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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 ~~i/f!k,$/~ ,AiJ~. ~..c Cl,~~ ~fn-~ ~ev ~P~t~~ ~a;~1 4u-~- - Authorized S~ture .2";;""1( Date ;?-, . '\' . , ~~. .<f . . "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 .................... :::::::::::::::::::; .. --~~!.:::;,:-::.~:...:,: :-:\:,i:~':\:~.~::~7j. ^" ',"'=6~..:fo.~~j!'" ,,"' 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...... .. ",rkLt . ~ ~ ~'(r'fll' y ~. ... 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 ~ ~ a "~. . ~ "'.,~ ~..~~ ~. }-\ b~J? ~ \ ;r i_ ~~'; (t, . ~ar}~d' 0 :z. 10 . _dO II ::~~ ~ 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 . 620~' . r~ ~ Jf<, f J. ~i' . . .;~ ~ ~ . " , . .J ; N N '" o ~ 8 , t~. .~,<>\" 6~ \",~ ::J.:-'" .....~.. .",,,. 5600 - .". I ,,""x..,.... < , -~.. "..., ........... .~~ ~ - .tfV.d' 77.~' 6~0.8 D r r,lg~ ./1C!~ ~~ If< ~, \ ~ p ~ -r . \ ~ ~ ;5 4 3 #4'1''" sr .M-.G- .. ----- -- - ".... 4l,~ 6'., 4<a0' 5700 ' 5800 5900 . _ S~COND, I~ !~ 2 \ '. Q, o ::f I~ " t~~~~~~ "J """"/""""'1 ~ 700 '~7. 73' . ~ ' . .. ~ ~ ~~ ~ t'~, ,J 'J '/(-'("(,,J/. J"{u.L. 4$. - ~...., ~....... ~...'t '''~ :"Jr. -, ,6201 , ~~ 6202 ~ .. ~ .,(-, $ \ i '''i.'.J , I~Y ....~ ~ ~ ~b-)'~ :-:~}I ~ , 6205 ~ !\ " ~.'" ~~ ~ , ~ _ ........_9?'5:::r'~...~ ~.~~""'~ 4900 >'TS5' 4800 I ~ ~~ .~ ~~ .~ , ~ s " I . ( ) . 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