HomeMy WebLinkAboutPermit Septic Tank 1989-9-19
REQUEST
FOR:
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SEPTIC SYSTEM VERIFICATION
TOWNSHIP ",,""'Ii .~nON 1/4 B~QH TAX LOT BUBIlIVIBION I PAl'ITlnON
17 03 27.3.2 133
-'oc'''r~''''F A I R V I E VI DR I V E, S P R I N G FIE L 0, 0 REG 0 N
LOT f PARCEL BLOCK
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8TRUCTURII.8 NOW ON PROPERTY
EXISTING SINGLE FAMILY DWELLING
",oPOaED Wi IlESlOEHTlAL COIIIIERaAL UUJUSTRlAL ,uIUC NO. Of IJTORIEB
RESIDENTIAL USE
~1II1l'llON (II' PROPOSED WORK
SEPTIC SYSTEM VERIFICATION FOR LOAN
NO. Of KDROOta
NO. 01' iElll'LOYEEB
COHSTRlJC'OON C08TIYALUII.
aorm;: IN8TAum
WATER IH8TAUm
'DlRECTlON. TO BIll f"OIl COURTHOU81
COBURG ROAD, TO CENTENNIAL TO SPRINGFIELD, LEFT ON ASPERN, RIGHT ON TAMER .K
LEFT ON FAIRVIEW DRIVE
OWNERB NAIIE .. AOOltE48
EVERETT GABERT,
IO:ONT"..CTOR HAlItE
NA
SAME AS THE JOB ADDRESS ABOVE
OSII UCOISE ,
NA
PHONI 746-7613
PHONE 747-8721
PMONli
NA
C
97477
APPUCANT NAIll.. ADDREa.
JEANETTE BISHOP,
,
> MAIL PERMIT TO:
JEANETTE BISHOP, 1216 MOHAWK BLVD., SPRINGFIELD, OREGON
t NAill
,
I hava carefully read BOTH
JEANETTE BISHOP
ADDREas
13""",d On Tho
and correct )
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and
hereby ce~1 that II Information Is true
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DATE
PRM'NAM&
........ ..
,........... ....
.. ......
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FEES DUE: $ APPROVED BY: ~) ~ ___ DATE Cl-/q~P9
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CALL FOR INSPECTIONS (SEE BACK OF FORM FOR\!!)fSTRUCTIONS) 687-4065
SEPTIC permits are good for one year. ALL olhar permits expIre after 180 days unless Inspections are current.
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C74-213
- VIOLATIONS. -,
SHl'BACKS AND onmR CONn_OF APPROVALMUST DB S'IRlCJL Y OBSERVED. VIOlATION CANRBSULT IN RBVcx:AnoN OFnm PBRMJT.
CITATIONS MAY BB ISSUED UNDER mE PROVISIONS OF LANBCOUNTY'S INFRACI10N ORDfNANCB ANDJOR onmR RBMEDIES AlLOWED BY LAW.
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A MINIMUM OF AT LEAST 24 HOURS AnV ANCE NOTICE MUST BE GIVEN FOR INSPECTION 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 omClAL RIGHT 1'0 TRESPASS ON PRIVATE PROPERTY ORS n5.OIO
POWER TO PNIER UPON LAND. TIm COMMISSION, AND ANY OF ITS MBMBERS, OFFIcmtS AND BMPLOYRS, INmB PBRPORMANCB OF nmIR. FUNcnONS, MAY
ENTBR UPON ANY LAND AND MAXR EXAMINATIONS AND SURVEYS AND PLACE AND MAINTAIN nm NBCBSSARY MONUMHNTS AND MARKERS ..~...
REQUIRED INSPECIlONS
FOUNDATION INSPECIlON: To be made after excavations for footings are complete and any required reinforcing steel is in place.
UNDERGROUND PIPING INSPECIlON: To be made after all underground piping has been installed, prior to any backfill.
CONCRETE SLAB OR UNDER-FLOOR INSPECIlON: 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 INSPECIlON: To be made after all dueling and gas piping has been installed and prior to being covered.
ROUGH PLUMBING INSPECIlON: To be made after all plumbing rough-in is in place, prior to being covered.
FRAMING INSPECIlON: To be made after the all framing, fire blocking, bracing and roof are in place and all pipes, chimneys and vents are complete
and the rough electrical, plumbing, and mechanical inspections have been made and approved.
INSULATION INSPECIlON: To be made after all insulation and vapor barriers are in place, prior to covering.
LATH AND/OR GYPSUM BOARD INSPECIlON: To be made after aU 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 INSPECfIONS MAY BE REQUIRED, such as but not1imited 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 inspections have been made and approved.
FINAL MECHANICAL INSPECIlON: To be made jusl prior to the structure or remodeled area being occupied and prior to operating any equipment
FINAL PLUMBING INSPECIlON: To be made just prior to the building, structure or remodeled area being occupied.
FINAL BUILDING INSPECIlON: To be made after fInish grading and the building, structure or remodeled area is completed and ready for occupancy,
MOBlLE/MANUFACTURED 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 foundation requirements for mobile homes or as recommended by the manufacturer.
Minimum fmished floor elevation shall be certified when required by Aoodplain Management
Tiedowns, if required, shall be installed and ready for inspeclinn within 30 days after occupancy. Tiedowns shall be installed per enclosure.
, . APFROY.AL 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.
APPROVED PLANS MUST BE ON TIlE JOB SITE AT ALL TIMES DURING WORKING HOURS.
TIllS PERMIT WILL EXPIRE IF WORK DOES NOT BEGlN WTIlIlN 180 DAYS, OR IF WORK IS >Iurrr.u OR ABANDONED FOR MORE TIlAN 180 DAYS,
SUSPENSION OR REVOCA nON MAY OCCUR IF nus PERMIT WAS ISSUED ON TIlE BASIS OF INCOMPLETE OR ERRONEOUS INFORMA nON,
ANYONE PROCEEDING PAST THE POINT OF REQUIRED INSPECTIONS WILL DO so AT THEIR OWN RIS!{.
Your signature on the front of this fonn verifies the followiiig: I HA VE CAREFULLY EXAMINED TIllS COMPLETED APPUCA TION, 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
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 r"'r--~)' 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 noled 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
form. 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 alloned time constitutes a violation of ORS 454.605 to 454.745 and this rule.
SUBSURFACE SEWAGE DISPOSAL SETBACKS SEPTIC TANK
From: Interior Y'_Y_" lines 10'
Edge ofroad right-of-way 10'
Building foundation 5'
Wells or other water sources 50'
DRAlNFIELD
10'
lO'
10'
100'
.
,
Please complete all lines inside white boxes, if possible.
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OWNER OF PROPERTY (U--not um. _ abo..) ./ ~ ... .... _ .
L~~~:~~ F.;;2.
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ZIP
7,f;.:~f/7:2f
'17 r.,c:d"3
ZIP
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MAP, PARCEL NUMBER
(Found on to: m.,.1n 1M ~.nt. T.xaJon Dept.J
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lownllll' Hangot Dec:bOn 1/4 ~ IlUl Lot
Township n;;;g;- s.cdon 114 Section
Tn Lot
I own""., Hangoe u<<:UGn 114 ~uon
In Lot
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Existing Buildings or
Improvements on
Property
,Eg House ~O"t:r:P..Q.,Q
CJ Barn '} ,
CJ Garage
CJ Mobile. Home
CJ Shed.
SEPTIC INSTALlED
tz3,Yes
CJNo
Water District
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Directions to site
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MAIL eEBMIT TO: _
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land Management Dlv. stall can
not be held responsible for
evaluations or rocommendatlons
based on falso, Inaccurate or
Incompleto Information
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For Mobile Home
Placement Only
Brand
Year
Size
No. of Tip,outs
No. of Bedrmo
License #
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W: 5 LANE COUNTY DEPT ENV MGT RECEIPT 0 259189 DATE 091589
e i~PPLICANT GABEFn, JEANETTE ADDR i 5(,7 FAIRVIE~J DFL, SPRINGFIELD, ()f~E e
TI...~:' 170:52732001:33 SUDDTV LOT DLI<,
NEW BLDG TYPE USE R BDRMS:0 UNITS 001 STORIES ODLDGS 001 PHONE 746 761t1n
. OWNEf~ NME GABERT., ,JEI1NETTE ADDI:~ 1567 FAmVIEW Df,., SPRINGFIELD; ORE.
. ,CODE APPL NO ACTION DESCRIPTION SQ FT UNIT COST VALUATION FEE DAYS
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W: 5 LANE COUNTY DEPT ENV MGT RECEIPT . 259189 DATE 091589
e ,~PPLICANT GABERT, JEANETTE ADDR 1567 FAIRVIEW DF(., SPRINGFIELD, ORE.
TLI 17032732'00133 SUBDIV LOT BLK
NEW BLDG TY~E USE R BDRMS 0 UNITS 001 STORIES IBLDGS 001,PHONE 746 761JO~
. OWNER NME GABERT, ,JEANETTE ADDR 1567 FAIRVIEW DR. I SF'RINGFIELD, ORE.
CODE APPL NO ACTION DESCRIPTIpN SQ FT UNIT COST VALUATION FEE DAYs
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MECHANICAL FEE
STATE SURCHAf,GE
PLAN CHECK FEE
FT. RAIN:
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5%
25%
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EST. COMPLETION DATE
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