HomeMy WebLinkAboutPermit Building 1978-5-11
~ "
.... ./,
.? '",..:-
. ... .?~
oms; TL~
;,,,0 ~\""",
Subdiyi5ion:
'/
..... '.... /.!-
/
, -18.,.<(2-06.4.2
/
TL #700
Job Location
Written Directions
3200 ST ro JASPER lG'lEI.L RD
31.DJ'
S,I.#~B- ~,-.:-;,
GARDEN OA.VENUE
,
i
~;;
r
SITE FEASIBILITY REPORT FOR SUBSURFACE AND ALTERNATIVE SEWAGE DISPOSAL
b
NANCY flv,^""" . . 1125 SAVII.J:E
/'
/'
NANCY ~
7-2112
/
/ '
.. WATER SUPPLY , , WIiT'HIN ONE MILE OF THE CITY OF (NO)
,.. ,I. her~bY certify that the above statements ~~ true~c:iac~urate, and that'l h;vt;he following legal interest in the property: owner of record;
contract purchaser; potential buyer~ X.x.... realtor or ag7nt, I further certify that (if not the owner) I am authorized to act for the owner of
"record; and,that said owner!s aware and appro'Ves orttiiS'action, , , J ~,
TEST HOLES~c;,...-... \ /Signaturp ct av. c.... d,/l. 9--- Date '--~\ \ \ \ i \h
\ .} , r ~ , '"
\ . . J Y
* * * * * * * * * * * * * * * * * * * * * * * * \ * *OFFICE U~E ONLY BELOW THIS LINE'* * * * * * * * * * * * * * * * * * * * * * * * * * *
\ / '
SITE: IRI,MEETS STAT.E STANDARDS 0 DOES NOT MEET STATE STANDARDS,
~~'f~AEr' 4-A _.-'~
l.;/~'~ 1 ~ J. I t~~WfV[CF-
,'!V ~ ~~,A ~ r ~t ~~
r. ~~~(tJO'r~~f~,~,
(7L, /'t-~c.f'''~ r~ k-~e:6\
THIS IS A PRELIMINARY REPORT WHICH DOES NOT ENSURE 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 AP~OVED, SEE REVERSE'SIDE.
~~"'- )~
'-- AUTHORIZED SIGNATURE
Permit Processing Sestion"
125 EAST 8TH AVENUE,EUGENE, OREGON 97401
~,
f,
,
"
f
~
NA
Lot ..
Block
EtJGI'NE VN:A>U'
APPLICANT'S NAME AND ADDRESS
OWNER'S NAME AND ADDRESS
LEROY TAYIOR
8619S
\
Mail report to ( ) Applicant () Owner
(X) Prefer to pick up, Call,
NClilE
.UCTURES NOW ON THE PROPERTY
r,lOBILE HrnE SITE
PROPOSED USE OF PROPERTY
r'~ WELL
v:J -?/~~
AUTHORIZED SIG'NATURE
l,.-'
Division of Water Pollution Control
6-.s:: 7 f'
DATE
LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
C55-32
. '~__"''-'_~~''''--J_ ._~~, _'._
. r___''_.,____.:._n _~__.__'___~~__">~__L_c__ ___.
SOOTH ro END OF IAUREL
688-1099
, Phone
, Phone
(owner, etc,) when ready,
.'
NA
,.-t:"Af'J D-V~COMP LI ANCE
Zoning \.. ~ J.( ~ \ "\ "
Acreage or Lot Size"-="v:.,, "JL~ (TOTAL)
Partitioning ifF~~ ( ) Completed
~- C ^ ( ) Pendmg:,
Parcel #=-- ' \ )'-.)
S\\\
DATE
687-4061
II
OAR Chapter 340, Division 7, Section 72.020(6): This report shall remain in effect until issuance of a
permit to construct, unless in the meantime conditions on this or adjacent properties have been altered in
any 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 issued pursuant to
this section,
Before construction is started bring this form to the Department of Environmental Management and apply
for a building permit. Exact specifications for the sew.age disposal system will appear on the permit.
If the property is only a portion of a tax lot, a partitioning or subdivision must be approved before the
permit will be issued,
Only persons having a valid license issued by the Department of Environmental Quality under ORS 454,695
to install subsurface sewage disposal systems or an owner or contract purchaser or his regular employees
may install subsurface sewage disposal systems. A certificate of satisfactory completion will not be issued
if persons other than the above perform the installation,
"
,
,
~
'~
,"~
~,
.
.
D_ ,
',-;
.
" ..
_._,....-~.- &,..
"
.'
,
~'...
-,'-...'j...'!;;,~~~.",,,,-"'.~.8':.''''IF~.,;:;:''Ji..1oW:",,,,,,,,,,,'~.i.Al~...~W;:.L''a.o~~I'.~''A;i:o.L'l";., . ,.;rl.,,,,;.."~:J~..~........:.:.;:~'~ ',,,, "_..,.;.IOJ...:t:S~~~~.J";_t:o:'~l~"'
'''.,-,~,,-~,.
.- ---..,..... ,.
N.W.I/4 SE,II4SK06 "t18 S, R.2Wl1lM. -
LANE COOtlTY
18 02 06 . f
)
IS. - eOl.I.
:=; THIRO ADD, TO MEADOW
't': 'ooo....._,j.~ GREEN ESTATES FOURTH ADD ~ ~ -
~ _ TOMEAPOW I ~ 1
. s.: , OOICE GREEN ~ ~ lOt . . ~_,._
~~"""~.~ STR ESTATES ..~. ~~, . ,.~~. ~
: >000 1~ ... ''"'''' 1 :- t15' En~. ,... .~ "~7 ~ l'w<-,oil''':-~
........~ u "'0 ~ i 1700 Ti"" . l G?.o- ''\..~ 'ut l l
noo z " 3..... '-:E1 IQ',:'; I' I' ~ .. '~, - "i~~'"";'''' ~ )
,'8 "'" , ). -"---. 'It -':>:UJ" '7" ,.
~..: '" ~ MOl ~'_' '400 :'i \_1:0 1~:}9 to-- _ -~ ----- 1:..~':~\)'" ~4t s -~. i :.
in<>' - '_ ". 1-1 ~il i'rQ-"7"-i"'~.I1,t:~-;-.-:~~-" '1
~ ='r Q: ~fii"'" '.. om . ~ '00 .
~ ~A;,.' . at'\ """""';~..... ...
.... '-''') '/ -' ~ [' ..:::.-
'-' ~.,. 'l;" '~.' ,~-- -- / - ,'-
___ l)i, ,,.. liS " ,.. .,~.. ..
. -- c .-~- ., '-J ';J: /1 i 'I -
_ ARDE" : I' ... ~ ..... _ .~oII3 ~
~~J"":'~ ~-.:. ,~:: - - 1t::'~'-~~flD"'-:S:~ADr..;r~: I)
;i I' : - ~~ J-~ ' . '"'' ':,ii".'
l,l I - -;:-2DJ ,"2 ~r~ ~, -
r _' _0" - "p..h\E.: II I .
. I \ "'Ie -~;;" '~ I ~ 8
I;'~ . . 11~~..: ~ 8
1"1' I. ~ sr - ': .
. ~ - .
!~ -I~l-- ;
(.100-
~
..0
-
"
I
.-
"
...
. .
i,
\oJ
019..28 <I)
20
'l;"
i! ~'
, l (!)
I
"-
~I
,-
/ ..
t'X
~
A
,
\
.
I~
~
It -
, ,
.~:
~
:t
t-
...
~
a::
::lo____
~-
I-
--=
---
~ 1
I.
, j
Ill>
::>
,j I 'i
, ~--:-w>-,' ,
...,. I'
h
I..... I
------',.....-
i
I
~1'~
"
-
.'
I'
; ,
:~-:
,
, ~ ..
~----~~~.J I~o-
...........
I I ~'-'~-~-2
~u..l - -
.
-
-
--
Plat
Plan
Job Location (Address) n.f.I dJ-/~ .)'Pr;J -h;;..,'/ Qr
Permit II'\'O~~ FOG~ r"J~,V Permit 'II For'
Permit II For Permit IJ For
Permit II For Permit II For
T'f..s " T!-.-I-f -020 ro (/2 -#=-- '7&0
Subdivision
Lot
Block
.
I'
""
"
""
'"
J.1.t._4...t'I--Lo,
, -
..
4
3
~~
-
N
\ficinity Map
C74-150
SIt
# 1 T EST H 0 L E # 2 T E S T H 0 L E
PERCHED WATER PROFILE PREDICTED WATER PROFILE
Predicted in. Inch Predic ted in. Inch
Observed in. Observed in.
Date Date
12 - ~a/kM.,/ 12 - i.&
~'(/
SATURATED ZONE SATURATED ZONE
Predicted in, 24- Predicted in 24 -
Observed in, Observed in
Date Date
Restrictive Layer ~'
Impervious Layer /Y in,
Mottling '>Ifrw.... in,
SLOPE #f %
SITE DOES ~ DOES NOT
ADMINISTRATIVE RULES REOUIRE A MINIMUM DEPTH OF:
- -
0 36 inches to an impermeable layer
0 30 inches to a restrictive layer
0 60 inches to a permanent water table
0 24 inches to a temporarily perched water table
OTHER REASONS FOR DENIAL
fb.Q1 PLAN:
Stream
- ...........-
Drainage or
pond
.. t........"...,.
Road
--.--
Test Hole QD
~ % Slope
"
Cut Bank
';~;i~'
Fence
.
.K-K-X
.
36 _
36 -
"6 ~~; Restrictive Layer ..u.rt
48 _ / .. ---, - fupervious Layer A. XV - in
Mottling ~. in
"
48
~~
60~_
SLOPE ~ %
ti
60
,
o
MEET MINIMUM STANDARDS.
ON YOUR PROPERTY THE DEPTH
~:
inches
inches
inches
inches
r~~~-~.. ,......,....~'
, r.,.!. t. -t...t
! : . . . r" ~ I . .
l,' ';:;;:1':1 '1<:--:': ,:;,1<1:; ,:,:J;':!;~' , i
I . j, , : , .': t I, : ': '" ': j 'J44t:" . 'ft "
I ...... +-~ t,......l r ~;;;L
i " ~ ~ ... , ~ ;, . " ., ~ ... ,. ." t '. I .
, . , 1-. ~,t... i t (}-4- ,.... . 1 . . r I . I .
-,.'; r;~~-;-t-l' . ' 'M1 ; ! It~, +--;~, l;-;-:-7-:- ,I ,-~:-:-- 1-- ~, . '-1
, . ... I',' -1-' -I ~ . .' '. -, . . : 4' . . -r . . I... . -; I +, , ...,
.. " 'i -, -; t',l 1 1'- ... .t t. ; I. t....
;C~t ~";-+::~r ~+l ,.t~.i
, ,j 't. j. 1 1 ' '1 " " -' 1;-
; 1-' . -... t .' '" +, -, ~ ~ t. j- ,~. t . t. t' 1
1-. .~. .--t+ '~.Il::,t ....t,.I~.r+ .,........
~
~~--T- ---~'~.I-. - ..
, . : ~ . -t I: :. I .
"
j:
. - ) I ,
1 '
1'-"--'"
l.',
L.___
I
t"'," ,
1 ./ "1
~
, '
, '
, ,- :--:-,-T+-:-'
'-'.; i" "I .
- t-... ~ " . J . .
~ . ,- '" t . ... ' . ;
" j 'r'- I t ->. t-t' t ;--t: t t . It..
I ~' '....1'" + + . , ~ ~ ,I, +..- ! f ; + .;. ,. . ~
.. .. I l- -+ + -, t ' t ' .~ .. i 'i ~
~ j .,...,~.... j..... Ii.. ....... 1 . t, - I : : ~ 1 l ~ +. t'
. i .j t ~ . ~ t.. If J... . ~ , , T t... t .' +
. -... 't . ....- l- t. 1-" . I J ,-... 1"+ to. . 'r 1 t -.-... ... . .
'; I" . j:,/,!' t' \,:,+'1',', ,ij'[ ",1- , ",' j t' 1 l, ,Ii
" , - .. + . , ' .. ~ . , + ! : l' 1 + . --t l + .f. ~ 1 ~ : '
---;.--1--...-
tit . . I ,,' ~ -~, _ ! ~ .. t ~ . - + II .. ~ ~ --+ : i; - : ! i
j .: ->. . L r-t ~ t . - - I .. t . '- r ' t.- + 1 .... + + j
,; ..i~, ;'II;l:l r:~,,1.. tl::1L~t:..;J ""'1::,.'1'
.' ".1.,,1,,: ...1 [',ll1-:'"'t'l '." .,1"1""
. l ~ . + ... t t" t-, . ..l... 1. + I- t - + ..' -->-.!...' I . J , ,-
. - '- I -. I . . .1,:. .j.... t. 1 ... -> ..., 1 ,I .... . i j
. . t + .. I'" t . .1- ~ . ..- + ~. I '- '- l' , I
_ ~~_: ~~:J,.._t_~C_L~11J ~~~~l___~_ '_Lll . ~.~
" '
.1.-
t. ,
t \ I!
,
i I
I"!
., ,
,
,
L _ '_0<
.,
SI# Tf-[;,<if.2.
SITE EVALUATION WORKSHEET
LOCATION: TWP. If' RANGE ()2... SECTION bJ(2- TAX LOT # 7c'-O
ZONING: PROPOSED USE: S-r=J)
SIZE OF PROPERTY: - AMOUNT USABLE AREA:
WATER SUPPLY: COMMUNITY D PUBLIC 0 INDIVIDUAL IJ?J.
SUBDIVISION/PARTITION LOT BLOCK PARCEL
IF SITE MEETS STANDARDS FILL OUT:
Multi-family
Commercial
gpd
gpd
Single Family
Industrial
:;J<ro
gpd
gpd
gpd
Type of structure and approximate sewage flow:
Ins ti tutional
MINIMUM DESIGN REQUIREMENTS:
Length of disposal trench required
Distribution Method: Equal 12SL..
Curtain drain required: Yes 0
Othe r:
/.5-0 ~ P
(/
Serial D
No CZL
/150 gal.
SPECIAL SITE CONSIDERATIONS OR VARIANCE OPTIONS OR OTHER ALTERNATIVES:
NAME: Vi ~ DATE OF EVALUATION: 6if:7F
t/ .
C74-l26 ,
. .
.... .:~
If' (")2 ofo If.2 -=tI'.?CD
~ ;l ~" sf..-
L-.
~e.Y C6~
Job Location I'J-Ff ,!J.J~ k/ _c;/r'j Jja-/~ Or.
,jill'.R'" ,L,~ /kif .5,., u .u J... ~.df t!Y -:Jt?~ ~ - ) ef~O ~ dhJak
INFORMATION SHEET I ~Q{'i ..f'- SJ /"/"-J-
Oe> IlL<... 4ra.., a....
~ite Feasibility Study for Septic Tank. Number of sites_/
TRS, TI
Written Directions
) Building Permit
Acreage or Lot Size ") tL-rA ~ Test holes will be ready
Partitioning #_rYl- 3/.<, 77 ( ) Completed Subdivision
""j?4J'ending _
APPLICANT'S NAME AND ADDRESS II;) ~ . \d ,J: i4 ~~! ~
OWNER'S NAME AND ADDRESS, if different from a licant's .i/~\J 7;/0"', S'ro/?,p..,,'1~ v. ./' I
CNTRACTOR'S NAME AND ADDRESc; ,
~' permit or results of site f~ibility s}>,~ toj?4-.ApPlica~ ( ) Owner ( ) Contractor.
-refer to pick up, Call -4n...ri ~...r lowner,etc,) when ready, Contractors 0, S. #
(,f,,/-:J.II:2...,
STRUCTURES NOWONTHE PROPERTY -y'!r>h P_
PROPOSED USE (this permit) 1fl/J h: Ip ~
WATER SUPPLY P""'IlOrP.-I) (,1.),.../1
I
Lot
Bloc~
Phone~ -:-d) 91
Phone ~4't:. - 3 ';'0
Phonp
.s,. If"
l'~
,~
(existing or proposed well, etc, If public, name of system!
SEWAGE DISPOSAl
(pxisting or proposed septic tank, etc,) S.1. '"
PLUMBING BY
..,AA.l
Address
) PROPERTY IS WITHIN ONE MILE OF CITY L
S/' r I"V) :/; e.../'/ )
*******************************************OFFICE USE ONLY BELOW THIS LINE ************.*********************iI-*****,***,*
.) New Address Necessary ) Facility Permit Necessary
ZON'" SETBACKS: Front Side Facing Street
(FROM CENTERLINE OF ROAO)
) Special Permit Area,
Minimum Elevation:
I nterior Side Yard Rear
(FROM PROPERTY LINES)
To: Planning/Building Inspector/Sanitarian/Surveyor.
This applicant appears to have a problem with
Your assistance will be appreciated.
By
Permit Processing Section
ResponsP'
CSS,12
By
DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
Permit Processing Section
125 East 8th Avenue
687-4394
r'livision
\
\
\