HomeMy WebLinkAboutBuilding Miscellaneous 1976-2-26
.....3174' - .QUEST FOR SITE FEAS IB IL!TY STUOY .
'Ii~: ~~f~ce~~ \~-63 \{ \ ~
Rece i ved bv"- Code C. T. Number Soec i a I ~rm i t Area
S I#'\~ -~S
.. 1tP. /lffO
Yes No
Urbanizino Area
THIS IS A PRELIMINARY REPORT WHICH OOES NOT INSURE THE ISSUANCE OF A FUTURE BUILDING PERMIT. ....\
PLANS OR EXPENOITURES MADE IN RELIANCE UPON THIS REPORT ARE AT YOUR OWN RISK.
If Subdivision _ Name: '1~~~~ ~E P R I N T
1-1 n!J? Y~-:-S-~O ':n'7~~o/lA)
~ Range Section Tax Lot No. Owner of Property
~0..J; (). lflJ t:e-V(]/J
N':n1'" J) I
\. )M. q '-A~A/ No. of Acres $
Ma~( Address A
-1:LL~-7I L.r-LILJr.~ Tota I $
J,d'J,-O/29.. X . ~~e~ .~CUI.q/J..;1~~~t:f
Telephone # / Si~;;J;re of Appl icant Daty.:la;>h 110wner
Proposed Use)' Appl icant's Interest Buyer
of Property: ~ L--?,7"'L-- in Property: Other (Specify):
0'))// / Q... ,-":i~'if() ~-
~perty Size Legal Acces~ Road Name Existing StruJ'ures on Property
~s Propeyty Within One Mi~Of City,. Proposed W~r Supply
es V What City? \. Publ ic ~istrict:
No - th I Spring Well Other (Specify):
h/~. );-h~~ 4~
,( '\all ~ ~ ~,(,,\t"'i!-b)
No. of Sites
Lot #~
Yes ~ No
Owner1s Consent
\-.., .,,~
$ \ \~
Block #,<:?
;0
/
II>
~ f-:> 0<::)__
/
....
r-
'It
Seller
Realtor~
Property Location (Oirections):
When Will Test Holes Be Ready? '--~-\.\.
MARK TEST HOLES WITH OUR FLAGS (Date)
Location of Test Holes on Property:
Draw diagram of property sh~wing location of any landmarks and relationship of test holes to
these landmarks: .' .'
.'
.
L._
'.
MAKE CHECK PAYABLE TO: ENVIRONMENTAL MANAGEMENT
MAIL TO: LANE COUNTY DEPARTMENT OF ENVIRONMENTAL
C5S-55
Phm e: 687-4065
MANAGEMENT. 135 E. 6th Ave., Eugene. Ore,
APPROVED \f.
NOT APPROVED
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~fn-~ ~ev
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- Authorized S~ture
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Date
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"0 # 1 T EST . L E # 2 .S T H 0 L E
;....J
,
, PERCHED WATER PROFILE PREDICTED WATER PROFILE
Predicted in. Inch Predicted in. Inch
Observed in. Observed in.
Date Date
12 - 12 -
SATURATED ZONE $L SATURATED ZONE
Predicted in. 24- Predicted in, 24 -
Observed in, Observed in,
Date Date
36 _ 36 -
Restrictive Layer / in, Restrictive Layer in, ~/
/
Impervious Layer~~ in, 48 - Impervious Layer in 48 -
Mottling ~\ in, Mottling in
~
60 ,
60 -
SITE DOES
qJ
DOES NOT
o
MEET MINIMUM STANDARDS.
ADMINISTRATIV~ RULES REOUIRE ~ MINIMUM DEPTH OF:
0 36 inches to an impermeable layer
0 30 inches to a restrictive layer
0 60 inches to a permanent water table
0 24 inches to a temporarily perched water table
OTHER REASONS FOR DENIAL
ON ~ PROPERTY !!!!l. DEPTH
WAS:
inches
inches
inches
inches
'- )
PLOT PLAN:
--
Stream
- -
Drainage or
pond
...."............
Road
~ % Slope
p
~~
----
Test Hole l8>
Cut Bank
;" ",
Fence
,K-1l-)f
.
.
v'
... "-'l.
\
SITE EVALUATION WORKSHEET
LOCATION:
TWP.
n
RANGE () J
SECTION ,.,2;;L
TAX LOT #
,~
ZONING:
PROPOSED USE:
SIZE OF PROPERTY:
rfO k 1/ (l
AMOUNT USABLE AREA:
---
WATER SUPPLY:
COMMUNITY 0i(J
PUBLIC 0
INDIVIDUAL I I
IF SITE MEETS STANDARDS FILL OUT:
Type of structure and approximate sewage flow:
Multi-family gpd
Gommercial gpd
Single Family
Industrial
/~
c/ ~
gpd
gpd
gpd
Institutional
MINIMUM DESIGN REQUIREMENTS:
Length of disposal trench
Distribution Method:
Curtain drain required:
Other:
required
Equal lYJ
Yes U
/tTf) 1'/
Serial 0
No 0
/150 gal.
SPECIAL SITE CONSIDERATIONS OR VARIANCE OPTIONS OR OTHER ALTERNATIVES:
NAME:
.~~~
DATE OF EVALUATION:
;2...2.(,. ?(..
C74-126
NWI/4 SWI/4 Sec. 22 TI7S. R.3W.WM
LANE COUNTY
1"= 100'
Center of
'Section
See Map 17 03 22 I 3
.
... .
.~,
~ FLAMINGO
....................
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..
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,,"' r", "",."//,,, """"" "-./J /'i"""" "", ",J",T". ',,I, 'I,
::..... 77 6 n 5 "4 .0 3 77' 2 114.82.' I 80
t~ 600 ,500 '400 ,300 200 ~ 100 ~
r<.I1L.-,\.I~t"\~-,",~l'\\.,p.J\~ : ~t ~~
~ " l~ .... .. 3 ... ..... .... Q
,..... .... .... ... ... ~ Q .....'
o .. ,.1. "III 0...... ..
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... 77. 77" .77' 77' 77' 8~ s/' {
.N.s~~57JtJ~t?'PH..u.1"~ ~'f,f""" ((, :' (/" 'L//""" /(" "'(,",."" f"'" t" I' . '/', L- . '/# . :' t ""'-
.AldO.04-'IC/-P~./O'6,t!. .'......!1b.o. ....... "''''.5lt7.4''~ ""dlJ,d." ..... ~~O' ~..., ....'...,..,"', ,......... ,). .
./.w:"'~ M~~ . o~c.
ftitc.-rflj p:~.e. - 6212 6213 6214' 6215 6216' 6217
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FOrcel ~r.IV ~. ~,
A-1 . PINE D.ALE' .
d:Jp'
ii; 6211
::.
A'J1:1-4r'NW,
dfb,(7' Jt,1t!J'
6209 6208
AVE,
dltl#'
6210
4ad'
~07
=Jt>' .'A
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5600
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4 3
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4l,~ 6'., 4<a0'
5700 ' 5800 5900
. _ S~COND,
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2
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t~~~~~~
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~ 700 '~7. 73'
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'J '/(-'("(,,J/. J"{u.L.
4$. - ~...., ~....... ~...'t '''~ :"Jr.
-,
,6201 , ~~ 6202
~ ..
~ .,(-, $ \
i '''i.'.J ,
I~Y ....~ ~
~ ~b-)'~ :-:~}I
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, 6205
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_ ........_9?'5:::r'~...~ ~.~~""'~
4900 >'TS5' 4800 I
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( ) . BUILDING PERMIT APPLICATION NO.
c:;V
7/0 -7~
BUILDING SITE EVALUATION
.. . ' .,
-~
~ SITE INSPECTION
PLANNING OIVISION Not
_p Ucable
I. Zoning Ordinance Compliance: Zone ( )
2. Subdivision Ordinance Compliance ( )
3. Requ i red Access ( )
4. Building Site (Area, Width, Frontage) ()
5. Other (see comments) ( )
COMMENTS:
/?4~
T 1__ R 03 S () 2- TAX LOT ..s'01J
SUBDIV~N:
LOT: BLOCK:
APPLICANT
DATE
No Yes
T) TI 6.
( ) ( )
( ) ( )
( ) ( )
( ) ( )
PLANNING DIVISIDN ACTION PENDING: YESl ) NOl ) APPLICATION#
BUILDING INSPECTION DIVISION
Not
APDI icable
( )
( )
( )
( )
7. Plans Submitted
8. Soil Stability (footings)
9. Flood Plain
10. Other (see comments)
COMMENTS:
WATER POLUTION CDNTROL
Not
Applicable
( )
( )
II. Meets Department of Environmental
Quality Standards.
12. Other (see comments)
COMMENTS:
No Yes
T) TI
( ) ( )
( ) ( )
( ) ( )
No Yes
T) wr
( ) ( )
CK'D BY: .~ . 2--o:j~7:t
Setbacks from ell of road:
Front . II
Side Exterior I~ ~
Setbacks from interior i~nes:
Side
Rear
CK'D BY:
DATE
CK'D BY4PJ ~
f
,2-2("1'
DATE
TD APPLICANT:
Your Building I Site Inspection:
It! ~ Can be approved.
'1{f< ( ) Cannot be approved at this time as Indicated on item NO. above.
~ ~- Questions and further information on items I through 6 contact the LANE-
7" COUNTY PLANNING DIVISION. Questions and further information on items 7
through 12 contact the LANE COUNTY BUILDING AND SANITATION DIVISION.
( ) Will be held in this office until you can resolve the problems indicated.
( ) Is being returned.
( ) Your building permit ap'pl ication fee is bein.'3 retu~n.!l.d under seoarate c:nver,
OEPARTMENT OF eNVIRONMENTAL MANAGEMEHI
135 Sixth Avenue East Eugene Oregon 97401
PHONE: 687-4065
LANE COUNTY PLANNING DIVISION PHONE: 687~4186
C55-28
rJ
~n.
. - Surname
-- .
Twp. Range Section Tax Lot Code
Census Tract
Receipt No.
Date
I Owner
Owners Consent
Yes No
~EQUEST FOR SITE FEASIBILITY STUDY
THIS IS A PRELIMINARY REPORT WHICH DOES NOT INSURE THE ISSUANCE OF A FUTURE
BUILDING PERMIT. ANY PLANS OR EXPENDITURES MADE IN RELIANCE UPON THIS REPORT
ARE AT YOUR OWN RISK:
Name $
and No. Sites
Addreso $
No. Acres
TOTAL $
Telephone No.
'Appl i cants Interest
Sprinq
in Property I Prop?s~d Use of Property
Name Ispecial ~ermit Area ., Urbanizing
Yes No Yes No
Is Property Within One Mile of a City?
What City? Yes No
Other
Specify
Area
Property Size
Legal Access - Road
Existing Structures
Proposed Water Supply
Pub] ic District
Well
Property Location: (Directions)
',.,'
APPROVED
NOT APPROVED
.,
.::
, .
BEFORE CONSTRUCTION IS STARTEO bring this form to the Department of Environmental
Management and make app] ication for a building permit. If the property is a por-
tion only of a tax lot, a metes and bounds description of the parcel must be fur-
nished. Exact specifications for the sewage disposal system will appear on the
building permit. Two sets of building plans and a plot plan will be required.
LANE COUNTY DEPT. OF ENVIRONMENTAL MANAGEMENT
135 EAST SIXTH AVENUE, EUGENE, OREGON 9740]
Authorized Signature
C55-32
Date