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Home My WebLink AboutPermit Septic Tank 1984-8-30 (2) .... ! &NGE -- TOWNSHIP / ? S~BDIVISION/PARTITION t:J3 / (if applicable) ;:l~;3, 3 OF FOR OFFICE USE ONLY Appl~ca tion/ /) / L / "1-.p-/ L Perm~ t # ~ r/ t? () c.r o Two Copies of Plans o Three Copies of Plot Plans o Mech/P 1 umbing Checklis t DLegal Interest Document o Plan Check Info Sheet . LOT/PARCEL BLOCK Jt!fl ././'.YJ PROPOSED USE OF PROPERTY o/~~A1"~~. ~eside.ntial 0 Industrial 7// 0 Commercial D Public. . ~ ) ./ d/./ / -? "'4 -k~~~:A?~ ~- :~ k~ -- ~BE~4k- ~:i~.) TA~ ;7;;;;~ - # OF~~ WATER S~;;:-Y'- - ..~~'~/.&-~ ~ /Z?9 ~~~-/~ eO~OR'j,~~DOS~!r ~~~~ - ~- .;/;;; ~/CJ ./ ~'// ~~~ /4./~ ~~/ 7~ T BE MAILED TO- ~P'A~ ./ _ r - ~~/ /'~ ~ ...../'~~ - ,r I HAVE CAREFULLY EXAMINED THE COMPLETED APPLICATION FOR PERMIT, and do hereby certify that all information hereon is true and correct, and that I have the following legal interest in the property: []owner of record; []contract purchaser;~uthorized agent with evidence of authority attached. I f~rther 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 pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without the permission of the Building Division. I fur- ther certify that registration with the Builder's Board is in full force and effect as required by ORS 701.055, that if exempt the basis for exemption is noted hereon, and that only subcontractors and employees who are in comp' e wit ORS 701.055 will be used on this project. I HAVE READ AND CHECKED THIS PPLICATION THOROUGHLY. ~py 4[re-#L -, NAME (please print) DECLARED $ VALUE -= ~./ :J Proposed I Existing TELEPHONE NUMBER 32:?- f/?7' NUMBER' L~UL'lD.t..K ~ - r B,..3tJ-$1Lf DATE ..J. . [] PLANNING/ZONING: READ THIS SECTION CAREFULLY. YOUR AUTHORIZATION HAS BEEN BASED ON THE FOLLOWING CONDITIONSl zone;& / C C ~t' Minimwn se~~~L,~./? -;.v? .;"7 erJ.or "''''''"'', 7' U:? /:?"'~.&d.d' /' ~~~ ~4'L~ , ,. . r-/ .., - -" - - Partition # Parcel # Parcel Size d/ /4' " rear Date: 8-e-?~-cf;Y ~ ~ANITATION: S. I. # ~ ~Installation Specifications: Gallon Tank Lineal Feet of Drainfield Installation Record Issued? DYes D No Maximwn Depth ~ P:;~"h"~f' Date: ~:3/d?f" _~I B. P. # COMHENTS:~ , /~ALLr J~ F4 ~~.<.. ~A '1 ; . [] PLANS EXAMINATION: Type Group Use COMHENTS: Date: n , TOTAL VALUATION $ CONSTRUCTION AUTHORIZED BY THIS PERMIT Description Sq. Ft. Fixed Fee'! Unit Cost Floodplain Subsurface Fee Fees TOTAL FEE ___ L";t> 0'- p-p $ $ ,<;,,:," C $ $ $ $ $ $ $ ~ ,,~~ - ~ -~~ ~)~- ~I.(/ ~ /G r: j?-:JJ_J7c/ ~ PERM~~OVED~BUILDING aJF~CIAL/DESIGNEE (per ORS 456.805(1)) .~ LANE COUNlYDEPARTMENT OF PUBLIC WORKS LAND MANAGEMENT DIVISION, 687-4061, C 14- 25 125 EAST 8TH AVENUE, EUGENE, OREGON 97401 SEE REVERSE FOR INSPECTION INFORMATION // . -. ~~/ -7 Building E'ee l-1ech/Plmbg Fee Plans Check Fee State Surcharge DEQ Surcharge e e ~ , SETBACKS AND OTHER CONDITIONS OF APPROVAL MUST BE STRICTLY OBSERVED. VIOLATION CAN RESULT IN REVO- CATION OF THIS PERMIT, CITATION UNDER PROVISIONS OF LANE COUNTY'S INFRACTION ORDINANCE, AND/OR OTHER REMEDIES ALLOWED BY LAW. WHEN READY FOR INSPECTION, CALL 687-4065. A MINIMUM OF AT LEAST 24 HOURS ADVANCE NOTICE FOR INSPEC- TION REQUESTS MUST BE GIVEN. Have the folLowing infOrmation ready: permit number, job address, type of inspection, when it will be ready, your name and phone number, and any special directions to site. BUILDING DIVISION: REQUIRED INSPECTIONS: 1. Foundation Inspection: To be made after trenches are excavated and forms erected and when. all materials for the foundation are delivered on the job. Where concrete from a central mixing plant (commonly termed "transit mixed") is to be used, materials need not be on the job. . - 2. Concrete Slab or Under-Floor Inspection: To be made after all in-slab or under-floor building service equipment, conduit, piping accessories, and_other ancillary equipment items are in place but before any concrete is poured or floor sheathing installed, including the subfloor" 3. .Framing & Insulation Inspections: To be made after the roof, all framing, fire blocking, and bracing are in place and all pipes, fireplaces, chimneys, and vents are complete and all rough electrical and plumbing are approved. All wall insulation and vapor barrier are in place. 4. Lath and/or Gypsum Board Inspection: To be made after all lathing and gypsum board, ~nterior and exterIOr, is in place but before any plastering is applied and before gypsum board joints. and fasteners are taped and finished. 5. Final Inspection: To be made after the building is complete and before occupancy. APPROVAL REQUIRED. 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 inspections required. NOTE: All building permits require inspections for the work authorized, such as but not limited to: A. Block Wall: To be made after reinforcing is in place, but before any grout is poured. This inspection is required for each bond beam pour. There will be no approval until the plumbing and electrical inspections have been made and approved. B. Wood Stove: To be made after completion of masonry (if applicable) and when installation is complete. Installation shall be in accordance with an approved, nationally recognized testing agency and the manufacturer's installation instructions. C. Mobile Home: An inspection is required after the mobile home is connected to an approved sewer or septic system for setback requirements, blocking, footing connection, tiedowns, skirting, and plumbing connections. 1. Footings and piers to comply with State foundation requirements for mobile homes or as recommended by the manufacturer. 2. Mobile home minimum finish floor elevation shall be certified when required by a flood- plain management letter. 3. Mobile home tiedowns, when required, and skirting shall be installed and ready for inspec- tion within at least 30 days after occupancy. Tiedowns and skirting shall be installed per enclosure. D. Swimming Pool: Below grade when steel is in place and before concrete is poured. Above grade when pool is installed. APPROVED PLANS MUST BE ON THE JOB SITE AT ALL TIMES DURING WORKING HOURS. THIS PERMIT WILL EXPIRE IF WORK DOES NOT BEGIN WITHIN 180 DAYS, OR IF WORK IS SUSPENDED OR ABANDONED FOR MORE THAN 180 DAYS. SUSPENSION OR REVOCATION MAY OCCUR IF THIS PERMIT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS INFORMATION. ANYONE PROCEED~NG PAST THE POINT or REQUIRED INSPECTIONS WILL DO SO AT THEIR OWN RISK. SUBSURFACE AND ALTERNATIVE SEWAGE DISPOSAL SYSTEMS: 1. Permits shall be effective for one year from the date of issuance. 2. Upon completing the construction for which a.permit has been issued, the permit holder shall notify the Lane County Department of Planning and Community Development by submitting the installation record form. The Department shall inspect the construction to determine if it complies with the rules contained in this division. If the construction does comply with such rules, the Department shall issue a certificate of satisfactory completion to the permitlholder. If the construction does not comply with such rules, the Department shall notify the permit holder and shall require satisfactory completion before issuing the certificate. Failure to meet the requirements for satisfactory completion within a reasonable time constitutes a vio- lation of ORS 454.605 to 454.745 and this rule. Setbacks - Subsurface Sewage Disposal Septic Tank From: Interior property lines 10' Edge of road right-of-way 10' Building foundation 5' Wells, other water sources 50' Drainfield 10' 10' 10' 100' , . . e e ACTIVITY INFORMATION idne county .,; SHEET ~ ~~ COMPLETE THIS SECTION. INCOMPLETE FORMS WILL DE REJECTEU! :_ I "j" . 1 . : 1 NArtlCV rv-rt N Ci (') 5 P~SON MAKING REQUEST 210cr mJ9t'..Ne YR,'vp MAILING ADDRESS' . JJ\..ei1'l e \r TO..J It0. 51,t.r~ T(J tV 783) D- CITY STATf zip CODE PROPERTY OWNER ; MAILING ADDRESS CITY STATE ZIP CODE ' j-ZtJ6-373-cr/l<J' BUSINESS TELEPHONE # HOME TELEPHONE # BUSINESS TELEPHONE # HOME TELEPHONE # . 2 PROPERTY ADDRESS / 3 9 '3 C 07TON 1/I)0t9cl . (IF DIFFERENT FROM MAILING ADDRESS) . l~L>JdJ n.R~. '. 3 MAP & PARCEL NUMBER (REQUIRED INFORMATION) (from tax maps in Department of Assessment and Taxation or from tax statement) TOWNSHIP RANGE SECTION TAX LOT(S) OR PARCEL # ZONING To1[rfsiffJ> RANGE' SECTION TAX LOT(S) OR PARCEL # ZONING I TOWNSHIP RANGE SECTION TAX LOT(S) OR PARCEL # ZONING TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP: ACRES 4 SUBDIVISION (if applicable) LOT BLOCK 5 REQUEST (state exactly what you plan to do) ~ !11CL1// 'yJ2.J/J~ "_._-.. - - - _.- - -- --- .- - .-. - - . ,; ,~ ; 6 01 RECTIONS TO SITE: il!rt1l/~_.. _.hOC-A.fe 4 .~. . IfiCjhr.'h .l:)-e,h'N.J . PBTk .e,o(V\6J.'t~ ..s'.6e.. : t'lF l~. 'Se) <J-n Lao rI Pffi"~~-_:rJ..w ytJ.--It-fi!-6-._2.kt__..t1.lI!d %~If/ q~ ~fl-f:"') . f . . . ~. . ** FOR STAFF USE ONLY ** NUMBER ~ (./') ZONE/LAND USE: BY: DATE: DATE ~ -l .r-: T mE IN: OUT: ----.--. - --".. - --- --- ..- - - . ". - .. .------ - --- - - - -------... ----...--.--..------- LAND MANAGEMENT DIVISION / 125 E. Rth AVE.. EUGENE. OR 97401 / 687-4061 . e e ACTIVITY INFORMA1'ION idne county SH EET ~ ~~ COMPLETE THIS SECTION. INCOMPLETE FORMS WILL DE REJECTEU! -:..1_;' j . 1 ~ V W 8.e A I / PERSON MAKING REQUEST /tJS9 G) J/If\J~)1- MAILING ADDRESS S~/..-CJr.I (1e -, ~ t:. STATE q7Lf77 ZIP CODE {:'.,..A NC,~oS PROPERTY OWNER J?1;::;If. f!/P. cl.,.; &Ie MAl LI NG" ADDRESS ~ v-e.~er-TlJttl IA4sb,;.f'rtottl crtSIO CITY STAlE ZIP CODE #Art! c. V / 2709' 7J.f7- 5,J6tJ 1-2t'Jb-;173-9/Z!l BUSINESS TELEPHONE # HOME TELEPHONE # BUSINESS TELEPHONE # HOME TELEPHONE # : 2 PROPERTY ADDRESS! S. Cf.:j.._ _ _ r~ mrJ C;JeJoJ g(2-r-,W~ ~eL( nf<.p_ (IF DIFFERENT FROM MAIUNG Auimmr- I / ~./, : 3 MAP & PARCEL NUMBER (REQUIRED. INFORI1ATION) , (from tax maps in Department of Assessment and Taxation' or from tax statement) TOWNSHIP RANGE SECTION TAX LOT(S) OR PARCEL # ZONING To1iNslffJ> RANGE SECTION TAXmrOT(S) OR -PARCEL II ZONING TOWNSHIP RANGE SECTION TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP: 4 SUBDIVISION (if applicable) 5 REQUEST (state exactly what you plan to do) TAX LOT(S) OR PARCEL # ZONING ACRES LOT BLOCK - --_. . - - -.- - -- -.- .- - -.- - - : 6 DIRECTIONS TO SITE: . . ! , . ..- -'." ----- - -- ..- . ,. . -. - - .. -. " . - . . . . .. - .'. - "."...... - - . --- ----.----------.-.. -.- ** FOR STAFF USE ONLY ** NUMBER .. ..... /;J -1 A:I In ZONE/LAND USE: BY: DATE: DATE ~ -l ,r-: TIME IN: OUT: ---.----.---.-..-.---.----.-..-..-- - ...,. ..---.-.--".--,.--- ..-. - -- - ------_...-----_.._---_..~----- -------..- .-------- LAND MANAGEMENT DIVISION / 125 E. Rth AVE.. EUGENE. 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