HomeMy WebLinkAboutPermit Septic Tank 1986-8-14 (2)
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CHI:.CKED J.1i'G U 7
Lane County Authorization
Se7J~ S;r77-:-7?-> I )~-rLt':/7; ;,uh)
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FOR OFFICE USE ONLY
Application/~/L'~';~ _~~
Perm1.t #. r:?fY7 r-/? ~
- WWl,SHIP /' 0' I RANGE /J '} I SECTION/,/ 3) TAX LOT~21UT OF I PROPOSED USE OF PROPERTY
(J {/ ~ /J ~.~ /r 7~ 4 t?/ ~eSidential 0 Industrial
SCBDM~ti{1CX0 (f5~~b~ ~ ~ I WT4CEL I BiK I 0 Corrunercial '0 Public
LOC/YiO~oy;fS /"1'T \" ' CITY ZIP
/?-,~/ ~4?/??/C~ ,)P~,/H~'F~2/J O~C;V~
~ES CURRENTLY ON PROp:E~ / ~ ""
('--n / / G-t'_C// Af7;n;:7'?': Y 4' /lj/r:7/' '77? /C
1J/3?~~IJ/7S~2:R~ /:f?' all-a~-s~_
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~ES~PTION OF PROPOSED WO?,,~ SPEC.IFIC ~/ ./ _ _ ') l.)'ECLARED :;i V.y.UE
. <.. ~"7/ L:..~ ~) ';.' VC;;/// ~.A-_.r-J...L~/U MR- A#~../
"-OF BEDROOM~ J ~ OF ~TO~9' I" JF ~. YECS :.---1 WATER SUPPLY Rpr~po~ed
:=:L-- ~/~~ /~~~ EXIstIng
O:~ER;;:~r?D~r-)/gC-0 ~~ ~ ~~V1~ 1~7W7
~e-ANlJ~~S<1.A:J. ~/L ~/~/ t7~~Lf:
PA?~L2LEDro~~~~~r-~/-/2' 4R'b: 97~7717~~
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1 HAVE CAREFULLY EXAMINED THE COMPLETED APPLICATION "'OR PERMIT, d.t,d ,]0 hcrcl.Jy certify t:hat all information hereon is true and correct, and that I
have the fOllowing legal interest in the property: Downer of record; 0 cont:r<1ct;. purCha5cr~thOrized agent. .
I f:.::rther certify that any and all work performed shall be done in accol'dilllCt) with thu OrdllHl.nCtll; of lAne County and the Laws of the State of Oregon
pertaining to the work described herein, and that NO OCCUPANCY will ~ made of anr structure without the permiSSion of the Building Divi&ion. I fur.
t.her certify that registration with the Builder's Board is in full force nnd effect as required by ORS 701.0S5, that if.exempt the basis for exemption
is noted hereon, And that only subcontractors 4Jld elllployees who are in compliance with ORS 701.055 will be used on this project. I HAVE READ AND
CHECKE ~'S ';;T10" 7~~~A /' (};M~ . )> ~D1:E/f?
mIME (please print) S,q;NATURE / ~
READ THIS SECTION CAREFULLY. YOUR/~THORIZATION ~AS BEEN BASED ON THE FOLLOWING CONDITIONS!
o PLANNING/ZONING: Zone ff E ff- Partition 11 Parcel 11 Parcel Size ./ ~(/2-
C / C /
Ml.nl.mum Setbacks: L, front L, side _ J.nterl.or _ rear
CO>!>'ENTS, ~ P7~4.2/?h ~---,,//;Jd~~c7~
, " Date, f// ~~
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~ SANITATION: S. I. 1+ B. P. # Installation Record Issued? 0 Y'es DNO
Installation Gallon Lineal Feet Maximum Depth
Specifications: Tank.7f _ of Drainfleld of Trenches ~
Coo"'ENTS, /fl~,.1 j)di::L,~~ S,D,~. ~ ----~L.~' ~ ....
~' l' '. / . . II -:l.:lL . I
~1--;;tL, Fo J /J;~MUt.). o'......J~Date~ ?-I'f-dC- .~
o ~ EXAMINATION: Type Group Use
CO!-iHENTS :
Dat.e:
n
_~4) ?A..(<,- R. ~rc a-/f/-C~
~ APPROVE~ Bt'-'1!UILOyeJ OfFICIAL/DESIGNEE (Der ORS 456.805 (1)) DATE
LANE COUNTY DE~RTMENT OF PUBLIC WORKS LAND MANAGEMENT DIVISION, 687-4061,
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
~l<'l<' 'DPUPR~P Pf"'lR Tl\.1~op:r'T'T()N TN]::'()"RMh'T'T()N
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SETB,\CKS AND OTHER CO~WITIO:-;S OF APPROVAL MUST BE STRICTLY 08SERVED. VIOLATION CA:-l RESULT IN REVQ-
C';7IO~1 OF ,HIS rER}llT, CITATIO~J U~DER PROVISIONS OF LANE COLi,;TY'.') INFRACTION ORDI,;ANCE, AND/OR OTHER
REMEDIES ALLOWED BY LAW.
,
\>,'HEN READY FOR I:>SPECTION, CALL 687-4065. A ~l1NHlU~1 OF AT LEAST 24 /lOURS ADVA/;CE NOTICE FOR INSPEC-
'1'ION HEQ\,;I:::;"l'S ~;usr UI:: GIvEN. Have the tallowing information ready: permit number, job address, type
of inspection, when it will be ready, your name and pho~c number, and any special circctions to site.
BuiLDING DIVISION:
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REQUIRED INSPECTIONS:
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1. Foundation Inspection: To be made after trenches are excavated and forms erected and when all
materla~s tor the foundation are deiivered on the job. Where concrete from a central mixing
pl.ant (commonly termet! "transit mixed") is to be used,' materials ne:d :.',?t be on the job. ;
2. Concrete Slab ~ Under-rloor Inspection: To be made after all in-slab or under-floor building
serv~~e equipment, condu~t, p~p~ng'accessories, and other ancillary equ~pment items are in
place but before any concrete is poured or' floor sheathing installed, including the subfloor.
3. Framin9 ~ Insulation Inspections: To be made after the roof, all framing, fire blocking, and
brac~ng are ~n place a~d all p~pes, fireplaces, chimneys, a~d vents are c9mplete and all rough
electrical 'and plumbing' are approved.......All wall insulation and vapor barri'er are in place.
4. Lath and/or Gv~sum Board InSEcction: To be made after all, lathing and gypsum board, ~nterior
ana-exterIOr, ~s ~n~e but Detore any plastering is app~ied and before gypsum board joints
and fasteners are taped and finishe~.
. 5. Final In6pection: To be made after the building is complete and before'occupancy.
APPROVAL REQUIRED. ~o 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. .
NOTE: All buildinq permits require inspections for the work authorized, such as but not limited to:
A. Block Wall: To be made after reinforcing is in place, but before any grout is poured. This
~nspe~t~on is required for each bond beam pour. There will be no approval until the plumbinq
~nd electrical inspections have been made and approved. .
B. Wood Stove: To be made after, completion of masonry (if applicable) and when installation is
complete. Installation shall be in accordance with an approved, nationally recognized testing
agency and the manufacturer's installation instructions.
C. Mobile Home: An inspection is required after the mobile home is connected to an approved
sewer or-5eptic system for setback requirements, blocking, footing connection, tiedowns,
skirting, and plumbing connections.
1. Footings and piers to comply with State foundation requirements for mobile homes or as
recommended b~ the manufacturer.
2. ~obile home minimum finish floor,elevation shall be.certified when required by a flood-
plain management letter.
3. ~lobile home t.iedo....ns, when required, and skirting shall be installed and ready 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 is in place and before concrete is poured. Above grade
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 j.1AY OCCUR IF THIS PERHIT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS
INFORMATION.
ANYONE PROCEEDING PAST THE pOlin or REQUIRED INSPECTImJS WILL DO SO AT'THEIR OWN RISK.
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SUBSURFACE AND ALTERNATIVE SEWAGE DISPOSAL SYSTEMS:
1.. Permits shall be effective for one year from the elate of issuance.
2. Upon completing the construction for which a permit has been issued, the permit holder shall
notify the Lane County Department of Planning and Community Development by submitting the
installation record form. The Department shall inspect the construction to determine if 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 the permit
holder and shall require satisfactory comple~ion before issuing the certificate. Failure to \\,
meet the'requ~rements for satisfactory completion w~th~n a reasonable:t~me constitutes a Vid~l\
lation of ORS 454.605 to 454.745 and this rule. ' ., " /,
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SeLbacks - Subsurface
\,
Sewage Disposal
Septic
10'
10'
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SO'
10'
10'
10'
100'
Tank
Drainfield
Fro:n;
Interior property lines
Edge of road ric;bt-of-way
Buildinq foundation
~ells, other water sources
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. W: ~>' LANE COUNTY DEPT ENV MGT f,ECEIPT ~'2494El6 DATE 080681-
,~PPUCANT ,JOHNSON, GENE ,~DDR ~216 NOHAl~I< BLVD., SPRINGFIELD, emE .
TLI1802061307900 SUBDIV LOT BLK 11\
.NEW BLDG TYPE:: USE fl. BDRMS 0 UNITS: .00'1 STOIUES ':~BLDGS 001 PHONE 746 7"69.'
OWNER NME DE::MOSS, STEVE ADDR 1030 DONDEA. SPRINGFIELD, OREGON
CODE APPL NO ACTION DESCRIPTION SQ FT UNIT COST VALUATION FE~ DA~r
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LC 249486 SDSV
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ACTI~TY INFORMATION~HEET
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COMPLETE THIS SECTION. INCOMPLETE FORMS WILL BE REJECTED!
~f- ~~Sa1
P~MAKING REO. EST -
/oiJ~ ~!/tt/j-- 4t/d
- MAIliNG ADDRESf /.' .
\;)11 ;9~ 97~77
c;..ny. STATE ZIP CODE
7f'1f ~ 7~/ ..2-7{J7cM?/l /t/~ -?I/tf;:
BUSINESS TELEPHONE # HOME TELEPHONE # BUSINESS TELEPHONE # HOME tELEPHONE # I
2 PROPERTY ADDRESS / If J/) ;J #/1 r! M --- -W /UG9 ~#
(IF DIFFERENT FROM MAILING' ADDRtSS) ';/' /' , .
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J7B~ .iJ-: IIf!? Y-Y
, PROPERTVl)WNER
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MA-I LI NG ADDRESS
,y;~Yk;; S~~
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ZIP CODE
3 MAP & PARCEL NUMBER. (from tax maps in Department of Assessment and Taxation
(REQUIRED INFORMATION) or from tax statement)
. /f_ cJ2 tJ.6--;;2
TOWNSHIP RANGE SECTION
TOWNSHIP RANGE SECTION
TOWNSHIP RANGE SECTION
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP:
4 SUBDIVISION (if applicable)
5 REQUESyi(state exac~y what you plan to do)'
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6 D~CTIONS TO SITE:
7?CltJ
TAX LOT(S) OR PARCEL #
ZONING
TAX LOT(S) OR PARCEL #
ZONING
TAX LOT(S) OR PARCrc-#
ZONING
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** FOR STAFF USE ONLY **
ZONE/LAND USE:
14-33
LAND MANAGEMENT DIVISION / 125 E. 8th AVE., EUGENE, OR 97401 / 687-4061
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