HomeMy WebLinkAboutPermit Septic Tank 1993-6-28
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. "PERMIT #
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'REQUEST
FOR:
11111
SEPTIC SYSTEM VERIFICATION
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-17 OW<;E 0 3 """"'2 2 :'1":'~
TAXLOT 14 ,S~'PARTTTDN
lOTIPARCELEl.COI:
PROPOSED USE SEPTIC NSTALLED WATER N3TAUE)
RESIDENTIAL USE CITY
I'nOFSTORES
NO OFEMPLOVEES
cor..snUJCTICHO'JSTNAl.IAi
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LOCAIICW AODRESS
650 MALLARD STREET, SPRINGFIELD, OREGON
STRUCTUAES NOWON PROPERTY
EXISTING SINGLE FAMILY DWELLING
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SEPTIC SYSTEM VERIFICATION
NQ~1lEDR<XMl
OlklOCTIONS TO SITE FROU NEAREST MAIN NTERSECTION
EAST ON HARLOW ROAD, TO PHEASANT STREET, LEFT ON PHEASANT TO LEFT ON
MARRARD.
APPLICANT NAMlii.. ADO~B
LINDA O'BRYANT,
OWNERS NAME' ADDRESS
GENE & FRAN ARNESEN, SAME AS THE JOB ADDRESS ABOVE
PI-iONE
465-8125
PHONE
741-2787
CXHTRACTOA INSf All.ER.' BUILDER /'tAMl::.
NA
l MAIL PERMIT TO:
LINDA O'BRYANT, 1600 OAK STREET, EUGENE, OREGON 97401
\ NAMe STREET
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I have carefully read BOTH sides of this app~IICatlO and hereby certify that all Information
LINDA O'BRYANT _~......'.,JAu ;(1),~. H._I-
\I PRHTNAME ,..,. '-"" ~
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11" REA'O 'CAREFULL VI Vour Authorization la Baaed On The Following Conditione
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FEES DUE: $
APPROVED BY:
DATE
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CALL FOR INSPECTIONS (SEE BACK OF FORM FOR INSTRUCTIONS) 687-4065
,~~~..!'e~m../~~~~_ ~~':! for one year.__'!....~~~~her permits exp/ro efter 180 days un/eas /nsp~c"ons ere current. -I
LMO 040 Rev. 6192
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VIOLATIONS
SBTBACKS AND 01HBR .................. OF APPROV ALMU$TBB STR.Icn. Y OBSERVED. VIOLATION CAN RBStn.T IN REVOCATION OFnns PBRMrr.
,CITAnONS MAY DB ISSUED UNDER nm PROVISIONS OP LAND COUNI'Y'S INPRACTION ORDlNANCB AND/OR OTHER RBMBDIBS AlLOWBD BY LAW.
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A MINIMUM OF AT LEAST 24 HOURS ADVANCE NOTICE MUST BE GIVEN FOR INSPECI10N REQUESTS
Have the following infonnation ready when you call: 687-4065
Permit number - Iob address - Type of inspection required When it will be ready
Your name and phone mnnber - Any special directions to the site
PUBLIC OFFICIAL RIGHT 1'0 TRESPASS ON PRIVATE PR.OPERTY oas 2l!.0I0
POWER TO BNTER UPON LAND. nm COMMISSION, AND ANY OP ITS MEMBERS, omcms AND BMPLOYBS,lNnm PBRPORMANCB OPTHBIRPUNCllONS, MAY
ENrnR UPON ANY LAND AND MAKB BXAMlNATIONS AND SURYBYS AND PU.CB AND MAINTAIN nm NECESSARY MONUMENTS Aloo"D MARKERS nmRBON.
REQUIRED INSPECTIONS
FOUNDATION INSPECTION: To be made after excavations for footings are complete and any required reinforcing steel is in place,
UNDERGROUND 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 service equipmen~ condui~ piping
accessories and other ancillary equipment items are in place but before any concrete is placed or floor sheathing installed, 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 INSPECTIQN: To be made after the all framing, frre 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 barrien 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 board joints and fastenen are taped and f!Dished,
ADDITIONAL INSPECTIONS MAY BE REQUIRED, such as but not limited to:
BLOCK WALL: To be made after reinforcing is in place, but before any grout is poured. 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 anyequipmenL
FINAL PLUMBING INSPECTION: To be made just prior to the building. structure or:remodeled area being occupied. .
FINAL BUILDING INSPECTION: To be mad. after finish grading and the building; structure or remodeled area is completed and ready for occupancy,
MOBILE/MANUFAcruRED HOMES: An inspection is required after the mobile home is connected to an approved sewer or septic
system. prior to covering s~wer or wat~r lilies. for' ~etback requir~ents. bl~king: tiedowns' and plumbing 'connections.
Footings and piers to comply with State fO\D1dation requirements for mobile homes or as recommended by the manufacturer.
Minimum f!Dished floor elevation shall be certified when required by Floodplain Management
Tiedowns, if required, shall be installed and ready for inspection within 30 days after occupancy, Tiedowns shall be installed per enclosure.
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.
APPROVED PLANS~MUST BE ON TIlE JOB SITE AT ALL TIMES DURING WORKING HOURS.
11IIS PERMIT WILL EXPIRE IF WORK DOES NOT BEGIN "'..,~, 180 DAYS, OR IF WORK IS " vr nu OR ABANDONED FOR MORE TIlAN 180 DAYS.
SUSPENSION OR REVOCATION MAY OCCUR IF TIllS PERMIT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS INFORM A TION.
ANYONE PROCEEDING PAST THE POINT OF REQUIRED INSPECTIONS WILL DO SO AT THEIR OWN RISK.
Yoursignature on the front ofthis form verifies the follow~g: I HAVE CAREFULLY EXAMINED THIS COMPLETED APPUCATION, and do
hereby certify that all information hereon is true and correct. and that I have a legal interest in the Y......Y.....J as owner of record or authorized agent. I
further 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 per-
taining to the work described herein, I further certify that ifl am not the owner of the property, my registration with the Builders Board is in full force
and effect as required by ORS 701.055, and that if exempt the basis for the exemption is noted hereon. and that only subcontractors and employees who
are in compliance with ORS 701.005 will be used on the job,
SUBSURFACE & ALTERNATIVE SEW AGE DISPOSAL SYSTEMS:
When subsmface construction is complete. the permit holder shall notify the County Land Management Division by submitting the installation record
fonn. An inspection 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 completion
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
From: Interior r'-r-',' lines 10'
Edge of road right-<lf-way 10'
Building founaation'" 5'
Wells or other water sources 50'
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(3!<98/93
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ZIP
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~SEPTIC INSTALLED
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Watar District
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nearest main Intersection
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COMMENTS /FOLLOW~UP .. ...
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Land Management Dlv. stall can
not be held responsible for
evaluations or recommendations
based on falso, inaccurate or .
LMO,... 2192 incompleta Information.
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I,); ~) :3 L.(.1HE COUNTY DEPT ENV r'lGT I":ECEIPT ,~ ;:.'~'40?3 llPoTE 01.,2.'3
APPLICANT ARHESEN, GEHE AD DR 1600 OAK ST., EUGEHE. OREGON
TL. 1703221314300 SUBDIV LOT BLK
NE,:vJ BLDC, TYPE: USE 1';: DDi'diS 0 UNITS 00'1 STORIES ,:~BL[)GS 001 PI-IONE,: 74', 27.'
OWNER NME ARNE:SEN, GENE ADDR 1600 OAK ST., EUGENE:, OREGON
CODE APPL NO ACTION DESCRIPTION SQ FT UHIT COST VALUATION FEE
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