HomeMy WebLinkAboutMiscellaneous Sewer Connection Record 1989-11-8
S.L# 5?9~/9/
Cf~Cf Filbert Lane, Springfield, OR 97478
,
I-5 to 42nd st. exit. Right on 42nd to Jasper Road;
right on Jasper to Filbert; right on Filbert
U6B!$pe
.
SEWAGE DISPOSAL SITE EVALUATION
iF.tJ2 .()~~. 3/.2.01
I
TRS,TI
Job Location
Written Directions
Subdivision:
Lot
Bloc~
APPLICANT'S NAME AND ADDRES1" Cvnthia A. IvilloUQhbv
OWNER'S NAME AND ADDRES1" Rav Jackson P. O. Box
STRUCTURES NOW ON THE PROPERTY
WATER SUPPLY
91023 Marcola Rd., Springfield, OR .
297, Walterville, OR 97478
PROPOSED USE OF PROPERTY
Phone 7266874
Phon.. 344-5274
r hereby certify that the above statements are true and accurate, and that I have the following legal interest in the property: _owner of record: _contract purchaser; _potential buyer;
_realtor or agent. I furth~ thai (if not the owner) I am authorized to act for the owner of record, and that said owner is aware and approves of this actio~. .
. TEST HOLES READY n_~1 ~1...tL- Signaturek~{ JI191'--' '1JA (Q~JUr. //JLlUJlfPlfI.:,tA 10/16/89
... '" '" "'... '" '" '" '" '" '" '" "'.. '" * '" '" ** '" '" '" '" ** ** "'.. '" ** '" '" '" '" * ** '" "'.. '" '" '" '" '" '" ** OFFICE USE ONLY BELOW THIS LINE **.. '" "'.*..... ft...
'" "'.* .*. *** '" .-.*.0. "'.. '" '" **** '" *.*.*. '" "'..
SITE MEETS STATE STANDARDS YES NO YES NO
Standard System jl( 0 Low Pressure Distribution 0 0
Sand Filler 0 0 Holding Tank 0 0
1 Foot Capping Fill 0 0 Other 0 0
~f!e./j~~j'" _____;:pz, :e:e.k~aef:.
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THIS IS A PRELIMINARY REPORT WHICH DOES NOT ENSURE THE ISSUANCE OF A FUTURE
BUILDING PERMIT. ANY PLANS OR EXPENDITURES MADE IN RELIANCE UPON THIS REPORT
ARE AT YOUR OWN RISK, IF SITE IS APPROVED, SEE REVERSE SIDE,
~ ~-'-
.--' -UTHOR~
LANE COUNTY ENVIRONMENT~EALTH,
C55-32
LAND USE COMPLIANCE
zoningJ.l hC'1,/">r'r; Acreage or Lot Si.'"
Partitioning #
COMMENTS:
---1.!,)i.\-hi"
(TOTAL)
Parcel #
) Completed
) Pending
11~ q~ Si'r.,...",s...tcl
?-,"">\-\ L("-Il.o-~
FLOODPLAIN INFORMATION
o Approximate
Study Area
o Detailed
Study Area
o Floodway
I/-F-P<J
DATE I
125 EAST 8TH AVENUE, EUGENE. OREGON 97401 (617-4051)
All or part of this site may be in a flood hazard
area for which 100 year flood levels have not
been established. Extra precautions may be
appropriate to assure that the building site will
be reasonably safe from flooding.
All or part of this site may be in a flood hazard
area for which 100 year flood levels have been
established. A building elevation above the 100
year flood level may be required.
All or part of this site may be in a flood hazard
area in which a f100dway has been designated.
Building may be prohibited subject to
demonstration that the cumulative effect of
proposed development will not increase the
100 year flood level at any point.
MEMO
TO: APPLICANT
FROM: LANE COUNTY ENVI RONMENT AL HEALTH
SUBJECT: CONDITIONS OF SITE APPROVAL
.
lane county
-
Any alteration of the natural conditions in the area approved for the on-site system or replacement area may void this approval.
This approval is given. on the basis that the lot or parcel described above will not be further partitioned or subdivided and that conditions
on subject or adjacent properties have not been altered in any manner which would prohibit issuance of a permit in accordance with
O.R.S. 454.605 through 454.755 and Administrative Rules olthe Environmental Quality Commission. Any such subdivision,
partitionin9 or alteration may void this report,
WARNING: This document is a technical report for on-site sewage disposal only. It may be converted to a permit only if, at the time 0.1
application, the parcel has been' found to be compatible with applicable LCDC-acknowledged local comprehensive land
use plans and implementin9 measures or the Statewide Planning Goals, The Statement of Compatibility may be made on
the attached form or its equivalent. Authorized Agent approval is required before a construction permit can be issued.
This report is valid until an on-site sewage system is installed pursuant to a construction permit obtained from Lane County, or until
earlier cancellation, pursuant to Commission rules, with written notice thereo' by the Department of Environmental Quality to the'
owners according to Department records or the County tax records. Subject to the foregoing, this report runs with the land and will
automatically benefit subsequent owners.
Only persons having a valid license issued by the Department of Environmental Quality under ORS 454.695 to install subsurface
sewage disposal systems or an owner or contract purchaser or his regular employees may install subsurface sewage disposal systems.
A certificate of satisfactory completion will not be issued if persons other than the above perform the installation.
.
.
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S,W. 1/4 N,W, 1/4 Section 5 T,I8 S. R,2 W,W,t,A,
LANE COUNTY
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LANE COUNTY DEPT ENV MGT F(ECElPT 'tl' 890194 DATE'10168'
APr"L.ICMT. JACI<SON.. 1~f.1Y ADDI~ F'. O. BOX )'17., WALTE:F:VIL.LE.. Ol~ .
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· NEW. BL.DG TYPE USE: X BDfmS 0 lJlHTS 001 STOfUES '~BL.DGS 001 F'HONE .726 .',874
OWNE~ ~ME JACI<SON, RAY. ADDR P.O. BOX 297, WAL.TERVIL.L.E, OR ,.-
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. LANE COUNTY DEF'T ENV MG T HECE I PT '~890194 DATE 10168'
APPLICANT ~ACKSON. HAY AD DR P.O. BOX 297, WALTERVILLE, OR
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. NEW BLDG TYPE USE X BDt<MS 0 UN l'i'S. 00'f"'ST01tlh. '~-BEDG-S; 0~1''{HqNE 726 6874
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APPLICATION # ,.P7' - /9 t./
LOCATION4~:?- ~,
Cu,-z.,~ u JAft.JJ^-,A
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'7 I (J ,J. 7 Wlrl/r-<,..JA. r2J
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NAME
ADDRESS
ZIP CODE
The Lane County Building and Sanitation Division cannot proceed with processing
your application because:
1. ~~complete application (items deficient).
~ Address and/or directions to application site.
Proposed number of bedrooms in dwelling.
Approvable plot plan (see attachment).
Notification of date test holes will be ready.
~
,
2.
D
o
Verification of existing system required (see attachment).
Two test holes (2'x4'x5' deep) required for expansion or repair
of existing sewage disposal system in the area of the proposed
drainfields.
3,
4. 0 Other: Lt' ';Il- G-,. ,dp::e;,Le,,{ ,at,;f "A.,., .-zbk, ,
.:l:;:L) I M ~C" ~./Jh-(::eh-/'.b- ' .d'AA__~.Lu;{" I O/A^ -f'i1,...,,)-;;
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from to
OFFICE HOURS
DATE
U'7. ..77..),;7
PHONE
//7 - /p-"F' 7
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If no response has been received in regards to this matter by /('7() -/1
the application will be denied.
LANE COUNTY ENVIRONMENTAL HEALTH SERVICES
Courthouse-Public Service Bldg. / 125 E. 8th Ave. / Eugene, OR 97401 / 687-4051
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