HomeMy WebLinkAboutPermit Septic Tank 1992-08-20U6 8 (ezzzt
a743PERMIT #
-72--,
REAUEST SEPTIC SYSTEM VERIFICATION
FOB:
17
OREGONEUGENEILOYD DRAKE,
ABOVE PlloxE
aoNrnacroR IIAME NANA
NA
COCT/VALUEOFtlo.rc.nSIALLEO
OFxo.P RIVATE USE
ONY OAKS ST.,
SAI.lE AS T HE J OB ADDRESSKEN J{FFERIS,OSR LICENgE
FROI'
STRUcTUREB xow
EX I ST I N G
ORTH
400c?
AI.1I LY D!IELL I N G
PROPERTYSINGLE F
of sroBlEg
6Ftmo}{oF
t'1 VERIFICATIONSEPT I C SYSTE
oliEclloNg IO glTE
5815 coL
19.4'
PRoPoSED usE
343" 969i
PHoNE lzo-0550
NONE GIVEN
SPRINGFIELDT 0REG0i'l35ttl STREET,
N ME
K OREGON 97I+01STREET, EUGENE,i461 oAK
and
LOYD DRAKE
sldes ol thls aPPllI have carefullY read BOTH
andelsetlontrunlormallthatcertlly correct
DATEFEES DUE:
'
APPROYED BY:
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CondltlonsTheOnBasedlsAuthorlzatlonYourYICAREFULLREAD
687-4065tNSTRUCTIONS)FORMOFBACK(sEEINSPECTIONSFOBCALL current.areunless180afterinspectlonsdaysotherALLexpirepermlteoneforareyear.goodSEPTICpermlts
sBrB-Ac-KsANDorHER"o*-o*'omP,:alY-'Jl'Jhqtffi3ffi..,"^Ig1s:gla13sl.-rNR'vocAnoNoFrHrsp,Rrur.clrArloNsMAYBElssusDt^Ddii*pnovrsiriirTiii'-Lilrtrilffi'v,snnnlcntivb:ffiiid'iriir,o*orr***rr
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A MIhIIMUM OF AT LEAST 24 HOT RS ADVANCE NOTICE MUST BE GrVEN FOR INSPECTTON REQLESTS
rlave the following information ready when you ca,: 6g7-4065
Permit number - Job d{":, _ Type of inspection required _ When it will be readyyour name and phone numbei _ A"y specij dtections to the site
powERroEN,ERUpoNLAND. ,*""ffi*l?.irlBi^['s5l']y.#ffirif:H.i*'iffi'"ffi13H$Hft';gH*.r^,,*op*BrRp,NcrroNs,M
yENTER' I'JPON ANY LAND AND MAXE BXAMINATTONS AND SURVEYS AND PT.ACB AND MAINTAIN T1IE NECESSARY MONUMENTS AND MARKERS THEREON.
F.LTNDATI.N INsPEcrroN: ro be made **^.11T-"*.TL:?"T*:?fl::1ff:*: any required reinrorcing steer is in prace.L'NDERGRoUND PIPING INSPECTI0N: To be:nadeafter all undffiund piping has t""rr'i*tuit"a, pnor to any backfill.coNcRETE SLAB oR UNDER-FLooR INSPECTIoN: To be made it",
"u i*rr"u or under-floor byilaine service equipme,nt, conduit, pipingaccessories and other ancillary equipment items are I Plle ura u"r"." -y "onoa is placed or floor sheathing installed, including the subfloor.R0UGH MECHANICAL rNsPEg[oN: To be madeaft* all ducting aid gas pipingias been rr*,"1"a and prior to being covered.RoUGH PLUMBING INSPECTIoN: To be madeafter uu plr*b;;;ou;-in is in prace, prior to being covered.FRAMING INSPECTToN: To be made after the g t.-,t e, rir" uro"ctini, ta"i"g -a r*r -" a oi;" and au pipes, chimneys and vents are compreteand the rough electical, plumbing, and mechanical inspections hav" b""n-iud" and approved.INSULATIoN INSPECTIoN: To be made after {l inzulation *a *pooiri.r, are in prace, prior to covering.
iti{:ffif-},&!i'H,!?#.'ffi:ffi?*Tffi:Xgiffi'#i'ffi*-;ffi;"ffiin,eriorLdex,erior,isinp,acebu,beroreanyADDITIONAL INSPECTION.S MAY BE iIEQUIRED, SUCh '" U,t-,.Ot Ti-it"A tO;BLocKWALL: Tobe.madeafterreinforcingisi.place,butb"f;"rtgrrtispo,red. Theinspectionisrequiredforeachbondbeampour. Therewill be no approval until the plumbing ana etlucalinspections t "r" u""i-"6" and approved.FINAL MECHANICAL INSPECTToN: To be made just prior to tt
"
,u*no. * ,",od"bd area being occupied and prior to operating any equipmenrFINAL PLUMBING INSPECTToN: To be made jruiryyl ," ,rr" i"iiot , l*"*" or remodeled ,." u"ing occupied"FINAL BUILDING INSPECTIoN: To be made
"rt"1-n"itrt grJtt g ;d ;r" building, ,*"*" *ronla"bd area is completed and ready for occupancy.MoBILEA'IANUFACTURED HoMES: An inspection is re{uirea-ater trr",nouit" t ome is conne"t"d to an approved sewer or septicsystem' prior to covering sewer or water lines, for setback requirements,tl*r*rg, tiedowns and plumbing connections,Footings and piers to comply with State fowrdation requt;;; f;. -obile homes o. i" ,"**"nded by the manufacturer.Minimum finished floor elevation shall be lrtifiea when r"quir.a Ly Fbodplain ManagementTiedowrs' if requied' shall be installed and ready ror inspeciioi *i i,in so duy, "r* "i*p-"y. Tiedowns shal be instared per encrosure.
APPROYAL REQT,rIREDNo work shall be done onany part-of the building o1-s-tructure berond the point indicated in each successive inspection without first obtaining theffi#,|lff:I.1*'6:'k'ilil*rffii 'utt" gi"enonlv
'rt";;i,tp""tionshallhavebeenmade oreach successive srep inthe construction
TIrIs PERMr wrLL ,,.'IRE " *#lt?H'*iHl'"Xyilf,ffiI#f'^,f":3ffiif"',.'HS"?HBTf ['^Hi,S'ffiMoRE rHAN ,80 DAyssusPENsIoN oR REvocATIoN MAY occuR IP nrrs psRIWr wes is-iuro oN THE sesls oF N?oMpLETE oR ERRoNEous INF'RMATI.N.
ANYONE PROCEEDING PAST THE POINT OT REQTITRED INSPECTIONS WILL DO SO AT THEIR OWN RISK.Your signature on the front of this form verifies 0re following: I HAVE CAREFULLY EXAMINED THIS coMpLETED AppLJCATIoN and dohereby certify that all information hereon i" ;; -d correcq hd that I have a legar interesi ," ur" p1"e"iy as owner of record or authorized agent. Ifrrrther certify that anv and all work perfot"Jrrr"iiu" a"r," ir, """oia-" *ia o" oroirarrce, ofl-alr" iounty *d rili;;;;,il sor" of oregon per_taining !o the work described herei"' r ruttr,". "*tifu that if I ; il tlr"-;;*
"r tr," p."p"riy, ,"vllgil",r" with the Builders Board is in tull force#;t:*Xr#:Tilt5fl$|r'i.|rf*,il**:j{"i*'pi*'i^i'' i"'iiJ"J.p,i.n i, ,,o,"i i ot,,liia tr,"t o,,ry *r".",,*i"i'*o emproyees who
SUBSURFACE & ALTERNATIVE SEWAGE DISPOSAL SYSTEMS:when subsurface construction is complete,
-the r"""11 rrgra".g.u ;rtfy;; county Land Management Division by s,bmitting the insta[ation recordform' An inspection will be made bv a qutlini r;*ir,. If;;;;i*
"J-ou;r with an rd;; ;;rdfi"ate of completio, i1i t" issued ro the permitholder' If construction does not complv;ith rub;, rh" p";;ilrd; *iliL *,in"a, ."e"u ;;;;il"lr,"u b" -^d;';i;;; "
ii,m..* of compretionwill be issued' Fail,re to meet satisfaciory "ffi"tio" within the arottJ ti,nl *nstitutes a riotarion oidns 454.605 to 4il.745rand this rure.
SUBSURT'ACE SEWAGE DISPOSAL SETBACKS SEPfiC TANKFrom: Interior p,roperty lines iO'
Edge of road right_of_way 10,
Building foundation 5,
Wells or other water sources 50,
DRAINFIELD
l0'
t0'
10'
100'
+
+
lmprovements on
Property
# nor""fJ s"m
E Garage
E fvlobile. Home
E Shed
SEPTIC INSTALLEOl-J Yes
Eltlo
Water District
Bulldlngs orPlease complete all llnes lnslde whlte boxes, if posslble.
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MAP, PARCEL NUMBER
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ITIA|L PERTUIIT TO:
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Land Management Diy. staff can
not be held responsible for
evaluations or recommendations
based on false, inaccurato or
11e- ztsz incomplete lnlormatio
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APFLICANT JEFFERIS, HEN ADDR ?54? N ^ 35TH S'[. , SF'RINGFIELD, ORE'
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