HomeMy WebLinkAboutPermit Septic Tank 1990-9-11 (2)
--
REQUEST
FOR:
~ELOCATE EXISTI~G SEPTIC SYSTEM
,
TO.....' 18 ......02 .",n.. 06.r:j
~O';..ArO}f AOORUI
luLlLi, DO:~DEA STREET, SPRINGFIELD,
ITRUCTURII MOW ON HlOPERT,.
EXISTInG SI~GLE FAMILY ~~ELLING
TAll LOT 31 0 0 IUIQlVISION ,p""nTlON
L.OT/"~l&.oc:K
OREGO"
97L:78
J
PROPOSED va.
BEPnC ~BTAu.aD
WATER ".TALLaO
IIO,ClPlTOlU1m
NO,ClPillPLDYKD
COIGTRUCTIOJI c:08TlYAUlI
PR IV"TE USE
DillCRlPnON OF P'ROPOBID ~K
RELOCATE EXISTING SEPTIC
QllllCnONI TO IIIU P"OM-e;;oURTltOU"
MAIN STREET SPRINGFIELD,
NO. 01' HDROOIAI
SYSTEM
EAST TO 32ND
5T. ,
RIGHT TO JASPER,
RIGHT or~ DO~DEA
AND RIGHT ON FIRST CUL-DE-SAC TO SITE ABOVE
A'PUCANT HAIlE a ADDRESI
KEVIN M. JOHNSON, SAME AS THE JOB ADDRESS AJOVE
OWNERS ........ . AODRI..
SAME AS THE ABOVE
,,"ONI 7~7-273~
NtOJilI
SAME
'NO.'
NA
l
CONTRACTOft NAIll 0IlJII UCOlaa _
NA NA
t MAIL PERMIT TO:
MAIL PERMIT TO THE O~NER AT THE JOB,ADDRESS ABOVE
l NA'" ADD"IIS' I
I hava carefully read BOTH sides of this aptJZlI I and hs~e;tlfy that
KEVIN ~1. JOHtJSON _ rn\./~-
PAM' NoW!; ;;
DATi
J
all Information Is true and correct
10 Baoed On The Following Condltlono
"
,
FEES DUE: $
.
APPROVED BY:
DATE
7'rf! -9~
.
(CALL FOR INSPECTIONS (SEE BACK OF FORM FORI2:STRUCTIONS) 687-4065
SEPTIC permits Bra good for one yesr. ALL other permits expire sfter 180 dsys unless Inspections
8re current.
."
.
...
VIOLATIONS
.
~
SETBACKS AND 01HBR _.'_.. ....... OF APPROVAL MUST BB STRlcrt.. Y OBSERVPD. VIOLATION CAN RBSUL TIN RBVOCAnON OFnn5 PERMIT.
CITATIONS MAYBE ISSUED UNDER 1HB PROVISIONS OF LANE COUNI'Y'S lNPRAcnoN ORDINANCE ANDjOR onmR. RBMEDIBS ALLOWRD BY LAW.
A MINIMUM OF AT LEAST 2A HOURS ADV ANCB NOTICB MUST BE GIVEN FOR INSPECTION REQUESTS
Have the following infonnation 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 OFFICL\L RIGlrr TO TRESPASS ON PRIVATE PROPERTY cas n5.OIO
POWER. TO RNI1lR UPON LAND. nIB COMMISSION, AND ANY OF ITS MEMBERS, OFFICERS AND EMPLOYES, IN nm PBRPORMANCB OP1lIBIR PUNCIlONS, MAY
ENTER UPON ANY LAND AND MAKB BXAMINATlONS AND SURVEYS AND PLACE AND MAINTAIN TIm NBClSSARY MONUMBNTS AND MARKBRS ntERBON.
REQUIRED INSPECI10NS
FOUNDATION INSPECI10N: To be made after excavations for footings are complete and any 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-Ft.OOR 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 INSPECI10N: To be made after the all framing, frre blocking, bracing and roof are in pl""e and all pipes, chimneys and vents are complete
and the rough electrical, plumbing, and mechanical ~pections have been made and approved.
INSULATION INSPECI10N: To be made after all insulation and vapor barriers 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 pl""e but before any
plastering is applied or before gypsum board joints and fasteners are taped and fmished.
ADDITIONAL INSPECfIONS MAY BE REQUIRED, such as but not limited to;
BLOCK WALL: To be made after reinforcing is in pl""e, but before any 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 !ll!d. approved.
FINAL MECHANICAL INSPECI10N: To be made just prior to the slrUCture or remOdeled area being occupied and prior to operating any equipment
FINAL PLUMBING INSPECI10N: To be made just prior to the buildmg, strueture or remodeled area being occupied.
FINAL BUILDING INSPECI10N: To be made after fmish grading and the building, structure or remodeled area is completed and ready for occupancy.
MOBILE/MANUFACfURED HOMES: An inspection is required after the mobile home is connected to an 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 fOlmdation 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 point indicated in each successive inspection without first obtaining the
approval of the building official. Such approval shall be given only after an inspection sh~l have been made of each successive step in the construction
as indicated by each 'of the inspections required.
APPROVED PLANS MUST BE ON TIlE JOB.SITE AT A.LLTlMES DURING WORKING HOURS.
.. "".,
TIllS PERMIT WILL EXPIRE IF WORK DOES NOT BEGIN WITHIN 180 DAYS, OR IF WORK-IS SWPPED OR ABANDONED FOR MORE TIlAN 180DA YS.
SUSPENStON OR REVOCATION MAY OCCUR IF THIS-PERMIT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS INFORMATION.
. .... . , j
... '" - ~ . . - . ..
ANYONE PRO......um'G PAST THE POINT OF REQUIRED INSPECflONS WILL DO SO AT THEIR OWN RISK.
,,~ _.'.. '
'-.
Y oursignature on the front of this form verifies the following: I HAVE CAREFULLY EXAMINED TillS COMPLETED APPUCA TION, and do
hereby certify that all information hereon is true and correct. and that I have a legal interest in the Y....Y.....J' as owner of record or authorized agent. I
further certify that any and all work performed shall be done in accordance with the Ordinances of Lane County and the laws of the State of Oregon per-
taining to the work described herein. I further certify that ifl am not the owner of the r"Y-A~/' my registration with lhe 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 SEW AGE DISPOSAL SYSTEMS:
When subsurface construction is complete. the permit holder shall notify the County Land Management Division by submitting the installation record
form. 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 pefIT!,it~h.older. will be notified, and all corrections shall be made before a certificate of completion
will be issued. Failure to meet satisfactory completion within the allotted time constifutes a violation of ORS 454.605 to 454.745 and this rule.
SUBSURFACE SEW AGE DISPOSAL SETBACKS SEPTIC TANK
From: Interior r'-r-", lines 10'
Edge of road right-of-way 10'
Building foundation 5'
Wells or other water sources 50'
DRAINFIELD
10'
10'
10'
100'
...
....
/
\
_ ()l./1 1.-.
.' - ~.#II~ ~ "--
,------- ~
~<~;,~"
--''"'-- ~ ~ '--
"-:'!< ~
'-- -,*~
----- <!-;---?>
t()#
,J,Wtt,.o'SPOSAL
A Ilennlt Is APPROUED
Iltfor to start; required
DATF 0 "' COIIstructlon
BY . ..Sf( - r:r 0 ~
E . -.
nvuur::nta/-llealthSe .
Eu East 8th Arenue . .
gene, Oregon 97401
.
~
~..~.
\
.
~,
~.
-
,
j
\.
____I
v
C:l-t~~ I) - Skk:-
.,
SE.P- 6-90
~':';.'- lA~! COUNTY'BOllOltfC 'PI:iMW'. N'o. .608 : 'eS~.').~
":";"........ ..
. ~.., .\a~. CoImty ~~. .....~~ ?~~97~:,. ,:. "if
. =or.t.. tlUM..... ~::~::Z:::::::7 1t;:. ~~ :: ~~.:::
10(.1I.~.. ,'........ ..lIdi"" I."""" OI""h ~e' ~ .~'\f""t?~<f':"'1"I;t ..~~ , .:
tINt .............. . . ~ <I .: '.
b'atlroa Stl'y(i"''''C Oft 'rotM,..." . tf 10, '. I ,~ -..JtT.....,,~'.:
1>00< ........, I.... ~.I "....1 '1M H 'J, ......" ..J . 'A ....-.~ A .,-<' . .
. . ..-... 7' A--'...D/ U ~:'_U.~~~.,/!.tC"""'~?" .
'...
V'
lines inside white boxes, if possible.
,LhfJ5~
~f1 - 9Q...
";;; V7~
ZIP
t'nUNl:;.
ZIP
:?M? ~ ,~~,~ <',
......... .....:.:.:.~..:.:.::.;.:.;-:...:.}: "
'.:. ::~ ::::,:.<::,:~,::,':'::.":'::.:"~:::.:::.::
....::....-:-.....,
.0"......................
:~;~:::::.:::.......
,
MAP, PARCEL NUMBER
(Found on to mep. In the ........m.nt . Tulltlon DcpL)
To~n~IP H~; s~!:n 'f/~ln -~~.OE
Town.hlp n;;;- SecUon tl4 S.ctlon h.-lot
;;;:i;; Hange
lown.nlp l;j~l.on \/4 ::o.cl.IOn 'ax LOI
,
,
SITE ADDRftS sl- !:._LC
/(J~<.{ ,~"'A ,/,R"'I eM?
,
;"...
MA~L PERMIT TO:
"("~/)o"> /J) JrJhnJ;nY1
. MC
.!J.f:f! l/unrfl'.4 . 'S f
SAa-nc. [".,'LA (.I{)
...,1 t i
Q'1V,?V
ZIP
land Management Dlv. staff can
not be held responsible for
evaluations or recommendations
based on fals9, Inaccurate or
Incomplete Inlormatlon
.
Existing Buildings or
Improvements on
Property
~ouse
c:J Barn -
c:J Garage
c:J Mobile. Home
c:J Shad
SEPTIC INSTALLED
c:J Yes
c:J No
Water District
.,
".
,
.
.,
C'vLde<;llc /oV'"" ..o/M~
j
9?rJr"
ZIP
~':. 1
For Mobile Home
Placement Only
Brand
Year
Size
No. 01 Tip-outs
No. 01 Bedrmo
Licenso #
J:
'\
~
. .... . .
'j' .
. .. .
1m I n~ ~
. .
,
. .i
(
. .~
.
~
,
. .
,
, ~ I. ~ I" II
fl rl. HIl
. .:
. .
. .1
,
j
. .~
.
.. )1 ;1 J J~
I,' I"j
/1'" ~ " :
. .:
. -
LANE COUNTY DEPT ENV MGT RECEIPT ~ 297090 DATE 091090.
. APPLICANT JOHNSON, KEVIN AD DR 1044 DONDEA ST., SPRINGFIELD, OREGON
TL~ 1802061308100 SUBDIV LOT BLK
NEW BLDG TYPE USE R BDRMS 0 UNITS 001 STORIES ~BLDGS 001 PHONE 747 2731 .
. OWNER NME JOHNSON, KEVIN ADDR 1044 DONDEA ST., SPRINGFIELD, OREGON
ki~ODE APPL NO ACTION DESCRIPTION SQ FT UNIT COST VALUATION FEE DAYS~I'!
alF' -II
BP ~
ElF' . (
....F' j
~ \
PL
.ECH
SUR
PCK
e>oS
~ ~ frDEQ
.
~FIX/BATH :
SWR: FT. WTR:
MECHANICAL FEE
STATE SURCHARGE
PLAN CHECK FEE
FT.
RAIN:
FT
.
.1
5%
25%
,
.
LC'297090 SDAR
FEE
140.00
5.00
.~
.
jlji
.
CATG: PLN
e>EQU:
TAKEN BY RLH
RA
SDS
1
EST.
ELE PCK
ISS
/
SI
OTR
COMPLETION DATE
DEPOSIT **
145.00 CK
..
1
!
-I
2
.
.
;
i
.;
. ~~. .
rit I '.
~..... ." ;.' . ,
""..... ~. ., . .
...~ . . ,
. .
~m nm
.. .
. .
",I ,
. .
. / ...- .
~
'HIIU Hm
o I.n .$
. .
. .
. .
. .
tl~!~ . ~~~H
. . - .
----------~-~~----~~~------~~\-------------
.. . ..~
..... "
. .
LANE COUNTY DEPT ENV MGT HECEI'F"f. ~ 297090 DATE 091090
'. APPLICANT JOHNSON, I<E'IIN " s.. ADDH \044 DOI~DEA S'l~ ~PI~INGFIEL)j, Or~EG(JN.
Tl..~' 1 B():?06\ 3()B1 ()0 SUBDI'i(,:'<. . . -".. --! I...OT l:<L.I<
Ni::W BLDG TYPE .uS[~t)~I~MS () UNITS Nl\ STORIES '~BL.DGS 001 PHONE 747 2731
. OWNEF~ NME 'Jgj~./lS'ON, I<EVIN "il)DI:~ 1044 'DONDEA ST., SPf\INGFIELD, OREGON.
lI"I1.',':ODI:;. APF'L. NO ACTION DEscrnPTION S(~ FT UNIT COST VAL.UATION FEEDAYS'/"Jj'
ti~ff\<':~~ HhN~
.IF' 'u\ ) .
BP
ElF'
.1" .
F'L' ~'FIX/BATH'
.tECH o'? _ \\- ?
SUR . .
PCK-.,~...~ ~
.;DS 1)~-297090 SDAR
H 1Ir?IPEQ-''\:) . FEE
uH!
.
SWI~, Fr.., WTR,'
MECHANICAl... FEE
,
ST,'iTE SUf~CH{~r~GE
PLAN CHECK FEE\.
FT.I~AIN:
FT
.
~)%
2~5%
\40.00
5.00
.
~m
.
CATG, I"LN
.;EQU,
T'AI(EN BY r,I..H
f,A.
SDoS'
1
[ST.
EL.E PCK
ISS
")
':M
I
S1 OT'"
,;.
COMPL.ET I ON J)(~lrE
J)EPOS I T lH,
\ 4~). N) CK
.
.
~
.
.