HomeMy WebLinkAboutPermit Septic Tank 1991-06-13u&ts SPt
PERMIT #
t72q-qt
SEPTIC VERIFICATION FOR LOAN REV]EW
REOUEST
FOR:
Pr ivat,e Yes
DESCRmOI Of PRO?OAED WORX XO. Of, IEDaOOII
Septic Verification for loan review
otnEcTroNs ro &TE Fnor couRrxousE
Coburq; Rd. to Harlov; Harlow to Wayside"
,{ s€C'loal I^I LOT lock I03
PHO"E
Ron Farner 2836
OAi LrcEX3E '
TO|VNSIiIP BAT{GE sEcIoN z
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READ CAREFULLYI Your Authorlzatlon ls Based On The Followl Condltlons
APPROVED BY:FEES DUE: S DATE
oF FOZM FOB INSTRUCTTONS) 687-4065
SEPTIC permlts are good tor one year. ALL other permlts expire after 180 days unless inspectlons are current.
CALL FOR TNSPECTTONS (SEE
-
APPLICANT NAME & ADDRESS
(worl< ) 465-5766
ls true and corrscthJql--lnformatlon
.- VIOLATIONS -
SBTBACKSANDOTHBN,CONDITTONSOPAPPROVALMUSTBBSTRICILYOBITER\ED. VIOIITTONCA}TNSSULTNRBVOCATTONOPTIIUIERMIT.
CTTATIONS MAY BB TSSUBD T,NDBR, THB PROVUIIONS OP I"ANE COI,,NTY,S INFRACTION ORDINA}ICB AI\TD/OR, OTIIER. RBMEDIBS ALLOWBD BY LAW.
A MTMMUM OF AT LEAST 24 HOURS ADVANCE NOTTCE MUST BE GwEN FOR TNSPECTION REQIIESTS
Have the following information ready when you call: 6874M5
Permit number - Job address - Type of inspection required - When it will be ready
Your name and phone number - Any special directions to the site
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EN]ERT'IPONANYLANDAND MAKBEXAMINATIONS AND ST'RVEYS ANDPLAG ANDMAINTAINTHENEGSSARYMONTJMBtr{TS ANDMARKER.!| THBXTON.
REQI.IIRED INSPECTIONS
FOUNDATION INSPECTION: To be made after excavations for footings are complete and any required reinforcing steel is in place.
LTNDERGROUND PIPING INSPECTION: To be made after all underground piping has been installed, pnor to any backfill.
CONCRETE SLAB OR LINDER-FLOOR INSPECTION: To be made after all in-slab or under-flocr building service equipment, conduit, piping
accessories and other ancillary equipment items are in place but before any concrete is placed or floor sheathing hstalld, including the subfloor.
ROUGH MECHANICAL INSPECTION: To be made after all ducting and gas piping has been installed and prior to being covered.
ROUGH PLUMBING 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, bracing and roof are in place and all pipes, chimneys and vents re complete
and the rough electical, plumbing, and mechanical inspections have been made and approved.
INSULATION INSPECTION: To be made after all insulation and vapor barriers are in place, prior !o covering.
LATHAND/ORGYPSUMBOARDINSPECTION: Tobemadeafterdllathingandgypzumboard,interiorandexterior,isinplacebutbeforcury
plastering is applied or before gypsum board joints and fasteners a.re taped md finished..
ADDITIONAL INSPECTIONS MAY BE REQLJIRED, zuch as but not limited to;
BLOCK WALL: To be made after reinforcing is in place but before any grout is poured" The inspection is noquired for each bond beam pour. Therg
will be no approv.al until the plumbing and electrical inspections have been made and ap'proved.
FINAL MECHANICAL INSPECTTON: To be made just prior to the structure or remodelbd area being occupied and prior to operating any eEripmenr
FINAL PLUMBING INSPECTION: To be made just p,rior to the building, strucure or remodeled area being occupied
FINAL BLTILDING INSPECTION: To be made after finish grading and the building, strucure or remodeled area is completed urd ready for occupanry.
MOBILEMANUFACTURED HOMES: An inspection is required after the mobile home is connected to ur ryp,roved sewer or septic
systemr prior to covering sewer or water lines, for setback requirements, blocking, tiedowns and plumbing connections.
Footings md piers to comply with state foundation requirements for mobile homes or as recommended by the maorufacturer.
Minimum finished floor elevation shall be certified when required by Floodplain Manageme,lrt
Tiedowru, if required, $aU be installed and ready for inspection witlrin 30 days after occupanry. Tiedovms slull be installed per enclosure.
APPROVAL REQUIRED
No work shall be done on any part of the building or structure beyond the point indicated in each successive inspecrion without first obtaining the
approval of tlr building official. Such approval shall be given only after an inspection shall have been made of each successive ste,p in the construction
as indicated by each of the irspections required.
APPROVED PI.ANS MUST BE ON TTIE JOB SITE AT ALL TMES DURING WORKING HOURS.
THIS PERMIT WILL E)(PIRE IF WORK DOES NOT BEGIN WIII{IN I8O DAYS, OR IF WORK IS STOPPED OR ABANDONED FOR MORE TTIAN I8O DAYS.
SUSPENSION OR REVOCATION MAY OCCUR IF TTIIS PERMIT WAS ISSUED ON TI{E BASIS OF INCOMPLETE OR ERRONEOUS INFORMATION.
AI\TYONE PROCEEDING PAST THE POINT OF REQIIIRED INSPECTIONS WILL DO SO AT THETR OWN RISK.
Your signanfre on the front of this form verifies 0re foilowing: I HAYE CAREFULLY EXAMINED THIS COMPLETED APPLICATION, and do
hereby certify that all information hereon is true and correct, and that I have a legal interest in the property as owner of record or authorized agent. I
further certify tha! Ty and all work pe_rlormed shall be done in accordance with the Ordinances of Lane County and the laws of the State of Oregon per-
taining to the work described herein. I furtlrer certi$ that if I am not the owner of the property, my registration with the Builders Board is in fulifo;
and effect as required by ORS 701.055, and that 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 complete, the permit holder shall notify the County Land Management Division by submitting the installation record
form. An inspection will be made by a qualified sanitarian. If constnrction complies with all rules a certificate of iompletion iill be issued to the pefinit
holder. If construction does not comply with rules, the permit holder will be notified, and all corections shall be made before a certificate of compLtionwill be issued. Failure to meet satisfactory completion within the allofted time coristitutes a violation of ORS 454.605 to 4il.745 and this rule.
SUBSURT'ACE SEWAGE DISPOSAL SETBACKS SEPTIC TANK DRAINFIELDFrom: Interior property lines l0' 10'
Edge ofroadright-of-way l0' 10'
Building foundarion 5' l0'
Wells or other water sources 50' 100'
Frts,t
lntqstate
Bank
First lnterstate Bank
of Oregon, N.A.
Corporate Banking Center
P.O. Box 1786
Eugene, OR 97440
503 465-5768
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(@"*REQUEST FOR ASSISTANCE
Land Managemenl Div- 125 E- Bth Ave- Eugene, OR 97401
Exlstlng Buildtngs or
lmprovements on
Property
l-=(House
t----'l Barn
f,ZFGarage
f---1 Mobile. Home
El Shed
SEPTIC INSTALLED
EI Yes
I---..l No
Water District
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Please complete all lines inside white boxes, if possible.
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P HONEOWNER OF PROP€FTY (if nol sm. rr.bovc)
OWNEHS AOOFESS (il not tlme !r abovc)
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MAP, PARCEL NUMBER
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Townthip Renga Setion l/4 S.ction T.r Lot
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Directions to site
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Land Management Div. staff can
not be held responsible for
evaluatlons or recommendations
based on falso, inaccuralo orlncompleto lnformatlon
Partition I Subdivislon
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