HomeMy WebLinkAboutPermit Septic Tank 1993-9-29
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('-PERMIT #
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, REQUEST
FOR:
SEPTIC VERIFICATION FOR LOAN REVIEW
YADDRESSING
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SPRINGFIELD
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SLIlOMSlCNIPAR1'TI'I:N
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17 03 27
TOCATlOO ADDRESS
1523 FAIRVIEW,
STRUCTURES NOW ON PROPERTY
HOUSE
""""""'USE
RES.
S9'T1;NSTAUm
YES
WAffii'NSf'.w.ED
NO. OF STORES
NO.OFEMPlOYEES CONSnu.lCtr.H<XlSTNALlE
I;lE5aW7OCNa::PAOPOSEDWCRK
NO."''''''''''''''
VERIFICATION OF EXISTING SEPTIC SYSTEM FOR LOAN REVIEW.
DIRECTIONS TO SITE FAa.I NEAREST MAIN NTERSECTION
CENTENNIAL EAST OVER 1-5: LEFT ON PRESCOTT: LEFT ON FAIRVIEW.
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""'Pl..lCIWTNN.lE..AD~S
MICK HOOVER, 1142 WILLAGILLESPIE RD.#7, EUGENE 97401
OWNERS NNotE. ADDRESS
DOROTHY DEGGA, 1523 FAIRVIEW, SPRINGFIELD 97477
PHONE
484-9815
PHONE
747-9142
CONTRACTORfNSTAU..El'lIBUI~ NAMf
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PHONE
) MAIL PERMIT TO:
MICK HOOVER. 1142 WILLAGILLESPIE RD.. #7. EUGENE
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97401
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I have cerefully read
.M'Lrj( ~f"l("'l"H'R
PRM' NAME
STREET
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Is true and correct t
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BOTH sides of this application and hereby cer~fythat all Information
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~FEES DUE: $ APPROVED BY: DATE
(CALL FOR INSPECTIONS (SEE BACK OF FORM FOR INSTRUCTIONS) 687-4065
SEPTIC permits are good lor one year. ALL other permits expire aller 180 days un/ass Inspecl/ons
LMD 040 Rev. 6192
CARE FULL VI
Your Authorization Ie Based On The Following Conditione
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VIOLATIONS
'- ,-'" , Sln'BACXS AND onmR. _"_..._.'~ OF APPROVAl. MUST BB S11UCIL Y OBSERVED. VIOLATION CANRBSULT IN REVOCATION OFTInS PERMIT.
... . .0- CrrATIONS MAY BB ISSUBD UNDER TIm PROVISIONS OF LANE COtJNrY's 1NPRAC110N ORDINANCE AmlJOll 011iBR RBMEDIBS AlLOWED BYLAW.
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A MiNIMuM OF AT LEAST 24 HOURS ADVANCE NOTICE MUST BE GIVEN FOR INSPECTION REQUESTS
.
Have the following infornation 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 OFFICIAL RIGIITTO TRESPASS ON PRIVA'I'X PROPERTY oas ns.olO
POWER TO BNTER UPON LAND. nIB COMMISSION, AND ANY OF ITS MEMBERS, OPPlCBRS AND BMPLOYBS, IN nm PBRPORMANCB OF nmIRPUNCllONS, MAY
ENTER UPON ANY LAND AND MAKE EXAMINATIONS AND SURVEYS AND FLACH AND MAINTAIN nm NBCBSSARY MONUMHNTS AND MARKERS nmREON.
REQUIRED INSPECTIONS
FOUNDATION INSPECTION: To be made after excavations for footings are complete and any required reinforcing steel is in place,
UNDERGROUND PIPING INSPECTION: 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 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 INSPECTION: To be made after all ducting and gas piping has been installed and prior to being covered.
ROUGH PLUMBING INSPECTION: 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, chinmeys and vents are complete
and the rough electrical, plumbing, and mechanical inspections have been made and approved.
INSULATION INSPECTION: To be made after all insulation and vapor barriers are in place, prior to covering.
LATH AND/OR GYPSUM BOARD INSPECTION: 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 fmished.
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 until the plumbing and electrical mspections have been made. and approved.
FINAL MECHANICAL INSPECTION: To be made jusf~or to the s~e Or.iemodeled area being occupied and prior to operating any equipment
FINAL PLUMBiNG INSPECTION: To be made just prior to the building, struc~ dr remodeled area being occupied.
FINAL BUILDING INSPECTION: To be mad<, after fmish grading and the building, structure or remodeled area is completed and ready for occupancy,
MOBILE/MANUFAcruRED 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 plumbing connections.
Footings and piers to comply with State fO\U1dation requirements for mobile homes or as recommended by the manufacturer.
Minimum fmished floor elevation shall be certified when required by floodplain Management
Tiedowns, if required, shall be installed and ready for inspectinn 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 flIst 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.
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APPROVED PLANS>MUST BE ON TIlE JOB SITE AT ALL TIMES DURING WORKlNG HOURS,
TIllS PERMIT WIll EXPIRE IF WORK DOES NOT BEGIN WTIlIIN 180 DAYS, OR IF WORK IS ~,vnci) OR ABANDONED FOR MORE TIlAN 180 DAYS.
SUSPENSION OR REVOCATION MAY OCCUR IF TIllS PERMIT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS INFORM A TION.
ANYONE PROCEEDING PAST THE POINT OF REQUIRED INSPECTIONS WILL DO SO AT THEIR OWN RISK.
Your signature on the front of this form verifies the following: I HA VB CAREFULLY EXAMINED TillS COMPLETED APPLICATION, and do
hereby certify that all infonnation hereon is true and correct, and that I have a legal interest in the t,....t""".~; as owner of record or authorized agent. I
further certify that any and all work performed 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 property. 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 SEWAGE 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, 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 violation of ORS 454.605 to 454.745 and this rule.
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SUBSURFACE SEW AGE DISPOSAL SETBACKS SEPTIC TANK
From: Interior property lines I rr
Edge of road right-of.way Irr
Building foundation 5'
Wells or other water sources 50'
DRAlNFlELD
10'
10'
10'
100'
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Please complete all lines inside white
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boxes, if possible.
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CITY
ZIP
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OWNER OF PROPERTY (If not ume .. sbon)
/$"01.3 ,4r'~cJ;e--W .::$'~Q.;-'>9 t/e-Ic/
OWNERS ADDRESS (II nol ..1M .. ..0.,.)
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ZIP
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MAP, PARCEL NUMBER
(Found on tax maps In the ......,.,.nl I Ta.Uon Dept)
/7 0.3 a 7 ~Cl /.9Ct>
low".n,p -n;;;;- ~ 1/4 tJtoC(lon I.. L01
FLOOD PLAIN
Tow".h!p "'A;;- Section 1/4 Seellon Tax Lot
IOwns",P ~ 5eclion 114 l:IlClIon IU LOl
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SITE ADDRESS 1.5'01.3 Mrte cJr~-r-V <:5p.Q.I""Th~lcI
MAIL PERMIT TO:
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STAFF EVALUATION
Information. Request "Only. CI
TRS VeriliedClYes NoD
. Allowed Use "=Yes ..No'= '.'
Land Management Dlv. stall can
not be held responsible for
evaluations or recommendations
based on false, inaccurate or
LM0149.2192 incomplete information
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1'114-68 02/92
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ExIsting Buildings or
Improvaments on
Property
J!S. House
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c:::J Shed
SEPTIC INSTALLED
!2SYes
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Water District
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Directions to s/le trom
nearest main In/arsectlon
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For Mobile Home
Placemen/ Only
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Year
Size
No. of Bedrms
License f'
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LANE COUNTY DEPT ENV MGT RECEIPT ;,:. 300893 ',DATE, 08209~
AD DR 1142 WILLAGILLESPIE RD. ~7. EUGENE~,
LOT 'BLI(
UNITS 001 STORIES OBLDGS 001 PHONE 484 9815
ADDR1523 FAIRVIEW, SPRINGFIELD .
SQ FT UNIT COST VALUATION FEE '~~l'S
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APPLICANT HOOVER. M~CK
TLO 1703273200136 SUBDIV
NEW BLDG TYPE USE R BDRMS 0
OWNER NME DEGGA, DOROTHY
CODE APPL NO ACTION DESCRIPTION
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STATE SURCHARGE
PLAN CHECJ<-PEE--::'---
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LC 300893 SDSV
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