HomeMy WebLinkAboutBuilding Miscellaneous 1974-8-14
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~~4IILEST FOR SITE FEASIBILITY STU~~ S.I.#
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Code C.T. Number Soecial Permit Area Urbanizino Area -
THIS is A PRELIMINARY REPORT WHICH OOES NOT iNSURE THE ISSUANCE OF A FUTURE BUILDING PERMIT.
PLANS OR EXPENDITURES MADE IN RELIANCE UPON THiS REPORT ARE AT YOUR OWN RISK. t:::>
P lEA S E P R I N T ;;J. q -ll~
If Subdivision - Name: M~~p ~.vJO ad Lot #s Block #?, ::::;7
",.5
3/74 .:>
IFor Off;~e j
US<l--Only ~
.R~e i ved bv
/7
.j;Ly
Sect ion
Tax Lot No.
03
Township
Range
L ~ oN l.... 1<, ",1.1 F,T
Name
~ ~ go 1-:;' ~ I KY, ~ A-II E
Mail ing Address
<:pPD.~r:?E
. .
? q /p - 2, '->? e:-
Telephone it -
Proposed Use
of Property: S,NG!€- P,4~I''r' PcS.
70 '/./01,",- t. N 1I,,"n, "'
?o ~ I'" nr.=..J.R....t::~
Property Size Legal Access - Road Name
~s Property Within One Mile of City?
es i/ What City? <r:>F D
No .
If-<t32-
NoXY
Owner of Property
No. of Sites ~
Yes V No
Owner I 5 Consent
$ $0 -00
$
$ u O. 00
No. of Acres
~~
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-l
r-
'It
Owner Seller
Appl icant's Interest Buyer
in Property: Other (Specify):
v
Rea I tor
[\10"1 E
Existing Structures on Property
Proposed Water Supply
Publ ic ~ District:
Spring Well
I? A I 1 bo uJ
Other Specify,!:
Property Locat ion (0 i rect ions): I (; F r t':> N_I (. 7t. 0 F E-J{ A Y /) t~ ILl IS' ~RCJ,.
When Will Test Holes Be Ready? fS-1- 71-
MARK TEST HOLES WITH OUR FLAGS (Date)
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Draw diagram of property showing location of any landmarks and relationship of test holes to
these landmarks: ./1
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, 1,-01 '~~~1;~'
Location of Test Holes on Property:
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70 I b..
f-~7~~
/'.
fZ~Arz.
Po P- (, 0 N
7 (l,D
3fldL3J' ~
D61~O"6(\JW
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PAYABLE TO: ENVIRONMENTAL MANAGEMENT Phone: 687-4065
LANE COUNTY DEPARTMENT OF ENViRONMENTAL MANAGEMENT, 135 E. 6th Ave.. Eugen". Ore.
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MAKE CHECK
MAIL TO:
C55-55
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APPROVED ,~
NOT APPROVED
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Date
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Sii~tion II 7tj-~ ~
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EVALUATl<>>l
FOR DETERMINING SIn SUITABILITY
FOR DEVELOPMENT UTILIZING
SUBSURFACE SEWAGE DISPOSAL METHODS
LOCATION I
Twp. 17
n pJ ('IHi?
Range Q L Sec. !2. q Tax Lot II
:;d-J9.dc/ LI\ f 2"1--{;- 13J.r h
Are public sewers available or nearby? (Distance) ) m I
,
Are there Koning or environmental considerations? O'Y 0
She of property I '70tl/~ +- 'l6i IJ2L Amount useable area
Are other systems in area known to be malfunctioning? ~ ~
Is there room for future expansion? 'Y e.-I:.
Surface Feature considerationsl (Explain)
Slope I (1'/100')
Flood plain.
Plants.
('J
N",
(X)
Rocks I
Low area I
Drainage_YI
Stresmsl
Cut bank or slope I
Water Supply and Utilities I (Sketch in Plot Plan)
Community Waterl No
Individual Waterl Exist. D Proposed ~
Water Linesl Exist. D Proposed D
Gas Linesl Exist. D Proposed 0
Wells on adjacent Exis t. 0 Proposed 0
properties I
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I #1 TEST HOLE #2 T H 0 L E
,
I .
r Perched Water PROFILE Perched Water PROFIi.-r
Predicted in. Inch Predicted in. Inch
Observed in. lIlserved in.
Date Date
12- 12-
Saturated Zone <;;i- ~llUrated ZoRe <ft'L
24- 24-
Predicted in. Predicted in.
Observed in. Observed in.
Date Date
36. 36.
Restrictive Layer____ in. Restrictive Layer____ in.
Impervious Layer ____in. 48,. Impervious Layer ____in. 48-
Mottling in. Hottl1nll in.
/ 60<' ---- 60-
.. / .
SITE DOES SITE DOES OOT Meet minilWm standards for ind1vidua 1
waste disposal.
IF SITE DOES .NOT KEEl STAftDARDS SPECIFY BAS: S OF DENIAL:
- Administrative Rules Require - - Your property found to be Deficient -
IF SITE MEETS STANDARDS FILL OUTI
Type of structure end approximate sewage flowl
Hulti-family GPO,
Commercial GPD,
Single Familv
Industrial
Institutional
~
GPD
CPD
GPD
NOTE: Soil absorbtion area in square feet
Area necessary for sewage disposal systems
6-0 ) ;i,__l -?+ - /.b"c!--U6Yl-.
ARE ALTERNATIVE SITE LOCATION, DESIGN OR MODIFICATION AVAILABLE, DESCRIBE I
.... d 'lU,J,L
DATE OF FIELD EVALUATION.
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Appl ication No. 7c/- <632-
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'~' e { 0$ ~ ;J. nC\ ttC\C\ Lt 2(fs 81
T 7 tE S 21/ TAX LOT 6
C S TRACT .
BUILDING,SiTE EVALUATION
-.
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APPLICANT:L . +I-
NAME A' VI /11 e.
ADDRESS
( )
( )
( )
Bu i I ding Pe rm i t
Site Inspection
Pre-Permit Investigation
PHONE
DATE '>('-Q - 7V
Yes
( ..y-'6.
(<-Y'
( ...y'
( ...y-
( )
I
Setbacks from c/l of
Front
Side Exterior
Setbacks from interior
Side
Rear
~~ . ,
BY: ~.2/ Y-9-7V
'Date
road:
'-:;-0
PLANNING DIVIS ION No t
API)licable No
1. Zoning Ordinance Comp liance: Zone;&;~A:X ) ( )
2. Subdivision Ordinance Compliance - ( ) ( )
3. Required Access ( ) ( )
. 4. Buildin!; Site (Mea, Width, Frontage) () ( )
5. Other (see comments) ( ) ( )
CmlMENTS :
CK'IJ
lines:
S-
7' .
. -----
PLANNING DIVISION ACTION PENDING: YES( ) NO ( ~ APPLICATION n
BUILDING INSPECTION DlvI~lUN ....... . ~~ 11',..,.1'- ,...-"
aDDl icable
6. Plans Submitted ( ) ( ) ( )
7. Soi I Stab i I ity (foot i ngs) ( ) ( ) ( )
8. Flood Plain ( ) ( ) ( )
9. Other (see Comments) ( ) ( ) ( )
COMMENTS:
WATER POLUTION CONTROL NOT NO YES \ jlCfQ ~
app I icab I e , pJ}// 1. .!/h</
10. Sewage Disposal ( ) ( ) ( )
(
11. Usable Area ( ) ( ) ( )
12. Water Supply ( ) ( ) ( )
13. Other (see Comment s) ( ) ( ) ( ~
COMMENTS:
TO APPLICANT:
~t/Your
~/J 'fi
( )
( )
( )
Building Permit I Site Inspection:
Can be approved.
Cannot be approved at this time as indicated on item NO. above.
Questions and further information on items 1 through 5 contact the Lane-
COUNTY PLANNING DEPARTMENT. Questions and further information on items 6
through 13 contact the Lane Countv Buildinq and Sanitation Division.
Will be held in this office until you can resolve the problems indicated.
Is being returned.
Your building permit application fee is being returned under separate cover.
DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
135 Sixth Avenue East Eugene Oregon 97401
PHONE: 687-4065
LANE COUNTY PLANNING DIVISION PHONE: 687-4186
C55-28
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Section
C7:;J S- dVt{.. c; - ~
'0 r J-" " (; ~~
Tax Lot ~ Census
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r,:::r" '1'
Surname
,. . \.
Receipt No.
.v ~ eutJt). ili.e.;< 0=..-
/' ' /'
~ 03
Twp. Range
7y-
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-+J
... t I ; i '. 'I
Tract
Date
8/i9/"{l1
I Owner
I Owners Consent
Yes:; No
REQUEST FOR SITE FEASIBILITY STUDY
THIS IS A PRELIMINARY REPORT WHICH DOES NOT INSURE THE ISSUANCE OF A FUTURE
BUILDING PERMIT. ANY PLANS OR EXPENDITURES MADE iN RELIANCE UPON THIS REPORT
ARE AT YOUR OWN RISK:
Name Ls:~~ L ~(INt:ETi' 2 $ liD"CO
and 1680 No. Sites
Addrese D"lIlOSE AVEr,wE $
57:11 G p No. Acres
C:l"aO:l TOTAL $ j:.(;:l
Proposed Water Supply
Pub) ic tt District
~pplicants Interest in Property I Proposed Use of Property
2UYER SIi;!G:'Z FA~.n:.Y ~;~:":In::::~c(~n
Lega I Access - Road Name, ISpeci a 1 Perm it Area I Urban i zing Area
~;:J:1Ti1 16.1': DnROO~ I Yes No 1I Yes No .~
Structures I Is Property Within One Mile of a City?
What C i tv? $?R I m;:1' '!LO Yes :: No
Other
Specify nAINOO~
SprinQ
Wel I
Te I ep'hone.No.
1<,u"YllJ
Property Size
-(~u1 ~:;
Existing
i~::':)j!r-:
Propertv Location: (Directions) L:;:n ON 16nl C7. l-lAVO[N ElI:lDGE ROAC
APPROVED
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"
NOT APPROVED
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BEFORE CONSTRUCTION IS STARTED bring this form to the Department of Environmental
Management and make application for a building permit. if the property is a por-
tion only of a tax lot, a metes and bounds description of the parcel must be fur-
nished. Exact specifications for the sewage disposal system will appear on the
building pirmit. Two sets of building plans and'a plot plan will be required.
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LANE COUNTY DEPT. 'OF ENVIRONMENTAL MANAGEMENT
135 EAST SIXTH AVENUE, EUGENE, OREGON 97401
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Authorized Signature
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15 ~ /), lei-
Date'
C55-32