HomeMy WebLinkAboutPermit Septic Tank 1993-01-25rua6rz:4
PER
SEPTIC SYSTEM VERIFICATIONREQUEST
FOR:
DIRECTIONS TO SITE FROU NEAREST MAIN T.JTENSECTIO'I*E"A$i"dN*HAYDE'N *Bn i'ce RoAD To 35tn srREET.
LI42 rltILLAGILLESpIE RoAD' #7' EUGENE, oREGoN
OIVNEBS MliiE t ADORESSKID PARKS, SAME AS THE JOB ADDRERSS ABOVE
02 58
?'ffH^*r,ionrH 55rn
SEPTIC SYSTEM VERIFICATION
APPLICNT NAilE E AOORESSMICHAEL SIMS,484-9815
NA NA
7
4
DESCRPIIC.'I OF PrcFC6ED !\iofi K
PHONE
PHONE
PHONEcc8,
NO.
19
NONE GIVEN
Cd^fi RACIOH /NSTALTEP BIJILDER NA4E
NA
PRIVATE USE
STREET, SPRINGFIELD, OREGON 9
EXISTING SINGLE FAMILY DWELLIN
all information ls true and correctcertify thatI have carelully read BOTH sldes
MICHAEL SIMS
this appli
PRINT NAME
READ CAREFULLY!our Authorization ls Based On The Followlng Conditions
DATE t-23--q?APPROVED BYFEES DUE: $
CALL FOR TNSPECTTONS (SEE BACK OF FORM
SEPTIC permlts are good for one year. ALL other permits expire atter 180 days unless lnspectlons are current.
t N9TB U CTTONS) 687-4065
LMD 040 Rev. 6/92
NGFIR2495 NoRrn 55t
VIOLATIONS
SBTBACKS AND OTHER CONDITIONS OF APPROVAL MUST BB STRICTLY OBSERVBD. VIOI.ATION CAI{ RBST'LT IN RBVOCATION OF THIS PS&YIIT.CITATIONS MAY BB triSUBD LTNDEn lHB PROVIIIONS OP LANE COt NTY'S INTnACTTON OnOnreNcs-,lxolon orHEIt RBMEDTBS ALLO\IBD By LAW.
A MINIMLTM OF AT LEAST 24 HOIJRS ADVAIYCE NOTICE MUST BE crVEN FOR TNSPECTTON REQLESTS
Ilave the following information ready when you call: 6974Cfl5
Permit number - Job address - Type of inspection required - when it will be ready
Your name and phone number - Any special directions to the site
powBRroENrERrrpoNLAND.
"*""ffi*1?"1,T1ff^i#3Flffi*B'rk::He*'ffiffii3HBHH'*H".-'^**opr,ErRF,NcrroNs.MAyEIITER I.JPON ANY LAND AND MATB EXAMINATIONS AND SURVBYS AND II.ACE AND MAINTAIN TIIB NECESSARY MONI,'MEIVTS AND MARIGRS THBRAON.
REQr.IRED INSPECTIONS
FOLINDATION INSPECTION: To be made after excavations for footings are complete and any required reinforcing steel is in place.
LINDERGROLIND PIPING INSPECTION: To be made after all underground piping has been installed, prior to any backfil. -
CONCRETE SLAB OR T NDER-FLOOR INSPECTION: To be made after all in-slab or under-floor builting service equipmen! conduit, piping
accessories and other ancillary equipment items are in place but before any concrete is placed or floor sheathing instaUed, including the subfloor.
ROUGH MECHANICAL INSPECTION: To be made after all ducting and gas piping has been installed and prior to being "or"rJ.ROUGH PLUMBINC 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, b,racing 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 INSPECIION: To be made after all insulation and vapor barriers are in place, prior !o covering.
L,ATH AND/OR GYPSUM BOARD INSPECTION: To be made after all lathing and gypsum board, interiorLd exterior, is in place but before anyplastering is applied or before gypsum board joints and fasreners are taped and finished.
ADDITIONAL INSPECTIONS MAY BE REQIIIRED, such as but not limited to;
BLOCK WALL: To be made afterreinforcing is in place, but before any Srout is porned. The inspection is required for each bond beam pour. Therewill 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 equipmenr
FINAL PLUMBING INSPECTION: To be made just prior to the building, strucure or rernodeled area being occupied.
FINAL BIIILDING INSPECTION: To be made after finish grading and the building, structure or remoaebd area L completed crd ready for occupancy.
MOBILEMANUFACTURED HOMES: An inspection is required after the mobile home is connected to an approved sewer or septic
system, prior to covering sewer or water lines, for setback requirements, blocking, tiedowns and plumbing connections.
Footings urd piers to comply with state formdation requirements for mobile homes or as recommended 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 installed per enclosure.
APPROVAL REQIIIRED
No work shall be done on any Part of the building or stnrcture 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 oleach successive step in the construction
as indicated by each of 0re inspections required.
APPR.OVED PT.ANS MUST BE ON T}IE JOB SITE AT ALL TMES DIJRING WORKING HOIJRS.
TItrS PERNIIT WILL H(PIRE IF WORK DOES NOT BEGIN WTIIIIN I8O DAYS, OR IF WORK IS STOPPED OR ABANDONED FOR MORE TTIAN IEO DAYS.
SUSPENSION OR REVOCATION MAY OCCUR IF TIIIS PERil/trT wAS ISSUED ON THE BASIS OF INCOMPLETE oR ERRONEOUS INFORMATION.
At\YoNE PRoCEEDING PAST THE PoINT oF REQLIIRED rNspEcTroNs rryrLL Do so aT THErR owN RrsK.
Your signature on the front of this form verifies the following: I HAVE CAREFULLY EXAMINED THIS coMpLETED AppucATIoN and do
ler9by certify that all information hereon is true and correct, and that I have a legal interest in ttre properry as owner of record or authorized agent, I
further certify thal any and all work performed shall be done in accordance wi0r the Ordinances of L"n" County and the laws of 6re State of degon per-
taining to the work described herein. I further certify that if I am not the owner of the property, my regisuation with the Builders Board is in full force
and.effect as required by ORS 701'055, and 0rat 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.
SUBSURFACE & ALTERNATIVE SEWAGE DISPOSAL SYSTEMS:
When subsurface construction is.completg the permit holder shall notify the County Land Management Division by submitting the installation record
fo11. .!- inspection wil! be made by a qualified sanitarian. If constmction complies wi0r all rulis a certificate of completiol iitt U" 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 comptetionwill be issued. Failure to meet satisfactory completion within the allotted time consdrutes a violation of ORS 454.605 to 454.745 and this rule.
SIJBSITRFACE SEWAGE DISPOSAL SETBACKS SEPTIC TANK DRAINFIELI)From: Interior property lines l0' 10,
Edge of road right-of-way 10' 10'
Building foundation 5' l0'
Wells or other water sources 50' l0O'
E
K lmprovements on
Property
ffHouse-E Barn
E3 Garage
Ef lrrlobile. Home
E Shed
-SEPTIC
-Eyee.-
Bulldlngs or
INSTALLED
Etlo
Water District
all lines inslde whlte boxes, if posslble.'Please
?ta>>
ztP
INSTALLEB / BUILDER / COTTRACTOF Llcanla t
IFOIIE
nol tl ?tP
htrectlons to slte lrom
nearest maln lntersectlon
tlr N" 15+,
4aftc--d\
MAP, PARCEL NUMBER
lFcund on l[ mao3 ln lh. Arurmnt I Turllon D.Dtl
J*,' #k,ko#P
ffiffiffiriiEiiii'ffi
't!$r-EF- E- Silfi- t7fEii6- ...Etri-
S'rE ADDFESS /1l
i
TO:MA'L Home
Pla ent Only
I e.
License #
No. ol
Year
Size
from
srA EVAL
Water
to:
Land Managemenl Div. gtall can
not be hsld responsible lor
evaluations or rscommendations
based on false, anaccurate or
l1s_ z$z incomplete lnformatio
X
ilr4-68 02/92
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