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HomeMy WebLinkAboutPermit Septic Tank 1993-01-29OGB I <?trLD c" q-frPERMIT # REQUEST FOR: 4r I have carefuily read BOTH sldes of thls appllcatlon and hereby certlfy that ell DAlE lnformatlon ls trug and correct READ CAREFULLYT Your Authorlzatlon ls Based On The Fo!Condltlons /-z 7-7)APPROVED BY:DATEFEES DUE: $ CALL FOR TNSPECTTONS (SEE BACK OF FOBM FOR SEPTIC permlts are good for one year. ALL other permlts expire after 180 days unless inspectlons ate current, 687-4065 VIOLATIONS "iHtffi-ffi ,ffi ffi ffi I,u?ffi.1;sffi ,irffi s*p*mxm,ffi HJffi"'""i3#"THe A MTNTMUM oF AT LEAsr 24 HouRs AD'ANCE NorIcE MUsr BE GrvEN FoR INsPEcTIoN REQrlEsrs Have the following information ready when you calL 6874065 Permit number - Job ad&ess - Type of inspection reqtiied - When it will be rdady Your nalne and phone number - Any special directioru to the site ruruc oryrgw RrGrrT To TnEsPAss oN PnryAlE PBoPERTY oRs 215.0t0 '"ffi ffi *ffffi ffi ff#X?l'li,#^il*,il#ffi H;ffi Stffi ffiTiJ.ffi ffiffi ffi HTffi #" REQI.IIRED INSPECTIONS FOTINDATION INSPECTION: To be ma<ie after excavationi for iootings are complete and any required reinforcing steel is in place. LJNDERGROTIND PIPING INSPECTION: To belnade after all underground piping has been tulstaUed, prior to any backfill. CONCRETE SLAB OR LINDER-FLOOR INSPECTION To be made after all in-slab or under-floor building sen ice equipment, conduit, piping accessories and other ancillary equipment items are in place but before any concrete is placed or floor sheathing installed, including the subfloor. ROUGH MECHANICAL INSPECTION: To be made afterall 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 arid vents are complete and the rough electric4l, plumbing, and mechanical inspections have been made and approved. INSULATION INSPECTION: To be made after all insulation and vapor barriers ar.e in plpce, 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 plasterirg is applied or.before gypsum board joints and fasteriers are tryed -a n"irfr"a. - .' ADDITIONAL INSPECTIONS MAY BE REeLIIRED, zuch as 'but not limite.d to; BLOCK WALL: To be made after reinforcing is in place, but before any gout is poured. The inspection is required for each bond beam po*. ifro" will be no approval until the plumbing and electrical inspections have been made and approved. FINAL MECHANICAL INSPECTION: To be made just prior to the structure or remodeled area being occupied and prior to operating any equipmenl FINAL PLUMBING INSPECTION: To be made just prior to the building, struchre or remodeled area being occupied. FINAL BITILDING INSPECTION: To be made after finish grading and the building, structure or remodeled area is completed and ready for occupancy. MOBILEA'IANUFACTURED HOMES: An inspection is required after the mobile home is connected to an qproved sewer or septic systemr prior to covering sewer or water lines, for setback requirernents, blocking, tiedowns and plumbing cormections. Footings and piers to comply with State formdation requirements for mobile homes or as recornmended by the manufacturer. 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 insrrlled per enclosure. APPROYAL REQTIIRED 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 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 0re irupections required. APPROVED P["A'NS MUST BE ON THE JOB SITE AT ALL TMES DURING WORKING HOIJRS. TI{IS PERMIT WILL EXPIRE IF WORK DOES NOT BEGIN WTHIN I8O DAYS, OR IF WORK IS STOPPED OR ABANDONED FOR MORE THAN 180 DAYS. SUSPENSION OR REVOCATION MAY OCCUR IF THIS PERMIT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS INFORMATION. ANYONE PROCEEDTNG PAST THE POINT OF REQLIIRED TNSPECTTONS WILL DO SO AT THEIR OWN RISK. Your signature on the front of this form verifies the following: I HAVE CAREFULLY EXAMINED THIS COMPLETED APPLICATION, and do hereby certify that 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 thal any and all work performed shall be done in accordance with the Ordinances of Lane County and the laws of the State of degon per- taining to the work described herein. I further certify that if I am not the owner of the property, my registation with the Builders Board is in full forie and.effect as required U1 QnS 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. : :'lSUBSURFACE & ALTERNATIVE SEWAGE DISPOSAL SYSTEMS: When subsurface construction is complete, the permit holder shall notify the County Land Management Division by slbmining the instdltatien record form. {1 irspection will be made by a qualified sanitarian. If constmction complies with all rules a certificate of iompletiotr iitt U" issula io t}re permit holder. If construction does not comply with rules, the permit holder will be notified, and all correcrions shall be made before a cenificate of compietionwill be issued. Failure to meet satisfactory completion within the alloned time constirutes a violarion of ORS 454.605 to 454.745 anil this rule. SUBSURFACE SEWAGE DISPOSAL SETBACKS SEPTIC TANK DRAINtrIELDFrom: Interior property lines l0' 10' Edge ofroad right-of-way l0' l0' Building foundation 5' 10, Wells or other water sources 50' 100' I I: ? o 1 I a i t.. ai ,.., J.. .j: .'? i_tir; i",J i rJ$:ti*. i i::.l'i iir i.i rJ * l: ii ::3: 't'i"'i'a Lli lji i... i I:, i" i:'i' .1. Li i'.i ':. .i ti.i-...L' , i*i ril :... i..! Hiiii:l"lnl'i l. {.;r'rL. f'Hi::: ,Sf i\f'il: .:i.ii:.:i.ii-ii:Iiii;li:: i:ii..rti..i t.;H'ij.i.:lt Iri:-H r'! "ii+,1?.ii :i*,:i:; .1' te .1, n !'ii MUST BE Twnshp. \l IN BLACK INK form c55-11 6 0) =azpaa€6.9 6eos o-do-3 oaa { =5 U) 0) oo- g o{f,o I t.oofaozI lC. l.n lo lJ lp 5a 9r_ o doE)ofo Permit No.?c!-q3 Range o section aL\'q3 Tax Lor o1)\s Standard System X Alternative Job Location (Street Address) .r*"{ ffo"1l{ ,roi)o*L S{r Supdivision/Partition #Parcel Lot _ Block DETAIL SYSTEM PLAN AS CONSTRUCTED Scale I "= )'C ^ q E a o o) o lp tl f"r I oo 3 o l0- 1 DT 0 T o I 4o TF : a o Jt\o +l *q * to' -4 7 o 9) o t t"'+J ').1 I l!s' n VICINITY MAP O-c s0 6o o!r USE BLACK INK ONLY Gravel Depth Below Tile L,,FOR INSTALLER'S USE Trench Depth ?.1 ', Tank Capacity \Poo qq\Manufacturer i. \\ c'.* e Measured Distance fromVrll to Tank From Drainfield - 'Ibtal Length of Lines COMPLETE THE FOLLOWING IF A PUMP WAS USED ON THIS INSTALLATION I (installer's name) and Mercury Float certify thar a (Mfg.)(Model No.) Switch (Mfo. and No.)have been installed with this sewage installation 1o\*^t.< t"tl^Pump Signature Date FOR SANITAFIIAN'S USE ONLY: 6system Approved n System Disapproved tr Needs Correction COMMENTS R\e^ :g \oE Corrected Date DateSystem Capacity gal./day Signature INSTALLATION RECORD & CERTIFICATE OF SATISFACTORY COMPLETTON When ned by the County Sanitarian, this certificate is evi- system at the above locatton.dence as per ORS 454.665 of satisfactory completion of a subsurface sewage disposal To request inspection, return all three (3) copies of this form to: Lane County Environmental Health Services, located in the basement of thePublic Service Building, 125 E. 8th Avenue, Eugene, OR 97401. ,J' o +1 oIh I I I I , I o {^tt I t r MAR 22 1971 LAIiE COU)iT/ PLAI,iN iNG + IVt n Uttth V t l, Ycaelt Sctvrca ghlr"r, IU 9ot o rOi) T?3 g -.tzl, t7 JI-ZZt* .FZ Yg q,a v' l- bo on *l U0ca&f o\- .."-I21 ' I 3o * H At( D. j ''ER\DGE F o^\r> ort ' ,n_* ,( J ,/ 2 tJ L7t Yo(-A )A sr.) 3:: 2118d#H 5'FoN 't 7L.'Eoo. c has S chull alIUtz0o \Al rlb.r r fuileY .\r q --+TL ttoo {'l Y.l,6g1lcsr + 'tL l3N N,C, Rxrl"- trl Ed I $.5e€i t"'- loot L.Joh,',ta'- EGIEI\/I E,D l [t'r r j -' API-I 1 '1 1971 m l- UJ UJ( t- v) !n,t o U fc) F,, op 3 I T Pdoz LAtl5 flurlil hl:l\LTH DEPI' : n Aua t-i D F,IV E -8 I n4u \,ho. r\e ^hdLr.+ A d (e '''tr H A'( DEN OO NOT WRITE IN T HIS SPACE u X st') ii-ils llAP is FOR 'ilir Puilptls: oF tM r t\:O il [iL: I-] [r l',r; i:.] C i i .A,i'}i:tOV/'L' I I l3 i.jil I it'l I :-i:'iLiilji-r -i ii ill:i;'i::':s,.-:NT AN A,CCU;i,',1'i- iiiii\';"r' Ci' -ii'{; LAt'lD' V tc-I \\ ITY I.AAP D NO S<,ALE NOT E sEE cHECKLrir oN REVERSE slDE Approved as a ninor subdivision by tire Lai:: County Land Development Revielv Cor;i:';: i iiee LEE I,iiLLER, Co'.rrJt-TloFJS l t. No Pot*rl,', o F o' drrpota\ stlstevr^ ',r;tLl..lr"rc q errL - gur g!r. a,t\ o€ *lc fa <,c ieurcrg bg so* tr}r,* eas,fiavt1 I L 5o fcc* C Lo{ *l-raZ, MINOR SUBDIVISION IAx LOT(S) za SSESSORS MAP 1-1 - 6 4- SECTION 5 L tlt lcz 1C-tT J*!r F r TOWNSHIP ll S, nIUCE i'.,r j l-: ,. .- I GU\NER .8 BF\lfTCt{ ? 5t \,v, l.z Tu srri-eE] EUGEiuelciaEc-Otrl PREPAR€O BY :CALE I"= l6O/ - - 9-?-R l{ -G-E-L E= LD-,. CRf=, ailtii-iA/ 4U- u* !- IPH )NE KF--T!! AilTOWNER ADOR ESS uAl,l D co NUMBER M+ li- Zl ; I I I i I t :rl\1 F, 1* Bnanch Engfneenfng November 4, l-993 31O Nonth Sth Stneet Spningfield, Onegon 97 477 [5O3] 746-0e,37 FAX [5O3] 746-OsBsWalter Ford 558 South- 57th Street # 12Springfield, Oregon 97478 I DearMr. Ford: .1-\1 g N, 'LctA Branch Engineering and city of Springfield Engineering personnel recently conducted an inspection on your project 20th Street, Springfield Project No. 3-a26. The following items remain to be completed: 1. fnstall 3 type I delineators, 2. Crack seal joint between o1d and new asphalt paving. 3. Remove AC chunks. 4. Grind down concrete in gutter at weep hole patch. 5. Fix asphalt paving match line near North driveway. 6. InstaII driveway approaches at curb cuts, 5' of concrete and 4' asphalt paving. 7. Bring up asphalt paving where Iow, in front of driveway. The enclosed notices show that Gary Martin Concrete and. Asphalt is no longer insured or licensed to do this work. The city has indicated that the Final Occupancy Permit for the dwelling will be held until the above itens are complete. Please give me a caII to discuss how you wish to proceed on this proj ect. Thank your -/?eY, P'E attachments:Notice of insurance cancellation Statenent of license suspension cc:Ron Sather, Cfrief of Construction TFANSPOFTATION CIVIL SUtrVEYING NOTICE OF CANCELLATION OR NONRENEWAL OF POLICY NONRENEWAL OF POLICY TO THE FOLLOWING NAMED ADDRESSEE: 'issued to named insured N is terminated. Termination shall be effective at 12 :01A.r.4 ADDRESSEE - sL 85t8242A CITY OF SPR]NGFIELD 225 N 5TH SPRINGFIELD, OR 97477 ADDRESSEE.r lt6 \ 5fc f.- 1Cz / CANCELLATION OF POLICY FOR NONPAYMENT OF PREMIUM virtue of this notice. vour interest in Policv Number CONICRETE E RSPNRIT SL 85 L8242A SL 85L8242A OREGON CONISTRUCTIOI{ CONITRACTORIS BOARD STATE OF OREGON 700 SUMMER ST., NE, SUITE 100 SALEM, 0R 97310 STANDARD TINIE ,1 lf premium has been paid, premium adiustment will be made as soon as practicat after cancellation becomes etfective, or upon demand. lf premium has not been paid, a statement will be sent for the premium earned. This nolice is sent by the company that issued the above company being the one indicated bY policy, said 6 sereco INSURANoE ooMPANY oF AMERIoA N OCruERAI INSURANCE COMPANY OF AMEBICA_l I FTRSTNATToNALINSURANcEcoMPANYoFAMERIoA E SAFECO INSURANCE COMPANY OF ILLINOIS E SAFECO NATIONAL INSUHANCE COMPANY E sAFEco LLoYDS INSURANcE coMPANY f] SAFECO SURPLUS LINES INSURANCE COMPANY POR:GW:KR:4 r, ,] {1 iggS 3-1340 Col'tMr L MARKET INFURANICE AGENCY AGENI/IELEPHONE TYPE OF POLICY POLICY NO,sL 8578242A POLICY FOR LOCATION OF SAME IF X cN,7001/DP 1,92 PRINTED IN U S.A, I ., t ,,. . I T , lgg3SEPTEI'tsER I-AKE (