HomeMy WebLinkAboutPermit Sewer Connection Record 1992-8-21
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RESIDENTIAL
PERMIT APPLICATION
Inspection,;' 726.3769
Olf,ce: 726.3759
LOT:
SPRINGFIELD
BLOCK'
er
Q!1fOfl)
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
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TAX LOT: (C Y )~( ) ~
SUBDIVISION'
- OWNEU1~ (' -' \\\( tlrE I~r\)oaL PHONE:-r4(n-~~~1
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DESCRIBE WORK ~ c;D1\DQ f'r -+0 , iJO d; d H U
NEW
REMODEL
ADDITION
CONTRACTOR'S NAME
GENERA' '
NwY\OV,
PLUMBING'
MECHANICAl'
ELECTRICA' '
QUAD AREA:
" OF BLDGS:
OCCY GROUP: ,__
. OF STORIES:
WATER HEATER:
,DEMOLISH
OTHER
ADDRESS
CONST,
CONTRACTOR #
EXPIRES
PHONE
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
,
o Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prior to cover.
o Wall/Ceiling Insulntion - Prior to
Gover.
o Drywall - Prior to taping.
o Wood Stove - After lm;tallatlon.
o Insert - After fireplace approval
and Installation of unit.
o
Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
- OFFICE USE -
LAND USE: ~
# OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
RANGi='
~--'
~
'"
: ,
FLOOD PLAIN'
ZONING CODE:
. OF BDRMS:__
SECONDARY HEAT:
SOUARE FOOTAGE:
To request an InspectIon, you must call 726.3769. ThIs is a 24 hour recording. All Inspections requested before 7:00 a.m. will be ".
mmlc the same working day, inspoctlons requested after 7:00 a.m. will be made the following work day.
o Temporary Electric
o
Site Inspection - To be made
after excavation, but prior to
setting forms.
o
Underslab Plumbing/Eleclrlcall
Mechanical - Prior to cover.
o Footing - Atter trenches are
excavated.
o
Masonry - Steel location, bond
beams, grouting.
o Foundation - After forms are
erected but prior to concl'Ote
placement.
o
Underground Plumbing - Prior
to filling trench.
o
Undertloor Plumbing/ Mechanical
- Prior 10 Insulation or dcckinn.
o
Post and Beam - Prior to flOOf
Insulation or d<:cldng.
o Floor Insulation - Prior to
decl<lng.
~ Sanitary Sewer - Prior to filling
7\trench.
o Storm Sewer - Prior to filling
trench.
o
Water Line - Prior to tilling
trench.
o
Rough Plumbing - Prior to
cover.
o Sidewalk & Driveway - After
excavation Is complete, forms
and sub-base material In place.
o Fence - When completed.
o Street Trees - When all required
trees are planted.
o
Final Plumbing - When all
plumbing work is complet.e.
o Final Electrical - When all
electrical work is complete.
o Final Mechanical - When all
mechanical work Is complete.
o Final Building - When all
required Inspections have been
approved and building is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Sel.Up - When all
blocking Is complete.
o Plumbing Connections - When
home has been connected to
water and sewer.
o Electrical Connection - When
blocking, sel.up, and plumbing
inspections have been approved
and the home is connected to
the servIce panel.
"}
, ~ .
"j
,
o Final - After all required
inspections are approved and
porches, sldrting, decl<s, and
venting have been Installed,
Lot faces
Lot Type.
Lot sq, Itg.
Interior
Lot coverage
Corner
Topography
Total height
Panhandle
Cui-de-sac
BUILDING PERMIT
ITEM
SQ, FT,
X $/SQ, FT,
Main
Garage
Carport
Total Value
Building Perrnit Fcc
Stale Surcharge
Total Fec
(A)
Setbacks
PL, HSE GAR ACC
N
2-___
W
'.
. THE PROPOSED WORK IN 'tHE' ·
HISTORICAL DiSTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
-~----
Ae'pROVED'
VALUE
(B)
SYSTEMS DEVELOPMENT CHARGE (SDC)
PLUMBING PERMIT
ITEM
Fixtures
Residential Balh(s)
N'
FT.<350 '
Sanitary Sewer
Water
FT,
FT,
Storm Sewer
Mobile Horne
Plumbing Permit.
State Surcharge
Total Chargo
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Perm it
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut '"
It
Demolition
Slate Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
FEE
rJ () .00
'7().W
__.3~50
'13/;:;;0
_r7l.~.!'D
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
construction shall, in all respects, conform to ttle Ordinance
adopted by the City 01 Springlleld, including the
Development Code. regulating the construction and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Plan CIlecl< Fcc: ____~__.
Date Paid:
Receipt Nu/Tlbec_______
Rec(~ived By:
Plans Hcviewed Ov
Date
Systems Developmenl Charge is due on .:111 undeveloped
properties within tile City limits Wllich are being improved.
ADDITIONAL COMMENTS
By signalure, I state and agree, that I have carefully examined
the completed applicalion and do hereby cerlify that all
information hereon is true and correct, and llurther cerlily
that any and all work performed shall be done in accordance
with the Ordinances of the City of Springfield, and the Laws
of the State of Oregon pertaining to the worl< described
herein, and that NO OCCUPANCY will .be made of any
structure without pcrrni~;sion of the Building Safety Division.
I further certify Itlat only contractors and cmployees who
are in compliance Witll ORS 701.055 will be used on 1Ilis
project.
I further agree to ensure that all required inspections arc
requested at the proper time, that eacll address is readable
from the street, that the permit card is located at the front
of the property, and the iJpprovcd set of plans will remain
on the site al all times during construction.
Signature ~ ~ ~
1/:>.,.1J..-
Date
VALIDATION: P<~C:;
RECEIPT NUMBER 0-11 'I . )
DATE PAID j~ AI L: ,~ t7t
AMOUNT RE~ ~~( Olqr~-=t
RECEIVED B ~), :)
'LJ
..;,
, '.
. .JOB NO. ~
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
'." WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: ~ AD J ti['(\ ~ S
LOCATION: fl4f)l9,~C\ i {\. \F)\P 0 ot
DEVELOPMENT TYPE: \(Q~r\ff\n(1 L
BUILDING SIZE:
1. STORM DRAINAGE
IMPERVIOUS SQ. FT.
2. SANITARY SEWER-CITY
NO. OF PFU'S \ \
(See Reverse)
3. TRANSPORTATION
LOT SIZE
SQ. Ft.
X $0.192 PER SQ. FT,
c
----
')
---
X $39.78 PER PFU
C:4:l'~ ,~
-----------
NO OF UNITS X TRIP RATE X COST PER TRIP
X
X $401.05
X $401. 05
X $401.05
c )
------
$
$
X
X
SUBTOTAL (ADD ITEMS 1,2, & 3) $
4. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X .05
~
..... ---
TOTAL-CITY SDC $
5. SANITARY SEWER-MWMC
NO. OF PFU'S x $13.62 PER PFU + $10 MWMC ADMIN. FEE $
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
'4< ~~ ':S"Vl rJj f1 t>/m
~ Kip Burdick
SDC Coordinator I
$
TOTAL-MWMC SDC~~
..... ---
TOTAL SDC $ ~R.f)?
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FIXTURE UNIT CALCULATION TABLE: Number of New Fixtures X Unit Equivalent = Fixture Units (NOTE:
For remodels, calculate only the NET additional fixtures)
FIXTURE TYPE
NUMBER OF
NEW FIXTURES
UNIT
EQUIVALENT
Bathtub................................... ............ ...... ...... ..... ......
Drinking Fountain. ........ ..................................,... .....,
Floor Drain...,....................,...........,.............,......., 0...,
Interceptors For Grease/OiI/Solids/Etc.................
Interceptors For Sand/Auto Wash/Etc..................
Laund ry Tub /Clotheswasher......,..,.... ......... ............
Clotheswasher - 3 Or More.....................................
Mobile Home Park Trap (1 Per Trailer)..................
Receptor For Refrigerator JWater Station/Etc........
Receptor For Commercial Sink/Dishwasher /Etc..
Shower, Single Stall..,..,....,.,....,..,.".,.,..,..,......"..",..
Shower, Gang.,.,.....................,..,.......,.,..,.."...........,
Sink, Bar, CommerciaL..,.,....,..,..,.,.......,......,..,....",
Urinal, StaIlJWall.,.........,.........,..,.......,.,.........,...,...."
Wash Basin/Lavatory, Single"..."......,............"...",
Water Closet, Public Installation..........................,..
Water Closet, Private................,.....,.......,..,......",....
Miscellaneous:
2
1
2
3
6
2
6
6
1
3
2
1 /Head
2
2
1
6
4
TOTAL FIXTURE UNITS
.
FIXTURE
UNITS
Based on assessed value. If improvements occurred after annexation date in table,
CREDIT CALCULATION TABLE:
calculate credits separates.
I
I
Year
Annexed
Rate per $1,000
Assessed Value
Year
Annexed
$2.83
2.76
2.71
2.60
2.46
2,33
1985
1986
1987
1988
1989
1990
1991
1979 or before
1980
1,981
1982
1983
1984
Credit for Parcel or Land Ollly If Applicable
X $
(Rate X Assessed Value)
X $
(Rate X Assessed Value)
CREDIT TOTAL = $
Improvement (if after annexation date)
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
ResidentiaL.... ....., ........... ......, ......... ................. 0.4
CommerciaL................................................... 0.9
Ind ustrial.... ........ ............. ................,.. ......., ....... 0.45
GovernmentaL.....,....................................,...... 0.5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT
Rate per $1,000
Assessed Value
$2.16
1.90
1.60
0,25
0,87
0.50
0.16
,
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CITY OF SPRINGFIELD
I
IMPROVEMENT AGREEMENT AND APPLICATION FOR SEWER HOOKUP
We, the undersigned property owners, request permission to connect the
following described property to the sanitary sewer owned and maintained by the
City of Springfield. We therefore agree to pay a charge of $0.17 per square foot
of the benefiting property for the first 150 feet of depth as a deposit against
future assessments for sanitary sewer.
Tax Lot No.
17 02 35 42 00202
Receipt No.
bgOS
Property Description:
Address 7406 Main Street
Beginning at a point on the North margin of McKenzie Highway being North 3010.92
feet and East 862.62 feet from the Southwest corner of the J. Looney Donation
Land Claim No. 85 in Township IB South, Range 2 West of the Willamette Meridian;
thence North 150 feet; thence North 78'22' East 125.0 feet; thence South 150 feet
to the North margin of Mckenzie Highway; thence along said North margin South
78'22' West 125.0 feet to the Point of Beginning in Springfield, Lane County,
Oregon.
This agreement does not include the cost of a house connection to said City
Sewer, sewer user charges, connection fees, plumbing permits or other such costs
to be assumed by the property owner.
The applicant agrees to waive all right to remonstrate against an
improvement project for sanitary sewer to be duly initiated by the City Council,
but not the right to protest the amount or manner of spreading the assessment
thereof, if the same shall appear to Applicant to bear inequitably or unfairly
upon said property of Applicant.
NOW THEREFORE, the City agrees that if Applicant complies with the terms
of this agreement and with all other applicable laws of the State of Oregon, Lane
County, and the City, the said Appl icant shall be entitled to connect the
existing residence to the public sewer systems.
The covenants herein contained shall run with the land herein described,
and shall be binding upon the heirs, executors, assigns, administrators, and
successors of the parties hereto, and shall be construed to be a benefit and a
burden upon the property herein described. This agreement shall be recorded in
the Lane County Deed Records.
WHEREFORE, the parties have set their hand and seal this 21st-day of
O..Jd..ft...ll""" , 19jb
CITY OF SPRINGFIELD
By
APPLICANT
~ JJu,J fr;~
Director of Public Works
STATE OF OREGON)
) SS
COUNTY OF LANE )
On thi s -'b r- day of
before me and signed the
~
above 6bcument.
, 19'12, there personally appeared
.' "-0" . OFFICIAL SEAL ' :
, JAMESH.DOUGlAS
,~ NOTARY PUBlIC-oREGON
COMMISSION NO, 001882
MY COMMISSION EXPIRES SEPT. 29. 1995
,
dd4<<~q( /2di
Notary Public for Oregon ~ ~
My Commission expires q-;JCI-"f::i
Finar.ce Department Information:
Trunk Sewer
18,365sf * $0.17/sf =
Lateral Sewer $3.122.05
\CITY OF SPRINGFIELD - PUBLIC WORKS DEPT - 225 FIFTH STREET - SPRINGFIELD, OREGON
\.
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COVENANT
Sprinofield Memorial Garden. Inc. . being
the record owner{s) of all of the following described property located in the
City of Springfield, the City's Urban Service Area, in the County of Lane,
State of Oregon:
Beginning at a point on the North margin of Mckenzie Highway being North
3010.92 feet and East 862.62 feet from the Southwest corner of the J. Looney
Donation Land Claim No. 85 in Township 18 South, Range 2 West of the
Willamette Meridian; thence North 400.33 feet; thence East 195.89 feet; thence
South 360.00 feet to the North margin of Mckenzie Highway; thence along said
North margin South 78022'00" West 200.00 feet to the Point of Beginning, in
Lane County, Oregon; EXCEPT: That portion platted in BEANEL ACRES, as platted
and recorded in File 73, Slide 362, Lane County Oregon Plat Records, in Lane
County, Oregon.
In consideration for the issuance of a Building Permit by the City of
Springfield which allows the owners 'to construct a sanitary sewer, the record
owner{ s) do hereby make the fo H owi ng covenant (for the good and safety of the
public, in compliance with the Springfield Development Code and the building
regulations of the City of Springfield), covering the above described real
property, specifying that this covenant shall constitute a limitation to run
with the land and shall be binding on all persons claiming under them, and
that the covenants shall be for the benefit of present and future owner(s) of
said real property.
Be it hereafter known and agreed that the parcel of land described above which
includes two parcels, must hereafter be sold together without separation of
parcels or portions thereof as a single unit of land until appropriate private
sanitary sewer easements have been established across the land.
IN WITNESS WHEREOF, the
this ;.?kt- day of
undersigned have
a.u't I' <:.T
caused this instrument to be executed
, 1~ /n&d< hM
Owner
AlfiE' hll-c/(
Owner
On, this .2(~T day of ~ , 19-'lf:c personally appeared
before me, a Notary Publ ie, the wi-thin named aA'if J1.to,L-- 'yj/I,~_
......
lit (J cJ /( E
and acknowledged the foregoing to be their voluntary act and deed.
WITNESS my hand and seal this day and year last~itten abOV~~~
~ '4d:tuCJft.?-I. .
No ry Publ ic for 0
My Commission Expires: q-J2f-C(5
. OFFICIAfSEAL
. JAMESH:IlOUGW
",~" NOTARY PUBLlC.OREGON
, COMMISSION NO. 007882
MY COMMISSION EXPIRES SEPT, 29, 1995