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HomeMy WebLinkAboutMiscellaneous Plans 1993-11-22 VICINITY MAP . N ....-::> '~ tI l. )> i I' i i I OJ I :w-....J~ I V'olz ~~} ~ ~I I Qo . I)> ';'0 ~ " /J"'t m D~::::- " - , ,+):;1 .-1) ~ ;1=- 'i-J ..J T}~ " ' y- / o;l ro '0 ::T o :J , l"", (.vi 5 6'(f" ~ ~r '1' ii 'f:..' -<' : ~ 5'JoJ !~ -I ," ~ C:::7 o If"' ..... [ ~ OJ . L- a; -? '1') '~ - ~ '} , f ::;: o OJ a; , -D W :J lJl ~ ~ ....... ~ ~ ....., t> ~ I MUS'LBE IN BLACK INK ~T 055." Permit No. 3b.5! - 9. 3 Twnshp. J 7 Rangp3 Section L."2.. I Z- Tax Lot J ~O Standard System ~ Alternative System :::J (S()eci~ Type) r ~. .~ . F Job Location (Street Address) ;;;; ~ 74- ~e. t--o-r""~J ~DY-r~ ~ Supdivision/Partition # . Parcel Lot Block DETAIL SYSTEM PLOT PLAN AS CONSTRUCTED Scale = i ~.. o~ ~~ li)a::t:rif gsh :lEi!? -"l!?;t; .~~o"" :;g2 ~O~~ i:=!m o~~~) ( ~~igf I ~n..ii! ~iai o~'f . N r", ...... I " 1'\/ V) .j '-) 9 ~ --r:-, D 1- "5 , , Cv r: ~ cr t1' --r- . ~ 1.' "t ,,-' O~ ~ 1,.' ... ....", ...: ", USE BLACK INK ONLY FOR INSTALLER'S USE: Trench Depth :2 4- !\('l G~vel Depth Below Tile (P . TankCapacity 1000 Manufacturer \.~.ll"~"'~, V_l?""-'-''l-o...,- Measured Distance from Well to Tank 0- From Drainfield -0 I Total Length of lines02 :;> )" COMPLETE THE FOLLOWING IF A PUMP WAS USED ON THIS INSTALLATION. I (installer's name) certify that a (Mfg.) (Model No.) Pump and Mercury Float Switch (Mfg. and No.) . have been installed with this sewage installation. Signature Date FOR SANITARIAN'S USE ONLY. COMMENTS: j .0'/..//"_ ~System Approved .~LJ., _ I.. o Needs Correction o System Disapproved System Capacity 1/ 5/.) c Sy~ Corrected r~ .L'-.. Date Date /I/-z~/97 gaL/day Signature INSTALLATION RECORD & CERTIFICATE OF SATISFACTORY COMPLETION When signed by the County Sanitarian, this certificate is evi- dence as per OAS 454.665 of satisfactory completion of a subsurface sewage disposal system at the above location. To request inspection, return all three (3) copies of this form to: Lane County Environmental Health Services, located in the basement of the Public Service Building, 125 E. 8th Avenue, Eugene, OR 97401.