HomeMy WebLinkAboutPermit Demolition 1978-10-05lt,
l2No. & JJno. Sr.I1 bTRS, TL Location
Written Directions
Subdivision:Gle ru AcREs Privo t rvs
uot la Btock
-
SITE FEASIBILITY REPORT FOR SUBSURFACE AND ALTERNATIVE SEWAGE DISPOSAL
APPLICANT'S NAME AND ADDRESS CnlnLes GrurE !? Crrurrrirulal l-ooP, EucErrrE. 9?hOl
OWNER'S NAME AND ADDRESS Gleir Dri*r ?0 Gn ru (!axs Dir VE
Mail report to ()iaAppticant ( ) Owner
STRUCTURES NOW ON THE PROPERTY
PROPOSED USE OF PROPERTY DvEi-t nrc
WATER SUPPLY Rl t iir:ov tr,tar r:r D t sr.WITHIN ONE
I hereby certify that the above statements are true and accurate,
contrac,t purchaser; potential buyer; i){ realtor
record, and that said owner is aware and approves of this action.
certify that (if not
TEST HOLES READY q-?1 -?B Signature
p6sng 3}lq-q8:n
errone 68.9-8o9f
( ) Prefer to pick up. Call
Puuprr0us[ To tiE DEhr$Lls]lED
, etc.) when ready.
(NO)
-owner
of record;
to act for the owner of
and that I
or agent. I
have !owing
am authorized
Date g-Pl^1,1
F THE CITY O
in the
* r * oFFtcE usE oNLY BELOW THIS LINE . * *
ITS t,F
75
e
E STANDARDS E DOES NOT MEET STATE STANDARDS.LAND USE COMPLIANCEiiiZoning
i:t Zn "A *tfi nfr,
U
IZED SIGNATURE DATE
Division of Water Pollution Control
LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
c55-??
Acreage or Lot Size
Partitioning
(TOTAL)
( ) ComPleter
fi)f Pending
Parcel #-
THIS IS A PBELIMINARY BEPOET WHICH DOES NOT ENSUFE THE ISSUANCE OF A FUTURE BUILDING PERMIT. ANY PLANS OR EXPENDI.
TURES MADE IN RELIANCE UPON THIS REPORT ARE AT YOUR OWN RISK. IF SITE IS APPROVED, SEE REVERSE SIDE.
JEAN OTSffiffiUN lo-0r-73
I DATEAUTHOBIZED SIGNATURE
Permit Processing Section
125 EAST 8TH AVENUE, EUGENE, OREGON 97401 687-4061
,.r.u -1,{'"-i/ i'
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LANE COUNTY NEPARTMENT OF ENVIRONMENTAL MANAGEMENT
125 EA- dTH AVENUE, EUGENE, OREGON 9 I
PIANNING DMSION Current Zon
Partltlonlng l_ f]Rendins
Parecl No._
D^rtltl^hlhd I red
}l^?EN POLLUTION CONTROL
I.e Slt. In3pcctlon(.)
lols
AVERAGE PROCESSING
ted
6DS Conatructlon lJ Uey
Nulrb€r ol Bedroomsr.
Conncrclal,/Industrlal -
Othcr
J--'l Reoalr
I of Enrployee!_
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tl CONSIRU TION PERI4ITS AND INSPECTION(Seo abovc lor I of bedrooms,/f of enployeee)
E] :,bbllc Horoo'
tl permanenr
tr Temporary
t] Renesal
Structu16
FEE
TotaI Vtluation S
. Plurnbing fixtures at t
_ Sewernater Conn. at 9
al StEt. Surchargc
Plana Check Fee
Change of Occupancy
ltlnlnruro rtructura I I backg:
Froo centerlinc o!reets Front
Frolo lnt.rlor
PUBLIC
sq. Ft. valuatl
Each S
llach 3
TOTAL BUILDING PER}'IT FEE
U
6)F'
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Exterior Slde_
Iincs: Side_ Rear
tl
E
fl
f cono'l pI aheet to appllcant I CurU cut to appllcant
PUBLIC IAN tr Addresa t] Minimum Elevarion
tr Faciltty perrnit
c'd TOTAL S
APPIDAVITT If thIE permlt
ricu I tuuill be used for aglor no other
E}IV
Cat
thla appliea
purPose.tion are
for an agricultur.l bu11din9, I he reby declare thrt thiB bulldlng
I
purpolres as allowed by zoning and/or the state Bullding Code, andr certify that the statemcnta and other informatlon submltted ontrueaccurate, and that I have the following legal intercst In the
opttonproperty:oljne r of record;cont.ract purch.Eer i lesgee i holder of an excluclveto purchase,d uly authorizeif-Eo act for ! person wE6-hag the Elflowing legal lnterestr
am no
or th.t the oerer of record is knowl edgeable of thiaovner.further agree y with all 1c Ie codea relatlnt
kE acunty
to thls permlt.
, .ut -4_-2/-/_.79 Applicantra Signature 464df
1 THIS IS YOUR RECEIPt, AND DOES NOT GIVE YOU PER.UISSION TO BUILD.
TOR INFOR!,IATION A.BOUT THE PROGRESS OF YOUR APPLICATION, CALL PERMIT CONTROL, 687-'357 (687-IIELP'
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Eleva
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ll.6rc lrlnt - Rcr rm Applltatlon t,'
L...It lonlrt Lltcrr Cr.nl,lel r.d
@NTRACTOR
Alfolntnn.It Dxlr.
- AppLlcATl o N orrrce rrrc
'nrv*"*@:' ffi2f;! -15,,.,. s{.r - Tido'
^Dp,{riss*_ _ _€a^27-zAu-arr_e_1*;i ;;_;-;iA} r,i__e t
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Aot)l t s:i
TIIoNE
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fl rtetL c()!u'r.l.Tril) mRHlr rot-Jl. PnESENT USE OF tRor'ERTY (
- _ _. __coN'rtA(l'r()N's oRE. STATE Llcl:NsE
ER/corrt croR ((:lRcL[ oHrll -J pRTFER To prcx ul.
rerld.'ntlal; type of fnmlng; cot@rclcl or indutrl.ti vacrnti ctc.)/Z a / tlo
2, DESCIIBE STRU(:TURES NOU ON TIIE PROPIiRI'Y, NOIE ANY S]'RUC'TURES tO BI: DEMOLISIIED.,lt/L aruE l/rtrPTrr---?-4--'atz 5,42b
THIS PROPERTY (TIIlS APPLICAT )
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4. EUTUIE I't.ANS:--_-_
5. PLOT rLAJ{, Sketch (a) aIl roads (b)
proposed seage dlsposal(g) easeoents (h) dralna
r 1nd[strlal, shry frees
borndarles of propert!, (c) exlstlng/proposed bulldlngeareas (e) exlstlnB/proposed vells (f) extstlng/propose
8eeys, streaN, creeks, any ocher pertlnent fertures.tandlng si.8ns, parkln!t srees. INDICATE DIHENSIONs.
(d) extattng/
drlveuayt
comrclal
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StTT: INSI,ECTION TEST ITOLES READY (DATE)
l'N(),,0Sil) t,li\ Il:R St'l',,t.Y
Il.t(:Tlr IcIT1', r'r'Rr,i I :irtil) BY
Lr[_Lt._ st.RlN(;.__ Sl.t(t:AH LAK!:
EYTA
}iATURAL (;AS BY
l lRl: l)lliTH l( r
sc[o()1. DrslRlcT
PL[I}iD IS(; BY
Ittttt.trtttrttttrttrrr...tr..r. D0 NtlT U-RITt: BEl,Uii TlttS LINE trrrrirrrrtttrrttrttrrrt.rrtrrl
EETORI: YoUR AI.PI.IGll IoN ()\N BE rIOcESsED YoU MI:ST TTr}NISH: ..---__8!xI I PLoT T,LANS LEC^L DESCRIPTIoN
(DI MENS lOri t:D)
,4_6 1.9_f -- ___ __ D.\rr:7B
ldne carty
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LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
125 EAST 8TH AVENUE, EUGENE. OREGON 97401
NA TT
EY.ffiIt
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'r# 78- ? /9
LOCATION: TWP.RANGE SECTION /?
ZONING:PROPOSED USE:
SIZE OF PROPERTY:/Dooos?f|'t AMOUNT US$LE AREA:
WATER SUPPLY:CO}TIUNITY PUBLIC
SUBDIVISI0N/PARTITI0N 6leilon 1"."s
SITE EVALUATION WORKSHEET
/F
IF SITE },IEETS STANDARDS FILL OUT:
Type of st,ruct.ure and approximat.e se\^tage flow:
CJ TAX LOT #
Ril
4ll
INDIVIDUAL
LOT I2 BLOCK PARCEL
ItuIti-family
Conrnerc ia I
8Pd
Single Family
Indust.rial'
tso gpd/#,,
cPd
8pdcPd
MINIMUM DESIGN REQUIREI.{ENTS :
Length of disposal trench required
Discribution l'let.hod: Equal
Curtain drain required: Yes
Other:
lfo *oc 75 lnoo/ f/.
Institutional
1750 BaL,x r1Se aI fl
no .El
SPECIAL SITE CONSIDERATIONS OR VARIANCE OPTIONS OR OTHER ALTERNATIVES:
DATE OF EVALUATION:tr/",/ 7l
NAI"[:
DQC
Q"^ 7,'rl e
I
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c7 4- 126
StJon 7{
)lti
#Z EST HoLE#t TEST OLE
PERCIIED WATER PROFILE
Pre dic te d
Observed
Da te
1 n lnch
1n
L2
24
36
48
60
SATURATED ZONE q,
Predic t.e d
Obsc. rved
Date
1n
In <"
e
"7
I,o
to
Re striccive Layer &inImpervious Laye-r @iaflott ling -r**, V &O - i.,
S LOPE o/
PREDICTED WATER
Predic red
Observed
Da t,e
In.
]-n.
SATURATED ZONE
Predicte d
Obse rved
Dat.e
1n
Restriccive Layer _in,Impervious Layer in,
Motcling 1n,
SLOPE o/
PROFILE
Inch
12-
24-
36-
48-
60-
xSITE DOES DOES NOT MEET MINIMI.]M STA}IDARDS.
ADPIINISTRATIVE RULES REQUIRE A I'IINII'{IJI'j DEPTH oF:
36 inches E.o an impermeable layer
30 inches Eo a resEricE,ive layer
60 inches to a perrnanent water table
24 inches E,o a cemporarily perched !.rater table
OTHER REASONS FOR DENIAL
ON YOUR PROPERTY THE DEPTH
I./AS:
inches
inches
inches
inches
PLOT PLAN:
Stream
--h-.i-l^-Drrrinagc or
pond
Road
Test Hole @
\ % SloPe
Cut Bank
//t tlr
Fe nce
x-x
S* pL+ M^p Aof tl
t
a\
T
tr
T
tr
1n
s.l. #
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TRS, TL
Subdivision
b.
B lock
SITE FEASIBILITY REPORT FOR SUBSURFACE AND ALTERNATIVE SEWAGE DISPOSAL
Job Location
Written Directions
Lot ,4.
APPLICANT'S NAME AND ADDRESS Phone
OWNER'S NAME AND ADDRESS
-
Phone
(owner, etc.) when ready.Mail report to (' ) Applicant ( ) Owner ( ) Prefer to pick up. Call
IUCTURES NOW ON THE PROPERTY
gLL I ItPROPOSED USE OF PROPERTY
WATER SUPPLY
I hereby certify that the above statements are true and accurate, and that I
contract purchaser; potential buyer; realtor or agent' I
record, and that said owner is aware and approves of this action
TEST HOLES READY
WITHIN ONE MILE OF THE CITY OF (No)=-
have lowing legal interest in the property:
-owner
of record;
certify that (if not the owner) I am authorized to act for the owner of
Signature Date
* * * * * * * * t+ * * * * * * * * * * * * * * * * x xQfFlCE USEONLYBELOW THIS LINE ** * * * * * * * * * * * * * * it * tt * * * * * * * *
SITE: E MEETS STATE STANDARDS E DOES NOT NNEET STATE STANDARDS LAND USE COIVIPLIANCE
Zoning
Acreage or Lot Size (TOTAL)
U4 Partitioning
( ) Completed
1 ) PendingA
Parcel #
-
THIS IS A PRELIMINARY BEPOBT WHICH DOES NOT ENSURE THE ISSUANCE OF A FUTURE BUILDING PERI\4IT' ANY PLANS OF EXPENDI-
TURES I\4ADE IN RELIANCE UPON THIS REPORT ARE AT YOUR OWN RISK. IF SITE IS APPNOVCO' SEE REVERSE SIDE'
AUTHORIZED SIGNATURE DATE
Division of Water Pollution Control
LANE COUNTY DEPARTMENT OF ENVIRONT\4ENTAL MANAGEMENT
c55-32
AUTHORIZED SIGNATURE
Permit Processing Section
DATE
125 EAST 8TH AVENUE, EUGENE, OREGON 97401 687-4061
4.&.!1o
(1
(OAR Chapter 340, Division 7, Section 72-020(61: This report shall remain in effect until issuance of apermit to construct, unless in the meantime conditions on this or adjacent properties have been altered inany manner which would prohibit issuance of a permit, in which case this evaluation report shall be con-sidered null and void' Technical rule changes will not invalidate any evaluation report isued pursuant tothis section.
Before construction is started bring this form to the Department of Environmental Management and applyfor a building permit. Exact specifications for the sewage disposalsystem will appear on th; permit.
lf the property is only a portion of a tax lot, a partitioning or subdivision must be approved before thepermit will be issued.
Only persons having a valid license issued by the Department of Environmental Ouality under ORS 454.695to install subsurface sewage disposal systems or an owneror contract purchaser or his regular employeesmay install subsurface sewage disposal systems. A certificate of satisfactory completion will not be issuedif persons other than the above perform the installation.(.
LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
PIANNING DMSION Current Zon
Partltlonlng l_ f]eending
Parccl No._
P6rtl t lon lnq Requ i, red
Other
ntTEA POLLU?ION CONTROL I of S
DlcY Slt. Inspectlon(.)
6DS Conltructlon l--'] uen f] nepalr
Nunb€r of Bedroomst
Comcrclal,/Industrlal - I o! Ernployeer
Other
AVERAGE PROCESSING
ted
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CONSTRUCTION PERMITS AND INSPECTION(See abovc for I of bedrooms,/l of enployeea)
t] :{obrt€ Hot!€'
t] permanent
t] TcmPor!ry
t] RenewalStructur6 '
FEE
Sg. Ft. Vsluatl
TotEl V!luatlon S
, Plumblng fixtures at g
_ Seyery',,iter Conn, at t
Each S
rach 5
Address tr ttinlmun Elevltion
Pacillty Permit
.Y\
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oF'
ory,
al
al Stata Surcharg.
Planr Check Pec
Change of Occupancy
TOTAL BUILDING PERHIT FEE
Ittln lrnr.rn t truc turr I
Froo centerlinc of treeL; Front
Froo lntorlor I
Exterior Sldo
lines: Side-.- Rear
f Cono'l pla aheet to appllcant fl CurU cut to appllcant
PUBLIC
PUBLIC
u
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EMv
C6rh ChrcL-
AFFIDAVIT: If thlsuil} be used for agr
(--,
permlt
lcultu
c'd TOTAL S
for an agrlcultural buildllng, I hereby declare th.t this buildraPurPose!t as allowed by zoning and,/or the state Bulld ing Code,for no other purpose. I fu r certi,fy that the statemcntg and other intormation submltted onthlr application are true accurate, and that I have the following legal interest in theProPerty: _ometo purchase, d o act for a person wE6*hag the
r of record;contract purchaser;lessee;holder
E6fIowing
lng
and
of an exclurive opttonIegal lnterest:
Ie codes relatlng
462nt7
lffE colrntyuly authorl.zei[-t,
aPDIlcati,on,lt I am not thc owner I further agree
; or that the orrner of record ie knowledgeabte of thig
c y uith allto thls permlt.
rxlr. ?/ z// "8 n/Applicant'a Signature
THIS IS YOUR RECEIPT, AND DOES NOT GIVE YOU PERIqISSION TO 8UILD.
TOR INPORMATION ABOUT THE PROGRESS OT ']R APPLICATION, CALL PERMIT CONTROL, 5I
Addresg
l.{Inlmurn Elevation
'57 (687-HELP)
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l...fi lontrt tltr.rr Coq,lel r.d
AFPL
ADill( l:ss
otnl[r ( IF Dlrtt.l{t:NT)
AU)rtss_._.-
@NTRACTOR
APPLICATIO lv8y elaeLEJ H.6uadDz,ur craz -&6?_uZ___PHONE - ,.
"-{? -6.?o z4*-w-/_49* kq
Offlcc tlE. Only
3{,t - ?4do'
,t,, - 81_6EgE- r.tr.._.? 7 ttO /
l,loN f,
LIP
A}nolrrnx.ilt Drtr
PHONE
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or{iADDIESS_n _. _. --CON'rRA(:rl)l'S ()RX, STATE LICt:NSE
l.l^ll. c()rtlt.[.Tltt] rrRHtT To
I. PIESE]{T USE OI IIi()I'ERTY
ER/coNrR.t,cloR ((:lr{cLE oHrll I I'I(TFER TO PICK UP, CAI.L
tl!li typs of fAmlngi co@rclrl or lndutrlrti v.c!nt; etc,)
)
^RE:
,S 'b t dt{t c,trrt -6aZ,udarl)
f ,c dt"p 7
(rcrldcn
op4
2. DESCRIBE STRU(:TURIiS IiOU ON TIIE PROPIiRI'}. NOTE ANI S'I,RIIC'TURES TO 8T: DEHOLISIIEI)
*{4C-b- - - _Ts- _ _&-E___ _aut S.r'E)
ouE t/*1 P \
FUTURE I'r.ANs:- _ _,.firjli!.A1 5/A^;-_
5. PLOT TL}J{Sketch (a) oIl roadg
proposed silEte dlspo(g) easeoenrs (h) dr
or lnduqtrlal, shou f
(b) borndartee of propert!, (c) exlsting/proposed bul).dlnga (d) exlstlng/sal areas (a) exlstlnB/proposed velrs (f) exlstlnB/propoJed arir""iy"-"''alnaSseys, streaB, creeks, any other pertinent f"itures. rr co,,,"ailia1reestandlng clgns, parklng areaa. INDICATE DIMENSIONS.
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SITE II,iSI,ECTION TEST TIOLES READY (DATE)
I'li()ltosIt) lJi\ n:R sl'l.t,t Y
il.t:(:lNIClT'r fl'RiitsIII) BY
liATutr.Al (iAs nY - , _-.
flRI: lrlSTRr(-I
lrr.Ll. _ st'R lN(; _ S].Iil:AH t.At(E NAft
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SCIlOOl. trl51 RICT
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EEfORt: loUR Al'Pl'lC 1 loN (tr'N 8E IROCISSED YoU ]'lLlsT ]'l"rtl\ISBr .____.E\xl I PLoT ILANS LEGAL DESCRIPTION
(D I MENS IONT:D)
ldne currty
fl6{+tr I)l'r u 7B/
LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
125 El 8TH AVENUE, EUGENE, OREGON L _11
8Y-6nIr
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IHXIDIATE Pl-Ar-S FOR THIS (Tlils
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LOCATION: TWP.RANGE
RA
IF SITE MEETS STA}IDARDS FILL OUT:
Type of structure and approximate sewage flow:
ltulti-family
ConrnerciaI
8pd
cpd
SITE
r
MINIMUM DESIGN REQUIREMENTS:
Length of disposal trench required
SIf 7
UATION T"IORKSHEET
TAX LOT #
4ll
Single Family
Indus tria I
Ins t, i tu t iona 1
A{o il Of 75 1,.*/ f/
/7SECTION
R*)
CJ
ZONING:PROPOSED USE:
SIZE oF PROPERTY: /D 00 0 sPf| $AI'fl3TJNT US$LE AREA:
)so gpa/,4J,oo
8Pd
gPd
/150 gal.
Distribution Met,hod:
Curtain drain required:
Other:
Equal fil t:]
.El.
aISe ri
Yes No
SPECIAL SITE CONSIDERATIONS OR VARIAI.{CE OPTIONS OR OTHER ALTERNATIVES:
DATE OF EVALUATION:
t(,4T 7L
D O C 3tJon
btglolc
NAME:
c7 4-126
7{
I.TATER SUPPLY: Co}o{lJNITY 6 PUBLIc Ef INDIvIDUAL ll]
SUBDIVISION/PARTITTI 6/enclon Ac,'s LTTIZ BLOCK PARCTL
sl#
HOLE
#7 TEST
lnchBOLE#t TEST
lnch
24
36
48
60
t?
24
36
48
60
12
to"
q,
7e
"7
lo
strictive Layer _in
ervious Layer _in
SATURATED ZONE
SLOPE o/
in
ln
IN
i-n.
EDPREbrcr
ttling
ifl.
Predicted
ace
se rved
DaLe
Predict'ed
,Observed
Rcri Lrictivc L.ryer &in
Impervious Layer -N in
Ilottling --2a,", \* 66t ',
Dace
S LOPE o/
In
ln
in
in
PERC IiED
SATURATED ZONE
WATER
Predicced
Observed
Date
Predicced
Observed
SITE DOES DOES NOT MEET MINIMIJM STANIDARDS.
ADMINISTRATIVE RULES REQUIPC A MINIMIJM DEPTH OF:
36 inches co an impermeable layer
30 inches to a restrict.ive layer
60 inches to a permanent, \^rater table
24 inches to a temporarily perched water table
OTHER REASONS FOR DENIAL
ON YOUR PROPERTY THE DEPTH
I{AS:
inches
inches
inches
inches
PLOT PT.AN:
Stream
-.*rarfrr
Drilinage or
pc-rnd
Road S* ?L+ M^p /,of tl
Tesc Hole @
\ % SloPe
Cut Bank
77'T1'.7-T
irence
x-,