HomeMy WebLinkAboutPermit Septic Tank 1989-05-26I
,7
Lane Codnlv Au
V"<4"G
thorization for,
SEPTIC
AIER'
I HAVE CAREFULLY EXAMINED
"HE CO,TPLETEDrve the following legal interest in the propertyf:rther certify thaE any and al work perfomedIrtainingto the work OescriUea herein, and that'er certify that registration wi th the Builder,snoted hereon,and that only subcontractors ildECKED THIS APPIICAUON THOROUGHLY
INSPEC?TON FO R LOAN REVIEW
Parcel #
CL, side interior
PLANNING ACTION REQUTRED.
Iaws ofthe Euilding Divi f fu-exempt the basis for eproject. r nevi xenpti
READ AND
JNi
)F
n
, and that ft3
+5 l{/rL
READ THTS
fl PLANNTNG/zoNrNc
Minimun Setbacks:
COT!\ENTS
cL, front
NO SPECIAL
SECTTON CAREFULLY.YOUR AUTHORIZATION IIAS BEEN BASED ON THE FOLLOWT NG CONDITTONS:
Zone D
Parcel Size
!ear
Date.3-
I sanrtatrou, s. r. #
Installation
specifications
B. P. #Instat-tarion Recold rssued? [ v"" f] Ho
ltaxinum Depthof Trenches
Date
GalIon
Tank
Lineal Feet
of l)r:ainfield
I pmus EXA.I{INATION:Use
f5:#.""u"""'
oz_
Residentiat I rndustr
commercial I erufi"
PROPER?Y
ial
ZIP
zlrhLI
FOR LOAN EVR EWI
- ee specrF
ECTTONEPTICrNSP V.
OF
Proposed
Exi s ti
aNAMEAND
COMTIENTS
SEE REYERSE FOR .INSPECTTON INPORMATTON cu-is9.*
Date fl
S-
BY
LANE COUNTY
ORS 6 DATE.OF
PUBLIC WORKS LAND MANAGEM ENT DIVISION, 687-4001,
125 STHAVENUE, EUGENE, OREGON 97401
I
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r
SETBNCKS.'
cil1ON ut
RE}1ED 1 E S
^::'?''i?1.',?: " :il:l? "i'
"i.ii-n"o
BY LAH'
.iB"'1";t'"'T:?:""""?'Lli;":"?l"iT:'?
VlOLA'TlON
urnectroli ORD INAN
2 4 llouRs ADVANCE NOTlCE FOR INSPEC-
,t?l'"^l'#--"X?;-
A MIN1I'1U}1 on readY spec i aI C.i.r ect ionsinforma
ieady, Your name and Phone
OF AT
tr : Permi
atro attY
L number , job addr ess, tYPe
, to site.
I
uhen i
ON
t-{iII be
nunber,
insPec rion
BUILDING DlVlSION:
Ri!-u-t!2 lsSrcCrtoNS:
ro be made after trenches are excavateu 1i:"::tT:";t:":::,?:t ll:l^;"
\ Fouodarion rnspcction: ro be made ?t::t-^:':;";;; l;;. lihcre concl
;rffi ,or !5e ffinauii"n ?" d:l:Y:':: ?3 i!""]!!; ";;.;;"i; nFed nol be on the roD'
2U"="#-;.-*."-,'##,;,i#.,=*.,,i:i,"rii*?rili::i:xri^i;iii::l,il..l
, :H:": ffi; ;#;,";;il,;;;;:'iiql,;,il^iiLi,:ii.i::5ir?"'li!-li':ri'EircInq are rn ?lr
e}ec!rIcaI .^" o,iii,ll".?i..'ppl""!a. Ai1 waII Insulatj.on anc va*
4. Larh and/or.cyp:ur^T#"'**Ttiqo",; .l; :i.:'.::r:;':: :llrl::':l: i::'::';;l'ii'13;"^i3ll?l
';I;::::l::: ::.''J.;:;":";- i'"iin'a'
5. Final Inspection: To be made after the building is conPlete and before occuPancy'
i::t::t:.-::':::i ."::.::il""llll.3!ri:"::?*:ili:ii :fuli:lli.ll:.1':i:::i':i"il'l:li1!:1i"":i:;i"
:::tr}:;::tl":E:i i: ?i5il.?3}'oi'l'"ln"l''tiE'ii'";.";;;;; required' ., such as buE nor ,rmited ro:
i:' ::' ;"i "j'"";
;*-;",i'"..;u, # il# ili1 ,;;L:il*; i. : : :
:lrli:ir' "i ;' ir H:" .' ,*r i : n
l'il'!i""I'r."1'::;::::":;.::":.::;:.T::'"i.u=on., (i: aop,i.cabrel.ili"il;^,:::;i;)'.:'".:"::,,
B' H#,H'rll?*lri:ltil?il *"ifi::::l:li:':iil':*,:t:"-"',: connec,ed,. an dppr.ved
c ffiE e",:.,:"li:ii:ii:;"::"::fl"1[i'::;:"'::""T::i]:':'?:"i;";"lIIi'ri'ri' 'li'db'n"'
:il?ttt;;'-;X;-iri'itli"g connections' -- r^"hArtidn lequlrements for mobire homes or as
I. Footlnqs tta pl"t" to cgmPly-with stace foundation requlreme
recomendeo b! the manufacturer' r h-.prrified when required by a frood-
2. l4obile home t"t^" finish floor elevation shall be certifi€
Plain management letLer'
3. t?:1.;,Hffi :'."i:::".'.;":1,'""1|iliu;"lt3"i:i:"+?';:ill ::"':ii?li:: :*'i"i:"1!""iliB '-
per encrosure - :- -r.-a and befoEe concrete is poured' Above grade
D. "yli^i11."?:Ii"'"i;li:u:'"u"
when steel is in Place and before c'
wr6i-poot rs lnstalreq' -----.^ r.,^6?7Nrc ilouRs. THrs PERMTT v'lrLL-ExPrRE
tF"l3xl",::t-;*llii:il#;iii"'}:i.;ii3;lfiiiilii*Tlii#il'ii'l:*::-:i"I::"*li":;lx lll"Risi';
iuspe*sroot oR REVocA'
iuionraerron. ^r DF^,rRED rNspEcrroNs r,rr1,1, Do so AT THEIR owN RrsK'
ANYONE PROCEEDING PAST THE POINT OT REOUIRED
suBSURFAcE AND ALTERNATTVE sEt''AGE DISPoSAL gYSTEUS'
l. Pernits "n'rr iliT"tive for one vear from the dat: :t':::"::::., Lhe permit holder sharl
2. upon compretinq :::":;"3:;:;H:1.':; ;l:;1,""'1il-i:E:^iii'Xjj::::li""i]:!U*il3 i?",.notifv lhe Iane uou.Lv-"=t-ii.-'ri"."it e.t shilI inspecL the construcEr:'i ::-:':;;;iv-with such
il*ll:iti:t.':;:':.',::';".t!,f i:ilii,?::i:':?':.1i,::;=trl;:rt;*!lf ^i:,il:liitiiili;"'itils, tne Departnent sharr issue - tlln
"r.n rures, the Depar'trent- shi:.,??:::l tnFolrur. .oIf the construction does not compry ur
horder and "t'"ii-i"q'r'" satsisfactorv"!"ioi"i""-t!r:" :'::i::":ii"il;:t::i:iit'lll " "'o-
meet the ..0'i;:.;;l;.;;r saLisfactory completion wlth!n a rea
lation of o*"'Eiilioi !o a5a'?4s and this rule'
setbrcks - sj!:j4-esg sewage Drsposal
l
l:om: lrlerlor PrOPertY lincS
E.loe ot road rlqht-of-waY
nuilcirnq foundation
iiells, other water sources
septic Tank Drainfiel'd
I0'
10 |
50'
t0lro'
r0'
100 |
Dll1SlOr{Manageme
Please complete all lines inside white boxes, if possibte.Exlstlng Bulldlngs or
lmprovements on
Property
E* Hor""E Barn
E3 GarageEl ]r/obile. Homer*r sn"a
SEPTIC INSTALLEDEl yes
El No
Water District
L lt A
YOUB NAME UATE
1#futu rz
[4 ho] /,A+tg
ztP
44
ROF (il nol rn. I tlov4 PHOtrEl5-lr
(il nol 3rma rf ztP
GONIflACTOB fiama-T
Dlrectlons to site
from Courthouse
14
L
MAP, PARCEL NUMBER
(Found on tu map. ln thr Astcttmrnt & Tlrltion DcpL)
;;;,p-- *-;- SiEiiii- rru-EEii6i- rq-to-i-
o t,r
r*-ffiffiiliiilrffii-T-
.6ffiffi'- 'I{e-i- S;iEn- rffiiiiEi- -liiittr-
l
SITE ADDRESS 7-/)t
ztP
CIII
r
TO
ztP
MAIL PERTYT For Moblle Home
Placement Only
No. of Tip-outs
-
No. of Bedrms
License #_ *
Brand
Year
Size
Land Management Dlv. stalf can
not bo held responsible for
evaluallons or recommendatlons
based on lalse, lnaccurate orlncomplete lnformatton
ock
COMMENTS
w-u artitlon I Subdivisl
:li:iiiiiiiljjli.iiii::i :i]j:]l::ijiiji,TRS Verlfied l-lYes No l-r
Allowed Use
-yes No r-r
STAFF EVALUATION
lnformatlon, Request Only =:
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