HomeMy WebLinkAboutPermit Septic Tank 1989-12-27GBS flvL Fte
REAUEST
FOR:
I have carefully read BOTH sldes of thlr appllcatlon and hereby certlfy that all lnlormatlon 13 true and correct
DAIE
READ CAREFULLYI Your Authorlzatlon lr Based On The Fol Condltlonc
DATE /z-27 _//FEES DUE: S APPBOVED BY:
CALL FOR TNSPECTIONS (SEE BACK OF FOFM
SEPTIC permlts are good for one year. ALL other permlts expire alter 180 days unless inspections are current.
TBUCTTONS) 687-4065
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VIOLATIONS
SEIRACKSANDOTIIERCuTDITIONSOPAPPROVALIIUSTEBSTRICILYODSE$/@. VIOLATDNCANRBSTLTINRBVOCATIONOPTHISPtsnMlT.
CITATIONS MAY BE nlSIjED T'NDBR THB PROVTTSIONS OP LAT{B COT'NTY'S TNFRACTION (XDINANCB AI{D/ON. OTHE NBI{EDIBS AII'WBD BY LAW.
A MINIMUM OF AT LEAST 24 HOURS ADVANCE NOTICE MUST BE GIVEN FOR INSPECTION REQTIESTS
Ilave the following information ready when you call: 6874C65
Permit number - Job address - Type of inspection required - When it will be ready
Your name and phone number - Any special directions to the site
powER.roENrERU,oNLAND. '**iH,!li"ll1ffi.#3ffi3?AH*:lfI&1"1ffi'#[3HIi]itfi'*?--t**oFr,,,npu*crlo]irs,MAyEI{TER T'FON ANY LAND AND MAKE EXAMINATIONS A}ID SI'RVEYS AI{D PLACts AND MAINTAIN THE NBCBSSARY IIONUMENTS AI{D MART@RI| THEREON.
REQI.'IRED INSPECTIONS
FOLJNDATION INSPECTION: To be made after excavations for footings are complete and any required reinforcing steel is in place.
UNDERGROUND PIPING INSPECTION: To be made after all undergrormd piping has been irutalled, prior to any backfill.
CONCRETE SLAB OR UNDER-FLOOR INSPECTION: To be made after all in-slab or under-floor building sen ice equipment conduit, piping
accessories and other ancillary equipment items are in place butbefore 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 plurnbing rough-in is in place, prior to being covered.
FRAMING INSPECTION: To be made after the all &aming, fire blocking, b,racing and roof are in place and all pipes, chimneys and vents re complete
and the rough electrical, plumbing, and mechanical inspections have been made and approved.
INSULATION INSPECTION: To be made after all inzulation and vapo'r barriers are in place, prior to covering.
LATII AND/CR GYPSITM BOARD INSPECfiON: To be made after all lathing and gypsum board, interior and exterior, is in phce but before any
plastering is applied or before gypsum board joints md fasteners are taped and finished.
ADDITIONAL INSPECTIOI.iS MAY BE REQIITRED, such as but not limited to;
BLOCK WALL: To be made after reinforcing is in place, but before my grout is powed" 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 INSPECTION: To be made just prior to the structure or rernodeled area being occupied and prior to operating any equiprecrr
FINAL PLUIUBING INSPECTION: To be made just prior to the building, stmchre or remodeled area being occupied"
FINAL BLJILDING INSPECTION: To be made after finish gradirg and fte building, strucnlre or remodeled area is completed md ready for occupancy
MOBILEMANLTFACTURED HOMES: An inspection is requircd after the mobile home is connected to an approved sewer or sepic
system, prior to covering sewer or water lines, for setback requirements, blocking, tiedowru and plumbing cqmections.
Footings and piers to comply with State foundation requirernents for mobile homes or as recommended by the manufacturer.
Minimum fhished floor elevation shall be certified when required by Floodplain Management
Tiedowrs, if required, shall be installed and ready for inspection wittrin.30 days after occupancy; lf,iedowrrs shaU bE installed per e,lrclosure.
APPROYAT, nnqurREn
No work shall be done on any pafi of 0re building or structure beyond ttre point indicated in each successive inspection without first obtaining the
approval of the building official. Such approval shall be given only after an inspection shall have been made of each successive stqr in the corutruction
as indicated by each of the irspections required
APPROVED PLANS MUST BE ON THE JOB SITE AT ALL TMES DURING WORKING HOURS.
THIS PERMIT WILL EXPIRE IF WORK DOES NOT BEGIN WTTI{IN I8O DAYS, OR IF WORK IS STOPPED OR ABANDONED FOR MORE I}IAN I8O DAYS.
SUSPENSION OR REVOCATION MAY OCCIJR IF TTIIS PERMIT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS INFORMATION.
AI\TYONE PROCEEDING PAST THE POINT OF REQT,IRED INSPECTIONS WILL DO SO AT THEIR OWN RISK.
Your signature on the front of this form verifies the following: I HAYE CAREFULLY EXAMINED T[trS COMPLETED APPLICATION and do
hereby certify that all information hereon is true and correct, and that I have a legal interest in *re property as owner of record or authorized agent. 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 Oregon per-
taining to the work described herein. I further certifr that if I am not the owner of the property, my registration with the Builders Board is in full force
and effect as required by ORS 701.055, and that if exempt the basis for the exemption is noted hereon, and that only zubcontractors and employees who
are in compliance with ORS 701.005 will be used on the job.
SUBSURFACE & ALTERNATIYE SEWAGE DISPOSAL SYSTEMS:
When subsurface construction is complete, the permit holder shall notify the County Land Management Division by submitting the installation record
form. An inspection will be made by a qualified sanitarian, If constnrction complies with all rules a certificate of oompletion will be issued to ttre permit
holder. If construction does not comply with rules, the permit holder will be notified, and all corrections shall be made before a certificate of completion
will be issued. Faihne to meet satisfacto,ry completion within the alloued time constihrtes a violarion of ORS 454.605 to 4Y.745 and this rule.
SUBSURFACE SEWAGE DISPOSAL SETBACKS SEPTIC TANK DRAINFIELD
From: Interior property lines l0' 10'
Edge ofroad right-of-way l0' 10'
Building foundation 5' l0'
Wells or other water sources 50' 100'
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USE INK ONLY t(
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FOR INSTAL
Tank CaPacitY Manufactu Total Length of
Measured Distance from Well to Tank From Drainfield
COMPLETE THE FO LLOWING IF A PUMP WAS USED ON THIS NSTALLATION
I (installer's certifY ata (Mrg')
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(Model No.)
and Mercu Switch No.)have installed with this
Signature
FOR SANITARIAN'S USE ONLY:(system APProved tr System DisaPProved I Nes6.
COMMENTS
gal./daY Signature
Date
Date
INSTALLATION RECORD & CERTIFICATE OF SATISFACTORY COM PLETION When sig
disposal
by the County Sanitarian, this
dence as Per ORS 454.665 of satisfactorY completion ol a subsurface sewage 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
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Public Service Building , 125 E.8th Avenue, Euge ne, OR 97401 of the
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