HomeMy WebLinkAboutPermit Septic Tank 1978-12-05. POST THIS PERMIT ON MAIN BUILDING AT SITE
J6B ADDRESS: 2518 North 21st, spriogfield, ore8pn CONSTBUCTION PER[4|T +3825-78
TRS, TL: t7-on-24-4.3 * L07 Subdivision:
This permit Ior the referenced property is hereby approved. Setbacks and other conditions of approval must be strictly observed. Violation can
resuli in revocation of this permit, citation under provisions of [-ane County's lnfraction Ordinance, and/or other remedies allowed by law.
Applicant/Address: Louise Peebl-er, 2518 North 21st Springfiel-d, Oregon 97477
Owner/Address: same
Contractor/Address:/
Contractor's OS +r I Total Construction Value:
Telephone: 747-BZLB
Telephone:
Telephone:
Repair fail-ing system
Structures now on property: house and garage.
Water Supply:+r Bedroomsi na + Plumbing Fixtures:,.,,+ Empl oyeesna
PLANNING DIVISION Zoning: na Partitioning + na Parcel +
lVlinimum required structural setbacks, from: centerline of road, front:
side exterior: n6 ; interior property lines: nairear property line:
Speciallnstructions: NONE
na
na
na
Parcel Size
; centerline of road,
na
For information call 687-4394, Donna Lee Meigs
WATER POLLUTION
CONTROL DIVISION
Site lnspection +t na lnstallation specif ications: 1000
156 lineal feet of drainfield required; max. depth of trenches: 36"
Septic Tank
gal. min. septic tank capacity;
Setbacks
nterior Prop erty lines 10'
Special lnstructions: Insta1l an equal distribution system with 3-50 1ines. Lines
are to run in an east-west direction on the south end of the back yard
Drainfield area. Stay i-Ot from the house and property 1-ines with al-l parts of the*-lO- drainfield,
I eage of road right-of-way
Building foundation
Wells, other water sources
10'
5',
50'
10'
10'
1 00'For information call 687-3962 between 8:00 - 9:00 a.m.,Greg Gray.R. S.
CONSTRUCTION
PE RIVIITS/INSPECTION
DIVISION
Type of Construction: ,r,lnstructionsr NONE
For plans information call na
For inspections (see back of this pe
Group:na Fire Zone: na Use Classificatioqg,
between 8:00 a.m. and 9:00 a.m.,
rmit) call 687-4065 between 8:00 a.m. and 5:00 p.m.
lane county
Directions to Site
Date lssued:
c55-1 3
Mohawk Exir from I-5 rurn left to lgth/folIow Yo1anda to 2l-st,
By: Greg Gray, R,S.12-0s-78 BE,A1II[=|.j:I?5U=J[r3]S=#J1TMANAGEMENT 1 r' ---
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
0!'.-
Construction approved by this permit:
)
DEPARTI1ENT OF ENVIRONI4ENTAL I'IANAGTI"]ENT
PSB, I25 EAST BTH AVENUE
EUGENE, OREGON 9740I
Ci tv
Recei pt #
Job Address
Township, Range, Section, Tax Lot
a,
Appl icatioti t
Assigned Numbe^s
X- 4-
Subdivision LJ A.Lot Block
e'f )App I ication for' ,
Structures now on the Property
Proposed use of property: 17 Residential 17 Conrnercial
Affidavit: I,
p eaSe print
If this app
Lane County
lication is for an a gri cul tural bu lding it wi1
Code Chapter l0 (zonln g) and for no other PurP
/_/ Industrial /_/ Public
hereby certify that this informat.ion is true and accurate
'l be used for purposes allowed by the State Building Code and
ose. I have the following legal interest in the property:
le ssee; holder of an exclusive option to purchase;
bl e of thi s appl i cation.owner of record;----duly authorized
contract purchaser;
to act for the owner, who is knowTEEgea
S i g na ture/Addres s
Te1 ephone or Date
When permit is ready notify: /] Applicant /-/ }wner /-/ Contractor !a: /-/ mail /_/ phone
Owner
Con trac tor
z'l
zip)
Phonc
Phone
Contractor's 0SR#
If Commercial: # of stories
Residential: # of bedrooms
SI test holes ready
Fee
Code Descri pti on
# of employees
--
# of units
SDS: ry fxisting, AP #
17 Proposed, SI #
Uni t
Cos t
Plumbing by
Sq. Ft. or
# of Sites Fee
$
$
Total Valuation: $
Plumbing fixtures at $
Sewer/water conn. at $
4% State surcharge
Plans check fee
Change of 0ccupancy
$
each $
each $/:/ ta<h
yl{/ Check *
Received by
Su btota I
TOTAL $----
$
$
$
$
PERMIT PROCESSING Zone part. #
Minimum setbacks t, front t, side
Parcel #Parcel Si ze
Da te
int rea r
Comments
To be typed on permit
By
I,JATER POLLUTION CONTROL itooff,^^*'lnstal'l ation speci fications
a(
To
/go ft dra i nfi td;
By
x of trenches
c
be typed on
' zAr.-P*
permi t
Te epho te
Directions to site
/-/ stFo Pl ans to
i_/ ceq-
/-/ vtPC
/7 Planning
/*/ Public Works
, Elevation /-/ nla
/7 Address
/-/ f aci 1 i ty Permi t
/- / Envi ronmental Hea l th
CP& I
I.JPC
set
set
Da te
Requ i red
Hold Slip
to PCC
Da te
Compl eted
Da te to
PCC
o)
Valuation
c
L
f;tccipt #
Job Address
Tax Lot
A
Appl ication for
Structures now on the property
.llt,lorca ur of prop.rty:
Affidavit: I
If this appli
L u-a Se
Si gnature/Address
DEPARTI{ENT OF ENVIRONI4ENTAL I4,ANAGEMENT L-
PSB, ]25 EAST 8TH AVENUE
EUGENE, OREGON 9740I
e._
Clty
tt
cation is for an
/--l 0rx$ercirl /l ln$ttrtrt t-t *atx
hereby certify that this 'information is true and accurate.
cul tura bu lding it wil'l be used for 'l lowed by the State Building Code andl0(zonl ng) and for no other purpose. I have ng legal interest
pu rc 'lessee;holder of an exclusive
to ac owngr,le of this application
4,5't 477
Te1 ephone a47-f etE or te
€r !x
(zip)
/_/ rrall
purposes a
the fol lowi in the property:
option to purchase;
xR\
I'lhen permi t i s ready noti fy: l4tSpp l i cant
ovner k.u. st- \kb\lj*omer l7 contractcr
PJbe)
Contractor
Contractor 's 0SR#Plumbing by
z'l Phone
If Conrnercial:
Residential:
# of employees _I of unltr
SOSI /-J Existing, BP #
! Proposed, SI #SI test holes ready
fGt ,
gdr Sq. Ft. or UElt
# of Sttcs Catt Va'luati on Fee
Y
$
$
Tota'l Valuation: $
Plrrstng flxturer at $- each
Smr/rrter cqnn. at each $
Su btota I
$
uff
iFf ca*r t *\
Recei ved $
V,/ATER S UPPLY;
P R C POSED
YE
EXISTING
4% State surcharge
Plans check fee
Change of 0ccupancy
Parce'l #
$
TOTAL
PERMIT PROCESSING
Minimum setbacks:
o
Zonetfron t
Part. #Parcel Size
; t, side i nt.rear
Conments
To be typed on permit
By Da te
CP&I I
To be typed on permit
Group Fire Zone Use Classificati
By Date
PhoneFor p lans information call (area 'inspector)
-. Directions to si
Lt stro PIans to
i-/ cP&
ann i ng
fl Public lJorks
f7 Elevatton /-/ nla
l7 Address
/:/ Facility Permit
l7 Environnrental Heal th
CP&l set( s )i.lPC set(s)
Da te
Requi red
\?--L3
1d Slip
to PCC Compl eted
CJ
Date to 3,\6+
PCC
c74-L7 I
4
SuMlvlsion Lot
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-
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(
1.\.3
TRS, TL
Subdivision
Lot
Plcrt Flan
Job Location (Add
Pernlt /l
Permit
Permit
For ll
Pernit /l
Permlt
For
For For
For For
)
Block I
I
c74-L50
Vlclntty Map N
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W
Te(lao
stA
-)4-/.3 4 /o Job Location (Street, mile post fio oTRS, T
lock
-
Plot PIan
FOR SANTTARIAN'S USE ONLY: ffi System Approved fJ System Disapproved tl Needs Correction
COMIIVIENTS: i.il
ULAdD A
ul
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2
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frqrt>3t
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S nature
FOR INSTALLER'S USE: Trench Deptlt 3tl:t Filler Depth Below Tile
Tank Capacity lOtO6au Manufacturer Mrc tl$E&
IVleasured distance to well from tank NIA from drainfield pln
Date:
(t'
ClRs Feros I
sa
Lrlt-
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IIJtrff:
Xo6,4.-+
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e(!Partc
INSTALLATION RECORD AND CERTIFICATE OF SATISFACTORY COMPLETION
When signed by the County Sanitarian, this certificate is evidence as per ORS 454.665 of sat-
isfactory completion of a subsurface sewage disposal system at the above location.
Beturn this form to: Permit Processing Section, Department of Environmental Management,
Public Service Building, 125 East 8th Avenue, Eugene 974O1
11
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N c55-1 1
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POST THIS PERMIT ON MAIN BUILDING AT SITEl,
JOB AoDBESS: ..r.. ,j i.. CONSTBUCTION PERM lT #
TRS, TL: l, .: , , : .r Subdivision:
This permit for the referenced property is hereby ... -.. - Setbacks and other conditions pf approval must be strictly observed
result in revocation of this permit, citation under provisiona oI Lane County's lnlraction Ordinance, and/or other remedies allowed by law.
Violation can
Applicant/Address: Lmt*r kfot*r" t51E xarth f,l*t tprd**fiald, or:fmOwner/Address:
Conii."totlAddress: ]ffi
Contractor's OS + 'l Total Construction Value:
9I47?
h*a rnd Elr*rgr"
Telephone:
Telephone:
Telephone:
Construction aPProved bY this hfir *rl.Itag rrree&ffirrw lrfr oa F@p*!ttl
Water v
PLANNING DIVISION
+ Bedrooms:+* Plumbi Fixtures:+E
Zoning: Partitioning + Parcel +
IVlinimum required structural setbacks, from: centerline of road, front:
side exterior:
Special lnstructiontf
; interior property lines:
sffi{u
rear property line
Parcel Size:
-:t ; centerline of road,Ril
|l*
Is
For information call 687-4394,
WATER POLLUTION
CONTROL DIVISION
Site lnspection +
lineal feet of drainf
. lnstallation soecifications: HIS gal. min. septic tank capacity;
Blt required; max. depth of trenches' 'L*special lnstructions: rfist*ll m *Erildl #,etr{br*ta w*t*u utth }-t{,} Il&ffi.IJms
Setbacks
I nleiior property lines
Edge of road right-of-way
Building foundation
Septic Tank
10'
10'
5',
50'
Drainfield--10-
10'
10'
100'
rrsl & rr & m rlilt-ililt. dl,a*mi*r il t&* laeillh a* ef t-k brch tril.a... lttg IO' tb Eh tor. au{ prunq:t ltm ;tgf, rtt p.rE e} rUft-lrltrld!
Well other water sources
CONSTRUCTION
PERMITS/INSPECTION
DIVISION
For information call
Group
between 8:00 - 9:00 a.m.,
Fire Zone Use Classification:Type of Construction &I {lt ESlnstructions
For plans information call between B:00 a.m. and 9:00 a.m.,
For inspections (see back of this permit) call 687-4065 between 8:00 a.m. and 5:00 p.m.
lane county
Directions to Site
Date lssued:
ftea*. Gntt fm X*5 tnu: lrft to l?thrfiltlry Yalrnd. ta ll't.6l!'
-
Bv:
DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
COURTHOUSE / PUBLIC SERVICE BUILDING
125 EAST 8TH AVENUE, EUGENE, OREGON 97401c55-'13
12*S5*r$
For
c74- 150
Vlclnity Map I\r
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