HomeMy WebLinkAboutMiscellaneous Septic Tank 1989-7-7
REQUEST
FOR:
SEPTIC INSPECTION FOR LOAN REVIEW
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IIUODlYllolON I PAATnDlI
LOT I PARCIU.
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STRUCTURES NOW ON pkOitiiln
SFD
",OPO.ED uaa
ADlDENTlAL co=aRaAl,.
IJlDUUTFlIAL ""DUe
ND.01"'iffiiiiii1
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IiCO.GI'~".D
COfCJT1UICTlON COGTtYALUI
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. ~A1J'llOlll Q# PAOPOKO WORk
Dl~~g~ i,~ IllT~ v..~~~rto~~n
Take 1-105 to 42nd
Dm'T1C INSTALLED
.ATIER tNlITALLID
J;'nr T,n::an Rt:lI,Ti PloT
y
v
to Jasner Rd: turn
riaht
on
lJasner
ao
to
Donnp"
which is on the left: first cul-de-sac to the left
APPUCAIIIT MIUll. . AOORU8 I"NON.
.-Chri.s 1>. KiJn Pi'"rr (c:::if-t:lI ~Anr) 747_1qOl
OWM.Ra NAlila . ADDJIlllUl PHON.
Ed & Mary Griswold 2722 Harvest Ln. , Springfgie1d 726-5332
CClM~DR NAId oaR UC:PDI , PHON'
I MAIL PERMIT TO:
North""Rt. Flinn i na 1 fi "l"l Wi~lllf.:t tp St Rnapnp, 011 Q7401 _401 "l
. NAMi .~ 'L_'__~~_. _..__ "'_ __ ,__ _ _ .~,~A~~. __.<-.~
I have carefully read BOTH alde9 of thl9 application and h reby carllfy tha
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FEES DUE:
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APPROVED BY:
~7
~
DATE
7 -7--P'1
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CALL FOR /Il!SPECTIONS (SEE BACK OF FORr!l FOR Ir(;rTRUCTIONS) 687-4065
SEPTIC permits ora good for ono yoor. ALL olhor pormltD onplro after 180 doyo unloDD InDpocl/ono
,...... ~
ora cu"o",.
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C74-213
I
VIOLATIONS
SBTBACKS AND anmR _~..~..._.'''' OF APPROV ALMUSTBB S11UCIL Y OBSERVED. V1OU.TlON CAN RESULT IN RBVOCAnoN OPlHIS PERMn'.
crrATlONS MAY DB ISSUED UNDER nIB PROVISIONS OF LANBCOl1tn'Y'S 1NPRAC110N ORDINANCE AND,(lR anmR RBMBDIBS AU.OWBD BYlAW.
.
.
A MlNIMUM OF AT LEAST 24 HOURS AnV ANCE NOTICE MUST BE GIVEN FOR INSPECI10N 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
REQUIRED INSPECTIONS
FuUNDATION INSPECITON: To be made after excavations for footings are complete and any required reinforcing steel is in place,
UNDERGROUND PIPING INSPECITON: To be made after all underground piping has been installed, prior to any backfill,
CONCRETE SLAB OR UNDER-FLOOR INSPECTION: To be made after all in-slab or under-floor buUding service equipment, conduit, piping
accessories and other ancUlllI)' equipment items are in place but before any ._....... is placed or floor sheathing installed, including the subfloor,
ROUGH MECHANICAL INSPECTION: To be made after all ducting and gas piping has been installed and prior to being covered,
ROUGH PLUMBING INSPECITON: To be made after all plumbing rough-in is in place, prior to being covered,
FRAMING INSPECTION: To be made after the all framing, fIre blocking, bracing and roof are in place and all pipes, chimneys and Vents are oomplete
and the rough electrical. plumbing, and mechanical inspections have been made and approved.
INSULATION INSPECITON: To be made after all insulation and vapor barriers are in place, prior to covering.
LATH AND/OR GYPSUM BOARD INSPECITON: 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 fastene.. are taped and fInished,
ADDITIONAL INSPECTIONS MAYBE REQUIRED, such as but not limited to;
BLOCK WALL: To be made after reinforcing is in place, but before any grout is poured The inspection is required for each bond beam pour, There
will be no approval unti1 the plumbing and electrical inspections have been made and approved.
FINAL MECHANICAL INSPECTION: To be made just prior to the structure or remodeled area being occupied and prior to operating anyequipmenL
FINAL PLUMBING INSPECITON: To be made just prior to tho building, structure or remodeled area being occupied ,
FINAL BUILDING INSPECITON: To be made 'after fmish grading ai"r theDuitding, ltnicture iJr remodeled area is completed and ready for occupancy,
MOBILElMANUFAcruRED HOMES: An in..;_..:..: is required iJter the mobUe 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 pie.. to comply with State foundation requirements for mobile hOmes or as recommended by the manufacturer.
Minimum finished 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 fl1'St obtaining the
approval of the building official. Such approval shall be given only after an in........:_.. 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 JOB SITE AT AIL TIMES DURING WORKING HOURS.
TIllS PERMIT WIll EXPIRE IF WORK DOES NOT BEGIN WfTIIIN 180 DAYS, OR IF WORK IS S.ur<",", OR ABA.,vv"."o FOR MORE 11IAN 180 DAYS,
SUSPENSION OR REVOCATION MAY OCCUR IF TIllS PERMIT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS INFORMATION.
, ,-
ANYONE PROCEEDING PAST THE POINT OF REQUIRED INSPECTIONS WILL DO SO AT THEIR OWN RISK.
Your signature on the front of this fo";' veriilCS the following: I HAVE CAREFULLY EXAMINED TIllS COMPLETED APPUCATION, and do
hereby certify that all infonnation hereon is true and correct, and that I have a legal interest in the r' -r"'. as owner of record or authorized agent. I
further certify that any and all work perfonned 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 if! am not the owner of the "'r"'J' my registration with the BuUders 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
fonn, 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 within the allotted time constitutes a viol~ion 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'
DRAINFlELD
10'
10'
10'
100'
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Please complete all lines Inside white boxes,
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OWNER OF PROPERTY (II not ..m.~ abon.
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OWNERS ADDRESS (lI nol ..m. .. abon)
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If possible.
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ZIP
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MAP, PARCEL NUMBER
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Townahlp ~ Section 1/4 Sel:tlon T.. Lot
lownMlp '"'Jr.iig;"" HtcUon 114 I)4Cl,on
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SITE ADORESS \
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MAIL PERMIT TO:
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land Management Dlv. stall can
not be held responsible lor
evaluations or recommendations
based on la/se, Inaccurate or
Incomplete Inlormatlon
..
.
Exlsllng Buildings or
Improvements on
Property
c:J House
c:J Barn ,-
c:J Garage
c:J Mobile, Home
c:J Shed
SEPTIC INSTALLED
c:J Yes
c:J No
Waler District
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ZIP ~ ~
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For Mobile Home
Placement Only
Brand
Year
Size
No, of lip-outs
No, of Bedrrr-
Ucense #
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. W: 5 LANE COUNTY DEPT ENV MGT RECEIPT ~ 158289 DATE 06.1589.
APPLICANT PFAFF, CHRIS 6 KIM ADDR 1085 DONDEA.ST., SPRINGFIELD
TL~ 1802061311400 SUBDIV , LOT BLK ~:j
~EW BLDG TYPE USE R BDRMS0 UNITS 001 STORIES ~BLDGS 001 PHONE,747 1901.
OWNER NME GRISWOLD. ED 6 MARY ADDR 2722 HARVEST LN. SPRINGFIELD
CODE APPL NO ACTION DESCRIPT10N SQ FT UNIT COST VALUATION FEE DAY~
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SWR: FT. WTR: FT. . RAIN: FT .
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STATE SURCHARGE 5Y. '11'
PLAN CHECK FEE 25Y. .
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.' APPLICA,NT PFAFF, CHRIS l.. KIM AD DR 1085 DONDEA ST., SPRINGFIELD
" .TL~ 1802061311400 SUBDIV LOT
'.--NEW BLDGTYPE USE R BDRMS 0 UNITS 001 STORIES ~BLDGS 001 PHONE 747
, OWNER NME GRISWOLD. ED l.. MARY ADDR 2722 HARVEST LN, SPRINGFIELD
; ~CODE APPL NO ACTION DESCRIPTION SQ FT UNIT COST VALUATION FEE
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DAYS
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FT. WTR:
MECHANICAL FEE'
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PLAN CHECK FEE
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DEPOSIT **
10-
60.00 CK
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EST. COMPLETION DATE
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