HomeMy WebLinkAboutPermit Septic Tank 1992-4-14
.'
"
PERMIT #
/ .::2- 7Lj- 9~
,
,
O.~~
REQUEST
FOR:
SEPTIC SYSTEM VERIFICATION
:..: ..:.:::..1
j. TOWNSl-IP 17 RANGE 03 SECllOH 22, If ~LOH TAll LOT 5 0 0 BUIlDlYISlON II"AlmnON
Lo;'/'9 .Ft"AflI NGO AVENUE, SPR I NGF I ELD, OREGON
LOT II"ARCEJ. aloOCK
STRUCTURES NOW 0fII P"OPERTY
EXISTING SINGLE
PROPOSED USE SEPTIC "STALLED
PRIVATE USE
FAMILY D~/ELLING
WATDI "'ST"~D
NO. W SleMla
NI;J, QI' QlPLOYEQ
COHBTRUCTlON C08TIVAW..
DElJC;R1I'TlON 01' PROPOSED WORK
SEPTIC SYSTEM VERIFICATION
NO. Of" I&CRootaI
D1RECTlOfrilt TO blTlI: ..ROM COURTHOUSE
GAME FARM ROAD TO FLAMINGO AVENUE.
"l('~' NtJ't Mf'l"fj'~ ,
'NON' 4 55 - 8160
OWNEAlI NAIIA . ADORES.
t'1R. c. f1R S. KIM,
COiifiiiCT~ NAME
NA
~ M~/t NPWfU; 1% ,
PHONE
520-2002
OSR LlCENSI ,
NA
PHCNIi
NA
C'
1500 OAK STREET,
EUGENE, OREGON
97LI01
~ N.....E
I have carefully read
KEN SCH~lIDT
PRWT NAUE
"""l~' ''I',
11111...
BOTH sides of this appllc'lVOft' end ~y j3frtl~l!
J_~"'A"" c:r-~
. t ___ -
Information Is true and correct
, 4 -/4"-961
/} CATE -
,
"-
..
I
FEES DUE:
I PLANNWGIZONING'
'" 'NA
CAREFULL VI Vour Authorization
$
APPROVED BY:
DATE .#/4sJJ~
.
,
,4
CALL FOR INSPECTIONS (SEE BACK OF FORM FOR INSTRUCTIONS) 687-4065
SEPTIC permits are good for one year. ALL other permits expire aller 180 days unless Inspect/ons are current.
~ .. ~
.
.
'.
VIOLATIONS
SBTBACKS AND OTHER CONDmONS OF APPROVAL MUST BB S11llCJ'L Y OBSERVPD. VIOLATION CAN RBSUL T IN REVOCATION OFTInS PERMrr.
CITATIONS MAY BB ISSUED UNDER nIB PROVISIONS OFLANB COUNTY'S lNPRAcnON ORDINANC! AND/OR 01liER. REMEDIBS AlLOWED BY LAW.
A MINIMUM OF AT LEAST 24 HOURS ADVANCE NOTICE MUST BE GIVEN FOR INSPECTION REQUESTS
Have the following information ready when you call: 687-4065
Pennit number - Job address - Type of inspection required When it will be ready
Your name and phone number - Any special directions to the site
PUBLIC OWlClAL RIGJrrTO TRESPASS ON PRIVATE PROPERTY OBS 215.CIO
POWER TOBm'ER UPON LAND. nlBCOMMlSSION. AND ANYOP ITSMHMBERS,OFPICERS AND EMPLOYES, IN nIB PBRPORMANCB OPlHEIRPUNcnONS,MAY
ENTER UPON ANY LAND AND MAKE EXAMINATIONS AND SURVEYS AND FLACH AND MAINTAIN nIB NBCBSSARY MONUMENTS AND MARKERS 11IEREON.
REQUIRED INSPECflONS
FOUNDATION INSPECflON: To be made after excavations for footings are complete and any required reinforcing steel is in place.
UNDERGROUND PIPING INSPECflON: To be made after all underground piping has been installed, prior to any backfill.
CONCRETE SLAB OR UNDER-FLOOR INSPECflON: 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 INSPECflON: To be made after all ducting and gas piping has been installed and prior to being covered.
ROUGH PLUMBING INSPECflON: To be made after all plumbing rough-in is in place, prior to being covered.
FRAMING INSPECflON: To be made after the all framing, flTe 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 INSPECflON: To be made after all insulation and vapor barriers are in place, prior to covering.
LATH AND/OR GYPSUM BOARD INSPECflON: 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 fastenen; are taped and fmished,
ADDITIONAL INSPECTIONS MAY BE REQUIRED, such as but not limite<:! 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 INSPECflON: To be made just prior to the structure or remodeled area being occupied and prior to operating any equipment
FINAL PLUMBING INSPECflON: To be made just prior to the building. structure ur remodeled area being occupied.
FINAL BUILDING INSPECflON: To be made after finish grading and the building. structure or remodeled area is completed and ready for occupancy.
MOBILE/MANUFACfURED 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 Floodplain Management
Tiedowns, if required, shall be installed and ready for inspection 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 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 BEGIN WTIlIIN 180 DA YS,OR IF ,WORK IS . wrreO OR ABANDONED FOR MORE TIlAN 180 DAYS.
SUSPENSION OR REVOCA nON MAY OCCUR IF TIllS 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 RISK.
Your signature on the front of this form verifies the following: I HA VE CAREFULLY EXAMINED THIS COMPLETED APPLICATION, and do
hereby certify that all infonnation hereon is true and correct. and that I have a legal interest in the Y'-Y-'~J 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 ifl am not the owner of the y'_y_nJ. my registration with the BuUden; 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 SEW AGE DISPOSAL SYSTEMS:
When subsurface construction is complete, the pennit holder shall notify the County Land Management Division by sllbmitting 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 permit
holder. If construction does not comply with rules, the pennit holder will be notified, and all corrections shall be made before a certificate of completion
will be issued. Failure to m"!'t satisfactory completion within the allotted time constitutes a violation of ORS 454.605 to 454,745 and this rule.
SUBSURFACE SEW AGE DISPOSAL SETBACKS SEPTIC TANK
From: Interior .,""y_..jlines 10'
Edge of road right-of-way 10'
Building foundation 5'
Wells or other water sources 50'
DRAlNFIELD
10'
10'
10'
100'
jl
la~K \)J"S pu~ ~l
Tt::,I'-\.P S (}..IV s 5 ~T ie 'S-e./2<.T/ C e
(3 ~ ('(AJJ2.jPJ: B oo..,e 0 # rorob~ r
D e C( ~j (' (> IVS--e.. 4f=. 3 LI6'5' <(
D~ 1)7~-'1v
.
'5~~D. "
~
l -
, ~ ~-fliNlT{JR<tI\N Fie!f)
\ It ~ Ul...- .
~-
-
9!i
----
f-{()'4 5:~
/
OIR: v-€-
Ffq~fAJ JO
}l-()Qr!
~
.
.'
"
...6lt!l!l.......lfiilT...ril't'B..iA~~/~:T:,hr.< ..
::".';':\af: .: liaSI;\ :::tiLiln:'::"::l1:\7a \7),)Ii,;,:\.t.;.~' ":.:: .:
~iindllanage~en; .,D,",.,;,v,',;'~is:ii ... ...... ....: i.. . ... ..i<<..
...........................................
::;:i:!,;=:,:.!.!(.:,:,:.!::::::::,:,(-:::"
::;::~;;;:.:}(:::;:::;:(~:::::k~~!<:!:~;i;:{::{:~;~;:D;:}
. .. ". . ....
'. . .
... ... . .
. '.. . .
I.....~......../.
.........I~
:',':.,:. ::::~:::\:.;:.;~~:::.:.:):;~: ::;.:.;: ":':" :':::::':':'.:;;::, .",. 'C."
............:.:...::..,.,.....:,...,.;.'...;...;.::....,":"::'.':'"
'::;'.:.::': :::.:.:::.:::::.:..::;:.~-:;:.:. .;.:,. .;.::.. ::<:.::::: "'.':':'::.::'::. :,::":'.
i
Plea}[e omplete all lines Inside white boxes, If possible.
l'mJ1I ~AI ~~MlQ7 -.JervJ 7ftTe !? [, !;{;Llf-?c2
! (90 Of/K 'ST. tfi5"--tf00
TUUtt AUUH~~ C:: l..<.9'~ ~"GNt;
c~""o , ";.:.. ~!)t! €foV ii!7lf 0 L
/vi f? 't A II s J!; /V1 ~()-,;J.1Sr:J 2-
OWNER OF PAUPERTY (It not am. .. obove)
"HUNt!
OWNERS ADDRESS (11 nol ...... .. .bon)
ZIP
In::IllU.L~ f t;lU4L.UkH I \;UNIHAl,;IUH
LlCORH .
,
MAP, PARCEL NUMBER
(Found on I.. map. In tile ........nt . TuaUon Dopl)
/""7 03.:l;;1. 4;L s-ao
IOWnaftlp "1Iii;I HeCtIOn ,,. lMCuon IU L01
Towrwhlp ""iiU;:- 8ecUon 114 IIIlCUOn Ta Lot
lownsn. ,.. lMCuon 1'4 uecUOll ... LCH
.
, , .
-K S"E ~1J'!fSSF LaM. INjo rfP SpR,'~~; ee,o
~ ~. .. . ~ . ,..", ., ~ ,. ,., ~ .. . ~ ~, ~~~. ... . ,~~ , ., "
>< 'MAIL:f!!!J!!!l~O: .
. J?;;.I f::J M; (),- -,Jecw Tlt-7'e..
.... I~co 6f4 k" 5T.
.....(";' ~ 0 pN-@ ,~f?e{){YJ
I ' I
n. .'\""
R. f,
.....1
97l(ol
ZIP
~
.................:,........,<.'...
...............:..,...
wt~~i~~~~~[~ii~~~~;~J
TRSYerlfliKI ..,..,........".,S2v-V8e.as......".
A.llowiKI Usei '--'
.c::J'"
1'114-68 02/92
.
~':.:".
..
ExIsting BuildIngs or
Improvements on
Property
~US9
c:J Bam
c:J Garage
c:J Mobils. Home
c:J Shed
SEPTIC INSTAlLED
~es
c::J No
ire' ~Istrlct
apJ RAW
:....
..
DIrections to site from
nearest maIn Intersect~on
G;Q IJ..e Fo-tt M J!CA/
T6 ef.A^'f ,'1\/'7><:\
.
. n. .. ... ........ ....
........ ................................."...,...
9?L(?7
ZIP
.
"
or Mobile Home
P ement Only
nd
Ye /'
Slzs "'. / /'
No.of.~~
Ucsnss #
/ ,
,
/
.
,
W: 5 3 LANE COUNTY
APpLICANT SCHMIDT, KEN
. TL~' 1 703n4200~;00 SUBDIY
, ' NEW BLDG TYPE USE:: f( BDF,MS 0 UNITS 001 STORIES
. "II OWNEF, NME SCHMIDT, I(EN ADDF-: 1600 OAK
. CODE APPL NO ACTION DESCRIPTION SQ FT UNIT
BP
BP
. Ill"
BP
I'll"
.
PL
MECH
. SUF,
, " PCI,
1111 LR
.
~'F I X/B,';TH :
LC 127492 SDSV
.
CATG: PLN
SEQU:
. TAKEN BY RLH
R('~
SDS
1
EST.
.
hH
.
DE::P"" ,ENV, MGT REGEIPT ~ ,', _ 1:)74n~ _ -B~JTE 041492
ADbR 1600 OAK ~T., LU~EN~, 5~E~)~
LOT IlLK .
OBLDGS 001 PHONE 620 200~
ST., EUGENE, OREGON . III'
COST VALUATION FEE DA.'
..
.u
e
~
.~
I
.~
. 1.
"li
II i 'i;.
.1
s~m:
FT. WTR:
~1ECHANICAL FEE
ST A Tt: SUF,CHF,f(GE
PLAN CHECK FEE
ELE F'CK
IS'S.'
2
CDrjpLETION DATE
FT.
2~5%
/
SI
.
.
.
n ,II ~
,I.
.
.
.
J'" ,
1 n ~ G
.
.~
g
.
i'"
e~
..
5
.
er
<
e-
f(AIN:
FT
t- ~,
-)/..
7:5..00
.
OTR
DEPOSIT **
".
75,,00 cKef
.
~
;
.
.~
,
"p
.~-
. ( '.'
'f'
~
.
.
H' WI
" U
.
.
.
.
llHJUJ
.
.
.
.i."",
\ ~
-.
,.r."._
, ,
'\<"-'~'
t ' c",-,.'
.
.
.
~ ~ H'~
uU .
.
.
.
'. , ?7
.
m~
.
.
.
(IV1/} ,hr
/' .
r
,
~
41/1
I
I
-------------------------------------~-----
. / . .
,
W; 5~"" '.~ '" ,_ LANE COUNTY DEPT.ENVjGJ REG~IPT_ t_'?742l__DATE 041492
AI-'PL1 L,f.',N I SLH~iID r., I\I:,N AvDI, 1608 UAK oS r ., j:.UL,LNt, UI,U,UN
. TL;:, 170:~224200~500 SUElDIV un ElLK .
"U NEW ElLDG TYPE USE I~ BDI~MS 0 UNITS 001 STORIES \~BLDGS ~)01 PHONE 620 2('),0.':>,
BlaH mJNEF< NME SCHMIDT, I(EN t,DDR 1600 OAK ST., EUGENE, OREGON dilH
. CODE APPI_ NO ACTION DESCRIPTION S(~ FT . UNIT COST VALUATION FEE DA.'
BP
BP
. BP
BP
BF'
Sbj,
,1" L
.
.
.
.
.
PL . ,::,F'IX/BATH'
MECH
. SUR
Ml'HH PCK
~ LR LC 127492 SDSV
.
SWR, FT. WTR,
r'1ECHMHCAL FEE
STATE SUI'<CI-IARGE
PL,t,N CHECI( FEE
F1'. FU\IN;
FT
5%
2~5%
.
75.00 me
.
.
.
CATG, PLN
SEQU,
. TAKEN BY RLH
RA
SDS
1
EST.
ELE PCK
ISS
/
SI
OTr~
_.
COMPLETION DATE
DEPOSIT l!X
9
75.00 CK.
r,
~
.
.
Ulllln
n .t.
.
11~1I"
IoU,
.