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Home My WebLink AboutPermit Septic Tank 1973-1-17 i; " ./'Y'h ' } - / ' c..-;fl'{rf. tee.. /.,;;)-'<'-'7 --. LANE CO!:lN.UIL!>ING PERMIT O~ MOBILE H. BUILDING ~ MH 0 MAILING ADDRESS 155 GcmG Farm Rd., Eugene MAILING ADDRESS USE PERMIT PERMIT NO. 36-7? " .' . ,- PROPERTY OWNER Dry J t~cu'~" i ce CONTRACTOR PHONE 726-8045 PHONE ".,;'." PROPERTY LOCATION - INClUDe POST OFFICE l:k:rlo\'J Rd. to G<:mo Farr.J ild. to Kirk Av. - PleiJsc poone tJhol},,'golng out. PROPERTY LEGAL DESCRIPTION - METES. BOUNDS , / .' 3 SECTION 22.44 TAX LOT NO. 6200 CODE CENSUS TRACT TWP RANGE 17. 19-00 21-300 155 Giimle Farm Rd, EXISTING STRUCTURES ON PROPERTY Dwell ing LEGAL ACCESS TO PROPERTY Kirk Av, & Gcme Farm Rd. PROPERTY SIZE - FT. APPl. NAME & MAILING ADDRESS. trugene, Or. FOR MOBILE HOME PERMITS ONLY No. of Bedrooms Mcurlee ilry WIDTH DEPTH AREA STRUCTURES TO BE BUILT THIS PERMIT Connect to Existing Sewage System 0 TYPE CONSTRUCTION SQ. FT. +: BDRMS New System 0 VALUATION RE?iJlr crainfleld " ~ ~ SEWAGE DISPOSAL PLUMBING INSTALLED BY . FEES OWNER D OTHER. NAME WATER SUPPLY PUBLIC 0 BUILDING WASTE DISPOSAL PLUMBING PLAN REVIEW PARK TRAILER SEPTIC TANK 0 OTHERD 20.00 PUBLIC Ej D OTH ER c. " TOTAL . 20.CO COUNTY BUILDING & SANITATION SPECIFICATIONS DRAIN FIELD REQUIRED MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GAL. L1N. FT TRENCH WIDTH FT. OR SQ: FT. ,'Ita line must be hied iJt Ic,liJst 10 ft. fro=n the property I inc. TYPE OF STRUCTURE OCCUPANCY ZONE RA USE CLASSIFICATION PUBLIC UTIL. EASEMENT BLDG. SETBACKS __ FT. fROM CTR. OF ROAD RIGHT Of WAY FRONT 45 SIDE INT. 5 SIDE EXT. 35 AUTHORIZED SIGNATURE - DATE Isl aoss bv Harb~uqh REAR 5 G.~. Gr~y. R,S.T, DATE 1-17-73 BLDG. PERMIT - WHITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENROD Construction to comply with uniform building code and county regulations covering plumbing and sewage disposal. All buildings require a certificate of occupancy before being occupied. (See Statement on Reverse Side) (POST THIS PERMIT ON MAIN BLDG, AT SITE) LANE COUNTY, BLDG. & SAN. DIV" COURT HOUSE, EUGENE, OREGON 97401 FORM == CSS-13 BEFORE THE HEALTH DIVISION OF THE DEPARTMENT OF HUMAN RESOURCES In the Matter of the Approval of Local) Health Officers as to Suitabil ity of ) Lands for Subsurface Sewage Disposal ) Prior to Approval of Subdivisions, Land) Partitions or Plats or Plans Thereof ) and Prior to Disposal. Transfer, Sale, ) Lease or the Agreement, Offering or ) Negotiating to Dispose of, Transfer, ) Sell or Lease Lots or Parcels o~ Land ) ADMINISTRATIVE RULES Section I. Section I I of this rule is made a part of OAR. Chapter 333. sections 41-001 to 41-045. Section I I, (1) No governmental body shal I approve any subdivision, land partitioning or plat or plan thereof within the state of Oregon and no person shall dispose of, transfer, sell. lease or agree, offer, or negotiate to dispose of, transfer, sel I or lease any lot or parcel of land within the state of Oregon without having first compl ied when appl icable with subsection (2) of this section. (2) When the projected, immediate or future use of any of the property referred to in subsection (I) of this section will necessitate facil ities for the disposal of sewage or for the provision of domestic water. a proposed method for providing such property with sewage disposal and domestic water'shall be stated in writing to the governmental body, or to the transferee, offeree or proposed transferee. as the caSe may be, and in the case where the proposed method for sewage disposal is by subsurface means, the particular method for disposal shall first have been approved in writing by the local health officer having jurisdiction in the area and a representation that such approval has been obtained shall be included in the statement to such governmental body, transferee. offeree or proposed transferee, (a) A local health officer shall approve a proposed method for subsurface sewage disposal as required by this subsection only if the particular method proposed would, based upon the health officer's or his authorized representatives' investigation, meet the requirements of the statutes and rules of the state of Oregon relating to the sub- surface disposal of sewage. (OAR, Chapter 333. section 41-001 to 41-045; ORS 447.140): If approval is denied, the health officer shall afford the appl icant in writing, served either personally or by registered or certified mail, a statement as to the reason for denial, a reference to the rules or statutes reI ied upon for denial and a statement of the appl icant's opportunity to a hearing upon request before the State Health Division pursuant to ORS Chapter 183, (3) Any person who has been denied approval by the local health officer under subsection (2) of this section may request and be granted a hearing before the State Health ~ivision porsuant to the provisions of ORS Chapter 183. . /' .~ . . . : (=' - l!:!J:. 5 c:~ ~~~ =-= .:5 ~' ~ ~ '2." z -;: ,_: C1: :2 fW'w -, ":5 w "" ~ "5 I ~ - - . ~ k) 9 - .-.--...;...- ~.<;o"'o-zte,/ - ---- } fd. 7r ---;..;/ '. > ./ /./ ~i ~L~ , / -- -..J : ' - ----" / ..... - _.J 'r ~ \ ~ F .'-. '\ ------ .' /' " . . . '. .. _co G\A p(j Bu'ilding Permit Appl ication No. ~ c. - 7~-? TJ.iiLR o3s .:;>,;;, <<ffl\X c-.s TRACT APPLICANT: // NAME_ /1~ ADDRES~ ~' LOT 0~V'O BUILD LNG 'SITE EVALUATION () Site Inspection () Pre-Permit Investigation PHONE DATE /_/0 - 7.3 LANE COUNTY PLANNING DEPARTMENT 1. Zoning Ordinance Compl ian~e/l (Zone K-rr ) Subdivision Ordinance Compl iance NOT app 1 icab I e (' () ( ) ( ) ( ) ( ) NO YES NAME DATE ~iZ- 3. 4. Required Access ( ( 'f) ~~ ( ) ( ) ( ) ( ) ( ) J.8- 2. Building Site (I\rea, Width, Frontage, Setback) Other (see comments) 5. COMMENTS: BUILDING INSPECTION SECTION NOT NO YES appl i cab I e 6. Plans Subm i tted ( ) ( ) ( ) 7. So i I Stab il ity (foot i ngs) c.J ( ) ( ) 8. Flood Plain ) ( ) ( ) 9. Other (see' Comments) Q ) ( ) ( ) COMMENTS: NAME DATE tJ) ~L /-/6-13 SANITATION SECTION NOT NO YES NAMli DATE ~pl icable - 10. Sewage Disposal () ( ) (~ ,h II. Usable Area ( ) ( ) Ii ,I 11 W- 12. Water Supply ( ) ( ) ;")3 /v 1-- P' , 13. Other (see Comments) ( , ( ) COMMENTS: TO APPLI CANT: You~Building Permit / Site Inspecti~. (0' Can be approved. /-/t-73 ~ () Cannot be approved at this time as indicated on item NO. above. Questions and further information on items I through 5 contact the Lane- COUNTY PLANNING DEPARTMENT. Questions and further information on items 6 through 13 contact the Lane Countv Buildinq and Sanitation Division. () Will be held in this. office until you can resolve the problems indicated, () Is being returned. () Your building permit appl ication fee is being returned under separate cover. LANE COUNTY PLANNING DEPARTMENT 135 Sixth Avenue East, Eugene, Oregon 97401 PHONE: 342- I 311 EXT. 231 LANE COUNTY BUILDING & SANITATION DIVISION 135 Sixth Avenue East, Eugene, Oregon 97401 PHONE: 342-1311 EXT. 1+11 M55-28 . .:.,..:..~,I;AN~ '.COU.BUILDING PERMIT OR MOBILE H. USE PERMIT . ;< ; 'BUILDING 0 MH 0 PERMIT NO, MAILING ADDRESS . I',...., ',,:1.\"). '" ~'.. '.~dO -'.:~~~;'-:~ '. " \... PROPERTY OWNER ; CONTRACTOR MAILING ADDRESS PROPERTY lOCATION ...,..,INClUDE ,POST OFFICE' '. '., ",\A;. ",:t;.' I :;>'\-~.' LJ l': 1 ,:' "~:~~! '.;>~.!') . ...~" , L )h::-- ,,-'i' -...." . .~v. 0' PROPERTY LEGAL DESCRIPTION - METES. BOUNDS , r TWP " R~NGE .' " . , SECTION. C'1' t..., - ('o.:....-.; .' CENSUS TRACT ~~O;~C':.) TAX LOT NO. f~r~ '" ,-t", , CODE nSoCD APPL. NAME & MAILING ADDRESS EXISTING STRUCTURES ON PROPERTY ';;:)11 'OJ . ':i .~ (" . '7 ~t ,. :",",' ) ::~-.--' . .. LEGAL ACCES~ rq PROPERT~ ~-d ~'ll ,,"". l> (;i..:-:;} ~ 'eit' PROPERTY SIZE - fT. , .. WIDTH DEPTH AREA FOR MOBILE HOME PERMITS ONLY No. of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT .' ~.;..',; ,I t. Connect to Existing Sewage System 0 TYPE CONSTRUCTION SQ, FT. +: BDRMS SEWAGE DISPOSAL PLUMBING INSTALLED BY OWNER 0 OTHER: NAME WATER SUPPLY PUBLIC D BUILDING WASTE DISPOSAL PLUMBING PLAN REVIEW PARK TRAILER SEPTIC .TANK D ~ {-.., .".,..} o OTH ER OTHERD FEES PUBLIC tj TOTAL $ .', MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GAl. COUNTY BUILDING & SANITATION SPECIFICATIONS DRAIN fiElD REQUIRED UN. FT TRENCH WIDTH FT. OR SQ. FT. ,..... ~, , :~~:+'f:~ " , ~. .;c:: ,! ~J_~~ c.;i',-:~::t;.~ D lc~. TYPE OF STRUCTURE OCCUPANCY ~ONE ,~, PUBLIC UTll. EASEMENT BLDG. SETBACKS __ FT. FRO.M CTR. OF ROAD RIGHT OF WAY FRONT I . SIDE INT. >.1 SIDE EXT. . .,j AUTHORIZED SIGNATURE - DATE USE CLASSIFICATION REAR ;J (1. ~. ("'':1(':'';)0 .\ (' , ..,'.i. /'1' H,:- ~, . 1 " -;;>j'.J PHONE i'G'~~~;_, , PHONE New System 0 VALUATION " ". D~~E '.(.;. iO/,' BLDG. PERMIT - WHITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENROD Construction to comply with uniform building code and county regulations covering plumbing and sewage disposal. All buildings require a certificate of occupancy before being occupied, (See Statement on Reverse Side) (POST THIS PERMIT ON MAIN BLDG. AT SITE) LANE ~OUNTY, BLDG. & SAN. DIV., COURT HOUSE, EUGENE, OREGON 9740J F"ORM := CSS-l) CERTIFICATE OF OCCUPANCY ~EADY TO ISSUE L:::7 NOT READY TO ISSUE L:::7 OAT~-~J-;7~ INSPECT~~ /I~I Co jJ . SLAB FLOOR PLUMBING GROUNDWORK ApPROVED / / DISAPPROVED ~ DATE REMARKS GAS PIPING GROUNDWORK ApPROVED / / DISAPPROVED ;---? DATE REMARKS ROUGH PLUMB I NG ApPROVED / I DISAPPROVED ~ DATE REMARKS ROUGH GAS PI PI NG ApPROVED ~ DISAPPROVED ~ DATE REMARK 5 FINAL PLUMBING ApPROVED ~ DISAPPROVED ~ DATE REMARKS FINAL GAS PIPING ApPROVED L:::7 DISAPPROVED / / DATE REMARKS REMARKS #IJ nil / /LJ . INSPECTOR INSPECTOR INSPECTOR INSPECTOR INSPECTOR INSPECTOR . .. . i .J . LANE cour4t' BUILDING PERMIT OR MOBILE '-1: BUilDING 0 MH D '"' MAILING ADDRESS '. -'"~ '...." .,._.0 ~ . .J USE PERMIT PERMIT NO. ., '-..'( PROPERTY OWNE,R CONTRACTOR MAILING ADDRESS PROPERTY LOCATION - ],~~~UDE POST OF~F!~E o 0 r.,) "" ;" \::'-11 () ,.j-'" (-...'J"Y ~..... ," _ . '-' ._.....J '-' . PROPERTY LEGAL DESCRIPTION - METES, BOUNDS TWP R.,NGE ~.. ~,~~T10N :...:.: ;. (.. ~, TAX LOT NO. "..--, . CODE '~('-P" ~v----'-''-' CENSUS TRACT :-:';8:',',=. ,-~.. --~ APPL. NAME & MAILING ADDRESS EXISTING STRUCTURES ON PROPERTY (~'__:~' ~ J:~~, .('~ t~:V = .~.~. j "'[:. '.10 LEGAL ACCESS TO PROPERTY ~;.'<~ ~~Vo (J U(~ ., L' '~', PROPERTY SIZE - FT. '., " WIDTH DEPTH AREA FOR MOBilE HOME PERMITS ONLY No. of Bedrooms .. . ..5~R~CTl!R~~~.TO BE BUILT THIS PERMIT ,.. ( .4 C~lJ.). ~CI.I'" Connect to Existing Sewage System 0 TYPE CONSTRUCTION SQ. FT. +: BDRMS SEWAGE DISPOSAL PUBLIC 0 BUILDING WASTE DISPOSAL PLUMBING PLAN REVIEW PARK TRAILER PLUMBING INSTALLED BY SEPTIC TANK 0 t OTHERD OWNER 0 OTHER. NAME WATER SUPPLY FEES (_J..........' PUBLIC '0 o OTHER ':""".-";..J TOTAi. t MIN. SEPTIC TANK CAPACITY COUNTY BUilDING & SANITATION SPECIFICATIONS DRAIN FIELD REQUIRED WITH OIST. BOX: GAl. L1N. FT no '~:c. TRENCH WIDTH FT. OR SQ. FT. ,,~, 1', ."" ~ C'~'~;l: qw~ ('),~,~'" I)'h,' [) r (.-~; ::?~:1 ~ ,~~ " U:...)lII " c~ , .. ~ '-~ TYPE OF STRUCTURE OCCUPANCY ZONE ,,. .,;'J PUBLIC UTll. EASEMENT BLDG. SETBACKS n FT. FROM CTR. 9.F ROAD RIGHT OF w,~r: SIDE INT. SIDE EXT. u,' AUTI:lORIZED SIGNATURE - DATE FRONT REAR C' ;.J USE CLASSIFICATION ("o~;. ':~'(';"Jo \;0, 0'/0 ~' '" '.-., " , ".'0'" BLDG. PERMIT - WHITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENROD , / PHONE PHONE New System D VALUATION " " ,DATE Construction to comply with uniform building code and county regulations covering plumbing and sewage disposal. All buildings require a certificate of occupancy before being occupied. -". (See Statement on Reverse Side) (POST THIS PERMIT ON MAIN BLDG, AT SITE) LANE COUNTY, BLDG. & SAN. DIV" COURT HOUSE, EUGENE, OREGON 97401 FORM ::= C55-13 ;.; . SITE INSPECTION ApPROVED Cl DISAPPROVED Cl DATE REMARKS FOUNDATION INSPECTION APPROVEO f f D'SAPPROVEO;----Y DATE REMARKS FRAMING INSPECTION ApPROVEO I / D'SAPPROVEO Cl DATE REMARKS LATH OR SHEETROCK INSPECTION ApPROVED / f D'SAPPROVEO L----f DATE REMARKS FINAL INSPECTION ApPROVED Cl DISAPPROVED Cl DATE REMARK 5 /':l /7 / V /./ f fA ~ /71.....- ~ CERTIFICATE OF OCCUPANCY READY TO ISSUE / / NOT READY TO ISSUE ;---y DATE REMARKS . INSPECTOR INSPECTOR INSPECTOR INSPECTOR INSPECTOR INSPECTOR . . f 'J'.' /J,Ll- Yl-R..4P'J Installer's Name ~DIVIDUAL SEWAGE DISPOSAL SYST~CORD ~staller: Complete top part 0 rm to signature and return both copies 0 Lane County Building Sanitation Department. . v' Pr;-RMIT No. 36-73 GG I Property Aaaress 155 Game Farm Rd. No. Living Units IBearoomslBatns I Basement I Water SupJij.loy )... . Yes 0 No 0 Public V' Other-List Septic Tank: ~VI<'+: }1&; Ft. from well ~~~J. .7Concrete 0 No. Compartments InSJ.oe Dl.InenSJ.ons: .t"c. Length Width Applicant Name Diameter Depth Gal. Capacity. Tile Disposal Field: _,,- Distribution Box:Yes~ No 0 Other Distribution- Type Maurice Brv Mailing 155 Game Farm Rd. Address Eugene, Or. Length of Lines - Ft. I Trench l.ID?n lab 4. 5. 6. Width J Sketch (See instructions): Feet from Well Foundation Lot Line Front Side Rear ITotal Sq~Ft.betweenIFillerl .- IFiller deothlF1LLer aeptn . d ~ above below ft.~tJ 11.nes "'9 Type .... 't;!_~ ~ in t-;_!_~ ~ in - _." .- .~ L ,,0 i ffi @ r~ n -~VJ:cffi- t1 11 J1 MAR 0 1 1973 \ j ~ UlNE GOUl'lfY HEALTH UNII f ~, i' ! ,.. ~ ~ \ 7 . :)'" ( , J(J('~91I-7 ~ _~'lL~ f.+.(J ~F ~ Q:: 1: ~ <t ): . t ~ lj , :->A .~ .: -~--N . '- -- \ 1<", V' k Date 1_ 1_ 71 Signature .4. ~_..... A _._.../_ ~ 3}2..)73 F~~anitarian Use Only: ~Approved: System Installation Conforms to Current Standards o Disapproved: Does Not Conform to Current Standards ',.L\ -L Remarks: J;;-y '5n Y\..J <:Rfur, tz.N'\.,J/, Date: Lane County Building & Sanitation \J~,~ &(/;JJ~ J;?Z ~~'~ Sanitarian's Signature Dept. C55-11 Ij