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HomeMy WebLinkAboutPermit Septic Tank 1991-09-18965'SeazdFru PEHMITJ8 bz -?/ SEPTIC SYSTEM VERIFICATIONREQUEST FOR: SEPTIC NST LLED PR IVATE USE DESCflPnON OF PBOPOAEO WOBK SYSTEM VERIFICATIONSEPTIC EXIT, 7 47 "8545 SAME AS THE ABOVE EdiFlcron xrttle ogB LlcEl{sE, r,tA 7 OF STORIEg NCRTH EXISTIi,IG SINGLE FAMILY D\.JEL LING NORTH 21sr STREET AND 501Zb, .a5"t-l 21sr sTREET, sPR I t,lGF I ELD, 0REG0N SiEEcttoNB ro atrE Fiou coonrHougE r "105 To tloHAI'JK BLVD.RIGHT ON YOLANDA, LEFT ONORTH ON 19TH STREET, NA AS THE JOB ADDRESS ABOVE SAI'1E PI{ON E NA RHODODENDRON. DEAN DIAL, SAME hereby ls true and correct ffie//4ZL that all lnformatlont have carefully read BOTH sldes of thls DEAN D I AL READ CAREFULLYI ur Authorlzatlon l3 Based On The Fol CondltlonsYo DATEAPPROYED BY:FEES DUE: $ 7-4065'RUC,NSr,68TroNs)TIONS BAE OFCK FOBMLCAFORLINSPEC(sE current,areIafterda80LLAtheroinspectionsoneexpire'ysareermltsdforpermitsyearSEPTICpgoo E OWNER AT THE JOB ADDRESS ABOVE R TO TH unless VIOLATIONS SETBACKS AND OTHER CONDITIONS OF APPROVAL MUST BB STRICTLY OBSERYED. VIOLATTON CAI\I RESI'LT IN RBVOCATION OF THIS PtsRMIT' CITATIONS MAY BB IIIST'ED T'NDBR TIIB PROVISIONS OP LA}.IE COUNTY'S INFR,ACTTON ORDINANCE ANDy'OR. OTIIER REMBDIFS AIIOWED BY LAW. A MINIMUM OF AT LEAST 24 HOURS ADVANCE NOTICE MUST BE GTVEN FOR INSPECTION REQUESTS Ilave the following information ready when you call: 687-4M5 Permit number - Job ad&ess - Type of inspection required - When it will be ready Your name and phone number - Any special directions to the site powERroBNrERUFoNLAlrD. **""m"li.i,TlBrk#35ffiAHi::3$&*'tffi-rffiHfiHf;tgt--r rr*oFrHErRF,NcrroNs,MAy BNTER TJPON ANY LAND AND MAXE EXAMINATIONS AI{D ST]RYEYS AND PI-ACB AI{D MAINTAIN TIIE NECBSSARY MONIJMEI{TS AND MARKBRS TIIEREON. REQUIRED INSPECTIONS FOLJNDATION INSPECTION: To be made after excavations for footings are complete and any required reinforcing sreel is in place. UNDERGROUND PIPING INSPECTION: To be made after all underground piping has been -installed, prior to any ta*mt. - 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 insta[J, 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 rougtr-in ls in place, prior to being covered FRAMING INSPECTToN: To be made after the all framint, rlre trocun!, bracing and roof are in placl and all pipes, chimneys and vents are completeand the 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 GYPSLM BoARD INSPECTION: To be made after 8ll lathing and gyp#b"rrd, interior and exterior, is inplace butbefore anyplastering is applied or before gypsum boardjoints and fasteners are taped and finished. ADDTTTONAL rNsPECTroNs MAY BE REeIITRED, such as bur not limired ro; BLoCK WALL: To be made after reinforcing is in place, but before any grout is poured. The inspection is required for each bond beam pour. Therewill be no approval until the plumbing and elecnical inspections have been made and approved. FINAL MECHANIC'A'L INSPECTIoN: To be made juit prior to the structure or r"-od"l"d area being occupied and prior to operating any equipme*LFINAL PLUI\aING INSPECTI_ON:-To be made jrsiprior to the building, structure or remodelod rea being occupiod.FINAL BLJILDING INSPECTToN: To be made after finish grading and tt " uulaing, structure or r€modeled area is completed and ready for occupancy.MoBILEMANUFACTURED HoMES: An inspection it t"A;;'"ft";t" mouite tome is connected to an approved sewer or sepricsystem, prior to covering sewer or water lines, for setback requirernens, blocking, tiedowns and plumbing connections. Footings and piers to comply with State formdation requirements for mobile homes or as recommended by the manufacturer.Minimum finished floor elevation shall be certified when required by Floodplain Management Tiedowns, if required, shall be installed and ready for inspection witirin go iuys aft.r oJcupancy. Tiedowns shall be installed per enclosure. APPROYAL REQTIIRED No work shall be done on any part of ttre building or structure beyond the point indicated in each successive inspection without first obtaining theapproval of the building official' such approval shall be given only after an inspection shall have been made of each successive step in the oonstruotionas indicated by each of the irupections required. APPROVED PLANS MUST BE ON TIIE JOB SITE AT ALL TIMES DURING WORKING HOLRS.TTtrS PERMIT WILL EXPIRE IF WORK DOES NOT BEGIN WTHIN I8O DAYS, OB IF WORK IS STOPPED OR ABANDONED FOR MORE TIIAN I8O DAYS.SUSPENSIoN oR REvocAfioN MAY occuR IF TIIIS PERMIT wAs rsstpo oN rgr sAsli -oF tr'.LoMpLETE oR ERRoNEous rNFoRMATroN. Ar\rYoNE PROCEEDING PAsr rHE PorNT oF REQUTRfuD INspECTroNs wILL Do so AT THEIR owN RrsK. Your signature on the front of this form verifies the followinS, I YAYP CAREFULLY EXAMINED Tttrs coMpLETED AppLICAfioN and dohereby certify that all information hereon is true and correct, and that I have a legal inter_est in ttre property as owner of record or authorized agent. Ifurther certify that any and all work performed shall be done in accordance wittr the oroin-"", of t* iounty and tt " t"*, o.ia" State of oregon per-taining to the work described herein. I further certify tlnt if I am not the owner of the profirt)a -y."git "tion with the Builders Board is in full forceand effect as required by oRs 701.055, and that if eiempt the basis for the exemptio" ir not"i iio*nl-a tnot onty subconrractors and employees whoare in compliance with ORS 701.0O5 will be used on thelob. SUBSURTACE & ALTERNATIVE SEWAGE DISPOSAL SYSTEMS: When subsurface construction is-complete, the permit holder shall notify the County Land Management Division by submitting the installation recordform' An hspection will be made by a qualified sanitarian. If construction complies with all rulEs u ortiric"tu of completion will be issued to the permitholder' If construction does not complJr with rules, the permit hold". trut" "otin"d, and all correcti*r rft"U be made before a certificate of completionwill be issued. Failure to meet satisfactory completior, *itt in th" allotted time constitutes a violation of ORS 454.605 to 4il.745and this rule. SUBSURT'ACE SEWAGE DISPOSAL SETBACKS SEPTIC TANK DRAINFIELDFrom: Interior property lines l0' 10' Edge ofroadright-of-way l0' 10' Building foundation 5' 10, Wells or other water sources 50, 100, Exlstlng Buttdtngs or lmprovements on Property H HouseE\arnE GarageE lr/obfle. Homel-l Shed . SEPTIC INSTALLED EEI yes l-r No Wrter Oistrictl(o:nbac,- nol xma la Itma !3 J CITY zlP (it zi-- * Please comptete alt lines inside white boxes, if possible. 74s 7.{?7 ean ?(, MAP, PARCEL NUMBER(Found on trr mrp! ln th. A.363mrnt & TuEtion D.pL)k#c#,#* .?a/ ffid'-iE. ffi ffi rZEiii,- ffi r5Firtii-'Itans.- S;ilil- rTf$6iiEi- -f-Ei- ' Dlrectlons ,o srtefrom Courthouse 5+ ()n14 N. )l J+ -/o{ SITE ADDFESS MAIL TO Cr*l ) 7 For Moblle Home Placement Only Brand No. of Tip-outs - License # - Year Size Land Management Dlv. staff can not be held responslble for evaluatlons or recommendatlons based on false, lnaccurate orlncomplete lnformatlon lt q ADORESS rbovc) TRS, TL Job Locatlon (Add PermLt # Pernlt Pernl tlt 2 B t Ore on 97477 For PernLt # Pernlt Permlt ForPlot Plan For For For For Subdivision Lot Block z# TANK FENCE e!| o" t^ L---r y5 i\o{1b J.oIr11r ) I \ o $ U tU \ il-o 3l'^ 6" 60:0" l'{q ()q aiaa :C; t ot N E > (Dt a 5a Nu)x tr., ?o Bq o n7&-1 5n Vlcinlty Map DT C€NTER oF 2/ sr. STREET ( TRS, TL Job Locatlon Pernlt /I Pernlt Permlt 2 d Or on 97477ForPlcrt Plan For Pernlt # Pernit #- Permit For ForForSubdivision Lot For Block 2 FENCE 1'- O" - x-x,r TANK I SEP a<._( t \orlb t-- _ il-o 3 t:-6" I kq <)ka Baa a- q kl1\ E oy5 :r iF! J.olr\lr- ) o \h I \ CENTER oF Zl sz STREET )a l.<. (5t a{ ao l'- R<C 60:o"t O'. r:74- 1 qn Vlclntty Map N .- -r - U tUt\ t't l::. r... t"l Ioo a t 9.ta c :t I a :::80:3':j t iiF'R i I{fi ii [r "!' t'.i t" i" t... .1. r_,ANI' iirAi.-, iiriifii,i i"''|:\r'lE r-:ilLiNl'r oH[,k *"il[l*ti*l;ri;. "i'i'i...il f i!{-13:144:.:i:jrJ:}{..} i :itj*ii j:U i{i:tJ EL.}t; 'I Ti}[: i-iiiir l;i F].itti.l;i t] ili'l i:l ;i' i:r+ i i'lilfi j:[::;J' ilHl',{fiH llHE: iii:r:ii..., iilii.r:rii i\liiili :;t:::[ifi iq"iltl$[. 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