Loading...
HomeMy WebLinkAboutPermit Septic Tank 1991-10-17 (2) ~.;.. mvtf). ",. ,.. '- .,~. -. .-. '. . r)(;;6- fl.t~~ .'...'._._ AUTHORIZATION FORM ;>3/76 -;7/ , REQUEST FOR: \ Land Managamant Olvlalon 125 E, 8th Ave, Eugene, OR 97401 '". lAD DRESSING, REPAIR EXISTING SEPTIC SYSTEM QUI Q VAUD Q NEW ~.- uvy COOl f TOWNSHIP 18 UNOi 03 SECTION 02 . ~ BECTlOH TAX LOT 17 0 0 SU8t1VISIOM 1 PARTlTlOH LOCATION ADDRESS 210 DORRIS STREET, SPRINGFIELD. OREGON 97477 STRUCTURES NOW ON PROPERTY EXISTING SINGLE FAMILY DWELLING. SHED iiioPOSED usa SEPTIC I\ISTALLEO WATER I\ISTALUiD NO. OF STORlEB NO. Of EllP'wiiEs PR IVATE USE PESCRlI'nOH 01' PROPOSED WORK REPAIR EXISTING SEPTIC SYSTEM (DRAINFIELD) L.01/PAflc:u. -.ClCK ..I COfCSTJllET1DtIl COST/YAW& NO. Of' BECROOlII8 DlAlicrlONS TO 81111 I"ROII COUATHOUS8 OUTH SOUTN SECOND STREET. TO DORIS STREET. LEFT ON DORRIS STREET. FIRST HOUSE ON DORRIS STREET PAST EMPTY FIELD. APPUCANT NAME . ADDRESS VIRGIL TAYLOR, 1960 NORTH 18TH STREET, SPRINGFIELD. OREGON IWOH1"ACTOA flAME NA ~ MAIl. PERMIT TO: APPLICANT WANTS TO PICK-UP PERMIT ~ H..E '..'''B. l { I have cerefully reed BOTH sides of this ~IO"ltJ~"jher~1J~~at r#~ Information VIRGIL TAYLOR ..,.;...:. ~l-GiU f rr7 '" PRINTN.W!j -~ '{ { / '. DATIj _.'J ., .'OC'T:.: ~ ;.J2fU Cf'.!l2:"lL:" '!i You:' 1\,'",oi'!%,:lu:~ Ie !'lcc:;~; On 1 rl:; ;'01l0,;1,1[) CDi1(jl>Oi1U OaR UCaiSi . NA 97"llii 747-1098 PHON& SAME PHONI NA ( , 19 true and correct .. OWNERS NAMe: . AOORE88 SAME AS THE ABOVE :. >~- - -""'). --: . PLANNING/ZONING NA ZONE F,p.' UOAI;. ....OT' MINIMUM SETBACKS FRONT ~TLWI c.\,aoe lNTl[AIQR.,. 'EAR RIPARIAN CQ..MOITIl NO PLANNING ACTION REQUIRED. REPAIR OF EXISTING SEPTIC SYSTEf4 ONLY. ) SANITATION &llIPII:o\ll'b llY; .. ,,'- ,.. ,. ROGER HOLLI S hAtI! 10/16/91 /~fo'f.e:t:.-ki l.:::n 1<{ 0 lNBTALL lBllT. ....... P" r 1..J41Q6 .. /'JlJ qC- . APPROVED PLOT PUN. OATIlD . ~_ 0 THI 8YIT~ .PPURe TO .. WOfWMO SJ.' I.P.' INST.R~''';J''l.. . T,t.HK81ZE UN.~T'D' ,.........TR tlEPTlf..,. RlOHT. lFarsTEM'~u.yOU, ~~ I. JJ ..,o'i...A ."It It_._ .... .L:~: ' .. ' AL....,-.:, MUIT APPlY FOR A "IPolIA P&RiIIY ~f'hln .......T\..~ ~.t...t),. (l.'#')r...l. ....:-.. H...-'::OHOOM;TOEXI8TlHQ8Y8TOI COil' ct-; tnih 1-D lJ~lrlJ~ ~ ~.{.jfII):,R -iJ?:&...:~7"11- (\,S ~ "",,',+ :z.: ftl7-fro ~ '.pUJ. p/u.., J ~ ..... )n . "PP"OVIO 8Y; BUILDING 1 f'>' ~b", .- "'. GROUP us. CO'U'ENHh APPROVED BY: ~~ ..... 1 ) FEES DUE: $ . DATE 17M (/ . - , , CALL FOR INSPEC7IONS (S'=E BACI( OF 1"0:'1[.1 FOR INSTRUCTIONS) 687-4065 ~EP77C porml~octo_fJO~d -'or 0."0 yoar. ALl. olhsr permits o"plro ElftrJ~ 18~'tEl!..S':fI/C'JO!J -'nsfJ".etlonr;~ro cUl"ront~ . . VIOLATIONS SBTBACKS AND OTHBR CONDmONS OF APPROVAL MUSTBB snuCIL YOBSBRVED. VIOLATION CAN RBSUL TEN RBVQCA.ll0N OFniIS PERMIT. CrrATlONS MAY DB lSSUBD UNDER nm PROVISIONS OPLANB COUNTY'S INI'1tACJ1ON ORDINANCE AND/OR. OTHER REMEDIES AlLOWED BY LAW. A MINIMUM OF AT LEAST 24 HOURS ADVANCE NOTICE MUST BE GIVEN FOR INSPECflON 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 omCIAL RIGIn'TO TRESPASS ON PRIVATE PROPERTYORS n!.oSD POWER TO ENTER UPON LAND. nm COMMiSSION, AND ANY OF rrs MEMBERS, OFPICERS AND EMPLOYES, IN nIB PRRPORMANCB OPnmIRPUNCllONS. MAY BNTBR UPON ANY LAND AND MAKE EXAMINATIONS AND SURVEYS AND PLACB AND MAINTAIN nm NECESSARY MONUMBNTS AND MARKERS TImRI!ON. REQUIRED INSPEcrIONS FOUNDATION INSPEcrION: To be made after excavations for footings are complete and any required reinforcing steel is in place. UNDERGROUND PIPING INSPEcrION: To be made after all underground piping has been installed, prior to any backfill. CONCRETE SLAB OR UNDER-FLOOR INSPEcrION: To be made after all in-slab or under-floc! 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 INSPEcrION: To be made after all ducting and gas piping has been installed and prior to being covered. ROUGH PLUMBING INSPEcrION: To be made after aU plumbing rough-in is in place, prior to being covered. FRAMING INSPEcrION: To be made after the all framing, fJre blocking, bracing and roof are in place and all pipes, chimneys and vents ore complete and the rough electrical, plumbing, and mechanical inspections have been made and approved. INSULATION INSPEcrION: To be made after all insulation and vapor barriers are in place, prior to covering. LATH AND/OR GYPSUM BOARD INSPEcrION: 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 and finished. ADDITIONAL INSPECflONS MAY BE REQUIRED, such as but not limited to; BWCK 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 until the plumbing and electrical inspections have been made and approved. FINAL MECHANICAL INSPEcrION: To be made just prior to the structure or remodeled area being occupied and prior to operating any equipment FINAL PLUMBING INSPEcrION: To be made just prior to the building, structure or remodeled orea being occupied. FINAL BUILDING INSPEcrION: To be made after fmish grading and the building, structure or remodeled orea is completed and ready for oecupancy. MOB1LE/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 plmnbing connections. Footings and piers to comply with State foundation requirements for mobile homes or as recommended by the manufacturer. Minimum futished 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 fust 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 JOB SITE AT AU. TIMES DURING WORKING HOURS. TIllS PERMIT WILL EXPIRE IF WORK DOES NOT BEGIN WITHJN 180 DAYS, OR IF WORK IS S ourrr.u OR ABANDONED FOR MORE TIlAN 180 DAYS. SUSPENSION OR REVOCATION MAY OCCUR IF TIllS PERMIT WAS ISSUED ON TIlE BASIS OF INCOMPLETE OR ERRONEOUS INFORMATION. 1 '. ANYONE PROCEEDING PAST THE POINT OF REQUIRED INSPECflONS '(VILL DO SO AT THEIR OWN RIS:.. Your signature on the front ofthis form verifies the following: I HAVE CAREFULLY EXAMINED TIllS COMPLETED APPLICATION. and 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 furthcr certify that any and all work .....:_....ed 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 I am not the owner of the r'.r..'J, 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 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 pennit holder. If construction does not comply with rules, thc.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 violation of ORS 454.605 to 454.745 and this rule. SUBSURFACE SEW AGE DISPOSAL SETBACKS SEPTIC TANK From: interior property lines 10' Edge of road right-of-way 10' Building foundation 5' Wells or other water sources 50' DRAINFIELD 10' 10' 10' 100' . TRS,TI 1~-dJ-0.2,'1. 17CJO VICINITY MAP A / / /Y/ .JTA/V . ~~ ";< ~ ,t ~ ' ~ ~1 ~ ,~ \J '" '" ~ Cl> ~ . ~ ~ "0 "0 ~ \: <l: O"l ~ c: ~ ~ I co ~ ':': l' ~ ::;: - ~. ~ ~ Cl> E co ~t) Z ~. .'" << - \J c: ""-l '- \t l3 ~. ~ '- ~'" .!3 C. -' '"' , '" > a. ~)1'\ ~ 0- - .co <l: co l ~ N' Job Location (Street,milepost).:2/!' Pn,if'RJ5 5'T .5/'7.0 SUbdivision4f/lf/.:-lt:f2.k jTJ f'l ~-r.r rYJl= t-V'II.I, JI/?-.IJT5 Lotll-l-'/-2 Block.L2.- FOR SAN IT AR IAN'S USE ON L Y: 0 System Approved 0 System Disapprov::}d ~eeds Correction . .,t: I . I ~ . 11 . ..."tJ,'<1) . COMMENTS. "'" $j'$,.... ,---I!.~ " ~1w"l. lOr #.. t?It,.h7f ~. ~ .....~7"'~ ..10.. '''0+ _.t Ii. r.rl....~ eo.'J.f nl'~':".~ t1.f:.~I.;. !l0 A-ad,'J-,."y or I\II-U""DM to i/.~ e",sf,'-. .s~r...cl..l~ wln.J.e d....I,Lo,,~.~ 0)(/1,....+ a.JJ;~,' ~o 0""..1 -IJr~..A,". · Signature:~ Date:.:S-.v.,,71l 'FOR INSTALLER'S USE: Trench Depth "", -/ Fill'er De~th Below Tile" -/6 - Tank Capacity 1/h715 _ Manufacturer E'(/6-J:r~}J-<A/V,l} Measured distance to well from tank.....i:""/1 - from draiA1ield~; -J, O-I.J.~.. ...H.... 160 ~ u}n/8 >p/) ".': 01' (I ~ 1..sIJ1.P~ I;,~"?: '~,.'-?-',1 - '"\ 2 (~,,:'{,~ 0_:, "<1 8~ o' <,:,<, :~:6'o' , ~1H--J5' j , ,,'). '8 n.....,~ . ':..~> 110,) ~~,,~ :'\ -Ill bt ~ :17.;' ,<>o,l' ) :rL' _ , I ",(I(' , ~.s( r-- \...~ 1#t4J.t.. vl?,o$ , ------ '/ Scale:' ()o"f If;.! 5 T , INSTALLATION RECORD AND CERTIFICATE OF SATISFACTORY COMPLETION When signed by the County Sanitarian, this certificate is evidence as per ORS 454.665 of sat- isfactory completion of a subsurface sewage disposal system at the above location. Return this form to: Permit Processing Section, Department of Environmental Management, Public Service Building, 125 East 8th Avenue, Eugene 97401 C55-" ~ . , Please complete all lines inside white boxes, if possible. ~(lt~'II~)\r;~ .~1~gu~jFi ~ (7) ,c,r::lrlYltl .l'1.Q, rJ. OJr...f.(4.JZ...,Vl C~.' {Y 'J ctrt '~I )<iC\ \ 71 '7-/0 q R" t"nUhl:; rl'('71J IP OWNER OF PROPERTY (If not ..me .. above) t'nuru; OWNERS ADDRESS (II not ..me .. above) ZIP t.:ONTHAl;;IOH License. , , MAP, PARCEL NUMBER (Found on tn map. In the A.....m.nt .. Taxation DepL) l~w1.nIP ~~ ~~t= \/4 ~.on i "'I~~I TownshIp R;;- Section 114 S.cUon Tex Lot lown~'p Range ~ecuon 114~cl.on lax LOI \ . Sor. AD~RESS, .slh....I"'~ t ;-t..\ d , OR. C\1~'l~ Ie .Or1--1 (" '\T '-- \ . MAIL NAMt; PERMIT TO:// / /~ hh.;/~ ./ 7ZJ ~6Y ",UUHt::;;:;; !";IIT ZIP '. ExIstIng BuildIngs or Improvements on Property ts:?I House o Barn o Garage o Mobile. Home CiO;l Shed SEPTIC INSTAllED C!<I Yes DNa Water District :. " , DIrectIons to site from -fourthOJl!!e ,." 0..\' r)O'l\IVj 'l1Wl '.. 'It; DCJVvl9 ldT ov-J ~) i (~ L'vu-r,'t (j f) nLJvV1Jc. YC{fT !Z..vt\I7'fiJ .P.lt/~ ry-+ -I) ~ ZIP , , For Mobile Ho/me PlaCe~OnlY Brand Year Size . No. of Tip,tuj). , No. of B/ctrmr Ucense # land Management Dlv. staff can not be held responsible for evaluations or recommendations based on false, Inaccurate or _ Incomplete Information ~ '~J ,"Cr. ~~2>-L<;;; <; \021 CX::r. . 'l13M 'J. ~ ) ~" ~ )001 ~ A .,.. . ;/ofl.s-e. \ f.,5"1 ( J: oed ~- 4 ' )2.05' . ~. " ; . \ \ .):, :~~-~'~ ' "pi\'.'i"': ,~," . :~~'-;....~ ~, ~OA ~OA ~OA 5 If $+(' yV) ;..5 . , 1-4tLIIVC i/euJ peoftJSf?O S'-{sfeu-. ,O~ =//4 f) HUUad # Huuad f) HtlUad J pO (!j~s <;" JJoOQ ,- .N -'. ~J] ';..~! , \1.~ j dhf - 0 '" ~ t\:, ~ ~ ~OA ,f) :n:=ad ~OA ,f) Huuad ~OA f) H=ad o IZ (ij""sa~ppv) UO-pll:l01 qor O!;l-'7L:> dllM '<HUPl'A "'}~ \{1 Q'1 II) 't- L ,- .1L. ~ >JJ'~ -::::/" -- -z 1 :l{::lOTlI -z. r 4> 1/ ~o'I >;~t.~ , 1'1.......,'J1'rY'Of"f~'d rr...."'fUOlslrq.pqnS , UBld ~ald OPl/p L"Z.O-'i.CJ-.$1 11 '!nil . ~ . . . i,lf' . . . . ~ I ~ I . W: 3 L~NE COUNTY DEPT ENV MGT RECEIPT ~ 317691 DATE 101691 . APPLICANT TAYLOR, VIRGIL ADDR 210 DORRIS ST., SPRINGFIELD, OREGO~ TL~ 8030220001700 SUBDIV LOT BLK NEW BLDG TYPE USE R BDRMS 0 UNITS 001 STORIES IBLDGS .01 PHONE 747 1098 OWNER NME TAYLOR, VIRGIL ADDR 210 DORRIS ST.. SPRINGFIELD. OREGO~ CODE APPL NO ACTION DESCRIPTION SQ FT UNIT COST VALUATION FE€ DA~S BP '111,1 BP . BP BP BP . . . . "j i ~ . ':M e I"', .. PL IFIX/BATH: e MECH SUR PCK SDS LC 317691 SDSR . SDEQ FEE \, ,. . CATG: PLN SEQU: . TAKEN BY RLH RA . . SWR: FT. WTR: MECHANICAL FEE STATE SURCHARGE PLAN CHECK FEE FT. RAIN: 5% 257. SDS ELE PCK ISS / SI OTR 1 ' 2 EST. COMPLETION DATE DEPOSIT ** .- . II. ' . ^ .m €I e~ i iI e~ ., li~ .~ . el . " :. .~ " . ..l ., ". ,- e: . "e. e FT e 75.00 e 10.00 .,,' , . 85.00 CI"~; n ~ .~. " .: . I -, ..' . .' m~ . . . . mH . . . . 3m . ... J ~ -~ ~ , '_.",'- ........ ( , -... ~ . -. ...- -'." -$ , ~ '\ -':)'., ---~..........--: .:;, ":2 'l!. ... - . . ~HHH . . . . ~m . . . . Hm .' . W: 3 LANE COUNTY DEPT ENV MGT RECEIPT I 317691 DATE 101691 . ,!\PPL.ICANT TAYLOR, VIRGIL ADDo: 210 DCif(RIS S1"., SPRINGFIEL.D., OREGOt. TL.I 8030220001700 SUBDIV LOT BL.K NEW BLDG TYPE USE R 0DRMS 0 UNITS 001 STORIES 10LDGS 001 PHONE 747 1098 . OWNEI:( NME TfWLm;;, VIf(GH. (,lH'f! 21<1 DORfnS ST., SPfCl:NGFIELD, rH(EGClre CODE APPL. NO ACTION DESCRIPTION SQ FT UNIT COST VALUATION FEE DArS mH ~~;: BHHl! . BF' . BF' . [IF' PL MECH . SUI', PCI( SDS SDH~ . H ~~tU . ':~FIX/BATH : LC 3176'11 SDSf( FEE CATG: PLN . SEQU: TAI<EN EIY RLH . . F,A ----- SWR: FT. WTR: MECHANICAL FEE STATE SUo:CH~lRGE PLAN CHECK FEE SDS ELE PCK 1 EST. COMPLETION DATE ISS ,., ~ FT. RAIN: 5% 2~)% I SI OH DEPOSIT Hi . FT . 75. (~O . 10.00 ~UHH .,U . 85.00 CI<.e? . .