HomeMy WebLinkAboutPermit Building 1980-8-15
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L:ANE
COUNTY BUILDING
PERMIT.
, POST THIS PERMIT ON MAIN BUILDING AT SITE
CONSTRUCTION PERMIT # LC 1953-80
JOB ADDRESS:~ 3616 Duke Street, Springfield, Oregon
TRS, TL: 18-02-06.4.2, 1800 ~~~ IfDl>.
SUBDIVISION: Meadow Green Estates, Lot 2~ Block 3
CONSTRUCTION APPROVED BY THIS PERMIT: Renewal of SDS installation number
2833-78.
CONDITIONS OF APPROVAL: Install a redundant equal distribution system as
shown on attached plot plan stamped approved and dated August 12, 1980.
SDS installation specifications: 1,000-gallon tank; 150 + 150 feet of
drainfield; maximum depth of trenches, 24 ~ 30 inches. Keep'drainfield at
least 10 feet from all foundations and property lines, and 100 feet from
all water sources. Keep septic tank at least 5 feet from building
foundation, 10 feet from all property lines, 50 feet from all water
sources"and 10 feet from edge of right-of-way. .
PERMITTEE: Ted Morgan
DATE ISSUED: August 15, 1980
BY: Kathi Wiederhold/Candi Hart
Mailing address: 2142 North 11th Street, Springfield, OR 97477
WP 24423-4E-7
* * * * * * * * * * * * * * * * * * * * *
SETBACKS AND OTHER CONDITIONS OF APPROVAL MUST BE STRICTLY OBSERVED. VIOLATION
CAN RESULT IN REVOCATION OF THIS PERMIT, CITATION UNDER PROVISIONS OF LANE COUNTY'S
INFRACTION ORDINANCE, AND/OR OTHER REMEDIES ALLOWED BY LAW.
WHEN READY FOR INSPECTION (see attached) call 687-4065. Have the followin9
information ready: Permit number, job address, type of inspection, when it will
be ready, your name and phone number, and any special directions to site.
f.NVIIiONMlr-.;'^l MANA(IEMENl DE.PARTMENT
. 12m~~:'_YA~ENUE I EUGENE, OWN 97401
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.ti. I q 53- 80
OEPARHiENT OF ENVIRONI1ENTAL f1ANAGEMENT
PSB. 125 EAST 8TH AVENUE
EUGENE, OREGON 97401
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l$Q$4J&i.:~:~QhJ 1'1\11' ~~" Gof'PP"'- ~d"j,,~ ' l~qt? 'L :j\Jd?W 3
Appl ;cation for R..o ,^-I II H~ L, '" ~
Structures now on the propert~-:"~~..j' L/A#?f~:/ O~/ .J" ~~
Pl'llsedOU nHro ^fi;';r ~JllMlili!l\tlal1 n ftOllllllli'cfiiJf n Wlibjj\iti'ljjl) n !Plill'llf"
l;f~:~avit: l,c~IL~"I:JrO p'~J\\~r~~r, - =~'M~,_,3 ,~e;:~;~':";;~ tha: thi"~~;~~rmation is true and accurate.
11l11l~31t,ltMO!l1
If this appli tion is for an agricultural building it will be used for purposes allowed by the State Building Code and
Lane Co ode Chapter 10 (zoning) and for no other purpose. I have the following legal inter st in the property:
L owner of record~ contract purchaseri lessee; holder of an ex ve ?lPti to purchase;
duly authorized to 3:t for the owner, who ;s knowl~e~ble.~thiJl1ppliJ~' .. /#...
Signature/Address \____,.,3;;.. Y0..Qj'-U ., JC?Vt'/d-V/ II '/J, ~a, (ziD{?7iP..,7
l\ ., v'
Telephone '-l or Date
When permit is ready notify: I~I Applicant I~I Owner ~ Contractor
Owner 1-eo/"'9 $'. ~.r"n.._ - Z. \4 t- u,rh... 11m ~ 7', (zip) Phone 'J21. -I'J <; 4.6
Contractor f'i\1"l~1\V\.' ~Ih,..k,.... ~r'--=-/)Jc (zip)Q7477 Phone 7 7_/:. ~(')S4.D
~~contractor'sOSR# /Q4'77_ P1UmbingbY_~Lh-i~f:J)) O\IA...I..la)~A-
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~V,,',I1!,{,n,l,<1)$~7", "'ji,.!@!I;,l,Y,IC7'\
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If Conmercial: rf':~f:i~ae$1
,...,.? ::_X'<"':~',';,.', " r-
Residential: If'nfi!!ilic!H><II!(I!1
SI test holes ready
DU NUT WRITE BELUW THIS LINE
# of emPloyees~*~il~~~, ,
c$~n CI EX1st1ng,
CI Proposed,
BP #
Sl #
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.Feel
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l(/h~~~sjr- ...fh,A?/dff':'~/~Y7-",
Oiiscrfotlon'
;$4n:#:fttijb~
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Valuation
Fee
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0~ri'w,,~
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Total Valuation: $
IlIlllt~rll~I:~ :
Subtotal
$
$
$
$
$
each $
each $
,
TOTAL
$
$
$
$
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Water Supply
Proposed
Year Installed
Existing
4% State surcharge
Plans check fee
Change of Occupancy
=
PERMIT PROCESSING
Zone
1.. front
Pa rt. #
Parcel #
Parcel Size
into rear
Minimum setbacks:
ll. side
Corrments
To be typed on permit
By
Date
CP&1 Type
To be typed on permi t
Group
Fire Zone
Use Classification
By
Oate
Phone
For plans information call (area inspector)
Directions to site
CI SI FO
I~/C~
IlniPC
CI Planning
CI Public Works
I~I Elevation CI n/a
el Address
/~/ Facility Permit
~I Environmental Health
Plans to:
CP&I ~ set(s)
WPC _____ set{s)
Date
Required
H01.P
to C
Date
Completed
Da te to
PCC
.
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C74-171
INSPECTION RECORD
Approved Disapproved
1. Site Inspection
2. Foundation Inspection
3. Framing Inspection
4. Lath or Sheetrock Insp'ection
5. Final Inspection
6. Slab Floor, Plumbing Groundwork
7. Gas Piping Groundwork
8. Rough Plumbing
9. Rou9h Gas Pipin9
10. Final Plumbing
11. Final Gas Piping
Remarks:
12. Certificate of Occupancy:
_ ready to issue; _ not ready;
date;
.
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Date
Inspector
inspector.
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36
LANE COUNTY DEPT ENV MGT RECEIPT ~ 195380 De,TE 071 G.
APPLICANT MORGAN, TED E. AD DR 2142 N. 11TH, SPRINGFIELD, OR
TLI 1802064201800 SUBDIV MEADOW GREEN ESTATES LOT 2 BLK 3
NFl,' BLDG TYPE USE F~ NO BDRMS 00 NO UNITS 001 NO STORIES NO BLDGS 001.
COD~ APPL NO ACTION DESCRIPTION SQ FT UNIT COST VALUATION FEE DAYS
BF'
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NO. FIXTURES:
NO.
CONNECTORS:
MECHANICAL FEE
ST A TE SLmCHARGE
PLAN CHECK FEE
OF' 1 9~>378
5.00
EACH -
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MECH
SUR
F'CI(
SD,<;
4%
~50%
LC 195380 SDSX RENEWAL
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BY CH
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SI
PCK
OTH ISS
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TOTAL FEEH'
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EST. COMPLETION DATE
25.00 C~I :
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APPLICATION # IQc;~, Q")
LOCATION 3G'lIo- /),Jj,o,
IN! /-: f'f/IJ?f](/f'I/
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The Lane County Water Ponution Control Division cannot proceed with
processing your application because:
1. k') Incomplete application (items deficient).
NAME
~(+
C17l.f77
ZIP CODE
ADDRESS
r::J Address andJor directions to apPlication site.
c::J Proposed number of bedrooms in dwelling.
[_I-A"pprovable plot plan (see attaChmen11.i1PI/JtPlo.,'I1 {J{/dll.s /I
c::J Notification of date test holes will be ready.
Verification of existing system required, (memorandum
explaining this procedure attached).
Two test holes (2'X4'X5' deep) required for expansion
or repair of existing sewage disposal system in the
area of the proposed drainfields.
4. 1/1 Other:,(I1I,AJ filA 1/01/,,) _;dnl-:-.:!/r;,"/1 (dJ!rM!/VJ<h> J(j-u:)
/llJ1'/7'117/1110l 1J~.j//jhuhola' OMr:/, /:::;)1 ,,/tJ/1Jorl!..ifJIl'J'1.fw"(i,,-,
/ifrlJ,d liilt I./tJtMiJ OM; .h~/lIlji //I/}fr;>i//}IlJ: f'/lA) /I/id/.I:A.-Ic..'..:r
kr J ml'M. s't?l1yJ&.taO t'l.1/;!;J1?f)f)/ kn/,( (, ) /!;UJ/fJlJr..<..,
~T '/,... //
"fill \ U~"11 P vJ,/I-J -b/U 1- IJO/ANJ 0" J/ (jA/u! J ( /
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,Jll'liJJ, dick, ,,'\-
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_ J..r}jjiJJ ..,/;1, i,fifrifrlllfiff.rt..d/ /.1,' ---Il'lAml ,./>,,1 <,;,h'1Y,:.1
SIGNATURE - ,~.. -s-r I ' DATE a' - " -
/IIU*{J'1~ l/I';
, ... ! .V:~r!i'jrf((j/J~ ~ -"1vi' 1'1 " , , - 'i/J{n 1
(}/:J SMJ!OPHC["HOURS 1..{()iD I I PHONE; ~ - ,
If the necessary corrections a'e not made within I~ days, the
application will be denied, 'hor ~2 lhicJ"
BUILDING & .-,. TATION / ENVIRONMENTAL ,MANAGEMENT DEPARTMENT
125 East 8th Avenue / Pu'__.' Service Building/ Eugene,(.gon 97401 / (503)687-4061
2.
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3.
4541
DICTATION FORMAT
JOB ADDRE~ (g)
TRS, TL: UJ
SUBDIVISION: (4)
CONSTRUCTION AIPPROVED BY THIS PERMIT: (]D
CONDITIONS ~APPROVAL: (])
PERMITTEE: V)
DATE ISSUED: ~, BY: (2)
WP 28305-5E-2
***********************************************************************************************
CONSTRUCTION PERMIT Ci)
This is , 24-08-25, Program 011, extension , dictating a
building permit (or buildinq permits) on Word Processing form #2830S-5E-2, with 4 copies.
These are final copies to be single-spaced. I will need them by
morning, afternoon. I will pick them up. Please leave message when ready.
Note: Please type all numbers in numerical, unless otherwise noted.
.
Variable CD: Capital L Capital C. _ Space Lq ("",? hyphen 80 (All caps MH or TMH) ,
Variable (g): See 'pplicationor rural addressing sheet ,(
Variable G): 1:1 hyphen (;;2, hyphen 0& period "f' period ;Lcomma space !.rDO
Variable @: (If none, just say NA) SfT
Variable C[): See application or notes -
Variable~: See application or notes __
Variable (2): See application
Variable @': (Day after dictation date) cr!t s-
Variable (2): Plan Checker/Sanitarian/Clerk (You must1 say "slash" between names; and not all
names are necessary, see notes) lUA1 C [+
Directions to site, colon
.Ind. of Permit.
.-
New permit. Start over.
NOTES:
Variable 5:
Variable 6: Text: (Bldq.)
Paragraph Text: (Perm. Proc.)
Paragraph
Text: (Sanitation)
. 5l4- - c.., r~ '
, (
Paragraph: SDS installation specifications colon InvO' gallon tank semi-colon lev i- ISO
feet of drainfield semi-colon maximum depth of trenches semi-colon :J. <I-?v" period. Keep
drainfield at least 10' from all foundations and property lines comma and 100' from all water
sources period. Keep septic tank at least 5' from building foundation comma 10'from all property
lines comma 50~ from all water sources comma and 10' from edge of right-of-way period.
See back for setback requirements if required.
_'_U_'~'_.__ ,!.._=--=....._ _, ,,=,"""_=--"',"'_
-.". -.-
Paragraph
I
semi-colon
comma
Variable 7:
Variable 8:
Variable 9:
Paragraph:
End of permi t.
Minimum structural setbacks colon from centerline of road comma front
semi-colon (side exterior comma from centerline of road comma '
side interior property lines comma ' ,semi-colon rear property
, period.
,
comma
)
1 ine
, 19
/
/
Directions to site colon
NOTES AND SUGGESTIONS:
Variable 2: If on a new SFD please look at addressing'copy of new address. If on a septic
installation only, there usually is not an address, just a road name. Spell
out unusual road names.
Variable 5:
OnSDS you must say "All caps S as in Sam D as in dog, S as in Sam.
Sometimes there is not room on the permit for the construction aescription
to write down SDS installation or Cert. of Adequacy; the clerks will write
it down by the fees so be sure to look to see if the permit is for septic also.
Always hyphen and put the square footage of the structures being built.
Prepare before dictation.
Spell unusual names.
These names will differ due to who is involved with permit. If building and
sanitation are on permit, put both the names plus the clerk who took application.
Spell unusual names (McGuckin, Cruickshank, Weiderhold, etc.)
Suggestions: Speak clearly. Always say comma or period or parenthesis.
If you make an error see Dictation Instructions below.
BE PREPARED. Have all applicable sheets in order. On this form just write
SA for "see application" instead of writing out everything.
GENERAL DICTATING INSTRUCTIONS
Variable 6:
Variable 7:
Variable 9:
Dial 4541. If the connection is made, you will hear a short tone followed by
a soft continuous dictation standby tone. If the system is busy, you will
hear a busy tone, (This is a voice activated system--the tape is not running
unless you talk.)
If interrupted: Touch [1]. This will hold for three minutes before discon-
necting. When ready to restart, touch [1] again.
To replay,:
Touch [3] for 15 word revie\~.
Touch [7] to re\~ind to beginning (can stop by touchin9 [21,
[4J will take you back to where you stopped dictating.
then [J]).
To correct: Dictate the correction by prefacing with "special ist, please add/
delete/change beginning with the words..."
Don't touch [2J unless you want to record over'!~verything from that point on.
The first word must have no more syllables than the word you disatated previously,
or it will wipe out the last word you wanted to keep.
,/
Don't touch [5].
Automa tic
Touch .
d i sconnec t.
Wait for the supervisor to tiller.
Touch [3] to
For assistance:
--.....-- ....: -....-......:--
OEPARHiEiH OF EN'll RONi1EiHAL tlANAGEMENT
PSB, 125 EAST 8TH AVENUE
EUGEtlE, OREGOtl 97401
/)J!~P ~/', Cj.ty ,::ofc0.
Township, Range, Section, Tax Lot IX-r"5;:J,-f;r;, .<"/..:::;;J.-~,.-;7Ir""
Subdivision 11\l'f.'o", III G n>p,^ ;d",A,,' lot -? Blo,k 3
Application for R.o\"'JtIJ1r_J> L ~ ~
Structures now on the property/;I;t/?:7..1'~/:"7_~/ t?~t:-p-C~/_/;-~X
pro~ose~ use of property:. ~Resident;al CI Corrrnercial L/ Industrial L/ Public
Affldavlt: I, l....p;t:j J: _ fY\ ('}("t::~u_ . hereby certify that this information is true and accurate.
(please pr..int!
If this applic~tion is for an agricultural building it will be used for purposes allowed by the State Building Code and
Lane Cou~e Chapter 10 (zoning) and for no other purpose. I have the following legal interest in the property:
I../'Owner of record; contract purchaser; Ie, ssee; holder of an ex .;ve o~t;o to purchase;
duly authorized to ac.t f~ t~e owner, who ;s knowle,g~eable.o1.... thisv~epl is:aJ12.n. /
Signature/Address ---r. ~ ) ~ \fIJv>h' ~r?"-.It;i ~/ 1/ ->. ,,(zidf 747 7
II '" v
Telephone 'V or Date
When pennit is ready notify: C/ Appl icant C/ Owner 6''- Contractor
Owner I.....-'I~ "f\^./'\,rrfL_ 2.1d.L u..-h.. IllJf ",
Contractor 't\\n'l'1fl ",\ ~ ...J~,...b.- Qt},.,.i~ - I)..fr
'-.' '
II_____Contractor.s OSRI " C/d.'77 Plumbing by
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Job Address
(ZiD)
(ZiD)tf7d 17
.<'PT"' ,,J.,J J) DI,....L.;~r
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Phon~
Phone
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DO NOT WRITE BELUW THIS LINE
If Commercial: II of stories
Residential: # of bedrooms
51 test holes ready
II of employees
II of units
o
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SDS:
Existing, BP II
Proposed. S I #
Unit
Cost
Valuation
Fee
Code
Sq, Ft, or
# of Sites
Description
tJ/j/ // 1 )./ f/J?! 5-Lf )~ .J2/// Y'dc/~/ /./Y?;,
'~.. -:;ti- ~~::::r-;;5 V '-
,
/~~h '
Vcheck I ~7;;~ . .. ;.
Received bY_/ ~~
W()jO/fv'P1!o /
Total Valuation: $
Plumbing fixtures at $
Sewer/water conn. at $
Subtotal
Existing
4% State surcharge
Plans check fee
Change of Occupancy
Water Supply
Proposed
Year Installed
TOTAL
PERMIT PROCESSING
Zone 'f( ft-_
It, front
into
Pa rt, #
Parcel II
Parcel Size
It, sid.
Mfnimum setbacks:
~~,.
'. ,
Comments
To be typed on permi t
WATER POLLUTION CONTROL
lnsta 11 a tion' spec i fications: 1,0(\(1
, '2..,,11
'2H, - ']V , To be typed-on-permt
I
By 1w.nJU<.--
LSD 1- l5n
tank; ~r~ ~ ~ "7:.~ ft.
I'
\
/!?7~"!f-g)
/ Assigned Numbers
;
7 2.J. -I'J ~ 4-tJ
77. r:. r('J54D
c
Fee
$
$
$
$
$
each $
each $
$
$
$
$
V-::-:.a-)
/2-/ 170
rear
Date ?./ J ~ /' kO
depth of trench~
OA ..!:0S0Am
~. 'V
tJ~~ ~~~~'~#~~~
~~~~/~~~~/
. ft~ fM-
Telephone
4lio /
By
l2JJiA)
Directions to site
C/ SIFO
Plans to:
CPSI.set(S)
WPC _ set(s)
Date
Completed
HOlde
to
Date
Required
(!C~
I.JI-"'iIPC
C/ Planning
/~/ Public ~'orks
/~/ Elevation /~/ n/a
C/ Address
C/ Fac i 1 i ty Permit
/~/ Envlronmental Health
.
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((J;d :)
d~1'
Date
v
{Z-Au1?,
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Da te to
PCC
r
..
1. Site Inspection
2. Foundation Inspection
3. Framing Inspection
4. Lath or Sheetrock Inspection
5. Final Inspection
6. Slab Floor, Plumbing Groundwork
7. Gas Piping Groundwork
8. Rough Plumbing
g. Rough Gas Piping
10. Final Plumbing
11. Final Gas Piping
Remarks:
12. Certificate of Occupancy: ",,~.'
INSPECTION RECORD
Approved Disapproved
_ ready to issue; _ not ready;
date;
.
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Date
Inspector
, " i'nspector.
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::J;s.per 12d,
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Installer~1!/-I Jlt9 /..t
(Title as shown on DEQlicenseJ
Telephone /.. f(q- (,/<0
License No, .;3 L/ "/.2.4
pany )!,.~f/; Ms I-
r-- Date J',2()~SO
If Installed By Owner-
Dat~
lSignatureof Ownerl
Applicant's Name & Address
-r d I1pJ-QO..n
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S/,J..,~-f};'jj (f)1-iZ., Q7"1-77
-
I<y)() form c55-11--'
Tax LotI20-2tJtQJOIJ'tr)
MUST BE IN BLACK INK
Permit No, /q S'3- 110 Twnshp..-4-<;<' Range (")7.. Section (')/(>.4, '2.
Standard System ~ Alternative System 0 (Specify Type) '1(...--1" nJ_ ,,,r
Job Location (Street Addressl '?t.11.. 7)"r~- s I. -s.~~,:.",/.t, (j),,,,
SubdlVlslon/ Partition # /'1 p t2.r1nu,," II . ) c::....~P'1 j::,,'.f~arcel Ln' ;L
DETAIL SY~&J!,M PLOT PLAN AS CONSTRUCTED
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Scale-
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USE BLACK INK ONLY
FOR INSTALLER'S USE: Trench Depth ~,,," Gravel Depth Below Tilp Co"
Tank Capacity I /JJ?O Manufacturer L./dllLhle.He. r::;",<2.Y"'';''''''' "-
Measured Distance from Well to Tan~ ' From Drainfield Total Length of Lines 300 '
COMPLETE THE FOllOWING IF A PUMP WAS USEO ON THIS INSTALLATION:
I linstaller's name certify that a IMfg)
and Mercury Float Switch IMfg, and No,'
.
IModel No,! Pump
have been installed with this sewage installation.
Signatur"
, Datp
-
FOR SANITARIAN'S USE ONL~C!otj~lftr Approved L 0 System DisaQproved
COMMENTS: ~IV\<;', . 0 ()1JJ0vl <m rOhf..P/I] 20'Rri./fI'YJ'I
J 'lZI~Sys!e.'1'. r:;orrfj,~d
System Capacity Ljt:;C') gal./day S;,jnature c,raJ11A WI. f JI1(lCflIJWtA.{r;!
o Needs Correction
Date
Date
INSTALLATION RECORO & CERTIFICATE OF SATISFACTORY COMPLETION When signed by the County Sanitarian, this certi!i at is
evidence as per QAS 454.665 of satisfactory completion of a subsurface sewage disposal system at the above location.
"
Return this form to: Water Pollution Control Div., Dept, of Enivronmental Management, located in the basement of the
Public Service Building, 125 E, Bth Avenue, Eugene 97401,
Block -.r;
DETAIL SYSTEM PLOT PLAN AS CON~&ftUCTED
.fJvkE
.
VICINITY MAP
. JA-')/J EI? I? t!.
I
MUST BE IN BLACK INK
Permit No, /9"5'.J-f?'1J, Twnshp, Range
Standard Syst~m 0 Aliernative s;qtem 0 l}5ecJl: Type)
Job Location (Street Addressl f,/6 U F if
Subdivision/ Partition # /
A
ff~.J..lJ~ ,
cl~ /'I1p/ll5 PUr; I{' : ~ t ~ i ~ ~2.
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= ,,"
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DIII/;::-
form c55-11
Tax Lot
.,
Scale ";""- ..
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Installer !j,~/)/ (I LI..f2 L T
. Z as shoWn on ola liCensel
Telephone ?r-l, / )'IlJ
License No, _ ., If 7~L/
USE BLACK INK ONLY
FOR INSTALLER'S USE: Trench Depth "'Jo'
Tank Capacity, /tf?tJO Manufacturer I//:LL/tAII€7(c
Measured Distance from Well to Tank - From Drainfielci
COMPLETE THE FOllOWING IF A PUMP WAS USED ON THIS INSTALLATION:
I (installer's namo""l- certify that a (Mfgl -
and Mercury Float Switch IMfg, and No,l
7t?, '1'7'
Gravel Depth Below Tilo
1,,/1
.
--
Total Length of Lines "'300
inSlUreofLicensee
(Model No,l Pump
have been installed with this sewage installation.
If Installed By Owner-
Signaturp-
Date
FOR SANITARIAN'S USE ONLY:
COMMENTS: ~:r:; 1~~oKp~
System Capacity~~ gal./uay Si"naturp
o Syste
lSignatureolOwnerl
Applicant's Name & Address
JEe! ~/
.!1J 42 AI:' /J tf/{
,;; 'J.;1l / AI! FI Guf ;() /I'
natA
,
)Q f<{a!ft'or~;;';'!:f
en If 1'1
Date
Date
INSTALLATION RECORO & CERTIFICATE OF SATISFACTORY COMPLETION When signed by the County Sanitarian, this certificate is
evidence as per CRS 454.665 of satisfactory completion.ora subsurface sewage disposal system at the above location.
Return this form to: Water Pollution Control Div,; Dept, of Enivronmental Management, located in the basement of the
Public Service Building, 125 E, 8th Avenue, Eugene 97401 ,
.