HomeMy WebLinkAboutPermit Septic Tank 1992-06-25l)66-rZT)
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REOUEST
FOR:SEPTIC SYSTEIq VERIFICATION
2585 uJEST 11rH AVENUE, EUGENE, oREGoN 9744?J
NAM
I have carefully read BOTH sldes ol thls appllcatlon and hereby certlly that all lnformatlon ls true and correct
DAIE
SEE ATTACHED COPY
READ CAREFULLYI Your Authorlzatlon ls Based On The Followl Condltlons
APPBOVED BY:DATEFEES DUE: $
CALL FOR TNSPECTIONS (SEE BACK OF FOBM FOR TNSTRUCTTONS) 687-4065
SEPTIC permlts are good for one year. ALL other permits expire after 18A days unless lnspections are current.
-T1"34"H'tiurH 14tn pLACE, spRINGFIELD, oREGoN
EXISTING SINGLE FAIqILY DWELLING AND GARAGE
rto. oF sroilEE t{o. f ilPLoYEEg
TO 5?NoI RIGHT OVER RR TRACKSI RIGHT ON 54TTI
ARTHUR & BETH STUBBERFIELD, SAME AS THE JOB ADDRESS ABOVE
OWNERS NAME & ADDRESS
SAME AS THE ABOVE
coNii^croR NAME osn ucEx{gE,
15 0018a2c6.
PR IVATE USE
NO. OF 3EDR@TA
7 q6-9977
SAIqE
NA NANA
coNalBucflota coaT/YALUE
PHONE
PHONE
STEM VERIFICAT 0
SPR I NGF I ELD TO MA I N STREET I
LACE, G
ARTHUR STUBBERF I ELD
- VIOLATIONS
SETBACKS AND OTHEII CONDITIONS OF APPROVAL MUST BB STRICILY OBSRVED. VIOLATION CAN REST'LT IN REVOCATION OF THIS PBRMIT.CITATIONS MAY BB ISSUBD LTNDER THE PRoVISIONS OP LANB COLTNTY'S INFRACTIoN oRDINANCB AND/IOR OTHBR REMEDIES ALLOWED BY LAw.
AMINIMI.'M OFATLEAST24 HOURS ADVANCENOTICE MUST BE GIVENFOR INSPECTIONREQUESTS
Ilave the following information ready when you call: 687-4M5
Permit number - Job address - Type of inspection required - When it will be ready
Your name and phone number - Any special directions to the site
powERroENrERU,.NLAND. ,o"oi#*lioR1ffio1*'3FliHfiBiffBH&H"tffi[ffiI3HI3lifl'*H-.r**oFrHErRF,NcnoNs,MAy
ENTER I,'PON ANY LAND AND MATG EXAMINATIONS AND SURVBYS AND PLACE AND MAINTAIN TIIE NFCESSARY MONI,'ME}ITS AND MARIGRS THEREON.
REQURED INSPECTIONS
FOLJNDATION INSPECTION: To be made after excavations for footings are complete and any required reinforcing steel is in place.
UNDERGROLJND PIPING INSPECTION: To be made after all underground piping has been installed, prior to any backfill.
CONCRETE SLAB OR UNDER-FLOOR INSPECTION: To be made after all in-slab or under-floor building sewice equipmen! conduit, piping
accessories and other ancillary equipment items are in place but before any concrete is placed or floor sheathing hstalled, 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 rough-in is in place, prior to being covered.
FRAMING INSPECTION: To be made after the all framing, fire blocking, bracing and roof are in place and all pipes, chimneys and vents are complete
and 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 GYPSUM BOARD INSPECTION: To be made after all lathing and gypsum board, interior and exterior, is in place but before any
plastering is applied or before gypsum boardjoints and fasteners are taped and finished.
ADDITIONAL INSPECTIONS MAY BE REQLIIRED, such as but not limited to;
BLOCK WALL: To be made after reinforcing is in place, but before any 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 remodeled area being occupied and prior to operating any equipment.
FINAL PLUMBING INSPECTION: To be made just prior to the building, struchre or remodeled area being occupied.
FINAL BUILDING INSPECUON: To be made after finish gradinC and the building, structure or rernodeled area is completed and ready for occupancy.
MOBILEMANUFACIURED HOMES: An inspection is required after the mobile home is connected to an approved sewer or septic
systemt prior to covering sewer or water lines, for setback requirements, blocking, tiedowns and plumbing cormections.
Footings and piers to comply with State formdation requirements for mobile homes or as recofllmended by the manufacturer,
Minimum finished floor elevation shall be certified when required by Floodplain Management
Tiedowru, if requted, shall be installed and ready for inspection within 30 days after occupancy. Tiedowns shall be installed per enclosure.
APPROYAL REQTIIRED
No work shall be done on any part of the building or structure beyond the 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 step in the construction
as indicated by each of the irupections required.
APPROVED PLANS MUST BE ON TTIE JOB SITE AT ALL TMES DURING WORKING HOURS.
THIS PERMT WILL E)(PIRE IF WORK DOES NOT BEGIN WTITIIN I8O DAYS, OR IF WORK IS STOPPED OR ABANDONED FOR MORE THAN 180 DAYS.
SUSPENSION OR REVOCATION MAY OCCI'R IF T}IIS PERNtrT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS INFORMATION.
AI''IYONE PROCEEDING PAST THE POINT OF REQLIIRED INSPECTIONS WILL DO SO AT THEIR OwN RISK.
Your signahrre on the front of this form verifies the following: I HAVE CAREFULLY EXAMINED THIS COMPLETED APPLICATION, and do
hereby certify that all information hereon is true and correct, and that I have a legal interest in the property as owner of record or authorized agent. I
fiutlrer certify thal any and all work performed shall be done in accordance with the Ordinances of Lane County and the laws of the State of Gegon per-
taining to the work described herein. I further certify that if I am not the owner of the property, my registration with the Builders Board is in full forie
and effect as required by ORS 701.055, and that if exempt the basis for the exemption is noted hereon, and that only subontractors and employees who
are in compliance with ORS 701.005 will be used on the job.
SUBSURFACE & ALTERNATIVE SEWAGE DISPOSAL SYSTEMS:
When subsurface construction is complete, the permit holder shall notify the County Land Management Division by s'bmitting the installation record
form' { irspection will be made by a qualified sanitarian. If construction complies with all rules a certificate of completion will be issued to the 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 compietion
will be issued. Failure to meet satisfactory completion within the allotted time constitutes a violation of ORS 454.605 to 454.745 and this rule.
SUBSURFACE SEWAGE DISPOSAL SETBACKS SEPTIC TANK DRAINFIELDFrom: Interior property lines l0' 10'
Edge ofroadright-of-way 10' 10'
Building foundation 5' 10'
Wells or other water sowces 50' 100'
Erlstlng Eulldlngs or
lmprovements on
Property
EIHousetI BamEl Garage
E tr/lobile. Horne
E Shed
SEPTIC INSTALLED
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Wat€r Districl
atl llnes tnstde whlte boxes, lf posslble.
OvYN€n OF PRoPERTY (ll ml m. r. .boY.)
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Dlrectlons to slte lrom
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TIAP. PARCEL NUMBER
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For Moblle Home
Placement OnlY
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Land Managemont Dav. rtarf can
not be held responsible lor
evaluations or recommendationt
based on false, inaccurate or
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