HomeMy WebLinkAboutPermit Septic Tank 1993-01-20SEWAGE DISPOSAL
g-023/s Job
Written Directions
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SITE EVALUATION
a s.r.* ?2-o*G
TP.6,
Subdivision:
Lot_
APPLICANT'S NAME AND
WATER
.3 E Phone2*_ZE_Z&3/
OWNER'S NAME AND
STRUCTURES NOWON THE PROP lU ttz €PROPOSED USE OF PROPERTY 3 -E u-
rate, and that I have the tollowing legal interest in the property: owner of record; _contracl purchaser;
-potential
buyer;
I herpy certify tpthq above statements are true and accur'r' rcanot o(Wyl furthercertitythat (if not theowner)I am authorized to act for the owner of record, and that said owner is and of this action.
TEST HOLES Date /'Z-L{q >
OFFICE USE ONLY BELOW THIS LINE t t T i I t t t
SITE MEETS STATE SIANDABDS
Standard System
Sand Filter
1 Foot Capping Fill
NO
tr
n
tr
YES
D
!
tr
NO
n
n
n
YES
w
tr
n
Low Pressure Distribution
Holding Tank
Other
LAND USE COMPLIANCE
or Lot S|ze_CTOTAL)
Partitioning #_Parcel ) Completed
) Pending
coM
FLOODPLAIN INFORMATI ON
n Approximate All or part of this site may be in a flood hazard
Study Area area for which 100 year ilood levels have not
been established. Extra precautions may be
appropriate to assure that the building site will
be reasonably safe from flooding.
THIS IS A PRELIMINARY REPORT WHICH DOES NOT ENSURE THE ISSUANCE OF A FUTURE
BUILDING PERMIT. ANY PLANS OR EXPENDITURES MADE IN RELIANCE UPON THIS REPORT
ARE AT YOUR OWN RISK. IF SITE IS APPROVED, SEE REVERSE SIDE.
./-26 -73
DATE
tr Detailed
StudyArea
! Floodway
All or part o, this site may be in a flood hazard
area lor which 100 year flood levels have been
established. A building elevation above the 1OO
year flood level may be required.
All or part of this site may be in a flood hazard
area in which a floodway has been designated.
Building may be prohibited subiect to
demonstralion that the cumulative effecl of
proposed development will not increase the
100 year flood level at any point.
LANE COUNTY ENVIRONME
c55-32
NTAL HEALTH, 125 EAST 8TH AVENUE, EUGENE, OREGON 97407 (687-4051)
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MEMO
TO: APPLICANT
FROM: LANE COUNTY ENVIRONMENTAL HEALTH
SUBJECT CONDITIONS OF SITE APPROVAL
Lane
Countg
)
Any alteration of the natural conditions in the area approved tor the on-site system or replacement area may void this approval.
This approval is given on the basis that the lot or parcel described above will not be further partitioned or subdivided and that conditions
on subject or adjacent properties have not been altered in any manner which would prohibit issuance of a permit in accordance with
O.R.S. 454.605 through 454.755 and Administrative Rules of the Environmental Quality Commission. Any such subdivision,
partitioning or alteration may void this report.
WARNING: This document is a technical report for on-site sewage disposal only. lt may be converted to a permit only if , at the time of
application, the parcel has been found to be compatible with applicable LCDC-acknowledged local comprehensive land
use plans and implementing measures or the Statewide Planning Goals. The Statement of Compatibility may be made on
the attached form or its equivalent. Authorized Agent approval is required before a construction permit can be issued.
This report is valid until an on-site sewage system is installed pursuant to a construction permit obtained from Lane County, or until
earlier cancellation, pursuant to Commission rules, with written notice thereof by the Department of Environmental Quality to the
owners according to Department records or the County tax records. Subject to the foregoing, this report runs with the land and will
automatically benef it subsequent owners.
Only persons having a valid license issued by the Department of Environmental Quality under ORS 454.695 to install subsurface
sewage disposal systems or an owner or contract purchaser or his regular employees may install subsurface sewage disposal systems.
A certificate of satisfactory completion will not be issued if persons other than the above perform the installation.
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Eugene, Orc;cn 97ii)l
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