HomeMy WebLinkAboutPermit Septic Tank 1985-9-18
.
La:;r2u~ 4ut~?za,.tio~ for:
-~~~~~
WW:;sHIP / -; I ~':'G~.t:?31;?J:33 I />>b7COUT O,F
S~foN~ON (if'. app~o?O' I '7jl!'RC;" I ~~ , I
~ ~....#'"~/ fl".a>~.it".(') . _ / n:::...::::>,
~~AD. 7/~~~/~~d ~~.,'~:%~~?~) o/"7~'p:7
5TRUCT CURRENT r-ERT: . 'l.// ~ ' .
?' /#//Y~ P"--a:,~~.-d/ "
'LTC .,. _...~ /~~/Y/~ ,~#-1'
~ .~ 4'~-4".' /dZA~~A:)~~ ,:?,<~~
.O~~OSED RK~;~~, "'. ~' .I~./,,::. YCLARED'VALUE
. o~~~ #'or'S!sR}Eb?" ')lf~Y~~ WATER s~~l~ .# 'DProposed
_ ~../ .$//7 ~..,?~~ '/U:;?':":-r~ ~xisting
.~~7~/. ~~ /:Z' ~~~~/ TE~NE NUMBER.
~'?~~~- ~/tZ?jYc?d' ~~ 7~~~?>
~~ MAI~ to (,NNAMAM~E ADDRESS) '7.d./ 4,-<11.:" :' - /~, .. ~./L-' 7 1 ~$/!E~~<:?A
~~ ~~ ~ //,-?_..~ ~7y~ ~/P~....:>c:::r /C/
r I HAVE CA~FU~LY EXAMI~,THE COM,P~ ~;Cl\'~ION ~'Ofl- P~lIT. .~rjd ,'IO~Y certify that;11 information he~~~n is-~rue and correct, and that I
have the following legal interest in the propctty~Oowner of record; 0 c()nt:.raGt..'p\lrChaser;~thorizCd agent' . _. .
I f~rthcr certify that any and all work perfo~d shall be done in accoluilllCf, wi th 'tr:.t ord~ of Lane- County and th'e Laws of the Stat~ of Oregon
pertaining to the work described herein, and that NO OCCUPANCY will ~ ,made" of an~" structure, w~thout the permission,of't;he Building Division.' I fur-
ther certify that registration with the Builder's Board is in full force Rml effect dS require.d by ORS 701.055, that if exempt the basis for exemption
is noted hereon, and that only 5 contractors and employees who are in compliance with ORS 701.055 will be 'used 00' this project. I HAVE READ AND
CHECKED THIS APPLICATION TH Y.j' . , . _ /,' . .:
P$ __p~?:.<: '4& /77: h//!/T.r-
NAME "(pl.ease print) . , l. -4 - '. SIGNATURE "
-
.
G-c;-
'1-/t
.' .
FOR OFFICE USE ONLY
~~~;i~a~~~~~~
PROpOSED USE OF PROPERTY
~ Residential 0 Industrial
o cCllrunercia~ D Public.
DATE
READ THIS SECTION CAREFULLY,
YOUR AUTHORIZATION
4/~.
gAS BEEN BASED ON THE FOLLOWING CONDITIONS!
"
#....SANITATION: S. I. 1* _, B. P. #' Inst~~lat.ion Reco'r'd Issued? 0 Yes D No
Installation Gallon.."l r. . I Lineal ,Feet Maximum Depth
:;:::::t~~4~ ~~I>~,' ~;::f;' ~~~~ :en~.esh~,
/;1- .ith -zz..., -< ' Date, U () ~~ '3 - J.r h
o P:~:N:~INATION' Type Group .' Use '~~
p.~
Date:
n
~d/ ~/ ~S<' q-,;u~
",><---PERMIT APDRC~BY BU NG OFFICIAL/DESIGNEE Coer QRS 456.805 (1)) DATE
LANE COUN PARTMENT OF PUBLIC WORKS LAND MANAGEMENT DIVISION, 687-4061,
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
SEE REVERSE FOR INSPECTION INFORMATION C14-2SR~
:-':-
-.
,
.
.
"
--
,
SETB.\CKS A:-lO OTHER CO::OI1'IO::5 OF APPROVAL }tUST BE: STRIC7L\' oeSERVED. VIOLATIO!'l CA~"RCSULT IN REYO-
C';710~ OF TillS PERm., CIT.\TIO:. U~D~R PROVISIO:-lS OF L"~E COU:-:TY'J INFRACTION ORDI::ANCE, A:IIO/OR OTHER
REMEDIES ALLOWEDtBY, LAW. .... - .
~HEN READY FOR I~SPCCTION. CAL:'-6a7-';065. A mNHIU~l OF AT LEAST 24 !lOURS ADVA1:CE: NOTICE FOR IN'SPEC-
nu" Kt:QCl:::i.:; ;.j",:;T Ul:: I.;rVE~. !lave tne to11owi09 in!or:nation ready: rernllt number. Job address, type
of inspect.ion, when it,will be ready. your nama llnd ;:>hor.~ nu.~t1er. and any_special' directions to site."
BUILDING DIVISION:
,
.....
REOUIRE~ I~SPECTIONS:
.;...~
1. Foundation 1nseection: To be made after trenches' are_ excav!"t.ed and "for:ms erected ~~d w~e~ _all
~aterlalS lor tno toundation are delivered on the job. Where concrete from a central mixlng-
plant (commonly termed -transit mixed-) is to be used....!:Iaterials need not be on the job.
2. Concrete Slab or Under-Floor InsEection: To be made' after all in-slab or und"er-floor building-
servl;,:e c~ment, conoult" piping accessories, and"other ancillary equipment items are in
place bu~ bei~ore a!'ly concrete is poured or floor sheathing ,installed, including- the subfloor.
3. ~raming, 'Insulatio~"InSDections: To' be made after the roof. aU.framing: firo' blockinq; an'a'
raclng are 11'1 place a;a all pipes. fireplaces, chimneys, and vents arc complete' and all rouqh
electrical and plu,mbinq are approved.... -!,-ll :-all i!l~~la.tion and vapor barrier are in place..
4. Lath and/or Gvpsum Board Inspection: To be made after all lathing- and qypsum bOard, l.nterior
ana-e~rror, is 11'1 place but before any plastering- is applied and beiore g-ypsum.board joints
and fasteners. are taped a~d finished. ",
5. Final Insoection: TO be made after th~ building is complete and before occupancy.
APPROVAL REQUIRED'. SO work shall" be done on any part of the building o~. s~ucture..beyond the point.
indicated in each successive inspection without first obtaining- the approval of the building- official. .
Such approval shall b& qiven only after"an iryspection.shall have been made of each successive step
i~ the construction as i~d:ca.t.ed by..each of the inspections re.quired. ~. , ....
NOTE: All buildinq permits require inspections for the work auth~rized, such as but not limited to:
A. Block' Wall: To be made after reinfo~cinq is in place. but before any grout is poured. This
~inspectrOn is required for each bond.bea~ pour. There.wi~l pe 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 wh~~ in~tallation is
complete. Installation shall'be in accordance with an approved. nationally recognized testinq
agency and the Illanufacturer' 5 ~nstallation instructions.
C. Mobile~: An inspection is required after the mobile home is connected to an approved
sewer or septic system for setback requirements, blockinq. footinq connection. tiedowna,
skirtinq, and plumbinq connections.
1. Footinqs and piera to comply with State foundation requirements for mobile homes or aa
recommended by the manufacturer.
2. Mob~le. home minimum finish floor elevation shall be certified when required'by a~flood-
plaln management letter. . " .; .. --;.... ~ ~: '.
J. ~obile homo tiedowns. when required, and. skirting shall be installed and roady for inspec-
tion within at least 30 days after occupancy. Tiedowns and skirting- shall be installed
per enclosure. .
D. swimmin9 Pool: Below grade when steel i8 in place and before concrete is poured. Above g-rade
wnen pool-rs-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 11AY OCCUR IF THIS PERMIT WAS ISSUED O~ THE BASIS OF INCOMPLETE OR ERRONEOUS
INFORMATION.
ANYONE PROCEEDING PAST THE, ~OWT or REQUIRED INSPECTIONS WILL DO so AT THEIR OWN RIS,X. ....
"--
.
SUBSURFACE ~ ALTERNATIVE SEWAGE DISPOSAL ~:~ .
~. Permits shall be effective for one year from the date of issuance.
2. uPon completing the construction for which a pormit haa been issued, the permit holder ahall
notify the Lane County Department of Planning and Community Development by submitting- the
installation record form. The Department shall inspect the construction to determine it 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 permit,holder.
If the construction does not comply with such rules. the Department shall notify tho 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 Sewaqe Disposal
Septic ~
F~o~: Interior property lines 10'
Edge of road riqht-of-way 10'
Buildinq foundation' S'
Wells. other ~ater sources 50'
Drainfield
10'
10'
10'
100'
......
"
,
, '
....
,
.
J'
tj~/
.-
-
1
~.
~
L--
J os- ~
~ ~
- ~
=
\ ""
<!:: ""
~ ~
;0
- '.
~ i
,
(?-'"
.~ ... I
~~~/ '1
~
"3~ r ",...".
,
'" -.j) I
-
\. '-
,
.
.
Idne COJnty
.
'.
ACT.ITY INFORMATION SHEET
COMP~ETE THIS SECTION. INCOMPLETE FORMS WILL BE REJECTED!
_I \,~- nfr-.(/~P.ul/1 ')
PERSciN' MAK I NGREQUEST
,;iL~< ~~~.,~ A
' MAILING ADDRESS
c:::- I"l. \' ~
' ~., CITY
-r'_, '--1
7C/~ - Llo t. f')
BUSINES~PHONE #
'Or- 9'7d')7
STATE ZIP CODE
7~~--5't9 0
HOME TELEPHONE #
2 PROPERTY ADDRESS d, 10 d, I fY\-.t\Y\ t'\ r
(IF DIFFERENT FROM MAILING ADDRESS)
"
.C;;,,'c~1 C't1(VP
PRtiJ>tRTY OWNER
c=J.&, d, I 'fYI-f. VI n-r-' \jr
MAILING ADDRESS
, cv.J c-I
~.. CITY
Or
STATE
9'7tQ.L
ZIP CODE
BUSINESS TELEPHONE #
\>-r
HOME TELEPHONE #
3 MAP & PARCEL NUMBER (from tax maps in Department of Assessment and Taxation
(REQUIRED INFORMATION) or from tax statement)
, 17-03..;J.3- 33 t:.d/--tt1~
TOWNSHIP RANGE SECTION TAX LOT(S) OR PARCEL # ZONING
TOWNSHIP RANGE SECTION
TAX LOT(S) OR PARCEL # ZONING
TOWNSHIP RANGE SECTION
TAX LOT(S) OR PARCEL #
ZONING
, ,
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP: ACRES
4 SUBDIVISION (if appl icable)~.1 -=? IJ1"krJ; (; /llh",,-'c6f-' -BtOCK.
5 REQUEST (;;tate exactly what you plan to do) ~~.-, 1) _._~,.1, ......-_ T-
.:t 1/, A, ,1~--,,-'^2.-~
6 DIRECTIONS TO SITE:
NUMBER
DATE
.
-<
'"
VI
** FOR STAFF USE ONLY **
ZONE/LAND USE:
BY: DATE:
TIME IN:
.
-<
.-;
OUT:
LAND MANAGEMENT DIVISION / 125 E. 8th AVE" EUGENE, OR 97401 / 687-4061