HomeMy WebLinkAboutPermit Septic Tank 1987-10-6 (2)
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Vh~ -~~OFFI~~ ONLY
Lane eounty Authorization for:
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SEPTIC INSPECTION FOR LOAN REVIEW
Application~/1/'~ ~~
Perm~t ,~/// / -r7 I"
TOW~5HIP t'" ~ RANGE~ ~
S~BDIVlSION/PARTITION (if applicable)
I ~~/,YJ T//~;:b~
I LOT/Ph~(,E~ 'BLOCK
?ROrOSED USE OF PROPERTY
(8! Residential D Industrial
o C"nunercial 0 Public.
7PZ9 P~/?L?r.:;d_ ,V~//2./-~/~ ~~
'ST~TURES CURRENTLY ON PROPERTY (/ "., -. ~ h
<<("2;' :;u C/,;?/;14 ( ) ~/.7 I'h/ /-=- r..4'// /77.//'-'" . ~u/c-ZL-L/" / C
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uE;SCRIPTION OF PROPOSED WORK --SE SPECIFIC I DECLARED S VALUE
SEPTIC INSPECTION FOR LOAN
?:?_ t' OF 7~ I n O~~ tiATER SUPPLY &/f~~- ~~~~~~~~:
0;, SI""AME AND ADDRES~ _' ;7~ . / r? /7 ~ ,.LTELEl:HONE NUMBER
7~~/?C:=-?/7 /?-~E' \ )./9?7:7~ ~ /~O'P"~I
I -':"., "'-~AM;';;.)R i 0. ~ 7/~// /7 ~ I ~p~E2-Z J
P~E HAILED TO 'N.,("Z~SS) ~) ~'LL- I/,?~_E.~~/ /.
/l/~/....47nH//c:...~ C::ZAbr//~ 7'7/0/ ~d. c..-/6 r-
I HAVE CAREFULLY EXAMINED THE ~PLETED APP&ATION FOR PERHIT, dnd ,10 hcr~l.J1' ce~fY t~hat inforl'nation hereon is true and correct, and that I
have the following legal interest in the property: Downer of record; 0 Cf,U'=t"dt:t;. p'lrcha:>er. t.horized agent.
I f:.:.rther certify that any and all work performed shall be done in aCl;oulu:!c": ..d th tb: 0r:rl n<l.nces f Lane County and the Laws of the State of Oregon
pertaining to the work described herein, and that NO OCCUPANCY will be :nade of a:,;: SI'Tllcture without ttle permission of the Building Division. I fur-
ther certify that registration with the Builder's Board is in full force ami effect. M. required by ORS 701.055, that if "exempt the basis (or exemption
is note~ hereon, and that only subcontractors and employees who are in compl~ancc w~th ORS 701.055 w~ll be used on this project. I HAVE READ AND
~;:L;4TH004?~./H' (:L;l d~-~
- NJ\HE /:.se pnnt) ~ SIGNATURE
DATE
READ THIS SECTION CAREFULLY. YOU! ~THORIZATION 'IAS
o PLANNING/ZONING: Zone ./I' / ~ Parti tion II
Minimum Setbacks: CL, front / CL, side
BEEN BASED ON THE FOLLOWING CONDITIONS!
Parcel ..
Parcel siZe
A.J.#?
,
interior
rear
COMHENTS:
SEPT! C
INSPECTION FOR LOAN REVIEW--NO SPECIAL PLANNING ACTION REQUIRED
//.-/47 rt=;j..::: :
-
Date :
~ANITATION: s. I. II
/\ Installation
Specifications:
COMHENTS, r)fJJ. u.-- tl1M~ .rD.)
~ljXJ ~^ U
Gallon
Tank
Lineal Feet
of Ilr:ainfjeld
d.,.lW./ t<J
"h.o
.M"f ..c..k^- ..J
oat:
Record Issued? 0 Yes 0 No
Maximum Depth
of TrenChes;? ~
J... 41' .uA-t..J
U/11 flt, -/7 ..&:1-
- -
B. P. if
Installation
o PLANS EXAMINATION: Type
Group
Use
COMHENTS:
Dat.e:
n
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'PE~PROVED BY BUtLoING ~AL/DESIGNEE (oer ORS 456.805(1)) DATE
LANE COUNTY DEPA~ENT OF PUBLIC WORKS LAND MANAGEMENT DIVISION, 687-4061,
125 EAST 8TH AVENUE, EUGENE. OREGON 97401
SEE REVERSE FOR INSPECTION INFORMATION
C 14-25 R84.
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SETB,\CKS A:m 07:!:R CC::OITIO::S OF APPRO'.'AL :,:UST fiE STRIC:-;'Y O."5::RV!:D. VrOLATIO:1 CACi RESULT IN RE\'O-
(,;';'10:; OF ';"!lIS pr;R~lL" CIT"no:; U::OER PROVISIO:;S Or L,\:>"E ('(H:::-;Y'.-; l~fR;\CTION ORDI::,\:'c~, ,\~D/OR OTIlER
RE~~DIES ALLOWED BY LAW.
"'HEN RE.:\DY fOR r::srCC7IO::, C';,-:' 687-~065. ,\ :H::r:.:U:-l OF ;\T Lt:;"ST 2~ HOURS ';OV;,::CE ::071CE FOR r:1SPEC-
1::0:; Ht;QCl::S":s ;';:';5. lJ!:: GIV;;:::---Ha':c the ~ollo'''''ing in:o:-:nationready: rcr:nit humber, job aoJdrc9s, type
-of""'inspuhion, when it. wil"l~ n!'3dy, you:" :1..;rmc <:lnd' ~r:0 !'Iu::1!1er7 and .3:1.'1- s?cciar di~cticris to"sit-e.
BUILDI~G DIVISION:
REQUIRE:l I::SPECTIO:.lS:
1.
Found.ltion Insp~ct~l ]'0. be mil_de aft.er ..tr'lllc.hc~ i!r~ ex..cayatcd..anQ forms c.ectcQ (tnd..whcn .'.1.11_ ~
~atcr1a15 ~or t e ioundation are uelivcrcd on the job. ~here concrete from a central mixing
plant (com:nonly termed ~transit mixed-") is to be Ilsed, materials need not be on the job.
COflcn/lte- S!ol.., o.r .\,;nder-~loc>c Insncction:.-'1'o be made 'tIfter il+l"in-s-Iab or under-floor-bui.lding.....
se=Vl~e c~uipmant, conuUlt, ?1p1ny accessories, and other ancillary equipment items are in
place but bel ore any concrete is poured or floor sheathing installed, including the subfloor.
Framin.9 ~ Insuldtion Insoections; To be made after the' roof, all framing, fire blocking, and
oraCing arc 1n ?lacc ana nil pIpes, fireplaces, chimneys, and vents are complete and all rough
electrical and plumbing arc approved, All wall insulation and vapor barrier arc in place.
. -.. ,~ -
2.,
3,
.<'
Lath and/or Gvusum Board Inspection: To be made after all lathing and gypsum board, 'nterior
ano-extcrior~n place but bel ore any plastering is applied and before gypsum board joint~
and fa~teners <:Ir:. t~ped ,and f...~,!:i~hel~: . _ . ._
5. Final Insvection: To be made after the building is complete and before occupancy.
AP~ROVAL REQUIRED. ~o ~ork shall be done,on any-part Gi tha buildi~g or str~Qtuv$ beyonp-~hc.point~
indicated in each successive inspection without fir3t obt~ining 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 iris?ections required.
.~. ., ._~--
NOTE: All building permits require inspections for the work authorized, such as but not limited to:
A. Block Wall; To be made after r~infprcing is in place, put bcfo=e any grout is poured. This
InSPeetIOn is required for oac~ bond beam pour. There will be no approval until the plumbing
and electrical inspections have been made and approved.
B. \~ood Stove; To be made after completion of !:lasonry (if applicable) and when installation is
compl~ 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,
s~irling, and pl~~bing connections,
1. Footings and piers to comply with ~State foundation 'requ~rements for n:ob..il~ho~S_2.r. as
recommended by the manufacturer.
2. ~obile home minimum finish floor clevation shall be certified when required by a flood-
plain management letter.
3. .'lobile home ticdowns, when required. and skirting shall be installed an~ ready for inspec-
tion within at least 30 days after occupancy. Tiedo~n5 and skirt1ng shall be installed
per enclosure.
D. Swimminq Pool: Below grade when steel is in place and before concrete is poure~. ~bove grade
wncn pool-rs-lnstalled,
,iPPROVED PLANS :.lOST BE ON THE JOB SITE AT ALL TIMES DURn:G WORKING BOURS. TillS PER.'lIT WILL EXPIRE
IF I.;'QRK DOES NOT BEGIN WITllH: 180 DAYS, OR IF WORK IS S1.;SPENOEO OR ABANDONED FOR :>10RE THAN 180 DAYS.
SUSPENSION fiR REVOCATION :.1.1\.Y OCCUR IF TillS PER;UT WAS ISSUED 0:>1 THE BASIS OF INcmlPLETE OR ERRONEOUS
lNFORHATION.
ANYONE PROCEEDING P,'\ST THE POI::T or REQUIRED INSPECTIOllS WILL DO SO AT THEIR OWN RISK.
SUBSURFACE ~ ALTERNATIVE ~ DISPOSAL ~;
1. Permits shall be effective for one year from the date of issu~nce.
2. Upon completing the construction for which a permit has been issued, the permit holder Shall
notify the Lane County Department of Planning and Co~~unity Development by submitting the
installation record for!:l. 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 ccrtifi~at~ofsatisfactory completion to the pcrmi~~older.
-......Ir...tlfe constructTh~ lloeri'iOt comply with-suC!i'rur'es',-the Department shall not:.fY-thnper~it~ --,_.
holder and shall require satisfactory completion before issuing the certi(ic~te. Failure to
meet the requirements for satisfactory completion w1thin a reasonable time constitutes a.viQ:_
l';'t'ion 01 dRS 454.605 to 45-1.745 and this rule.
Setbacks - Subsurface SQwaqe Disposal
Sl!ptic Tank
Dn.infield
:=o~: Inlerior propcrt, lines
Ed'Je of ro~d rlC;ht-of -W,lY
BU11Jino fOt;nGation
~clls, other water sources
10'
10'
5'
50'
10'
10'
10'
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W: 5 ' LANE COUNTY
I: I APPLIC'ANT PF.:AK E, KENNETH , ,
.Tl..~, ,\80;,'0613'1 '1200 SUBDIV
NEW BLDG TYPE USE R BDRMS 0
OWNER NME PEAKE, KENNETH
. CODE (11::Pi_ NO (ICTION DESCIUF'THlN
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DEPT ENV MGT RECtIPT . 301787 DATE 100187
,ADDR 1069 DONDEA, SPRINGFIELD, OREGON
L.OT ElL.l(.
UNITS 001 STORIES IElL.DGS 001 PHONE 484 2022
AD DR 1069 DONDEA, SPRINGFIELD, OREGON
SQ FT UNIT COST VAL.UATION FEE
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FT . WTf~ :
MECHANICrd... FEE
STATE SUf~CHAF(GE
PLr~NCHf::CI( FEE
FT.
RAIN:
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L.C 301787 SDSV
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DEPOS I T lH,
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EST. COMPLETION DATE
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ACTIVITY INFORM A TION SHEET
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'~l" an. ,
, I.ounty
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........."'''........_...''''....K...
............_,~ I..~_ ....~h
Please complete all Items above dolled line
FILLING OUT * LINES WILL GET YOU INFORMATION ONLY
*DATE) 'Zl I J I <67
* PERSON t '/ - ACTUAL /J
~la~ST t:J n i I'J tk k <:;/ -:' h l...Tt"'lY '" I 4ft'" ~~o:l:TY I~ Y\ n 'l7 t-1r. r.p a k P
ADDRESS 17:J(;' t-J;//t!Uo1"f"_tre .:5/ ADDRESS roG q .f)Oh lea:
CITY Eu :'e'_'" 4' STATE eJr- zIP9S>4"n/clTy,f;pf'1/1i.f,'p(J sTATEl/r ZIP 9]<(r,{
TELEPHONE (BUSLtV'l{ Cf-70 ;L-:2.-(HOMEl b 8<? -"2 7h C~ TELEPHONE (BUSl tHOME)
* PROPERTY ADDRES~ /00 q <!)o" IO(P ~ _
OR
MAP & PARCEL NUMBER (Found on lax maps in the Assessment & Taxation Dept.)
, STAFF WILL DETERMINE_
U ~ed ~IOOd Plain
I -5
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Range
obl-",
Section
__L-' jn6
Tax Lot
Township
Township
Range
Section
. Tax Lot
Zoned
Flood Plain
Township
Range
Section
Tax Lot
Zoned
Flood Plain
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP:
ACRES
* R E QUE S T (describe what you want to do)
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Directions to site
....................5taff Use On~....................
Comments:
Land Management Division, Public Works Department 125 E. 8th Ave., Eugene, OR 97401 phone 6874061