HomeMy WebLinkAboutBuilding Miscellaneous 1994-11-23
SEWAGE DISPOSAL SITE EVALUATION
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Written Directions --/J.l /qu.. -/-0 Yo Iii" d..o +n N rJl:b.._J)L.
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Subdivision: PQ"+~ ~~,,~
Lot'tf::-/ If Block
APPLICANT'S NAME AND ADDRESS '1i ~ N" / k...
OWNER'SNAMEANDADDRESS--l')I'''...;~ IUD ~~"L.,'C"_I Ea.J
STRUCTURES NOW ON THE PROPERTY N",., -L
WATER SUPPLY
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I h~brY certify that the above statements are true and accurate, and that I have the following legal interest in the property: -----owner of record; . "'ontract purchaser; ----...potential
buyer;
aaltor or agent. I further certify that (if not the owner) I am authorized to act for the owner of record. and ~wner is aware and approves of this action.
eST HOLES READY ->>~(/ L" Q-tf Signature //......-- ~ ~ Date-1::!o./ 19,/q<{
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * OFFICE USE ONLY BELOW THIS LINE * * * * * * * * * * * * * * * * * . * * * * * * * * * * *
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PROPOSED USE OF PROPERTY
THIS REPORT IS NOT A PERMIT FOR SEWAGE SYSTEM INSTALLATION
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The are:.. d!lscribed t6'n the attached plot plan dated
,~ ~Gf'D.
ADDITIONAL COMMENTS: ,d dzj;J/) .l)J.f p/47'I r"~
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NOTE:
. this report approves use of a sand filter or pressurized distribution
ill be required with the installation permit application.
THIS IS A PRELIMINARY REPORT WHICH DOES NOT
ENSURE THE ISSUANCE OF A FUTURE BUILDING
PERMIT. ANY PLANS OR EXPENDITURES MADE IN
RELIANCE UPON THIS REPORT ARE AT YOUR OWN
RISK. IF SITE IS APPROVED, SEE REVERSE SIDE.
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DEQ AUTHORIZED AGENT
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system, detailed construction design plans
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* * . . * * * * * * * * * . * * * * * * * * * * * * * * * * * * * * * * * . *
. . .
. WARNING: .
. .
* This Site Evaluation is a technical report to determine if a on-site .
. system will function properly. It does not approve the proposed use of .
· the parcel. This Site Evaluation may be converted to a construction .
: permit only if the parcel and use meet land use regulations in effect at :
. the time of application. YOU ARE URGED TO CONTACT YOUR LOCAL .
. PLANNING OFFICE FOR LAND USE REVIEW. .
.
* * * * * * * * * * * * * * * * . * * * . * . * * * . . * * . * * * * * * * *
rANE COUNTY ENVIRONMENTAL HEALTH, 125 EAST 8TH AVENUE, EUGENE. OREGON 97401 (687-4051)
C55-32
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MEMO
TO: APPLICANT
FROM: LANE COUNTY ENVIRONMENTAL HEALTH
SUBJECT: CONDITIONS OF SITE APPROVAL
1, Any alteration of the natural conditions in the area approved for the on-site system or the placement of a well within
100 feet of the approved area may void this approval.
2. This approval is given on the basis that the lot or parcel described above will not be further partitioned or subdivided
and that conditions on subject' or aajacent properties have not been altered in any manner which would prohibit
..'- issuance of a permit in accordance with O.R.S. 454,605 through 454.755 and Administrative Rules 'of the Environmental
:- '. ~1i" Quality Commission. Any such subdivision, partitioning or alteration may void this report. .
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~,~. This report is valid until an on-site sewage system is installed pursuant to a constructio'1 permit obtained from Lane
~ ~ b County, or until earlier cancellation, pursuant ~ t.~ ~omr:ni~sion r~les'. wit~ written noticel there.of by the D~~a~t~ent of
~"= Enviromental Quality to the owners according to Department records or the County tax records. SUbject to the
'-' I{'f{ foregoing, this report runs with the land and will automaiically l?e~efit, sUbsequen.t owners:. ,
4. Only persons having a valid license issued by the Department of Environmental Quality under ORS 454.695 to install
subsurface sewage disposal systems or an owner or contract purchaser or his regular employees may install subsurface
sewage disposal systems. A certificate of satisfactory completion will not be issued if person other than the above
perform the installation.
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L.ANE COUNTY DEf"T ENV MGT f~ECEIPT '~940508 DATE 11189.
AD DR 2198 L.OMOND. SPRINGFIEL.D
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LANE COUNTY DEPT ENV MGT RECEIPT . 940508 DATE 111 89.n "
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