HomeMy WebLinkAboutMiscellaneous Septic Tank 1990-4-26
,
REQUEST
FOR:
SEPTIC VERIFICATION FOR LOAN REVIEW
I- TOWNSHIi 8 '02
'&.OCATlON AODRUS
1027 Dixie
au:nOH
05
1I4BWTION
. L.4
'S1'OO
auaolVlslONI p.umTKIN
LOT/PARC:&L auxx
Dr. ,
Springfield
97478
aTRUIOTURli8 HOW ON PROPIlRTY
SFD
PROPOaED USI aEP1lC ..IITA1.LIlO
Resid. Yes
DEIICRlI"TlON 01' PROPOeED WOftK IIlO. 01' .~DOII8
To verify SDS for loan review
gIIRliCTlON8 TO alTI 'ROIl COUATMOU..
1-105 to 42nd; Right to Jasper Rd; Turn left on 1st street on the right
...TERIiIIITAU.liD
NO. W8TORlE8
NO.CI' EllPLOftElII
CONITRUC:TlOlI COBTIVALU8
is Dixie Dr.; Home is near end of street on left.
APPUCAHT HAIlE.. ADDRESS
Springfield
Dr., Medford
97477
97405,
'MON'
747-0755
Larr~ Alberts, 397 S. 72nd,
OWHERS HAUl.. AlnU1l18
Stan Price, 700 Crater Lake
CONTRACTOR NAIll
PHO....
770-1198
QUI UCIHIII .
'"OH!
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Eugene 97- 01
sides of this
,.:,:..'
READ CARE FULL W 'tour
>
FEES DUE: $
.
APPROVED BY:
:-/5 /'L ~
DATE
P-LC: -7 ~
........... ..~.~.
CALL FOR INSPECTIONS (SEE BACK OF FORM FOR(jpIsTRUCTIONS) 687-4065
SEPTIC permits sre good lor ons yssr. ALL a/her permits expIre after 180 days unless Inspccllons
"-
Dro curront.
.. ~OLATIONS ..'
SB'rnACKS AND 0THIlR __,_".._~ APPROV ALMUST DB snuCD.. Y OBSERVED. VIOLATION CAN Jl!lrT IN RBVOCAnON OPntIS PERMIT.
CITATIONS MAY DB ISSUED UNDER nIB PROVISIONS Of LANB OOIJNTY'S INPRAcnoN ORDINANCB AND/OR onmR RBMIlDIBS AlLOWBD BYlAW.
"
A MINIMUM OF AT LEAST 24 HOURS ADVANCE NOTICE MUST BE GIVEN FOR INSPECTION REQUESTS
Have the following information ready when you call: 687-4065
Permit number - Job address - Type of inspection required When it will be ready
Your name and phone number - Any special directions to the site
PUBLIC OFFICIAL RIGIIT 1'0 TRESPASS ON PRIVATE PROPERTY ORS n5.0s0
POWER TO BNTBR UPON LAND. nIB COMMISSION, AND ANY OF rrs MBMBERS, OPFICBRS AND BMPLOYRS, IN nIB PBRPORMANCB OF nmIRPUNctlONS, MAY
BNTBR UPON ANY LAND AND MAKE EXAMINATIONS AND SURVEYS AND PLACB AND MAINTAINTIIB NBCBSSARY MONUMBNTS AND MARKERS ..~...
REQUIRED INSPECfIONS
FOUNDATION INSPECI10N: To be made after excavations for footings are complete and eny required reinforcing steel is in pl""e.
UNDERGROUND PIPING INSPECI10N: To be made after all underground piping has been installed, prior to any backfill.
CONCRETE SLAB OR UNDER-FLOOR INSPECI10N: 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 INSPECI10N: To be made after all ducting and gas piping has been installed and prior to being covered.
ROUGH PLUMBING INSPECI10N: To be made after all plumbing rough-in is in place, prior to being covered.
FRAMING INSPECflON: To be made after the all framing, fIre blocking, bracing and roof are in pl""e and all pipes, chimneys and vents are complete
and the rough electrical, plumbing, and mechanical inspections have been made and approved.
INSULATION INSPECI10N: To be made after all insulation and vapor barrie.. are in place, prior to covering.
LATH AND/OR GYPSUM BOARD INSPECI10N: 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 fasteners are taped end fmished.
ADDITIONAL INSPECTIONS MAY BE REQUIRED. such as but not limited to:
BLOCK WALL: To be made after reinforcing is in place, but before eny grout is poured. The inspection is required for e""h bond beam pour. There
will be no approval until the plumbing and electrical inspections have been made and approved.
FINAL MEClfANICAL INSPECI10N: To be made JUSt prior to the structure'or remodeled area being occupied and prior to operating enyequipment
FINAL PLUMBING INSPECI10N: To be made just prior to the building, structure or remodeled area being occupied.
FINAL BUILDING INSPECI10N: To be made after fmish grading and the building, structure or remodeled area is completed end ready for occupancy.
MOBILE/MANUFACfURED HOMES: An inspection is required after the mobile home is connected to en approved sewer or septic
system, prior to covering sewer or water lines, for setback requirements, blocking, tiedowns and plumbing connections.
Footings and piers to comply with State foundation requirements for mobile homes or as recommended by the manufacturer.
Minimum fmished 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 }X)int 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 roB SITE AT AU. TIMES DURING WORKING HOURS.
THIS PERMIT WIU. EXPIRE IF WORK DOES NOT BEGIN WITIIIN 180 DAYS, OR IF WORK IS STOPPED OR ABANDONED FOR MORE TIlAN 180 DAYS.
SUSPENSION OR REVOCA nON MAY OCCUR IF TIllS PERMIT WAS ISSUED ON TIlE BASIS OF INCoMPLETE OR ERRONEOUS INFORMA nON.
ANYONE PROCEEDING pAST THE POINT OF REQUIRED INSPECTIONS WILL DO SO AT THEIR OWN RISK.
Your signature on the front of this form verifIes the following: I HAVE CAREFULLY EXAMINED TillS COMPLETED APPLICATION, end do
hereby certify that all information hereon is true and correct, and that I have a legal interest in the property as owner of record or authorized agent. I
further certify that any and all work performed shall be done in accordance with the Ordinences of Lane County and the laws of the State of Oregon per-
taining to the work described herein. f further certify that if I am not the owner of the '-'0'_"/0 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 SEWAGE DISPOSAL SYSTEMS:
When subsurface construction is complete. the permit holder shall notify the County Land Management Division by submitting the installation record
Conn. 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 w~thin the allotted tirr.Ie constitutes a violation of ORS 454.605 to 454.745 and this rule.
SUBSURFACE SEW AGE DISPOSAL SETBACKS SEPTIC TANK
From: Intcrior '-'O'--'J lines \0'
Edge of road right-of.way lO'
Building foundation 5'
Wells or other water sources 50'
DRAlNFIELD
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Please complete all lines Inside white boxes,
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CITY If n'
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OWNER OF PROPERTY (If not ..... .. ebo..)
'1~o rfl.-4 ~~.o,. fJ1dfurc}.'
OWNERS ADDRESS (II not ..m. .. .bow)
If possible.
.",7/;;2 ~
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9 i'l'11
ZIP
.tZ6 1/915
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ZIP
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TOWftMlp ~ 8tctJon 1/4 BeoUOn
Tax LoI
10wnalllp ~ titcuon '14_~
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ExIstIng BuildIngs or
Improvements on
Property
c:J House
c:J Barn
c:J Garege
c:J Mobile. Home
c:J Shed
SEPTIC INSTAll.ED
_Ves
c:J No
Water District
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DIrections to sIte
from Courthouse .)
T-/O~ - -fo 'I;).L &.
12.,"v hf. -to 1'<1.5 O'lr RcJ..
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D"- -+\-..I<' <19 h. t I~
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SITE ADDRESS-L
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MAIL PERMIT
TO~~WLu.. ~k L.-l R ( ftrr,.>; ~;~;
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Land Management Dlv. stall can
not be held responsible for
evaluations or recommendations
based on falso, Inaccurato or
Incomplete Information
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M14-53 FEBRUARY '90
ZIP
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For Mobile Home
Placement Only
Brand
Vear
Size
No. of Tip-outs
No. of Bedrmo
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. AF'PL rCANT ALBE:FnS, LA""y f~I lh ,~'i .0. 7 ...ND I SF F\f.NI,r IEL.D
TU' 1 f.)020~)i40B1 00 SUB!)IV LOT BU(
.'inJ BLDG TYPE . USE I~ BDI~MS 0 UNITS 00'1 STORIES '~BL.DGS' (101 PHONE 747 07~5~5.
OWNER NME PRICE, STAN ADDR 700 CRATER LAKE DR., MEDFORD
CDDE APpL NO ACTION DE:SCFW:'T!ON SQ FT UNIT COST VAUJATION I FEE
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LC 12439.0 SDSV
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TLI 1802052408100 SUBDIV LOT BLK
.'JEW BLDG TYPE USE R BDRMS, e UNITS 001 STORIES IBLDGS 001 PHONE 747 075~5.
OWNER NME PRICE, STAN ADDR 700 CRATER LAKE DR., MEDFORD
._ .CODE APPL NO ACTION DESC~tPTION SQ ~T UNIT.COST VALUATION FEE DAyBOD
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LC 124390 SDSV
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