HomeMy WebLinkAboutPermit Septic Tank 1987-08-27spc.yJ;"CI (,rc$ 6\. Gt!
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Applicatio
Permit #
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PROPOSED
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STREET AUGI?1987Di!Y30#/
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--=/.DESCRIPTION OF PROPOSED WORK . BE SPECIFIC Vsmar.u/G,qruCo.y>r,qo-r 4 Bz>z--o.v- ?.?,*ry
DECI,AFED S VALUE
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I Proposed
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= OF BEDROOMSI # OF STORIES
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# .OF EI,IPLoYEES
TELEPHONE NUMBER
7+/- t3</t-Tnrrtet rN-irn He-tt/ar-l t qq o ?Lensa nr* S+AND ADDRESS
TELEPHONE NWBERCONTRAC?ORIS NAME AND OSR #
TELEPHONE NUMBER7l /-r35/Jnnps HarPr4 tf*o P/<-nsau,{ *9 Se6t Or.F'N'IT TO BE MAILED TO (NAME AND ADDRESS)
I HAVE CAREFULLY EXA.IIINED THE COMPLETED APPLICATIOU i-OR PEIdIT, ar,d,lc hi:r.lr:/ certifi, that aII inforaation hereon is true and corrects, and that I
have the following legal interest in the property,fiorno. of record; I cr,nrra,,b prrrchaser; Iauthorized agent.
I f:rther certify that any and a]l work perfomed'shaII be done in ocuordait.re c'ith t):.: ordrnances of Lane Cowty and the Laws of the State of Oregon
pertaining to the work descrj.bed herein, and that NO oCCUPANCY witl be made of ar.; strrrcture without the pemission of the Building Division. f fur-
ther certify that registration with the BuLlderrs Board is in fulL force and effect as required by ORS 701.O55. that if exempt the basis for e
is noted hereon. and that only subcontractors md employees vho are in conpliance with oRS 701.055 will be used on this project. I HAVE READ AND
CHECKED THIS APPLICATION THOROUGHLY
4
DATE
READ THIS SECTION CAREFULLY. YOUR AUTHORIZAT]ON qAS BEEN BASED ON THE FOLLOWING CONDITIONS:
I pr,ens ExAt'trNATroN: Type- Grorp- use
Date:
rnstallation Record rssued? f vu" fl n"
l'laximun Depth
of Trenchesq2{
Date :
COMI1ENTS:
a.
col1}lENTS
Date T
tr
front c L,s ide
B. P. #SANITATION: s. I. #
cor{\ENTs
inte ri-or rear
Parce1 #ParceI SizeI plat'luruc,zzoNrNG
Lineal- Feet
of ttrainfieldil::il*:::"" /OgO;*i""
Minimrm setbacks, t",
Zone Partition *-
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PERMIT APPROVED BY BUILDING OFFICIAL,/DESIGNEE oRs DATE
LANECOUNTY DEPARTMENT OF PUBLIC WORKS LAND MANAGEMENT DIVISION, 687-4061,'fre D ue y'/25,& 125 EASTBTH AVENUE, EUGENE, oREGoN e7401
SEE REVERSE FOR INSPECTION INF'ORMATION cL4-25 R*
30
ft"5 */,\
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SETBiTCKS AND OTI1ER Co)iDITIo::S OF APPROI,'AL I1UST BE STRICTL]" OBSERVED. iTIOLATION CAr* RESULT IN REVO-
C;TION OT i]IIS PEN}IIT, CIT;TlOI UNDSR P}IOVISIONS Oi LIiNE
':)U)iTY'3
INFRACTIOIJ ORDI);ANCE, AND,/OR OTHER
RE}IEDIES ALLOWED BY LAW.
liHEN READY FOR INSPECTION, CAI,I 68i-t065. A }1INI}1U:'1 CF;T L:AST 2.{ IIOURS ADVAI,'CE NOTICE FOR INSPEC-
@ls.il:rctneto).Iowingin:ormationready:iermj.tnumber/]obaddress,typeof inspecEion, when it wrIl be ready, your name and phonc nunber, and any special Cirectj.ons to site.
BUILDING DIVISION:
REQUIRED 1r-SPECTIONS :
l. Foundation In:lg*lon: To be made after trenches are excavated and forms erected and when aLl
materials for the foundation are delivered on the iob. l'lhere concrete from a central mj.xing
plan! (comonly termed "transit mrxed") is to be used, naterial.s need not be on the job,
2. Concrete Slab or Under-a1oor Insoection: To be made after aIl in-s1ab or under-f1oor buildrng
iEiii^e equipmmr,-?SnEufE-piping aressories, and other ancillar\: equipment items are inplace but betore 1ny concrete is poured or floor sheathing installed, rncl,uding qtre sUbflo-or.
raming, f:.r. ufo.riing, ;na3. Framing & Insulalioa Inspections: To be made aiter the roof, a11 i
bracing are rn p]ace and all pipes, fj.replaces, chinneys, and vents are complete and a1I roughelectrical and plumbing are approved. A11 wal-l rnsulation and vapor barrier are j.n pl,ace.
4. Lath and/or Gypsum Board;nspection: To be made after all lathing and q:,psun board, interior
and exlerlor, is in place buL before any plastering is applied and be:ore gypsm board joints
and fasteners are Caped anci finished.
5. Final Inspection: To be nade after the building is complete and before occupancy.
APPROVAL REQUIRED. No uork shall be done on any part of the builCing o! structure beyond the point
i.ndicated j"n each successive inspection without first obtaininq the approval of the buj.Iding officiat.Such approval shaIl be gi./en cnly after an inspection shall have been made of each successive stepin Lhe construction as indj-cated by each of the ins?ectic.s required.
NoTE: AII buj.lding permits require j-nspections for the work authori-zed, such as but not Iimited to:
A. Block waII: To be maCe aftcr reinforcing is in place, but llcfore any grout is poured. This
in-sprcti6n is required ror each bond bean pour. There wili be no approval until the pLumbing
and el,ectrj.cal inspections have been made and approved.
B. lrood Scove: To be made after conpletion of masonry (if applicable) and when installation isffip]etL Installatron shalL be in accordance wieh an appioved, nationa.Lly recognized testingagency and the manufacture!'s irstall-ation lnstructions.
C. Mobile Home: An inspectj-on -is requj-led after the nobiLe home is connected to an approved
EEwE?-oi-!6ptic syslem for setback requirements, blocking, footing connection, tiedowns,
sk j.rt j.ng, and plmbing connections.
1. Footings and piers to conply with state foundaLion requirenents for mobile homes or asrecomended by the nanufacturer.
2. Mobile hone mj.nj,mum finish fLoor elevaLion shall be certified when required by a flood-plain nanagement letter.
3- MobiIe home tiedowns, when required, and skirting shall be installed and ready for inspec-tion within at least.30 days after occupancy. Tiedowns and skixting sha}l be insralledper enclosure.
D. Swiming Pool: Below grade when steel is.i-n place aod before conclet'e is poured. Above grade\ml-ls instalfcd.
APPROVED N*Nsi4"' BE ON THE JOB SITE AT ALL TIMES DURING I,IORKING HOURS. THIS PER}IIT I'ILL EXPTREIE WORK DOES NOT BEGIN WITHIN 180 DAYS, OR IF l4lOR( IS SUSPENDED OR ABANDONED FOR I1ORE THAN 180 DAyS.
SUSPENSION OR REVOCATION I.IAY OCCUR IF TIIIS PER}1IT I,JAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS
INFORMATION.
ANYONE PROCEEDING PASI TllE POI:.lT OI REQUIRED INSPECTiO:JS'/ilLL DO SO AT THEIR OwN RISK.
SUBSURFACE AND ALTERNATIVE SEWAGE DISPOSAL SYSTEMS:
L. Permits sha11 be effective for one year from the Cate of issuance.
2. Upon completing the construction for uhich a permil has been issued, the pernit holder shaltnotify the Lane County Depa!hent of Planning and Comunity Devel-opment by submlttj,ng thei.nstallation record form. The Departfient shaIl inspect Lhe constructj.on to determj.ne if iLcomplies with the rules contained in this Civision. If the construction does comply with suchru1es, the DePartment shall issue a certificale of satisfactory completion to the perniti holder.If the construction does not compLy with such rules, the DeDarment shal.L notj.fy the permit
hol.der and shaII require satisfactory conpletion before issuing the certificate. Failure tomeet the requiremencs for satisfactory com?Letron within a reasonabl,e time consticutes a vio-Iation of ORS 454.605 to.l54-745 and this ru1e.
Setbacks - Subsurf ace 9_:"glg 4jj)!Ef
septic rank 9l!]I!S]q
l-ron: Interior properti, Irncs i0' IC'
ECae oi road rrqht-oi-way 10' I0'
Bur lciinq foundation 10'
liells, othcr Hater sources 50' 100 I
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EF IBILITY REPORT FOB SUBSURFACE AND ALTERN SEWAGE D L s.r. #lii/- r7 Zt
TRS, T
td rh(rL 6-007Ep*' /7 oa -n, ss
Job Location
f7 Written Directions
Subdivision:r, :o.:1,, ,N-,'' . H/:-,*f;:w 'i
Lot B lock
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APPLICANT'S NAME AND ADDRESS
OWNER'S NAME AND ADDBESS
P1",on" F//:,r/f?'
Pnon". rf//*/Mail report to (ann licant ( ) Owner to pick up. Call (owner, etc.l when
(.
STRUCTUBES NOW ON THE PROPERTY PROPOSED USE OF PBOPERTY
WATER SUPPLY WITHIN ONE MILE OF THE CITY OF
I hereby eertify that above statements are true and accurate,that I have the following legal interest in the property:
contrac't purchaser; potential buyer; -----: realtor
record. and that said owner is aware and approves of this action.
or sgent. I further certify that (if not the owner) I am authorized
(Nol
,Xwner
to act for the
of record;
owner of
TEST HOLES READ Sign
* + * * * * * * * r+ r+ * * {+ * * * * * * * * ,+ * * * *Qf f ICE USE ONLY BELOW THIS L
o,-tt\-l lBt (.Date
INE * r*''* n * * * * * * * * * * n * * + * * * * * r * * *
SITE MEETS STATE STANDARDS
Septic Tank/ Drain Field
Sand Filter
Holding Tank
Other
THIS IS A P
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Zoning
LAND USE COMPLIANCE,lifr,f
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DATE
Acreage or Lbt Size
Partitioning #il2 OTAL)
( ) Completed( ) Pending
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Parcel #
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LIMINABY REPORT WHICH DOES NOT ENSURE THE ISSUANCE OF A FUTURE BUI ING PERMIT. ANY PTANS OR EXPEND
TURES MADE IN RELIANCE UPON THIS REPORT ARE AT YOUB OWN RISK, IF SITE IS OVED, SEE E ERSE SI
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Division of Water Pollution Control 687-4061 Perm ing Section
LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT 125 EAST BTH AVENUE, EUGENE, OREGON 97401
c55-32
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APPR
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D SIG TURE
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