HomeMy WebLinkAboutPermit Septic Tank 1987-6-16 (2)
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Lane County Authorizati n fo~:" '\ 1" . -I'
App ,:cat1onl /' <7/1 J 17
SEPTIC INSPECTION FOR LOAN REVIEW perm.t t /(/ I
""""SHIP 17 I RANGE 03
S~BDIVISION/PARTITION {if applicable)
23.4.4
I
) TAX LOT
108
LOT/PARCE!. I
LJUUl vr
PROPOSED USE OF PROPERTY
o Residential D Industr ial
o Corrunercial D Public.
SECTION
BLOCK
LOCATION ADDRESS STREET
2421 Dumas Dr., Springfield 97477
CITY
ZIP
STRUCTURES CURRENTLY ON PROPERTY
SFD
D1REC~IONS TO SIT~
Across from Paqe School
- Hayden Br. Rd. to Dumas - turn N off Hayden Br. - 2nd hs on right
~E:SCRIPTION OF PROPOSED WORK - BE SPECIFIC
SEPTIC INSPECTION FOR LOAN REVIEW
DECLARED ~ VALUE
~ OF BEDROOMS l ~ OF STORIES
a;,"NER I 5 NAME AND ADDRESS
WALDON, Katherine A.
CONTRACTOR'S NAME AND aSR *
BILL MEDFORD RLTY
I It OF EMPLOYECS
WATER SUPPLY
o Proposed
n Existing
TELEPHONE NUMBER
1216 Mohawk Blvd., Springfield 97477
TELEPHONE NUMBER
746 7613
P::;Rt-IIT TO BE MAILED TO (NAME AND ADDRESS)
TELEPHONE NUMBER
I HAVE CAREFULLY EXAMINED THE COMPLETED APPLICATION f'OR PERMIT, dhd uo hcrcuy certify t_hat all inforrnation hereon is true and correct, and that I
have tho following legal interest in the property: Downer of record; 0 contraGt;. purchaser; Oauthorized agent.
I f:.:.rther certify that any and all work performed shall be done in accoldilnc<: with tht! Ordinances of Lane County and the Laws of the State of Oregon
pertaining to the work described herein, and that NO OCCUpANCY will ~ made of ar,y st_ructure without the permission of the Building Division. r fur-
ther certify that registration with the Builder's Board is in full force and effect as required by ORS 701.05S, that if-exernpt the basis for exemption
is noted hereon, and that only subcontractors and employees who are in compliance with ORS 70l.05~ill be U~hi$ project. I HAVE READ AND
CHECKED THIS ;:~L~CA~I;:;::UGHLY' xPJ/ m J/~ 6-15-87
NAKE lplease print) . SiGN)'tlJRE DATE
READ THIS SECTION CAREFULLY. YOUR AUTHORIZATION gAS BEEN BASED ON THE FOLLOWING CONDITIONS!
[] PLANNING/ZONING:
ZonE'"
Parti tion #
parce 1 #
Parcel Size
Minimum Setbacks:
C
L, front
CL, side
interior
rear
COM.'1ENTS ,
SEPTIC INSPECTION FOR LOAN REVIEW
NO SPECIAL
PLANNING ACTION REOUIREO
6-15-87
Date ;
[] SANITATION:
5. 1. #
B. P. It
4-
-'
Installation Record Issued? Dyes D No
Lineal Feet Maximum Depth
n;;;;;ie~ ~~~he~f '_
VDate, d>-rfC/-?"7 ,~
Installation
Specifications:
cc~mENTS, ~
cdL -1%~ 77:~
,
Gallon
Tank
.f h..:-;t;I.......-- :<;.1"\ '" _
n ~. U
[] PLANS EXAMINATION: Type
Group
Use
COMI>lENTS :
Date:
n
r
~cJ
~~IT APPROVED BY
LANE COUNTY DEPA
/{--r' -P7
AL/OESIGNEE (ocr ORS 456.805(1)) DATE
NT OF PUBLIC WORKS LAND MANAGEMENT DIVISION, 687-4061,
EAST 8TH AVENUE, EUGENE, OREGON 97401
REVERSE FOR INSPECTION INFORMATION
~ lb._?~ ~A4.
SEE
.
.
SETB,\CKS A!-lO OTJlER CO:'OlTIO:-<S OF APPROVAL ~lUST BE STRICTLY 01:lSERVEO. VIOLATIO~ CA:-l RESULT IN REVQ-
Ci,:'IO~ OF Tllrs PERmT, CIT"TIO~1 u:-mER PROVISIO~S OF LA:>:E COli:;T'i'o; INFRACTION QRDI:-;ANCE, AND/OR OTHER
RE~IEOIES ALLOWED BY LAW.
IoiHEN READY FOR I~SPCCTION, CALL 697-~065. A ~lINHlml or AT LEAST 24 IlOURS ,\OVA::;CE NOTICE FOR INSPEC-
TIU:-l H.I::QI."J:;::iT::i ~;I,;:>T Ill:: GIV~.. Have tne {allowing information ready: rermit number, job address, type
of inspeCtlOn, when it 10'111 be ready. your name and ~hor.c n~~ber. and any s?ccial cirections to site.
BUILDING DIVISION:
REQUIRED I~SPECTIONS:
1. Foundation Inspection: To be made after trenches are excavated and forms erected and when all
matcrlalS ~or the toundation are delivered on the job. Where concrete from a central mixing
plant (commonly termed -transit mixedn) is to be used, materials need not be on the job.
2. Concrete Slab ~ Under-Floor Insp~ction: To be made after all in-slab or under-floor building
serVl~e e~uipment, conault, p1p1ng accessories, and other ancillary equipment items are in
place but before any concrete is poured or floor sheathing installed, including the subfloor.
). Framin9' Insulation Inspections: To be made after the roof, all framing, fire blocking, and
orac1ng are 1n place ~ all p1pes, fireplaces, chimneys, and vents Are complete and all rough
electrical and plumbing are approved. All wall insulation and vapor barrier are in place.
4. Lath and/or Gvpsum Board Inspection: To be made after all lathing and gypsum board, interior
ana-ext:'CrIOr, 15 1n place but berore any plastering is applied and be:ore CJYPSUl:l board joints
and fasteners are taped and finished.
5. Final Inspection: To be made after the building is complete and before occupancy.
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 shall have been made of each successive step
in the construction as indicated by each of the inspections required.
NOTE: All building permits require inspections for the work authorized, such as but not limited to:
A. Block Wall: To be made after reinforcing is in place, but before any grout is poured. This
InSpectlon is required for each bond beam pour. There will be no approval until the plumbing
and electrical inspections have been made and approved.
B. Wood~: To be made after completion of masonry (if applicable) and when installation is
complete. 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
~or ~eptic system for setback requirements, blocking, footing connection, tiedowns,
skirting, and plumbing connections.
1. Footings and piers to comply with State foundation requirements for mobile homes or as
recommended by the manufacturer.
2. Mobile ho~e minimum finish floor elevation shall be certified when required by a flood-
plain management letter.
3. Mobile home tiedowns, when required, and skirting shall be installed and ready for inspec-
tion within at least 30 days after occupancy. Tiedowns and skirting shall be installed
per enclosure.
D. swimmin9 Pool: Below grade when steel is in place and before concrete is poured. Above grade
wnen pool-rs-installcd.
APPROVED PLANS MUST BE ON THE JOB SITE AT ALL TIMES DURING WORKING HOURS. THIS PERMIT WILL EXPIRE
IF WORK ODES NOT BEGIN WITHIN 180 DAYS, OR IF WORK IS SUSPENDED OR ABANDONED FOR MORE THAN 180 DAYS.
SUSPENSION OR REVOCATION :1AY OCCUR IF THIS PE&~IT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS
INFORMATION.
ANYONE PROCEEDING PAST THE POIl1T or REQUIRED INSPECTIONS WILL DO SO AT THEIR OWN RISK.
SUBSURFACE ~ ALTERNATIVE SEWAGE DISPOSAL SYSTEMS:
1. Permits shall be effective for one year from the date of issuance.
2. Upon completing the construction for which a permit has been issued, the permit holder shall
notify the Lane County Department of Planning and Community Development by submitting the
installation record form. 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 certificate of satisfactory completion to the permitihOlder.
If the construction does not comply with such rules, the Department shall notify the permit
holder and shall require satisfactory completion before issuing the certificate. Failure to
meet the requirements for satisfactory completion within a reasonable time constitutes a vio-
lation of ORS 454.605 to 454.745 anu this rule.
Setbacks - Subsurface
I~terior property lines
Edge at road ru:;ht-of-way
Buildinq foundation
Wells, other water sources
S~wagc Disposal
Septic ~
10'
10'
"
'0'
Orainficld
Fro;:!.:
10'
10'
10'
100'
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W: 5 LANE COUNTY DEPT ENV MGT RECEIPT I 190387 DATE 061587
. APPLICANT BILL MEDFORD REAL TV, ADDR 1216 MOHAWK BLVD., SPRINGFIELD _
TLI 1703234400108 SUBDIV LOT BLK
NEW BLDG TYPE USE R BDRMS 0 UNITS 001 STORIES IBLDGS 001 PHONE 746 7613
. OWNER NME WALDON, KATHERINE ADDR 2421 DUMAS DR., SPRINGFIELD ta
CODE APPL NO ACTION DESCRIPTION SQ FT U~IT COST VALUATION FEE DAY~
BP
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IFIX/BATH:
SWR:
FT. WTR:
MECHANICAL FEE
STATE ,SURCHARGE
PLAN CHECK FEE
FT.
RAIN:
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LC 190387 SDSV
60.00
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DEPOSIT **
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EST. COMPLETION DATE
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ACTIVITY INFORMATION SHEET
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Pleose complete ell Items sbove dolled line
FILLING OUT * LINES WILL GET YOU INFORMATION ONLY
*DATE~I /51fl
*PERSON ~. ,!A () /) /J 7 7r~r;ruAL ,j/ , , /7/J
~rala~ST';p jJ?~r-: /~,.x U-f~~~o:E~T(~d"A---..L IJ ;JA)~A---
ADDRESS!.'?/!" ~. h'.L./fl. ADORESS.}'4I'~ / ~~_, 9.1.
Clr;//"--;f!~ STAT~..-- ZIP 9?'.r/7~TY~~_;,.../..~~ STAT~/ ZIP 9';7177
TELEPHONE (BUS) Jf{ - 1 t r3 (HOME) , TELEPHONE (BUS) /HOMEl
*PROPERTY ADDRESS,,241'.J'1 0~Ad- 0...,
OR .
MAP & PARCEL NUMBER (Found on tax maps in the Assessment & Taxation Dept.)
/ _ STAFF WILL DETERMINE_
/7 tJ3 ;2 ~ ~C/-PCJ/(J ~
Township Range Section Tax Lot Zoned Flood Plain
Township
Range
Section
Tax Lot
Zoned
Flood Plain
Township
Range
Section
Tax Lot
Zoned
Flood Plain
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP:
ACRES
* REa U EST (describe ,what you want to do)
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Directio~ to site ~_, .f:.~~.-e.. :] ~_
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~ .~- - ,'A-<!_"" ~ /I -;JL / .......
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....................5taff Use On~....................
Comments:
Land Management Division, Public Works Department 125 E. 8th Ave., Eugene, OR 97401 phone 687-4061
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