HomeMy WebLinkAboutPermit Sewer Connection Record 1985-02-20\-/6l!!--
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FOR OFEICE USE
Application,/
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s'-'BDIVISIoN,/PARTITION ( j.f applicable )I,OTIPAF.CEL BI.OCK f rruri"
et
Commercial
PROPOSED
Res identia I Industrial
OT PROPERTY
ZTP5I&Li 1'Y
EMPLOYEES WATER,Proposed
ExisLing
IS NAME'AND
o
APPLICATION FOR PERMIT, arrd do hereLy certify that all infomation hereon is true and correct, and that I
have the following legal interest in the property, Iowner of record; ! cc,r,tra.,*- lurc]taser; l]authorized agent uith evidence of authorj-ty attached.
I f:rther certify that any and aII work perfomed shall be done in accordanle w1!h tl:c ordruance! of Lane Costy and the Laws of the State of Cregon
pertaining to the work described herein, and that NO OCCUPANCY will lr nade of ail structule without the pemission of the Building Division. f fur-
ther certify that. regislration with the Builder's Board is in full force and effect
is noted hereon, md that only subcontractors ad employees who are in conpliance wi
EXAMINED THEI IIAVE
CHECKED ?HIS APPLICATION THOROUGHLY
DATE
as required by ORS 701.055, that if exehpt the basis for exenpti
701.055 wiU b€ used on thrs project. I HAVE READ AND
READ THIS SECTION CAREFULLY. YOUR AUTHORIZATION qAS BEEN BASED ON THE FOLLOWING CONDITIONS:
zone
-
Partition *- ParceL *- Parcel si'e-
l4axinum Depth
of
COMI1ENTS:
Date
COM}lENTS
D
Installation Record Issued?Iv""!
.Z 4
c
ITATION: S. I B. P
-8r
PLANS EXAMINATION: rype
Soecifications: Tank
Minimum Se interior rear
tallati.on GaIlon Lineal Eeet
of Drainfield
L. side
I pntulrnc,zzoNrNG:
9 ao-sr
APPROVED ING Der ORS 80s DATE
LANE COUNTY DEPARTMENT OF PUBLIC WORKS LAND MANAGEMENT DIVISION,6874061,
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
SEE REVERSE FOR INSPECTION INT'ORMATION cr4-2s R*
I
IES
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r
SETBNCKS AND OTIIER CONDITIONS OF APPROT/AL MUST AE STRICTLY OBSERVED. VIOLATION CAN RESULT IN REVO-
C;TION OF TIIIS PERI1IT, CITATIO:J UNOgR PROVISIONS Of LANE COU::TY'S INFRACTION ORDIr*ANCE, AND,/OR OTSER
RE}IEDIES ALLOWED BY LAW.
[{HEN RE.\DY FOR INSPECTION, CALL 687-{065. A }1INII',U}1 OF AT LEAST 24 IIOURS ADVAI';CE NOTICE FOR INSPEC-
@el]-.-E..ai6--[EEJoI1owinginformationready;Fernitnunber,jobaddress,tyiEof inspecrj.on, when it wj,Ll be ready, your name and phone nunber, and any spccial directions to site.
BUILDING DIVISION:
REQUIRED ]\"SPECTIONS :
l. Foundatiol ln!!Ss!iel: To be nade after trenches are excavated and forms erected and when aII
materials for the foundation are del,iveled on the job. Ilhele concrece fron a cencrai mixing
plant (comonly t-ermed "transit mixed") i,s to be used, materials need not be on the job.
2. Concrete SIab or tlnder-iloor InspecLioni To be made after aII i!r-sIab or under-fIoor Uu:-tainq
sEivlclulpmatl- conEu- p-rprn!-Eressories, and other ancillary equipnent it-ens are in
place but before any concrete is poured or floor sheathing installed, including the subfloor.
3. Framinq & Insulation Inspections: To be made afLe! the roof, aLI franing, fi.re bl,ocking, and
bracing are in p.l"ace and all pipes, fireplaces, cilinneys, and vent-s are conpleLe and aIl rough
elecLrical and plumbing are approved. A1I wall insulation and vapor barrier are in place.
4. Lath and/or Gypsum Board Inspection: To be made after all lathing and gypsun board, i.nterior
and exterior, is in place but before any pLastering j.s applied and betore gypsm board joints
and fasleners are taped and finished.
5. Final Inspection: To be made after the building is complete and before occupancy.
APPRoVAL REQUTRED. lio work shall be done on any part of the building or Structure beyond the point
indicated in each successive inspection wiLhout first obtai.ni-ng the approval oi the buiLding official.Such approval shall be gi.ven only after an inspection shall have been naCe of each successive stepin the conslruction as indicated by each of the inspecticns required.
NOTE: A1l- building pernits require i.nspections for the wolk authori-zed, such as but not Lj.nited to:
A. Bl.ock t^lalLr To be naCe after reinforcing is j.n pLace, but before any grout is poured. ThisinspEctio is required for each bond bean pour. There will be no approval unt.ii the plunbing
and electrical inspections have been made and approved.
B. Hood Stove: To be made after completion of masonry (if applicable) and when installation iscon-pf.etn Inst'alLation shall be in accordance with an approvea, nationally recognized testingagency and the manufacturer's insLalLaLion i.nstructions.
c. Mobile Home: An inspection is required after the mobile home is connected to an approvediE-w oi-GEptic system for setbacli lequirements, blccking, footing connection, tieCtwns,skirtj.ng, and plwbing connections-
I. Footings and piers to comply wilh State foundation requirements for mobile homes or asrecomended by the manufacturer.
2. Mobi]e hone minimum finish floo! elevation shalI be certified wher required by a ftood-plain managenent Ietter.
3. Mobile home tiedowns, when required, and skirting shall be installed and ready for inspec-tion within aL least 30 days afher occupancy. Tiedowns and skj.rting shall be instalLedper enclosure.
D. swiming PooI: Below grade when steeL is in pl.ace and before concreLe is poured. Above qrade;Ien p@I--i s-instalLed.
,IPPROVED PLANS !,IUST BE ON THE JOB STTE AT ALL TIMES DURING I.IORKING HOURS. THIS PERI'IIT WILL EXPIREIE WORK DOES NOT BEGIN WITHIN 180 DAYS, OR IF WORK IS SUSPENDED OR ABANDONED FOR }IORE THAN 180 DAYS.
SUSPENSION OR REVOCATION i4AY OCCUR IF THIS PERI.IIT WAS ISSUDD ON THE BASIS OP II,ICOMPLETE OR ERRONEOUS
INFORMATION.
ANYONE PROCDEDING PAST THE POIIIT OT REQUIRED INSPECTTONS WILL DO SO AT TIIEIR OWN RISK.
SUBSURFACE AND ALTERNAT]VE SEI4AGE DISPOSAL SYSTEMS:
I. Permits shall be effective for one year from the date of issuance.
2. Upon completing the construction for which a permit has been issued, the permit holder shatlnotify the Lane County Departrent of Planning and Comunity Developnent by submitting theinstalLation record form. The Department shall inspect the construction to determi.. if itconplies uith the ru.Les contained in this division. If the construction does comply with suchrules, che Department shaII issue a certificate of sa!isfactory completion to rhe-permiti holder.If the constructi6n does not comply wi-th such ruIes, the Depar-tment-shatI norify tire permitholder and shaIl- requ.i.re sati,sfactory completion before issuing the certific.rta. railure tomeet the requirements for satisfactory completion within a reasonable time constj,Lutes a vio-lati-on of ORS 454.605 to 454.745 and this rule.
Setbacks - Subsurfacc Sewage- Disposal
SeDtic Tank
10,fnEerior property lines
Edge of road riqht-of-uay
Buj.lding foundatj.on
Wells. other water sources
Dra i. nfie 1d
L0'I0'
10'
1.00 '
From i
hne county
ACTI VITY INFORMATION SHEET
COMPLETE THIS SECTI INCOMPLETE FORMS t^lILL BE REJECTED!
aE ?7/ro
68 7-2{NY 3v>-rz6l
HOME TELEPHONE # BUSINESS TELEPHONE #HOME TELEPHONE #
( IF DIFFERENT F ILI RESS
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BUSiNESS TELEPHONE #
2 PROPERTY ADDRESS 6
3 rvrap I PAFIeEL NUMEIEFI
( REQUTREp rNF0RI4ATr0N)
(from tax maps in Department of Assessment and Taxationor from tax statement)
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MAiLING ADDRESS MAW
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TOWNSHIP RANGE SECTiON
MINSFTP FANGE SEE]TON
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RP ZON i NG
m ZON I NG
MFRSTTP MNGE SEETMN W ZON I NG
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP:ACRES
4 SUBDIVISI0N (if applicable)LOT-BLOCKt-
5 REQUEST (state exactly what you plan to do) _-ge_ pJ1's--* ja:plcA o'.-hr
6 DIRECTIONS TO SITE:
** FOR STAFF USE ONLY **
ZONE/LAND USE:
BY : _ DATE :-- TIME I Nt_ OUT :-
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NUMBER
DATE
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