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.