HomeMy WebLinkAboutPermit Septic Tank 1980-06-04DEPARTI1ENT OT ENVIRONI4ENTAL I1ANAGEMENT
PSB, 125 EAST BTH AVENUE
EUGENE, OREGON 9740I
Job Address
t1-O'Z -1G -
itut:ili-- ie!:oc.ki.
Appl ication for
Structures now on the property
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ILLEL
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hereby certify that this information js true and accurate.
:[h:il.*E$fi:i:Ff fIf this application is for an agricultural building it will be used for purposes allowed by the State Building Code and
Lane County Code Chapter 10 (zoning) and for no other purpose. I have the following legal interest in the property:
owner of record;tract purchaser;I essee;ho lder of an exclusive option to purchase;
duly authorized to the own , who te of-TEii-a'[pl ication.
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Si gnature/Address 37*z1 7
Te1 ephone or Da te C
1.,/hen permi t i s ready noti fy:
Olner
Con trac tor .1
Contractor's 0SR#
If Commercial
Residential:
SI test holes ready
cant /_/ Qwner /_/Contractor !a: /-/ nail
z1
z1
P1 umbing by
# of employees _,#,,,,,cf,;:;unf t$;:;, -
.:$$r$,i':::l e-Z Existins, BP #
lW'roposed, 5l #
/ / phone
pnone t 4'7t=7ao
Phone
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:$f,ii.!,!!iEt:ii.i.!.or.:, ,:.tlni'f:::#.'.i0fii$l,t{i::: ,$q$i Val uati on Fee
Total Va.l uati on $
$
$
$
at
at
each $
each $
Rece i ved
Water Supply
Proposed _
Year Instal led
4% State surcharge
PIans check fee
Change of Occupancy
Subtotal
TOTAL
$
)
$
$Existing iTc;o
PERMIT PROCESSING
Minimum setbacks
Zon
t,
Part. #Parcel #Parcel Si z
fron t t, side 'i nt ; rear
By Da te
Group Fire Zone Use Cl assification
Comments
To be typed on permi t
CP& I Type
To be typed on permit
By Da te
For plans information
?\
(area inspecn
Di tions to site
tor
CP&l _ set(s)
lrlPc _ set(s )
Hold Slip
to FCC
P
ans to
/l Planning
/-/ Public l.lorks
ft Elevation
/-/ Address
/-/ Facility Permit
// Environmental Health
FOR INFORI!{TI0N about progress of your application cal'lC74-L7l '
Da te
Corlpi eted
Da te
Requ i red
Date to
PCC
n/a
permit Controt Center 687_HELP (687-4351)
APfu DG,FILED
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I,ANE COUNTY BUILDING PERMIT
P()ST THIS PERPIIT ON MAIN BUILDING AT sITE
CONSTRUCTI()N PERMiT # I-C I50] -t]O
JOB ADDRISS: 8101 Thurston Road, Sprjngfie)d, 0regon
TRS, TL: 17-A246,2, 205
SUBDIVI S ION: N/A
C0NSTRUCTi0N APPRoVED BY THIS PERI4IT: Renewal of subsurface sewage disposal
i nstal lation, permit number 1297'79.
C0NDITIgNS 0F APPR0VAL: Subsurface sewage di sposal sys'Lem "instal I a1:ion
specifications:1,000 ga1lon tank;200 feet of drajnfielc.l; naxirnunr depth of
trenches;24 inches. (eep drajnfjelrJ at least i0 feet fronr a'il foundations and
property lines, ancl 100 feet from all vrater sources. KegP septic tank at
i east fi ve feet from bu j I di ng foundati on, 10 'f eet frorn al 1 property 1 i nes
anci 50 feet from all water sources, 10 feet frorn edge of rightofway.
Install drainfield and reserve replacernent area as shown on the attached
pl ot pl an stamped approved and dated Ju'ly 15, -1980" Use equa'l di stribut'ion
it ati trenches can'be jnstalled a1, the same elevation vrhile maintaining
s peci'f i ecl trench depth. 0therwi se use se ri al di stributi on.
PtRMITTIIE: Lance Mi I I er
DATE ISSUED: Jul y !7 , 1980 BY: Kathi tie'iderhol dlcandi l-lart
DIRECTI0NS T0 SITE: 0ne-fourth nri 1e past ThursLon E'lenrentary School on
r.ight side.
l^JP 28305-5E-2
*********************
SETBACKS AND OTHER CONDITIONS OF APPROVAL MUST BE STRICTLY OBSERVED. VIOLATION
CAN RESULT IN REVOCATION OF THIS PERMIT, CITATION UNDER PROViSIONS OF LANE COUNTY'S
INFRACTION ORDINANCE, AND/OR OTHER REMEDiES ALLOWED BY LAhI.
WHEN READY FOR iNSPECTI0N (see attached) call 687-4065. Have the following
informat'ion ready: Perm'it number, job address, type of inspection, when jt will
be ready, your name and phone number, and any special directions to sjte.
OTHER QUESTI0NS? Call 687-4394.
INVll]ONlvit:N IAl. [4ANA(;t lvlLN I D[.PA']TN/FNT
125 [:AS t B I l-J AVINUI / EUCENE, OIiEGON 9740i
6m\,.lE7
ROAD
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APPROVED
DATE
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DVEra=rpre.P PR(] PE-r{Ttt-i:'-, I NC,
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APPLICATION # I:I'7.Ii i,'i;
LOCATION l(
irl,i.i(,; fiil ii ,l NAME
ADDRESS1l
I
--,.- zIP -coDE
The Lane County Water Pollution Control Division cannot proceed w'ith
processing your application because:
1. fl Incomplete application (items deficient).
l-] nOOress and/or di recti ons to appl i cati on s'ite.
2
El Proposed number of bedrooms in dwelling.
I-'!lApprovable plot plan (see attachm-ent)..''i)iL,l lltiul i.'iuirti (., /'
J-l Hottrication or date t'est'ti.i;, t{.rrTa''';.;;,{i:' f,'].,:;; i"":',1'', ," p:,), t-i:,t /t r : : r.,. t.r1.i t - r
Veri f icati on of exi sti ng system requi red (memorandum i\ ' ,' i.7 .,
"1expiaining this procedure attached). i
Two test holes (2'X4'.X5' deep) requi'red for expansion
or repai r ;of exi sti ng ,'sewdge.:rdi sposa,ll'.syS.tem i'n, ,the I ,
areaof theproposed,,;ilrainfields. !...,ii! : ', ,
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Other:
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DATE :.
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If the necessary corrections are not made w.ithjn
application will be denied.
t.,-.i ) days, the,,j i,-)
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WATER PoLLUTIoN CoNTB0L DrVrSi0N II25 EAST 8th AVENUE I PUBLIC SERVICE I]UILDING
ENV I RONMEN IAL MANAGEMENT DEP/ EUGENE, OREGON 9740I t$)I[Ulr
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t".i,::. i i t"" ',1.,
S IGNATURE
OFFICE HOURS
lane county
sfl@E,ffits ss,Bw
APPLICATION #
LOCATION
)
*.-1| ;'i,l 1 t'.)\ '(l
NAME
ADDRESS
,'
. ,.. i., I i.. i. .,. .t,..r .,' 1i :i ZIPC0DE
The Lane County Water Pollution Control D'ivision cannot proceed with
processing your appl ication because:
l.Incomplete app'l'ication (i tems def icient) .
Address and/or directions to application sjte.
EI Proposed number of bedrooms in dwe11ing.
lTl Approvabl e pl ot p1 an (see attachment) . 'I i" 'l: ,l
J-'] Hotification of date test holes will be ready.
Verification of exjsting system required (memorandum
explaining this procedure attached).
Two test holes (2'X4'X5' deep) required for expansion
or repair of existing sewage disposal system in the
4
area of the proposed drainfields.
0ther: "ri, j i't,tt,i.i) ,r. ;)l.l'i 1Jlili,'t
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WATER P0LLUTI0N CoNTBOL DrVrsl0N /125 EAST Bth AVENUE / PUBLIC SERVICE TJUILDING
If the necessary correct'ions are not made withi t1 ,,','.'days, t heplication wilI be denied.0r1 Z
ENV I RONI4EN TAL MANAGEMENT DEPARIMTNI,/ EUGENE, OREGON 9740I bU/-+UOI
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OEPARTIiENT OF ENV I RONI4Ei.ITAL IlANAGEI,IENT
PSB, I25 EAST BTH AVINUE
EUGENE, OREGON 9740I
Ci ty -, ['I.. t !- t:.t,: i itr !,'.:,
,i9';i-cati?,: il,,' \t: )
- 4:tit*d
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Township, Range, Section, Tax Lot
Subdivision
l,ii.,: .1 7l ,, , ' r.:.-;'
Lot _ Block . ... ,..
Appl ication for
When
Owner
Structures now on the property
Signature/Address
,,,' .,', ) ,. . :\'.,
Proposed use of property: /-/ Residential /l Cornrnercial l7 Industrial
'" ,. . . ,i ,t'- lt . ,il ,t ,.' ,i t' l::::---. , hereby certi fy that th
/.
, Pubtic
is information is true and.accurate.
t.by the State Building Code and
I interest, in the property:
exclusive option to purchase;
Affi dav i t: I ,
If this appl ic
(please print)
ation is for an agricultural bui 1din9 it will be used for purposes allowed
Lane County Code Chapter I0 (zoning) and for no other purpose. I have the fol lowing lega
owner of record;contract purchaser;1 essee;holder of an
duly authorized to act Tor the own e.r,
!-,
who e 1e of-tfrls app I i cation
Tel ephone 0r Da te
/-/ nail
O
permit is ready notify: ltl I icant /_/ }wner 17 Contractor !Y:/-/ phone
- z .,1 .")' .''- ^-: ,-), / ,Phone / jLL -Z I "-ljl1Z1
Con trac to r :' .'' ) ,' ,' ,'( zt p)Phone
Contractor's 0SR# :': '' "')Plumbing by
If Commercial
Res idential :
Fee
Code
# of stories
# of bedrooms I n
--\'2--
# of employees # of units
SDS: , Existing, BP #
lf,{roposed, SI #SI test holes ready
Desc ri pt i on
Sq. Ft. or
# of Site!
Unit
Cost Valuation
-i
J--
$
Total Valuation:
Plumbing fixtures at
Sewer/water conn. at
$(
(
$
Subtotal
TOTAL
each
each
$
/_/ Casn
E/ check #
Rece i ved
$
$
r/ater Supply :. ,'
Proposed __ Existing L.o-
4i; State surcharge
Plans check fee
Change of 0ccupancy
$
$
Year Instal.led
PERI,IIT PROCESSIi'iG
l'1i n imum setbacks
Comnre n t s
7-ot Part. #Parcel #Parcel Si ze
Da te
, front t, side int rear
To be typed on permit
By
t^lATER POLLUTION COI'iTROL
Insta l lation speci fications O ga1 . tank;
ZLl I'To be Or'l it
it. of drainfield; max.th of trenches
CP.f, I
r^itc
set(s)
set( s )
Hold S1 i p
to PCC
.Date
Da te
Courp I e ted
Te e nepho
Di rections to s e .; '.i
,:.P.lans to/ / stF]Da te
Rcqu i red
Date to
PCC
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.liPC
Planning
Publ ic !,lcrks
/ / Llevatron
/-/ Address
l l lact I i tj' Permi I
/-/ Lnuironmental Heal th
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F0R INF0RIlAII0N al'rout progre.,s of your app)ication cal l Perrnit Control Center 687-HELP (687-4357)
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