer Vent 3. 00 Bathroom Ventilation Fan & Duct 3. 00 - Range Hood with lvbchanical Exhaust 4.50 Wood Stove 6.00Air Conditioner Only 6. 00 _ Heat h.unp 6.00 Floor Furnace 6.00 Gas Piping System 1 to 4 Outlets Per Outlet 50 Other (specify) SIjB-TOTAL tb.& TOTAL FEE 5. 00 rer ng Machine 5. 00 AA .er ). 00 r. 00 e .00 lone counlyEnuironmental Management ACTIVIT ^ INFORMATION SF'T.ET 6r\-COMPLETE THIS SECTION. INCOMPLETE FORI4S WILL BE REJECTED: o OL s Rohe*T 114c C \ e \\ a- ^PROPERTY OWNER/CONTRACT PURCHASERAPPLICANT 5s q [ri t \ o v.., s-[[ e, Et.385 \/ oL n-*A * IVI.I\ILING ADDRESS MAILING ADDRESS 9lqo 1L{ \ f)&e \ 1I STATE ZIP CODE ClTY STATE ZIP CODE u1 gu1_loS3 \:"r - B6ro BUSINESS TELEPHONE NUMBER /UOME TELEPHONE NUMBER @ uerr, rNFoRr,rATroN To: gd6elrcaur,/REPRESENTATTvE ffi HOME TELEPHONE NUMBER I enoennry owNER/coNTRAcr PURcHASER @ rax MAp/pRopERTy DESCRIpTION NUMBER (from tax maps in Dcpartment of Assessment & Taxation or from tax statement): Tax Map Number / 7-o 2 -/?-3 Tax Lot (s) : I out of TL # By partiti-o. ll- Tax map nurnber of adjoining property in same ownership: !Xone I Unk.town Tax Map Number:Tax Lot (s) : @ SuaorvrsrON (if applicable):BLOCKi _ LOT: @ ngOUBSt (brieffy cescribe information needed): e @ torer, coNTrcuous PRoPERTY' rN sAi\lc oI^INERSHTP acres @ enoernrv ADDRESS @ rnesaNr usE oP PRoPERTY:R*= @ r.tuuarn oF srRUcruRES oN Modular home - Garage- I PROPERTY: Standard home I RV in use as residence - Shop '- MobiLe home -- storage - Barn Other (specify) @ eCcuSs TO PRoPERTY: Public Road Name YoL ct.Aa- Private Road Name Road Easement width #of Use rs @ orusn EASEMENTS ovER PRoPERTY: O tvntt;lt o I s't'RrC'l :?-.w.q-_R O rlxrs'I'lNG PERI'lrrs oN PRoPERTY: fuo @ rrna DrSTRrcr: COI\,IPLETE THIS SECTION FOR I,AND USE, CONSTRUCTION APPLICATIONS ORP *NOTE **FOR STAF US ONLY** NUMBER: DATE: TIME INITIATED CHECKED BY: ATTACHED E fl erot plans (2) f]constr. Plans (2) flsite etan fl copy of Tax MaP X oar,"r- SCREENING VERIFICATION : P1' .D1 . Date: Ti.me In Out: f]accept Routed to *NOTE: I neject ATTACH A COPY OF TAX I'IAP; SHOWN EXISTING STRUCTURES AND TAX LOTS IN YOUR OWN- ERSHIP. OBTAIN TAX MAP IN SELF HELP AREA. Fa Na €tr -7 /et (ovER) _sf. CO!4PLETE THIS SECTION E'OR I,AND USE OR @ enonosrD usE ou o"ope*rrX DETAIL: S-xa.u.---Ll"eL.11r4,[qr.- IONS **FOR STATT USE ONLY** Rw. Date: \ o BUILDING REQUESTS: Contractor's #3 b?. t:1_ Directions to Siter Errr \^r\,o-N (for mobile home setup also) Time In:_ Out:_- I eccept ! neject f] nlanning Application ! Construction Permit App. f] tnformation onty Zoning: Comp. Plan Designation: Check the type of permit'reguested: l-l owellins: ft rvew ! neptacement f] aaaition ! Alterationi Iuodular Home f]uobire Home - Model fl ov ! standard Constructioni fl er.r, check only [l commerci-a1: fl asricultural: Cofiunents SANITATION: By: Date: Time In:_ Out:_ f] accept I nelect ! Constr. Permit Issue ! site Evaluation rssue PERMIT TSSUED (SA]'lE DAY ONLY): Permit # By: Date: Time fn:out: f| additional; Year Use Floor Are Use Ploor Area [-l cr,u.,g" of use - How? @ saNrrnrroN REeuESrs: f] sit" evaluation for SDS feasibility f] uew system j-nstallation ! nePair,/rePlacement f, alteration/re locatiort [_J Hook to existing ADDITTONAL INFOR}IATION: . ZONE,/LAND USE: UK",s, u." Sn\^- fa--u.(n lane countY HOLID StIP APPLICATION # Z \ LOCAT I ON 64q t^J,, , o, NAME ADDRESS E The above application is being held for the followin g reasons I .?gott*. ;ryf,lFLc*TloFl., DY Arl wpN A?i+{l-(€cT oE" aql^I&-) THAT T+IE, EXt rAJ q hl,a- 3wrclq mt Otr ]H€, xl€, aY NaTWc[1O^I5 3. ftov tDa A 4. R v( 6, ?s. MAf.r uFilcTrl ze:Pe I NSrNJ*I1ON aN f?-a^t 3- TH€ PUILD lNq LX,N]Il.lr1 X+€ il "?f,-8 I DATE hl6]6l+T. Z.?q,r^t',Dq- trL This app)icat'ion will be held unti I t/Aht- If the jnformation required above has not been furnished by that?ateloui +plication will be cancelled. Building; fees paid for permits cancelled under these cjrcumstances wjll be prorated according to the work that has taken place as of the date of cancellation. Kqurul T\lts e-tP t,{tT+l TH€ qugsTw tNrcR-p1,NnoA. BUTLDING & SANITATION / ENViRONMENTAI- MANAGEMENT DEPARTMTNT 125 Easr gth Avenue / Public Service Building / Eugene, 0regon 97401 / (503)687-4061 ?=8b Yu*'tr Mr@ Anaxe.Oz. KV) NNT.IN3 OFF]TE_N-OUXS lane countyHOLID SLIP fi!'--7 APPLICATION # :-8r LOCATION Mr cxaeL NoBwooo NAME ADDRESSWr ttaugrre .* U,rn**.. U*. Zrp eOrU The above application js being held for the forlow'ing reasons: Txt anlcrng Foi n{E RooF RAFTERS cAUSE TxE ctrltNc Jorsrs ro FArL. PeovtoE REvlgroxs yo rHE noor/cerLrr.ro FRAxrHc, DEgTGNED By Ail Onecou ARCH Sprc Pnov r. E. TA XK Spec z&.z Txr D 3. )+. 5" ,rft/fi' OVER OES I SY ST GN LoADs. Pnov r DE E I TIIER THE uAilUracr r RER' s oRAr., r Nc FoR txE(luoooRi fr,r oR REVTsE THE pRoposEo suppoRr. Sec. Z&t (r) 1?lo l8t S IGNATURE 58?-\o6r (t-\ oN,-v) OFFTCE HOURS PH()NE This application will be held until - If the jnformation requiredabove has not been furnished by that-date Vour appl'icatjon will be cancelled. Building fees paid for permits cancelled under these circumstances will be proratedaccord'ing to the work that has taken place as of the date of cancellation. BUILDING & SANITATION / ENVIRONMENTAL MANAGEMENT DEPARTMENT 125 East gth Avenue / Publjc Service Building / Eugene, 0regon 97401 I (503)687-4061 5 lane county APPLICATION # LC ,Br LOCAT I ()N Yot- l ruoa MrcxlEr- Nonwooo NAME ADDRISS5j9 Ulr LLAMETTE --*ntot' o*' zru eoD, The above application is being held for the following reasons: 4. Txr enlcrNG FoR THE RooF RArrERs cAUSE THE cErLrNG Jot FnovrDE REvrsroNs ro rHE noor/cerLrNG FRAMTNG, DESTcNE /. aRcn rrEcr oR ENG T NEER. Sec. 3OZ(c){..1pecrFy rHE MoDEL or coLLEcroR ro BE usED. Src. 3Oe(e) { e*ouroE AN ELEVATToN AND scHEMArrc prprNG 'LAN FoR rHE HOLID ST,IP t.t. t PIPTNG FROM THE WATER STORAGE TANK TO b/HATEVER t/. r^NR', Src. 3Oe(a) t1t-o .^^cLu* "- -F*,lr {4- L\+t +. )PECIFY THE SIXE AND DESIGNATJON OF THE OROPOSED RIV { ln' $1, r },,, r / s,7i,]I.lif/i',,,7i*^;=# ili^,ff dt r lt'D /u --\''o- ( STS t DBYAN PROPOSED SYSTEM, I S SUPP IED BY TI.{E ETS.5ec.Joz(a)a *t.t"-6A *Yoa t') ORATORS APPEAR TO BE ovERSpANNED, BASED ON THE ALLOWABLE ALUMTNUM BENDING STRESSES AND THE DEs tGN LoAos, Pnov r DE E I THER THE MANUTAcT r RER's DRAvr NG FoR 'THE suppoRT sysreM oR REvrsE rHE pRoposED suppoRr. Sec. z8or(a) -t\ bou r .-Tr t'tr'x t'li'xr/r" ,,.L.trf4^tt d",?-3Y( d.I{*{- l.-*.- ; *";J"'[ ' A4 S IGNATURE NO WALK- INS . tz/ot /Bt _ DATE 68l-405t (t-4 oNrv) PHON EOFFICE HOURS Th'is application will be held unt'i 1 tz/zt/Bl If the information required above has not been furnished by that-dtte vouf-ipplication will be cancelled. Building fees paid for permits cancelled under these circumstances will be prorated according to the work that has taken place as of the date of cancellatjon. RETURN TH 15 SL IP V/ITH THE REQUE'sTED INFORMAT ION BUILDING & SANITATION / ENVIRONMENTAL MANAGEMENT DEPARTHENT 125 East Uth Avenue / Public Service Building / Euqene, 0regon 97401 / (503)087-406] B!ilCing Pernit-"ry1;:e CrJl:/ T;r-Pink -plrrb-. -_,:, ir.f-- Builc,.i-Grao Sani tiI iaft-Go l3e. rod Fite Marshall-Buii s L&EqH effieJrdYyi ewnum$&Bs PERF*qEY I Lone County Courtho*e, Eugene, Oregon 97401 Ovrner IJYT0SKI , John A. Moiling Address Controctor Moiling Address Locotion of Proposed Buildlng (ond Post Office): 3385 Yolqnda AYenue Existins Sir-r.ir.et ;;'i;;;;tiii*'--- *o lf so' describe: CT- "20- qOt Do.. jrop"rty hove legol occess? uat lf- so' describe: Yolanda Avenue Legol Description of Building Site - Mdtes ond Bounds Acldltion to l'lontebello Acres uS7q{c"a" Areo Squore FeoPge ryff-"f ct":tt"tl* Lot I and 2 Block 3, lst T*p. ll Ronge 92 Sec. el I w.4* Size of PropertY:\A/idrh DeP th Structures to he buih under this Permil: D:rrelling, llving area maln &Atached garager celled Recreation area over garage 1473 @ $ 12. I public water I septlc tank connection !nstal I set+age di sPosal system G$eirvie'* Street, SPrlngf iel 7r$-59e0 Bdrnrs.Vs!uation r325 Bhone $hon* h{o.F$r-LeaA t7,676" I ,936. {,olq) r*ood frame ; Driven ,1. @ $3.50 @$12. 553 56s proposed VrrP.l''gfr'dlp, r i p3611e s Proposed Sewoge DisPosol: Public Plumbing io be instolled by Orvner ( ; Spring ; Septic Tonk Plumber ( ) ; Well: Drilled - ; Pit PrivY |Gme of Plumber, ; Dug FEESI Building Woste Disposol Plumbing Plon Check $g&.oo 7.00 l9,oo 7 ft. PUE on back of both lots tdest side of lot I /cl liary t'fytoskl Signoture of APPlicont Dote TOTA.L SANITATION: Septic Tonk: A{inimum Liquid Copocity Subsurfqce Disposol Field Required: wirh Distribulion Box Lin. Fr. 2t$ 1000 Gols. Width of Trench, or 3ft. $ EffiEJNYY B&"$gLffig$\$& & gANETS-YB@N SPHffiBFECA , ,'8Y Sq. Ft. - 7?0 lnstall a fill thiee feet deep co*taining no gr*den loafl. Keep trenches ?0 feet frcnr edges trenchcs l0 feet apart. rock, sar:d, or cla'/. of fill on a!l siCes 0[CUr]A],1ieJ Dote TARIA},i Use 5ri STR,UCTURE: Zone AGT Bldg. Setbocks: Fronl l+5tfeer from Cenler of Roqd. Side, lnterior !l Feeh Exterior (if corner lot) 40.1 Feet frorvr lenter of Rood' CONSTBUCTION TO COT.,IPLY UIITH Ui.JIFORM BUILDING CODE AND STATE HEGULATIONS GOVEBNING PLUMBING AND SEW' A.GE SISPC)SAL. ALL COMiV'IERCIAL P.ND INDUSTRIAL BUILDINGS BEOUIRE A CEBTIFICATE OF OCCUPA}ICY BEFORE BEIT*G OCCUPiED. Ap crtlon,of the work covered bY this pcrmit shall be started within 60 days from dlte and irll work completed within one year, except sewage disposa I repair, which rnust begin inrrnediately lf not, the permit beco nless renewed by the cclunty building insPector. B't' IEVa 6.W'rtlli S{GNID Rrrt nl"u.-. ;1., $Y Tri: NG.I' sAt't tr t,i.j#,tttl*Fr?.ro*.,,,,.Gioo*,'--ts"Ui rilt lnrl+s p.Rr,irr rcF. Tl{t rrr*.ru*ru?.T:}S'"I$ro*. Tlt!5 Pri:&uT lfi A P;tQ,*ll.,l ENT LOCATIf}II O}.I OR T.DJACENT TO THt ltlAltn BUllDti{G AEING COF::T;{UCTID P05? 1I ,#2 Recor d- {- rndividual s.;;rre Disposal syster.n Ig" BE*-PERMrr COMPLETED BY INS TALLER: ISSUED TO:John A-l^/y tos k i .:..t lnstoller's nome Norn Moiling Totol n r#oter s . Euilding permit number 75-70 unrber: Living units_ Bed Property oddress Lot I anC )Block 3 lst Add to Hontebello Septic tonk: Dii tonce frorn wel ,oors '. '' B oths-=.-Bosement: Yes NN oI Acres De Greeupply by : Public system .' -' lndividuol system_ Communi ty system_=._-_ Totol liquid copociDiometer ft Liquid deptTile disposol field: Distribut ion box? YeLength eoch line Totol length Width of trench Totol squore footoge Distonce between tines Typ"of filter moteriol: Grovel Feet. M s terio No. of comportmengol. lnside length ft. lnside width ,:i ftft Oth ft. er Distonce from:ft. w feet.ft. Neorest Dept h of filter moteriol oyer tile inches [t. Lot line:Front[ SideI Reorfi _feet.,/a it Foundotio feet.Other---------.-.___. Depth of filter moteriol beneoth til SKETCH (See instructions)tt u1" l r,)I I fa ,iir iT I tirj ii iL:" l I li" ii i1; it-m , iii I 1 '/ 13i0 L^{i,iE [L]lji'ji] HEALTii Ui,:11 TJov l! ;N F,LL 5<//: 4 ) ) BE SURE TO INDICATE NORTHERLY DIRECTION Do FOR USE OF SAN ONLY: System opporentty Remorks ITARIAN wiil1b function sotisfoctoriry, ond is therefore opproved for occuponcr ff DisopP.oved'ff Signo tu re ARTMENT @r 6 will not ! LANE T SANITARIAN !)c *1 W)/' t 1'-t i ---*?3- I,AI{D FILL EVALUATION FORI{ Nane l-4) r, /.,.s ,{-" Date Townshlp Bange Sect 1on Perurlt No -1rr Iotlt t I tql Eouse No.cltylP. o. Rte. No, v- otAtt*t Yr.fu F1e1d personnels lnltal oPlnlon I rr. III. Slt"e condltlonA. Slope by lncllnometer " O-5 sllght' :-5-!5 moderate _L5-25 severe solI depth-:----Tapp1ns unlt :---E o B. So11 e. Sub so11 typetatle FIlI cond.ltlon 3 r _depthA. E€latlon toglequal toless then D. Type of ftIl oart ta1 _{ coap}ete ye -{no System condltlonA. Satlsfaetory3i_Fa1l1ag_{ resldentlal -r&group resldentlal commerc 1a1 -lndustr1a1 French draln age Lqo.--0 mater laI used ln f111 B. Conpactlon C, Vegetatlon meets speclflcatlons6v""no Percolatlon test 8.f111 materlal b se naterlal Yes -Y'nat lve Q"" -Planted JE. On slte materlal F. Cond.lttont -r"" -Aeooa. -_no . nat8lnar _POOr _fuo. ."63fi[Ht'3',' water table-ZFnyslca1 evldence( good. ) -physlcal evldence ( poor ) grade s IV Procedures ln data gatherlng Dhotoeraphs No. -chem16a1- -No. -bacterloTi@No. , Remarks