HomeMy WebLinkAboutPermit Septic Tank 1987-04-28'-L(aO*Z &+h
Lane County Authori za,'tt for,
\uul S'NGHEC
SEPTIC INSPECTION LOAN REVIEt^J
rOR OFFICE USE ONLY
Application/
Permit #t37 8-rr
?OWN-SHIP
IB
FANGE
03 02.2
SECTI,ON
I 400
TAX LOT Eour oF
s'JBDrvrsroN,/pARTrrroN (if aptlica6L)LOl/PAF.CEI BLOCK
FROPOSED USE OF PROPERTY
Re s idential
Cornmerc ial
&
STREET
2nd St.,
LOCATION ADDRESS L]I']Y ZIP
I 375 S.Spri ngfi eld 97477
STRUCTURES CURRENTLY ON PROPERTY
sFDlqL
Turn R on 2nd St. go to 2nd to last hs. on R. Big R/White barn - turn L into barn.
DIRECTIONS TO SITE
Go down lane to white hs.
DiSCRIPTION OF PROPOSED I,IORK - BE SPDCIF]C
SEPTIC INSPECTION FOR LOAN REVIEW
DECI,ARED 5 VALUE
OF BEDROOI,IS # OP STORIES # OT EMPLOYEES I^iA?ER SUPPLY roposed
Exis ti
O;iNERIS NAME AND ADDRESS
same as siteGARNER, E. E
TELEPHONE NUMBER
746 5972
CON?RACTORIS NAME AND OSR #TELEPHONE NI]MBER
P:RI'IIT TO BE MAILED TO (NAME AND ADDRESS)TELEPHONE NUI'IBER
I HAVE CAREFULLY EXA|.IINED THE COMPLETI:D APPLICATIoN !'OR P!]Rl.rIT, dr,C,lo hereL/ cerlifi thet all rnfolTatior) hereon is true and correct, and that f
have the following 1e9al interest in the property, [orru. of record; I cr,nrra,,t prrrchaser; !authorized agent.
I f:rther certify that any and all work perfomed sha1l be done in accor,lanr:. tith th,i Ordrr)ancec of Lane Couty and the Laws of the State of Oregon
to the work described herein, and that NO OCCUPANCy will be nade of anl strrrcture wilhout the pemissj.on of the Building Division. f fur-
ther certify that regislration with the Builderrs Board is in full force iind effect as required by oRs 701.055. that if exempt the basis fo! exempti
is noted hereon, and that only subcontractors ed employees who are in conpliance with ORS 701.055 wiLl be used on this project. I IiAVE REID NID
CHECKED THIS APPLICATION THOROUGHLY.
4-28-87
NAME (please print)DA?E
E. E. Garner
READ THIS SECTION CAREFULLY. YOUR AUTHORIZATION TIAS BEEN BASED ON THE FOLLOWING CONDITIONS!
Zone Partitionil
-
Parcel#
-
ParcelSize
fl prens ExAIltrNATroN: rype- crorp-
Date:
Date:
Use
COM}IENTS:
DaLe
Yes
^#col"r.r'lENTs
7
tr
front
E PLANNIN
E qryrylqeN: s. r. *B. P. #
CI SP
4-28-87
Installation Record Issued?
COI'L\ENTS
ZONING
re ar
Lineal Feet
of ttr.rinfield
Installation Gallon
soecifications: Tank
l'laximum Depth
of Tlenches
Minimum setbacks, "",
cr,, uid"-
S /J7
APPROVED
LANE COUNTY
OFF IGNEE Der ORS 456.805
1
OF PUBLIC WORKS LAND MANAGEMENT DIVI
8TH AVENUE, EUGENE, OREGON 97401
I DATF
lstoN, 687-4061,
SEE REVERSE FOR INSPECTION INFORMATION ct4-25 R*
l-l rndustrial
fleruri"
in te rior
SETBACXS AND OTIIER CONDITIONS OF APPROI.IAL MUST BE STRICTLI" OBSERVED. VIOLATION CA)I RESULT IN REVO-
cnTIoN oF TIIIS PER}I]T, CITATIO]J UND9R PROVISIONS OF LAN-E COUNTY'S INFRACTTON ORDINANCE, AND,/OR OTHER
RE}IEDIES ALLOWED BY LAW.
!$HEN READY FOR INSPECTION, CALI 687-.1055. A }1INI!1U}1 OF AT LEAST 2{ IIOURS ADVAIiCE NO?ICE FOR INSPEC'
@eN:--dIE-EE-7oIIowinginfornationready:permi!number,jobaddress,type
of inspecrion, when it will be ready, your name and phone nunber, and any special directions to site.
BUILDING DIVISION:
REQUIRED INSPECTIONS:
l. Foundation Inspection: To be made after trenche! are excavated and forms erected and when aIl
m31tTFr-or the fuundation are delivered on the job. l'Jhere concrete fron a central mixing
plant (comonl,y termed "transit mixed") j-s Lo be used, materials need not be on the job.
2. concrete Slab or Under-aIoor Inspecti.on: To be made after al1 in-sIab or under-floor buildj.ng
EErvT-E-equ-ipmot,-Zolfiuit, pipiia-;ressorres, and other ancillary equipment i.tems are in
place but beiore any concrete is poured or floor sheathing installed, including the subfloor.
3. Framing & Insulation Inspectionsi To be made after the roof, all framj"ng, fire blocking, and
bircing tre in ?lace and alI pipes, fireplaces, chj.mneys, and vents are complete and alI rough
electri.cal and plumbing are approved. AIl wal1 rnsulation and vapor barri.er are in place.
4. Lath and/or Gypsum Board Inspection: To be made after aI1 lathing and qypsun board, i.nterior
and exterror, is in place but before any plaster.ing is applied and before gypsum board joints
and fasteners are taped and finished.
5. Final Inspectj.on: To be nade after the buiLding j.s complete and before occupancy.
APPROVAL REQUIRED. No work shall be done on any part of lhe buj,lding or Structure beyond the poj.nt
indicated in each successj-ve inspection wichout first obtaining the approval of the buildj.ng offlcial
Such approval- shall be given on]-y after an inspection shal-l have been made of each successive step
in lhe ccnstruction as indicated by each of the inspections requireC.
NOTE: AII building permits requj.re inspectlons for the work authorj.zed, such as but not limiled to:
A. Block 1^1a11: To be maCe after reinforcing is in p1ace, but before any grout is poured. This
ii!-prcci6i- is required for each bond beam pour. There wilL be no approval uotil the plwbing
and electrical inspeccions have been made and approved.
B. l,lood Stover To be made after completion of nasonry (if appl-icabLe) and when instatlacion is
coilpfetn lnstallatj.on shaIl be in accordance with an approved, national-Iy recognized testing
agency and the manufacturerrs 1nstal]-ation rnstructions.
C. Mobile Home: An inspection is requj-red after the mobile home is connected to an approveal
EE-w oi-s6ptic s)rstem for setback requirenents, b)-ockj-ng, footing connection, tieatvns,
skirting, and plmbing connections.
1. Footings and p.iers to comply with state foundati.on requj-remenls for mobiLe homes or as
recomended by the manufacturer.
2. .\,lobil,e home minimum finish floor eLevation shaLl be certified when required by a flood-
plain management Ietter.
3. uobj.le home tiedowns, when required, and skirting shall be instalLed and ready for inspec-
tion uithin at least 30 days after occupancy. Tiedowns and skirting shall be insLaLledper enclosure.
D. swiming PooI: Below grade when steel is in place and before concrete is poured. Above grade
,Is p@1-Ts-instalIcc.
APPROVED PLANS UUST BE ON THE JOB SITE AT ALL TIMES DURING WORKING HOURS. THIS PERMIT WTLL EXPIRE
IF WORK DOES NOl BEGIN WITHIN 180 DAYS, OR IF WORK IS SUSPENDED OR ABANDONED FOR }IORE TIIAN I8O DAYS.
SUSPENSION OR REVOCATION i4AY OCCUR IF THIS PERMIT WAS ISSUED ON THE BASIS OF TNCOMPLETE OR ERRONEOUS
TNPORM.ATION.
ANYONE PROCEEDING PASI THE POIIiT OT REQUIRED INSPECTIONS WILL DO SO AT THEIR OWN RISK.
ALTERNATIVE SEWAGE DISPOSAL SYSTEUS:
Permits shall be effective for one year from the date of issuance.
Upon completing Lhe construction for which a permit has been issued, the permit ho!.der shall
notj,fy the Lane CounLy Department of Planning and Comunity Development by submitting the
installation record form. The Departhent shall inspect the construction to determine if itcompli.es with the rules contained in this dj.vision. If the construction does conply with suchrul,es, the Departnent. shall i.ssue a cerlificate of satisfactory conpletion to the permiti hoLderIf the construction does not comply with such rules, the Department shall notj-fy the permit
hoLd€r and shalL requj.re satisfactory completion before issuing the certificate. Pailure tomeet the requirements for saLisfactory completion withi.n a reasonable ti,ne constitutes a vio-lation of ORS 454.505 to 454.745 and this rule.
Setbacks - subsurfacc sewage DisposaL
Septic Tank Drainfield
Interior property lines
Edge of road ri.girt-of-uay
auildinq foundation
vieIIs, other water sources
SUBSURFACE AND
!'rom:r0,
10,
50'
1.0 |
r0,t0'
100 |
I.
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(. m,,,ACTIVITY INFORMATION SHEET
Please complete all ltems above dotted line
(.xo r^{r*Mlm orvrsraGDr.llwid or Pldc urrr
FILLING ouT * LINES WILL GET YoU INFoRMATIoN oNLY
*DATE 4 tas to'?
*PERSON
MAKING
REOUEST
ACTUAL
PROPERTY
s-- .\sa
CITY CITY
TELEPHONE (B TELEPHONE (B
{cpnopeRTY ADDRES q /3l.S- .\,r , N-A &nl,/ .S+
or&.--rpQ )<1>)ST ATE_ZIP-
.GSJ (O Be ,
OR
MAP & PARCEL NUMBER (Found on tax maps in the Assessment & Taxation Dept.)
IB o3 O.)'eO -i
Townshlp Range Section Tax Lot
STAFF WILL DETERMINE _
Zoned Flood Plain
Township Range Section Tax Lot
Township Range Section Tax Lot
TOTAL CONTIGUOUS PROPERTY lN SAME OWNERSHIP: ACRES
T
*REQUESTlaescrlbe what you want to do
Zoned
Zoned
Flood Plain
Flood Plain
Directions to site
Se<.{<.ods€
,.tar.rrr:.rrraarrttstaff use onlytttat.rrrrrraasrrrt,
Com ments:
h
Land Management Division, Public Works Department 125 E. 8th Ave., Eugene, OR 97401 phone 6874061
- Yo.r'', -E
AnnoEec
Ii &TTI.J l AN -rffi
= HETLAI{D I-AND USE iloTrFICATI0r{ Fu*}t
-- DIVISION 0F STATE LANDS I^IETLANDS PROGRAM
1775 Summer Street NE, Salem, Oregon 97310., 503/379-3905.-.
'I
Local Case Flle No.:/€cl)DSL Flle No.:
.4/r2. APPLICANT:
\
/ 37{ilU*r,e*( Sr
s tree
o 771'z
\
l. l
i5
Li"V.(-$.
o
1. County:
Cl ty:
name
s treet
st726 - /3 ltP
phone
LOCATIOH:T .'o ROf, s oAtt+:s-
NI,II quad map name
phone
!
Tax Lot(s> '6//4
clty()s tate ztp
3
Attached:
-
NHI map i/ Parcel map r'Sl te plan y'ot bd
4. SITE ItlF0Rl'lATIOll: lDEt'lftaOD oN grry oF : q??rr<afl€Le rdeTL-A/N( D r Nl V6ITD ZNHI Hetland Classlficatlon Code(s)
Sotl Serles Name (optlonal)UA.erzzO M vlYo//.jt<-
Adjacent Haterway (lf any)CoxlN?ED :rn y.ltuxv.rtrF4,In Floodp'laln? Y _aN ?Current Land Use Zonl ng /_,03 -F/o
( attach copy wlth slt ndl cated). ,fal,.cfrla
br-4'P-Y
el
her
T
5 PROPOSED ACTIVITY:
-
stte plan approval
-
grading permit
_ condltional use permlt
-Z butldlng permlt
_ Zone Change to:
Project Descrl ptlon:
_ subdivislon_ planned unlt development_ publlc works
-
other
Compl et
Addre s s
ed by /Contact:
(Thls form ls Eo ba conpleted
Date
Phone
plannlnq departmant staff lor mappad va?Laods)
7r/.?/r' (
72
DSL RESPONSE
A A removal-fill permit is required from the Division of State Lands.
tr A removal-fill permit will be required when the development project proceeds.
D A removal -fi I I permi t may be requi red.
A Information needed i ncl udes:
A A wetl and determi nati on/de I i neati on report -
tr
Q was issued D has been applied for
ru\eA ?et04r-
a,x State permi t
No emov 1-fi I I erm ti . req uired for the described r e t *
A A permit may be required by the Corps
Comments:,1^ {el.kr
of En ineers (32 95)
DateI from th
c.,r<j("rpfg cf2-U*+Vicrl,.y*
t
ec use:
Response compreted by , /en<Ae..r4allA* Ii the project is changed to involve fill or remova
state removal -f i'l 1 permi t wi I I be requi red.
e wetlands area, a
o
{rt s LANDOI^INER:\
..
: