HomeMy WebLinkAboutPermit Miscellaneous 1988-03-17Ueg- {r'ft,a 8^A 3 -Lgg
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Written Directions
Subdivision:
Lot- Block-WATER SUPPLY
APPLICANT'S NAME AND ?2r73 -ff{?
OWNER'S NAME AND A Phone '-%€
STRUCTURES NOW ON THE PROPERTY PROPOSED USE OF
above statements are true and accurate, and that I have the tollowing legal interest in the property: owner ol record;
-contract
purchasel;
-potential
buyer;I heTeby certity that the
rr( realtororagent.I further certify that (if not the owner) I am authorized to acl lor the owner of record, and that said and
TEST HOLES
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SITE MEETS STATE STANDARDS
Standard System
Sand Filter
1 Foot Capping Fill
YES NO
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YES NO
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Low Prsssure Distribution
Holding Tank
Other
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LAND USE COMPLIANCE
Zoning Acreage or Lol Size---OOTAL)
)Completed
) Pending
Partitioning #--Parcel #_(
q* 2:---
C Approximate
Study Area
FLOODPLATN I NFORMATI ON
All or part of this site may be in a llood hazard
area tor which 100 year flood levels have not
been established. Extra precautions may be
appropriate to assure that the building site will
be reasonably safe trom flooding.
All or part of this site may be in a flood hazard
area for which 100 year llood levels have been
established. A building elevation above the 100
year flood level may be required.
All or part ot this site may be in a flood hazard
area in which a lloodway has been designated.
Building may be prohibited subject to
demonstration that the cumulative etfect of
proposed development will nol increase the
1 00 year llood level at any Point.
tr Detailed
Study Area
THIS IS A PRELIMINARY REPORT WHICH DOES NOT ENSURE THE ISSUANCE OF A FUTURE
BUILDING PERMIT. ANY PLANS OB EXPENDITURES MADE IN RELIANCE UPON THIS REPORT D Floodway
ARE AT YOUR OWN RISK. IF SITE IS APPROVED, SEE REVERSE SIDE.
LANE COUNTY DEPARTME
c55-32
7
DATE
PUBLIC WORKS LAND MANAGEMENT DIVISION, 687-4061 , 125 EAST 8TH AVENUE, EUGENE, OREGON 97401
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COMMENTS:
ilEilO
TO: APPLICANT
FROilI: LAND MANAGEMENT DIVISION
SUBJECT: CONDITIONS OF SITE APPROVAL
Any alteration of the natural conditions in the area approved for the on-site system or replacemenl 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. Anysuch 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 benefit subsequent owners.
Only persons having a valid license issued by the Department of Environmental Quality under ORS 454.6gs to install subsurface
sewage disposal systems or an owner or contract purchaser or his regular employees may install subsurface sewage disposal systems.
A certificate ol satisractory completion will not be issued if persons other than the above perform the installation.
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