HomeMy WebLinkAboutPermit Septic Tank 1993-02-025 f ( / /,(,/)/t Z/il u6,8 Er.tW* tlloo,X?Z-ff
REAUEST
FOR:I NSTALL SAND F I LTER SYSTEM
reby certily that all information ls tru e and correct
- L -qvs of thls appl
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acarefu
READ CAREFULLY! Your Authorlzatlon ls Based On The Following Conditions
FEES DUE: S APPBOVED BY:
CALL FOB NSPECTTONS (SEE BACK OF FORM FOR INSTBUCTTONS) 687-4065
SEPTIC permlts are good for one year. ALL other permits expire efter 180 days unless lnspectlons are current,
LMD 040 Rev. 6/92
05 70
RE
OVER HILL ON THE RIGHT.
PHONE
7 26"
SAfqE
PERRCO.STORRS
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2t'ro srREET,
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MAIN STREET TO SOUTH
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I NGLE FAM I LY DWELL I NG AND GEX I ST I N
T0M WIRFS,
SAPIE AS THE ABOVE
PRIVATE U
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I NSTALL SAND F I LTER SYSTEM
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VIOLATIONS
SBTBACKS AND OTIIR, CINDMONS OP APPROVAL MUST BB STRICTLY OBSEAVSD. VIOI.ATION CAN RESI'LT IN NBVOCATION OF THIS PERMIT.
CITATIONS MAY BB IIISIJED I,NDBR, THB PROVBIONS OF I.A!{E COI,,NTY,S INI'RACTION ORDINANCB A}IDiIOR OTHBR RBMEDIES AI,OWBD BY LAW.
A MINIMUM OF AT LEAST 24 HOURS ADVANCE NOTICE MUST BE GTVEN FOR INSPECTION REQI.'ESTS
Have the following information ready when you call: 687-465
Permit number - Job address - Type of inspection required - When it will be ready
Your name and phone nrmrber - Any special directions to the site
powERroBNrERupoNLAND. .,r*""ffi,:l?.?:1ff^i#3Fl{Hffi:S&1"1ffi"#[3Hlg]ift'*H--"^r*oFrHBrRprrNcrroNs.M^y
BNTER I.JPON ANY LAND AND MAXB BXAI\{INATIONS AND SI,JRVBYS AND PLACB AND MAINTAIN TIIB NECESSARY MONI.'ME}ITS AND MAR,KERS THEREON.
REQI.IIRED INSPECTIONS
FOLJNDATION INSPECTION: To be made after excavations for footings are complete and any required reinforcing steel is in place.
LJNDERCROLIND PIPING INSPECTION: To be made after all undergound piphg has been installed, pnor to any backfill.
CONCRETE SLAB OR LJNDER-FLOOR INSPECTION: To be made after all in-slab or under-floor building service equipmeng conduit, piping
accessories and other ancillary equipment items are in place but before any concrete is placed or floor sheathing installed, 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 atl pipes, chimneys and vents are complete
and ttre rough electrical, plumbing, and mechanical inspections have been made and approved.
INSULATION INSPECTION: To be made after all insulation and vapor barriers are in place, prior to covering.
LATH AND/OR GYPSUM BOARD INSPECTION: To be made after sll lathing and gypzum board, interior and exterior, is in place but beforc any
plastering is applied or before gypaum boardjoints and fasteners are raped and finished.
ADDITIONAL INSPECTIONS MAY BE REQUIRED, such as but not limited to;
BLOCK WALL: To be made after reinforcing is in place, but before any grout is poryed. The inspection is required for each bond beam pour. There
will be no approval until the plumbing and electrical inspections have been made and approved.
FINAL MECHANICAL INSPECTIONT To be made just prior to the struchre or remodeled area being occupied and prior to operating any equipmenr
FINAL PLUMBING INSPECTION: To be made just prior to the building, strucnrrc or rcmodeled rea being occupied.
FINAL BUILDING INSPECTION: To be made after finish gading and the building, structure or remodeled area is completed and ready for occupancy.
MOBILEMANLTFACTURED HOMES: An inspection is required after the mobile home is cormected to an approved sewer or septic
system, prior to covering sewetr or water lines, for setback requirements, blocking, tiedowns and plumbing connections.
Footings and piers to comply with State fotrndation requirements for mobile homes or as recommended by the manufacturer.
Minimum finishd floor elevation shall be certified when required by Floodplain Management
Tiedowru, if required, shall be installed and ready for inspection within 30 days after occupancy. Tiedowns shall be installed per enclosure.
APPROVAL REQTIIRED
No work shall be done on my part of the building or struchre beyond the point indicated in each successive inspection without first obtaining the
aplxoval of the building official. Such qproval shall be given only after an inspection shall have been made of each successive step in the construction
as indicated by each of the irspectioru required"
APPROYED PI.ANS MUST BE ON THE JOB SITE AT ALL TMES DURING WORKING HOURS.
THIS PERMIT WILL EXPIRE IF WORK DOES NOT BEGIN WMHIN I8O DAYS, OR IF WORK IS STOPPED OR ABANDONED FOR MORE THAN I8O DAYS.
SUSPENSION OR REVOCATION MAY OCCUR IF T}IIS PERMT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS E.IFORMAfiON.
AIIYONE PROCEF'INGPAST THE POINT OF REQI.IRED INSPECTIONS WILL DO SO AT THEIR OWN RISK.
Your signanre on the front of this form verifies the following: I HAVE CAREFULLY EXAMINED THIS COMPLETED APPUCATION, and do
hereby certify that all information hereon is tnre and correct, and that I have a legal interest in the property as owner of record or authorized ageil. I
further certify that any and all work performed shall be done in accordance with the Ordinances of Lane County and the laws of the State of Gegon per-
taining to the work described herein. I furtlrer certify that if I am not the owner of the property, my registation with ttre Builders Board is in full fo;
and effect as required by ORS 701.055, and that ifexernpt 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 constnrction is complete, the permit holder shall notify the County Land Management Division by submitting the installation record
foTn. 4l^i^pection wil.l be made by a qualihed sanitarian. If construction complies wittr all rules a certificate of complerion will be issued to the permit
holder. If construction does not comply with rules, thc permit holder will be notified, and all corrections shall be madobefore a certificate of compietion
will be issued. Failwe to meet satisfactory completion within the alloued time constitutes a violation of ORS 454.605 to 454.745 and this rule.
ST,BSURFACE SEWAGE DISPOSAL SETBACKS SEPTIC TANK DRAINFIELD
From: Interior property lines 10' l0'
Edge ofroad right-of-way 10' 10'
Building foundation 5' l0'
Wells or other water sources 50' 100'
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Permit No.279.'92 MUST BE
Twnshp. I t IN BLACK INK
Range
Standard System Alternative
Job Location (Street Address)
Supdivision/Partition #Parcel Block
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DETAIL SYSTEM PLOT PLAN AS CONSTRUCTED
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VICINITY MAPo d i)e.- t t*r'*,. \,...*
USE BLACK INK ONLY\\trr.,-^\FOR INSTALLER'S USE
Tank
Meas
COMPLETE THE
I (installer's name)
and Me
Signature
FOR SANITARIAN'S USE ON
COMMENTS
Trench Depth 1
Manulacturer
to Tank
Gravel Depth Below Tile\,,Dr Capacity \oq: - qso
rc.r;ured Distance from Well\\^N From Drainfield
o N THIS
\\\ \."
Total Length of Lines
INSTALLATION
tv,*\.'1.-(Model tto.1 5 i{ Ef S.l eump.)
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h ;d b*" ir"t'll"d with this sewage installation
Date \).
System Approved iJ System Disapproved ! Needs Correctionx//
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ate
ate
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DSystem Capacity gal./day Signature
INSTALLATION RECORD & CERTIFICATE OF SATISFACTORY COMPLETION When signed by the County Sanitarian
dence as per ORS 454.665 ol satislactory completion of a subsurface sewage disposal system at the above location
To request inspection, return all three (3) copies of this form to: Lane County Environmental Health Services, located in the basement ol the
Public Service Building, 125 E. 8th Avenue, Eugene, OR 97401.
certificate is evi-
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form c55-11O2,L Tax Lot 7OO
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\5115 bDlAd
EVERGHEEN
LAND TITLE
COMPANY
1570 Mohawk Blvd.
P.O. Box 931
Springfield, Orego n 97477
(503) 741-1e81
Telefax No.: (503) 741-0619
Telex No.: 221120 EUG UR
CONSUMER INFORMATION REPORT
PREPARED ESPECIALLY FOR:
CT'TY OF SPRTNGF'TET.N DATE: DFr. 9, | 99.
ATT'N:
PROPERTY ADDRESS: On'rn OW .EHO,$q Vi"IBETS
PLEASE SEE AT-LACHED LANE COUNTY DEPARTMENT OF ASSESSMENT AND TAXATION PRINTOUT
FOR ADDITIONAL INFORMATION.
COPY OF: DEED x CONTRAgT MAP X OTHER X
THIS TITLE INFORMATION HAS BEEN FURNISHED, WITHOUT CHARGE, IN CONFORMANCE WITH THE
GUIDELINES APPROVED BY STATE OF OREGON INSURANCE COMMISSIONER. THE INSURANCE DIVI-
SION CAUTIONS INTERMEDIARIES THAT THIS SERVICE IS DESIGNED TO BENEFIT THE ULTIMATE IN-
SURED; INDISCRIMINATE USE ONLY BENEFITTING INTERMEDIARIES WILL NOT BE PERMITTED. SAID
SERVICES MAY BE DISCONTINUED, NO LIABILITY IS ASSUMED FOR ANY ERRORS IN THIS REPORT.
lssuing Agent for:
THANK YOU. WE APPRECIATE YOUR TRUST.
STE\A/AR.T TITLI'
a
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GUARANTY COMPANY rfir-rfrcX 1il)
9256G08
TL tro. l8-03-02-20-00700
lrPtto lo27o6-<./G.,6967
lct. Io. '579191
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YTSTTRX PIOXTTR TI C0. P. 0. Bor 10116
I1II8 INSTRI'}IENT TIILL TOT AIJ.OW USE OF THE PROPERTY
DESCRIBED IN THIS INSTRT'XEIf,I IN VIOLATION OP IPPLICABI,BIAND USE IAIIS N{D REGUIATIONS. BEPORE SIGNTXG OR
ACCEPTINC lrHIS INSTRUXENT, TTIE PERSON ACQUIRTXO AITY
I}ITEREST IN OR TO THB PROPERSY EHOULD CIIECX I{IIE I'IIB
APPROPRIATE CITY OR COU}(rY PI.INNIXG DEPARIITENT TO VERITY
APPROVED USES.
III I{ITNESS WHEREOP, the partlea have caueed thlc ltarranty Dsed
Pag6 1-I{ARRI,NTYDEED
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I mltr?Y pkrTr fgA{ET.G''tili4nEC l5.O
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rRAxx A. xoacrorrx and rosrr E. roscrorrx, url$ffJ'Ti&a$ttrfl'o a'm
Grantor, conv.y. and yarrant Co TBOma C. rIRfa and DIAf I. EIf8,hurband and vlfo, crant.., th. lolloylng dcrcrlbod rrat proprrtyi
8c. InmBrr A attacb.d b.r.to and by t!l.r ntrr.ncolncorporat d bareln.
Corrcnly brovTl ar 1275 6outb 2nd 6treet, Sprlngfl.Id,Lan. County, Or.gon 97a77.
harelnalter the rsal, prop.rty rhall be raferred to a. iprolxrtyr.
Ttr. tru. and actual conrldoratlon lor thlr convryanco 1r
$25, OOO. OO.
}laD and addrctr of p.r.on or enttty boldlng 1lrn or otbrr lnttrortcralt d by tllr doclDnts Xon..
Tho dcrcrlb.d Prop.rty Ir lroc o! enculobranc.r .xc.pt:
1. Zonlng ordlnancel, bulldlng and ua. rortrlctlonr,eaaeE€nta, covenanta, condltlona and rertrlctlont o! rroord,
2. Llens or oncunbrancca attachlng aft.r th. _ dayol SopteDbor, 1992, or vhlch arlae by, through or undci tbccrantroa i
l. condltlonr and rcrtrictlonr apparcnt fron a vlcuallnapcctlon of thc Prop€rty and rcstrlctlonr and rogrrlatlonrdlacovrrablo ln the publlc r.cordr o! any gov.rnrntal agcncy.
{. Rlght of publlc ln and to any portlon o! tho hrrrlndascrlbed tract o! ),antl J,ylng ylthln th. boundarll o! B.condStr..t.
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8.nd all tar atat -ntr tos no chanoc
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GR.DflfPRr
STATE OT ORECO}I
County o! Lan.
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R6a1 Propsrty Deacrlptlon
Page2-WARR^I{ITYDEED
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ln 8'lock ll of A,{ElloEo PL^T 0F.s Dlattcd rnd recor&d rt Paoa 78: thcncr North .lono thr Er3t-lln.,.02 feet to thr Erst:rly llnr of57' Erst rlono srld tritcrly
Elock ll (tl citended llrst):-,st crtcnslon. 219.02 fcct to thcl0 md ll ol $ld Slocl ll. ln
Southngrl
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THEREFRO{ .ny Dart that lt13 ytthtn thc'doundarlcs of
shcd ln thc Subdlvlrton of AI{ENoE0 PIAT 0F |ILLX{nE
NGFIELo. rr plrttcd rnd rGcordcd tt Pagt 7t of YoluncPl.t Rccords; tn Lrn. County, oragon.
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Recei.vecJ ir'nnr r Ifi7Y i-iiir"iL.5
f,on{;r'acizUrpn ; 41.3$ $ i. gT[,l'r-'i-T
Addr'essi; l.ti'S e STFI'tIT
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Property
..Eff,ouse[f Bam
F'{xage-E lvlcbile. Home
E Shed
SEPTIC INSTALLEDl-l Yes
)=16
Waler Distric{
Please complete all llnes lnslde whlte boxes, if posstble.
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MAP, PARCEL NUMBER
(Found on l.r mrp. ln th. A.3...manl & Tar.llon D.pL,){ Q3 d/,0 J.D 700.l6-rEii- EnF Ciiin- rIIEiiil -lf,E5i-
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Tom3hlp n nec Ectlon tL E.ctlon Tu Lot
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For Moblle Home
Placement Only
No. of Bedrms
License #-
Brand
Year
Size
CITY ztP
MATL PERTli'r7 TO:
O-: n€,./
Dlstance lrom Moblle
Home to:
Water Sewer/S€ptic
Land Managemsnt Div. staff can
not be held responsible for
evaluations or recommendations
based on false, inaccurate or
1*s- z,z incomplete i
ril4-68 02/92
OWNEn OF PROPEHIY (f ml m. r. .bov.)
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SEI"JAGE DISPOSAL
PLOT PTAil IPPROUED
A permit is required
Frbto construction.
il:alth Seryica
125 Er:t tth Avenue
Eugene, Cr. ,r !7,i01
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ISOO 6AL. COMBINATION SEPTTC A PUUP TANK
PRE-CAST, pRE-ENG|NEERED, D.E.Q. APPROVED
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COARSE SAND
URFACE WATER DIVERSION BERU
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30 ulL. PV.C. LINER
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FABRICATED PIPE BOOT
(AT ALL LINER PENETRA
4 ott
DAYLIGI.ITED 4U
DERDRAIN
\*- d'Bv.C. PIPE TO
DRAINFIELD
4.'RIGID PERE PIPE TIONS)
UNDERDRAIN TO O.L.OAESE SAND
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DOSING SYSTEM A EFFLUENT UNDERDRAIN PIPING MAY BE ROTATED IN
90" INCREMENTS TO FIT SITE '
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Lrrw Nr t- rr e I ev . (prlrop tarili)'lon of orl f ice (dos lng bed )
L)J.f l"e;:ort:e (statlc l:oad )
q'l 6, 'r.g
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II.iJW t','r';'l '
/r5 i,/3'' or'lflces at 0.41 GPI{ Ft\" = 18.4,i CF,r
FI}J FII.I C'rI O}i LOSS :
\1r: r't. 2 rNcii pvc L,r c' = 160
0.8628 ft./100 ft. ar 18./+5 GPr{
0.t62S x \.1- l.'l?ft. loss
LOS;, Sllr'l]ARY:
static heacl- t'? .o'lft.
flssu-rrcd bet! loss 'l- 5 ft - 5.ol'::ictiorr loss----- | ,q7 fl.
Tocal system heaa 2m;
ruilF S]iLEtITIOI,I:
llse i{yd:-or:n ttc g a 5o ut \
Puiri, cepar'ity 4o GPii G Ttt .o f r. TH.
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the c,nrrEtr-r-r(:t::i rrr nf
nppr-o'itld hy t-ltel il.1-:
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?. F.E,nf-rv€,', *11 lar-qe recl,: s." rt:at$ clr ctthelr- sharp mh-i elcts:. th"rt
r.r:i 11 d;-tnrar1 e the F!'fl I i rrer nr r.ri l1 cle*r:nm;:t:rsr: f rcrni t-iir* rcrefr cl{
the liilu-id'f i lt-er'"
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cmmprrr:: ti nrr lras ncrlrrmrJ, Thr.l earrtj i:ecj sh(:lt.tl rJ Lre H'tLfrrr-
rilnr;-r;'rc:tt3ci ta prervent srrbs.elcquent :;r*ttlJ.ng o{: the di:r.:inct
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