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HomeMy WebLinkAboutMiscellaneous APPLICANT 10/18/2010 , ~~~~~~--::i-/~ KEATING ENGINE NG LLC PROJECT li', :f.--==L." ..=1 159 EAST SIXTEENTH AVENUE EUGENE OREGON 97401 PHONE 541-242-0613 FAX 541-242-0614 emaiI keatingengmsn.com ADDRESS hfJ I ---! ~~-:--==:=:: ~":i '~-,-_._---- . - .-----..--. SCOPE DESIGNER STEVE KEATING DATE PROJECT NO REVISED 08/03 STORMWATER CALCULATIONS [PROJECT DESCRIPTION . CALCULATIONS FOR PRETREATMENT SYSTEM ---.._- ....,.." " -'.- [DESIGN PARAMETERS._ "" . .. - ,.,--.,,-,... ---,- J ~ IMPERVIOUS RUNOFF COEFFECfENT 0.09 OR AS'NOTED IN CALC SET PERVIOUS RUNOFF COEFFECIENT 0.45 SOIL PERCOLATION RATE 2"/HR MAX ALLOWABLE 5 YEAR DESIGN STORM 0 3.6 IN/HR WATER QUALITY EVENT 0.13 IN/HR -- ~ CQNTENTS NARRATIVE REPORT SITE AREA DIAGRAMS CALCULATED Q'S PRE DEVELOPMENT MODEL POST-DEVELOPMENT MODEL INFILTRATION CALCS 2 3 4 5 7 10 SEAL Date ReceiVed:~ Planner: LM DATED: 3 AUG 2010 Date Received: Planner: 10-1&--10 . . Narrative Description Due to a need for paving for the subject site, a storm water system to accommodate water quality concerns and manage the 5-year storm event is proposed. The site soils are identified in the Soil Survey of Lane County, Oregon as "Chapman", with a gravelly sandy loam in the surface strata, underlain by a gravelly sandy loam beneath. Soil infiltration rates are identjtjeda.s Ci~2Q.i9shesper hourin th~ YPP~rregi0ns"and::o:20inchesper hour in the gravel beds, Since pretreatment is mandated, aloam lining for the bio~v,rale and basin '" ': """"",,,~,,~, ", '_.. _~'~'~~""~ .' .,,~ .,., ,. ,""" .......,-,,""" '-'w"'~'''-<..,,<'-._.-. _, _-. .,_~."-..:_~.......~__..__<_.__~.=_.....,.,~"_,,,,.".._._ ""_. is' proposec( and the rii6~el Ilrrilts lb:filtration rates to 2" per hour. Emergency overflows are to the NW as per the existing conditioris, The present lot at 1415 Mississippi has a gravel surface and no apparent discharge for storm water. During normal rain events, the underlying riverine "Chapman" soil type seems to be infiltrating the surface water,.. as is repOlied by the owners and.those familiar with the site. During peak events, the overflow is reported by the owner to discharge overland to the north west, across the street, into an existing catchbasin at Mississippi and E 15th Ave. The proposed design places an infiltration basin at the NW corner of the site, and a wide flat bioswale intercepting the surface water and directing it to the basin, suitable for accommodating' a 5-year event. Contact time in the bioswale for the 5-year event is calculated at.l 0 minutes, at a flow depth of 0.6 ft. Fortl1e design WQevent, a 25-minute travel time is indlcated;.at a deptl1 of ,;. '..' . .. .Ci.'.....,_.....""-..,_._.. _ , 0,125 ft. A culvert betweerdhebloswale and the basin is ptbvidea~ ana moaeJ"ea'so iliat th~ -, ' - " " storm water in the bios.wale dO,es not overtop it. . A 5'year preaevelopment stoiTI! eveiifaild' a 5-year post developmeiii'sionTI event 'are 'modeled. The coefficients for the gravel lot are assumed to be 0.45, and for p,avement, 0.95. Based on the above, the proposed system will provide adequate infiltration and pretreatment. Date Received: In 1'0'1 ,~ Planner: lM ~ Date Received: 10 -{ HD Pldnner: ===-"'=-..--.=-"- KEATING ENGI RING LLC PROJECT FRANK STORGE 1415 MISSISSIPPI - GLENWOOD (SPRINGF STORMWA TER CONVEYANCE ? -~--~- - - ..~.=_..__..= - - =----.---""~O''''___= .----- ~._-.._-- . ""'=""=---------==== - - ._~-~- - - 159 EAST AVENUE EUGENE OREGON .97401 PHONE 541242-0613 FAX 541242,0614 email: keatinenmsn.com ADDRESS SCOPE DESIGNER STEVE KEATING DATE PROJECT NO REVISED 08/03 ce-'---" . '.. '. :;.'i'A~..\.\.~.-.I'."...:_<." .:-...~'.I';.:;.I n..':~..'~,.~~:._"."~.."J,.' 1'..'~~....-:f::'...---...~ :...~-.-',.: :.":...:'::,' .' 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Pia nfdr: LM ~ of' J' ~l-rf- \) (J.)G>F4t-1 Date Received: Planner; lD-/S-1D --- - .""."--"--""-"~- KEATING ENGINE G LLC PROJECT FRAN~ STORGE l<Pf 159 EAST SIXTEEN1, AVENUE ADDRESS 1415 MISSISSIPPI- GL 000 (SPRINGF EUGENE OREGON 97401 SCOPE STORMWATER CONVEYANCE PHONE 541242-0613 FAX 541242-0614 email: keatin en msn.com DESIGNER STEVE KEATING -. - --.,-~._-_._--- -_.--- ----- - -~--------.~ 9 ~ C.IA ~ lql~ 1 G-" 10 '11...J 1:-;. \."1 c.: ,'1'1 ~AJ~~';'1\1"1& ~uf (\;~~(Oj<?), .~.40._~. I. f?f <-tit{ .II~L 1--1 j" (0 vr (MI--I {,>Jh1.C fo~ q~,.J ~I~GC <t DATE 08/03 PROJECT NO REVISED ....,-,_.~ T'oT"" ...~ Af "10' "f/Ath,( ~~"-,--..--,._=.~.,~~..-,~.",,,-- .-" "., . .~- . 1<715 + l1''lt ( .1) ) ("l ~). . 0 ~ cf? ~~Q a..J f ~"rp.I( OUTPUT INFORMATION This report is for a channel running fulL The Flow Capacity is 0.433 cfs The flow velocity is 0.0802 fps .1 ~ 1',:g tV1- !<f- C; - 7f- 1?Ile-J-r- CHANNEL PROPERTIES The friction factor 'n' ~ 0.850 The channel slope = 5.00E-03 .ft/ft 'Trapizoidal' Shaped Channel: Width at top = 10.00ft Width at bottom = 8.000ft Height = 0.600ft Flow Area = 5.400 sq-ft Wetted perimiter = 10.33 ft Hydraulic radius ~ 0.523 ft The Flow Capacity is 0.0324 cfs The flow velocity is.0.0288 fps ~ J:~h'/ '1/0 kf- olf ~ CHANNEL PROPERTIES The friction factor 'n' = 0.850 The channel slope ~ 5.00E-03 ft/ft 'Trapizoidal' Shaped Channel: Width at top = 10.00ft Width at bottom = 8.000ft Height = 0.125ft Flow Area = Ll25 sq-ft Wetted perimiter = 10.02 ft Hydraulic radius = 0.112 ft ID-Iq-ID Date RGCelved: Planner: I ,.\ I, 0- I ._ Dete Raceived:~ Planner: ~M . FRANK LOT PRE DEVELOPMENT 5-YEAR Prepared by KEATING ENGINEERING LLC HydroCAD@ 9.00 sin 02262 @ 2009 HydroCAD Software Solutions LLC Area (acr.esf 0.182 0.041 0.223 Area Listing (all nodes) CN Descripti-",.~u_..__.... - (subcatchment-numbers) 45 GRAVEL AREA (1S) 95 ROOFS (43) T0TAI:. AREA' .. ;,:.'Tt.;.,t~:".:~,.j .. .~~1!;~ : ~ ';~~~~Ii ~. DISCH MISSI PAR/{INGI::OT . Printed 8/10/2010 Paqe t(; ROOFS"---- Date Received: I 0-1 ~-ID Planner: Date Received: Planner: LM . . FRANK LOT PRE DEVELOPMENT 5-YEAR Prepared by KEATING ENGINEERING LLC H droCAD@9.00 sin 02262 @ 2009 H droCAD Software Solutions LLC Type II 24-hr Rainfall=3.60", AMC=1 Printed 8/10/2010 Pa et" Time span=5.00-20.00 hrs, dt=0.05 hrs, 301 points Runoff py SBUH method,Split Pervibus/lmperv. Reach routing by Dyn-Stor-Ind method -.?Orlg. COJ!ting_byDyn-Stor-lnd.method.' . Subcatchment1S: PARKING LOT Runoff Area~7,918 sl 0.00% Impervious Runoff Depth~OOO" Flow Length~150' Slope~0.0150 'I' T c~3.1 min AMC Adjusted CN~26/O Runoff=O:OOcls 0.000 al $iJbcatchment4S: ROOI:S,-... Flow Length~100' Slope~00150 'j' . .- .<..-' '.'" ".--,.".""~- Runoff'Area=1;79S'sf6.6o<Y; impervious RunoffDepth>2.12" Tc~22 min rlMC Adjusted CN~S7/0 Runoff=0.16 tis 0.007 al Reach 2R: DISCHARGETO MISSISSIPPI Avg. Depth~003' Max Vel~0.53 Ips Inflow~o.OOT al n~0.OS5 L~200' S~O 1000 'I' Capacity~124 cis OUtftow~ 0.007 al Total Runoff Area'" O.223ac ~LJng!fJ/()!l!me~=-0.007af Average-Runoff"Depth =0:39" 100.00% Pervious = 0.223 ac 0.00% Impervious = 0.000 ac . /O-IR-/O Date Reoeived: ,. Planner: Date Received: Planner: LM . . . FRANK Prepared by KEATING ENGINEERING LLC H droCAD@ 900 sin 02262 @2009 H droCAD Software Solutions LLC hydrocad model to verify hand cales Printed 8/10/2010 Pa e 7 Area Listing (all nodes) Area (acres) 0.182 0.041 0.223 CN DEiscrlptlon (subcatchment-numbers) 95 PAVING AREA (1S) 95 ROgFS,.(4S)'- .... . TOTAl AREA ~.~~).. .~. ;..,./~~ .....\" SWA[~"/BASIN INFILTRATION BASIN ., PARKING LOT ROOFS . ',--,1'/ Date Received: I D-l~-IO Planner: Date Received: Planner: LM ., . . . FRANK Prepared by KEATING ENGINEERING LLC H droCAD@ 9.00 sin 02262 @ 2009 H droCAD Software Solutions LLC hydrocad model to verify hand cales Printed 8/10/2010 Pa e 8 Pipe Listing (all nodes) Line# Node In:lnVert O'uf-Invert Length Slope n Diem/Width Height Number (feet) . (feet) (feet) (fUft) (inches) (inches) 1P 97:00 9690 200 00050 0.011 6,0 .00 r- , , Date Received: .lo-l&-ID Planner: Date Received: Planner: LM . . FRANK Prepared by KEATING ENGINEERING LLC H droCAD@ 9.00 sin 02262 @ 2009 H droCAD Software Solutions LLC hydrocad model to verify hand cales Type 1/ 24-hr Rainfall=3.60", AMC=1 Printed 8/10/2010 Pa e 9 Time span=5.00c20.00 hrs, dt'=0:05 hrs, 301 points Runoff by SBUH method, Split Pervious/lmperv. Reach routing by Dyn-StorCtnd method - Pond routing by Dyn:Stor-lnd method Subcatchment1S: PARKING LOT Flow Length=150'Slope=0.Oi50 'j' Runoff Areao=7,918 sf. 0.00% Impervious. Runoff Depth>2.11" Tc=31 min AMC Adj~~t!'ci .c:Ji=;?71Q.Runoff'C0.69.cfs.0,032'af, . .. . ,- '. --' -~, ,.,... ~"'" . .'---" - . Subcatchment4S: ROOFS Runoff Area=1 ,798 sf 0.00% Impervious Runoff Depth>i 12" Flow Length=100' Slope=0.0150'1' Tc=2.2 min AMC Adjusted CN'=lmO Runoff=0.16 cfs 0.007 af Pond 1 P: BIOSWALE/BASIN Peak Elev=g796' Storage=334 cf Infiow=0.85 cfs 0039 af Discarded=0.03 cfs 0.015 af Primary=0.51 cfs 0.024 af Outflow=0.53 cfs 0.039 af Pond 2P: INFltTRATIONBASIN Peak Elev=9~.9 ' age=523 cf Infiow=0.51 cfs 0.024 af Discarded=0.04 cfs 0.022 af Secondar =0.00 c 0.000 af Outflow=0.04 cfs 0.022 af . IJO &iEJe-r t/Vln..."... , Total Runoff Area = 0.223 ac Runoff Volume = 0.039 af Average Runoff Depth = 2.12" 100.00% Pervious = 0.223 ac 0.00% Impervious = 0.000 ac c . _ __ _ m..,' Date Received: Planner: LM ed 10- \g-\D DAte RElcelv' : Icllanner: IN TRA TION BASIN PAGE DATE PROJECT NO. SMALL UNIT HYDROGRAPH BASED ON 5-YEAR STORM INTENSITY I DURATION CURVE - GLENWOOD, OR DESIGN RESULTS 500 sq. ft. 102J6 sq. .ft. 2 in.lhr. o cfs (length and width may vary) buildings and'pavihgareas -- FOR WQ ISSl:iES. noemer enc overflow INPUT PARAMETERS SOIL CLASSIF!CA TION I Cheh~lis~rv1_L INTENSITY/DURATION "n __",.,,~.~" ......~"',._..,,~.__,__.~!..;.__ __ . _:.._.__.".._.,~~~~: ''": - t '.~_ '_'^ ''''''-'1 .n . . , ... INFLOWS OUTFLOWS STORAGE TIME AREA' 'RAIN'IN RATE VOLIN PERCOLATION' VOL. OUT REQUiRED {minutes) (sQc'ft. (in.lhr.) . (cfs) (cu. ft, (in.lhr. (cu. ft: (cu. ft. 60.00 10216 0.62 0.1454 523 2.00 83 440 120.00 10216 0.46 0.1079 777 2.00 167 6JO 180.00 102-16 ---- -0.39 - "0:0915 .. .-.- 988 .. 2.00 250 738 -,.'. 360.00 10216. 030 0.0704 1520 2.00 '500 1020 720.00 10216 0.22 0.0516 2229 2.00 1000 1229 1440.00 10216 0.15 0.0352 3039 2.00 2000 1039 v Optimized storage 1229 cu. ft. required volume 1229 cu. ft. Provided storage 12500 cu. ft. NOTES MINIMl:JMDEPTHOF'EXCAVATIONIS REQUIRED FOR INFIL'h'lAfIONRATES USED IN' ABOVE CALCULATIONS. BASIN LENGTH AND WIDTH DIM- ENSIONS MAY VARY PRO D T A BASE AREA IS 50s ftmin 1'AUoer"" ~I--l '-/iFf: '7fS~ Ol!+JI""" EXCESS STORM OVERFLOWS TO PRESENT ROUTE ON MISSISSIPPI 5 YEA~~IQ8M.IS-'Nf:ILTRATED-WITH-2-IN/HR-INFII::-TRAlION RATE: ------ SCS MAPPING IDENTIFIES CHAPMAN (23) GRAVEL ~ ~ J-- '4s~ t-rl ~ Q 0..J ~~ 170...0 o..J , 0't1/ Date Received: 10-18-10 Planner: Date Received: Planner: LM :==-~:=~__:::~::~~ .KEATING ENG!NEE G LLC PROJEer \ A ~ b 'l =c:,'~".~~~~':-:~ 'CIVIL AND STRUCTURAL #IGINEERnJ ADORESsi ' .------- SHE,'-'____ -I ~~~~-=_.---:~.~-;~:~::~,:, ~59E. ,,16th STREET, EU,GE.NE- ,OR _ 97401,-1 >,0''''''"''"'' ww ~"w~" I:~ ~. 1 -- - ~ ::-=:-:":;:. ____ ~-::__~ I PHONE 541-242"0613 F'!,X 541-242-0614 T ~ DESIGN ~- PRO~NG E~ .. <___ I \ __ lema,,-keatlngeng@msncom i L_---"'-SIGliE,' I STEVE y;EATING _~__~_' ____-------..1 I I I I I II I I I I ! I I! I I I II I I I I I I II I I III I I I I I I II I I Iii I I I I I I III I 11111 I I I I ;::, (:) '--" '0 'C\" '() "I\) '" '" " '" ~ '" -~ "- '--"i \1' "0 \':i <\i "''' ~ '0 '0 ':i '0 ~ '0 ':i ~ '0 f(j)!N/~j)!.!. INTEN?ITY (/ncf;es/Hr), FIGURE 41 ~~,/ ':"',",,,,.. ,10;0fol/ InIMe;!,!, i!tJIiJ!/(}R om' U\.i::::l1\c f/ "oorpo""d requMc'Ij CUiVes fer EU9f?i7s U'eg0i7 :~':==u~::::,:'~~c., I !\ 30 .1. ,,~ ...".. \.O.~ r::,.~ ~'-'" ~. >=- ~;---"', .~\ ~..: \ bate Received: g~ ~Ived:~ Planner: LM fJllumer:' ,- i~ " . : : Ii! : Ii; Iii! I', yl //'1,/ /1'1 /1/ ! i \ i -1- 'L.i .I I: 1 , , ' I I f !: 'i Iii I i I i I; il I: I i I /: i i I I : ! '1'1 ' " I \ lLiJJ./ Y I i j : \ i i i i ! 1 i i i I i I ! I ! Y /: t y -Ii l i i,' 1,,1 : i i I I I Ii: ,ii i I i IV 1 II ;' II I , , I I i I '1"1 "':'<"'1 1,.1//./.1/.1.1",.'1_ ..',-' i , I I I I I I I I t I Iii i I \ 'I II/!I 'I /I I I I I ! ! I I I I I I I I I I I I I j Iii I ~ II I I I I I i I I I i I I , I ! ! I I II V A /1 / I / I I I!: ! l I ! 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I i I I I I f I I I I I TI III ,\71 II I l,-i;/Y/III IIIIV !II II I 11 !;1I1j,V~ J I ::?:, ,~ ! ~:\:) i I ! ! i~ I~ I I I '" ! ~ I <:l , \ ~ I - <() ~ 2? ::::t "---- ~ .~ '" ~ ~ I I I- I -- - I 1.__-:-1,-- - -~- I ' I.' , I I I I I I I \ <: ~ .~T:~,W:~Ci):i';; ".~.,.it;2,:~!;I;i:/""'. -: ~ ~ J' I ~ ./' I ~ .5 I ~ /'>. ~ f . --~ ~ ~ \D 1<1) 1;---' I: ~ 'r" I ~ ..l :r ~ . . LANE COUNTY DEPARTMENT OF PUBLIC WORKS APPLICATION FOR FACILITY PERMIT For Office Use Only DATE: /NC0MPLETE APPLlCA nONS W/LL NOT BE ACCEPTED SEE PAGE 2 FOR INSTRUCTlO'NS AND FEES ALL PLANS MUST BE 11x17 OR SMALLER UNLESS AN ELECTRONIC COPY IS PROVIDED (1) ~~ "_~U{, APPLICANT: Print Name iC;"l ~\(,"t'/ A'V\i . Mai!ing P.,ddress: SlreetA.ddress aJ(,~ i?~J121 City, State, Zip Code DaY1i1i~~~t~u~)\~ FAX Eve~t~lO- 409> Cell Phone, ~.J~E14 (? "1.17J-l 'W\ E-mail Address PERMIT # : 0(,'1 ~~J.;JI=- PROPERTY OWNER: Print Name (if different from Applicant) _v=;tl .1;;'\1;.'{..fhtr d Mc:i!ing Address: Street Address eU~f" '?- "l?rD4 City Slale, Zip Code ~J-:~:Z~1 Daytime Phone (Required) FAX Evening Phone Cell Phone E-mail Address (2) Road name ..-1~~/~lffl (3) MAP-TAX LOT 1'1 O~ 2-d ~ j~Dll. - ,~R nge ~ Subsection ax'Lot ,II rr (4) Street address (If not addressed put NfA) ----.b ? Approximate Mile Post of Road_~ (5) Nearest Town _$1FJ"J'?lfa..:I? (6)DirectionstositefromnearestmajorcrOssroad~~....J~..lLj ~.....vo ~ ""'I~ t~P'1 (7) CHECK ONE BOX BELOW THA T BEST DESCRIBES THE WORK YOU PLAN TO PERFORM AND A TTACHREQUlRED MA TERIALS (8) jlfDRIVEWAYAPRON PERMIT: YOU MUST COMPLETE A -H BELOW IF YOU HAVE CHECKED THE DRIVEWAY APRON BOX. a. Attach a pial plan 11 x17 or smaller. (If you are building or have a planning action, . turn in the same planyou will provide to Land Mgt) b. Choose One: [ ]Constructing New Ap~roach [)9ModifYingEXis~ing.Appro.aCh [JEv?I~~tionof Existing Approach . c. Width of. driveway access at the property line. ~~ (I{no choice. is maC/e, we,wil:'~ro~~cjer?~ W{tt:.~he.m~?imum requiref(1e'!t). d. Apron Surface Request: . }(JAsPhalt r JConcrete [JGravel ~as~~.~1t ~~ conc~et~.!m':!!.:~s.:~~Cfu~req~~(lpav.e.~ n!.ads) ',' .. _ e. How many tax lolswill lhls'access serve? l How many accesses currently exist? ~ f, Slaking or flagging of the area is required. Describe how the access is'marked:J~" J~ . 01-1 ~a g. Is this permit a requiremen; for: A Building Permit? yo or N 0 A Planning Action? ~ or NO (If yes-attach conditions ofapp(ovaJ) h. Describe the purpose of the access? (ex: home, RV parking, induslrial) {A.f:, 'S~ LD~. .' . . :., _ i. Additional Comments (9) 0 PROJECT DEVELOPMENT/ROAD CONSTRUCTION PERMIT: Engineered plans and surely may be required (SEE REVERSE) (10) 0 ROADSIDE LOGGING PERMIT: Slaking or flagging of the area is required. Describe how the location is marked Logging Co Phone Mailing Address including Zip Describe Logging Activity: (J I) 0 UTILITY PERMIT: Submil11X17 or smaller engineered plans. MUST mark locations with Pain! or flagging. Work Order # Approx mile post Description of Work (12) 0 OTHER WORK WITHIN THE RIGHT-OF-WAY: Work in the righl-of-way not covered above Please describe the work in detail. plan and supporting materials. Please stake or flag the area ~p.~ ~@~: fll(!!'lflef; Attach a site //J-J8-ID Appication is hereby made fOf a facility permit lor work 10 be done w~thin a County Road right-of-way, SVhjBCllo all terms, condilions. agreements, stipulalions, and provisions of Ihe issued permit, pursual1t 10 Ihe ruies al1d regutallonsregarding roads and rights-ol:way, as sellOrl hln Lanti-Code.15. 05-225al1d Lane Manuat 3.120.124 and 15.505.550, and any other applicable regutalion. law. or ordinance. The undersigned hereby declares, cefllfies and afrrrms under penally or law illal all informallon provided n Ihis form and al ehments are, 10 the besl of my knowledge, Iwe and complete. (13) SIGNA TURE (Property owner!aulhonzed agenl) -~ ' Date~/z;/~,~ RETURN TO Lane County Public Works Permit Desk, 3040 N Della HlghWa~elJ"'. OR 974Q!l IV (j 1) Tel. 541/682,6902 FAX 541/682-8500 Heann rr!~~~'l~!Il:i__ b Lane Co"nly<;omp~"s ""Ih $la'D and "eder., I."", ar d regulahons r"1311"9 10 d"~"f""'"t''''' ,n.;JuG "g 'he Amercan, ",,11'> DlSabilil'es Act (ADA) 1,Ii;Jnner: LM ;:o.~ 07101107 . . LANE COUNTY DEPARTMENT OF PUBLIC WORKS APPLICATION FOR FACILITY PERMIT For Office Use Only DATE: (I) ~t7I.le-l (.,. lc:-~....l , APPLICANT: ~I Name ~ 1C:;9 6 lIP ~ Mailing Address: Street Address ~i3-.I€ 0,.. 'tM-ol City, State, Zip Code 9f1-l%~-\)" \~ Daytime hone (.equir~d) , ~' &110-40'10 Evening one Cell Phone ~~c.E:J-l'~ f1t,....l . CoM E~mail Address (2) Road name 1'\1'.;4 ~I P PI INCOMPLETE APPLlCA TIONS WILL NOT BE ACCEPTED SEE PAGE 2 FOR INSTRUCTIONS AND FEES ALL PLANS MUST BE 11x17 OR SMALLER UNLESS AN ELECTRONIC COPY IS PROVIDED ~~ .~~~.. . PROP TY OWNER: Print Name (if different from Applicant) 2-c:7l\ l-It1A~ Mailing Address: Street Address GV"G-1rG . O~ q1 to~ Cit~:....S~ate, Zip c:ode. .. . ~'-~#f.Z.;l" Dayti e Phone equiredr PERMIT # : . . ~ OlPl'!- FAX FAX. Evening Phone Cell Phone E-mail Address (6) Directions to site from nearest major cross road (3) MAP-TAXLOTR- O~ 7,d 4; '1';Ob Township Ra ge ~ Subs~c~o!! Tax Lot Appmximate Mile Posl of RoaO.Ot;; (5) ~~~r~slTown ~:ItJG,~1-RQ t:~~,j ~t..\J1) l'-.l l#U3JLJO~ I _' y @ (4) Stree\ address (if not addressed put N/A) ~.10 Nf:- (7) CHECK ONE BOX BELOW THA T BEST DESCRIBES THE WORK YOU PLAN TO PERFORM AND A TTACH REQUIRED MA TER/ALS (8) 0 DRIVEWAY APRON PERMIT: You MUST COMPLETE A- H BELOW IF YOU HAVE CHECKED THE DRIVEWAY APRON BOX. a. Attach a plot plan 11x17 or smaller. (If you are building or have a planning 'action, turn in the same plan you will provide to Land Mgt) b. Choose One: [ JConstructing New Approach .M~odifying Existing Approach []EvaJuation of. Existing Approach c. W~dth of driveway access at the property'line ~ (If no choice is, made, we will provide you withth~ mini';'um requirement) d. Apron Surface Request: ~sPhalt [.]Concrete []Gravel (asphalt o! concre!e'finish is reqUiredo;;pavedroadS) e. How many tax Jots wi,11 this access serve? -__ "1_ ,,~ How many"-accesses currently 'exist?--;-. -"}j,;.' _ _ _ _ . f. -'Staki~g orfiagging of the area is required. Describe how the access is marked: r:1Att..,J(o (li..1 J'@.JC4!:' g. Is this permit a requirement for: A Building Permit? Y 0 or NO A Planning Action? Y ~or N 0 (If yes-attach conditions ofapp~oval) h. Describe the purpose of the access? (ex:'home, RV parking, industrial) . "tub...J1) c,q ~ i Additional Comments 11" C, 0 ~ (9) 0 PROJECT DEVELOPMENT/ROAD CONSTRUCTION PERMIT: Engineered plans and surety may be required (SEE REVERSE) (10) 0 ROADSIDE LOGGING PERMIT Staking or flagging of the area is required. Describe how the location is marked Logging Co. Describe Logging Activity: Phone MaiJing Address including Zip (11) 0 UTILITY PERMIT: Submit 11X17 or smaller engineered plans. MUST mark locations with Paint or flagging.. Work Order # Approx mile post Description of Work (12) 0 OTHER WORK WITHIN THE RIGHT~OF~WAY: Work in the right-of-way not covered above, Please describe the work !n~.detajJ. Attach a site plan and supporting materials. Please slake or flag the area Date ROGoi':ec:I: I 0-1 S~/i) Application is hereby made for a facility permit for work to be done within a County Road right-of.way, subject to alt terms, conditions. agreements, stipulations, and provisions of the issued permit, pursuant to the rules and regulations regarding roads and righls--of_way, as set forth in Lane Code, 15.205-225 and Lane Manual 3, 120-124 and 15_505_550, and any other applicable regulation, law, or ordinance. The undersigned hereby declares, cerj.nes arid affirms under penalty of law that all Information pro de 0 this form a 1tachments are, 10 Ihe best of my knowledge, lrue and complete: RETURN TO: Lane County Public War .ng Permit Desk, 3040 N. Della Highway, EUge~J &t::Jt~ Tel. 541/682:~,~~o~"'mm""."'''".o,''',.".~.,,~~~~;~~~~:~~~~;""",;~'",'m'"~"'~~~n~~~~a~~ Date BIz. /20'0 , (13) SIGNATURE (Property owner/authorized agent)