HomeMy WebLinkAboutBuilding Plans 1992-6-8
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MUST BE IN 'BLACK INK loom c55-11
Permit No J.5 _,rl - ;':1-, Twnshp_ 17 Range 0 S Section;.;t.. 2.. Tax Lot /000
Standard Systemi2l:"Alternative System 0 (Specify Type)
Job Location (Street Address) .~ '? L/-~- (..,r.A.YH~_ Y- ","I' ,.,.',' krl"..:;. DYlh',.'f-r::::!r!
Supdivision/Partition ", Parcel - Lot Block
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DETAIL SYSTEM,PLOf PLAN AS CONSTRUCTED
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USE BLACK INK ONLY , ,
FOR INSTALLER'S, USE: Trench Depth 3D' Gravel Depth Below Til" 6
;'Tank Capacity /,:>CVoA/ Manufacturer v.l'Llf'I" 77E r;/?I'-Y~7(.#e: .
'Measured Distance from Well to Tank ::l.cD '-I From Drainfield ;;2.00'... Total Length of Lines ;;1.00 ,
. COMPLETE THE FOLLOWING IF A PUMP WAS USED ON THIS INSTALLATION:
\ I (installer's name) certify that a (Mfg,) (Model No,) Pump
:and Mercury F!o'!,t Switch (tvIfg,.and No,) have been installed with this sewage installation,
Signaturp I/I/'_~ .K' Iud./.. Oat" .,- -,2 7 - - 2..
FOR SANITARIAN'S USE ONLY: I~ System Approved .. 0 Sy~tem Dis~pprov;d.....
COMMENTS: brDO"'O\lf'fJ ',~(.)y ~AR ',/+<J - 7/ _ J IU I k,.J
in s't/f/lrb .....::''5 ~U7r ~e..r7 r - ' ./
,,1J,...Syste~Corrected; pat..
. tern Capacity b OU gal./day Signature~, \.;4 I/'! ( ~:I'-at~.<d-/lr,gat..
o Needs Correction
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~ALLATION RECORD & CERTIFICATE OF SATISFACTORY COMPLETION When signed by the County Sanitarian, thIS certificate IS evt-
. ce as per OAS 454665 of satisfactory completIOn of a subsurface sewage disposal system at the above location
, request Inspection, return all three (3) caples of thiS form to' Lane County EnVironmental Health Servlces~ located tn the basement of the
ubl.c Service BUilding, 125 E 8th Avenue, Eugene, OR 97401
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Lane
County
RE:
citizen
TWP. / '7
service -
R. 0'3
septic Tank and Disposal
SEC. .;?~ TAX LOT
Field.
/600
1
Date 0/;~/9::J
Dear Citizen:
You have just acquired a treatment system to dispose of your
domestic waste water, as authorized by construction permit
# 1~~'?-S?C2 The design and installation activities complete
governmental requirements to assure that the system was installed
in accordance with state requirements.
The length of time your system will function properly is equally
dependent on the attention and maintenance you provide." ,The
enclosed pamphlet, provided by Lane County, will assist you in
performing the types of maintenance that will 'minimize premature
system failure.
The enclosed diagram is specific for the system serving your
structure and depicts your waste disposal system. To facilitate
cleaning and maintenance, the homeowner should have a diagram of
the septic tank system showing location of the house, septic tank
manholes, piping and soil absorption system. ~e recommend that
this information remain with this structure and that it be
presented to the new owner should you sell in the future.
We support healthy and environmentally sound waste disposal methods
through proper design and installation. Through the use of this
pamphlet, we hope you will provide the types of maintenance
necessary for proper operation. Do not hesitate to contact this
office at 687-4480 if you have any questions or require assistance
related to your waste disposal system.
sincerely,
~~~
s~~Vl. petrasek
MANAGER
ENVIRONMENTAL HEALTH DIVISION
SEP:rm -
ENCLOSURES
LANE COUNTY COURTHOUSE I PUBLIC SERVICE BUILDING I 125 EAST 8TH AVENUE I E_U,GE,I\iE",OR,E(301j ,~7<1OJ_
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~~ SEWAGE DISPOSAL SITE EVALUATION s.I.#P2~C7?'
. TRS,TL/7..:t:P3-ZZ ~...?'~6' Job Location "':):34~4?.q:.c:~~ ~~ c...!/(7~7"-r~~
WriltenDirections t<- E. o,v f3€L,t.JNE ;/IKT j-";) ';::teE~wIIY - t?JCC#T OAl
&frf1t: ht.R11 R;2.
Subdivision:
Lot Block / WATER SUPPLY 1)..1 c- L. L
APPLICANT'S NAME AND ADDRESS IJIC}(Uf)t?K.. /,4'1 !/ol-tG' EXCAUffT/;//C- _Phone b6'3-.;L..t-8f
OWNER'S NAME AND ADDRESS Roy (rR.lt'! / r379 SWJVj I)/( _ EU6- '77fo'f Phone,68-8 tt.'l'1:s-
STRUCTURES NOW ON THE PROPERTY PROPOSED USE OF PROPERTY i:JUf1 !11;vp !?r,g- ;>00;;.5
3 5H()W""S/~'TQI~F7S
I hereby certify, thaI the above statements are true and accurate, and that I have the following legal interest in the property: _owner of record; _contract purchaser; 72."ot8r:'tial
b~er; .. .
.5i:';>rir-l.N's'flirt'ifiLlurther c~ that (if not the ow~ I am authorized to act for the owner of record. and that said own~a~d approves 01 this e7ti , / -Jf? E:.I:J'r~ )..:;y<:..
XTESTHOLESREADykb:-~Y /,07/..o! ,,' Signature ~ j2..~ Dat" ;,.'-3-7.;>...
...... ....... *... ..... *. .lOft .................. ............ .... OFFICE USE ONLY BELOW THIS LINE ......... ............. ....... "..ft... ... ............
SITE MEETS STATE STANDARDS YES NO YES NO
Standard System ~ 0 Low Pressure Distribution 0 0
Sand Filter 0 0 Holding Tank 0 0
1 Foot Capping Fill 0 0 Other 0 0
Zonin~
Partitioning #
LAND USE COMPLIANCE
Acreage or Lot Siz...
<TOTAL)
Parcel #
) Completed
) Pending
COMMENTS:
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A-?i:>~r/e4I fi;r-- .$vb:scvfiu:F\ S(}.fI-.[(.'-4e
-pr amve. U~CL-<(p, M?s"f: oye: b:u-n'~a.ru:{
hN-fh err .qr?:lW~ ('lyC. /af-r<c~ P~. Sv/:;rn/c
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1/;;"',<"1 0fC"Ch c~n<t:-Y0c.&S)Y7
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f?Pr-rnr (, a'ic;I'?FtCr1yor ":',-7.
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FLOODPLAIN INFORMATION
o Approximate
Study Area
o Detailed
Study Area
THIS IS A PRELIMINARY REPORT WHICH DOES NOT ENSURE THE ISSUANCE OF A FUTURE
BUILDING PERMIT. ANY PLANS OR EXPENDITURES MADE IN RELIANCE UPON THIS REPORT
ARE AT ,!Ol:JJ OV',lN RISK, IF SITE IS AP~ROVED, SEE REVERSE SIDE,
y;iiYl(h;:~;p~~~ . 5js--f92-
U AUTHORIZED SIGNATURE' 'DATE
LANE COUNTY ENVIRONMENTAL HEALTH. 125 EAST 8TH AVENUE, EUGENE, OREGON 97401 (687-4051)
o Floodway
All or part of this site may be in a flood hazard
area for which 100 year flood levels have nOI
been established. Extra precautions may be
appropriate to assure that the building site will
be reasonably safe from flooding.
All or part of this site may be in a flood hazard
area for which 100 year flood levels have been
established. A building elevation above the 100
year flood level may be required.
All or part of this site may be in a flood hazard
area in which a floodway has been designated.
Building may be prohibited subject to
demonstration that the cumulative effect of
proposed development will not increase the
100 year floo.d level at any point.
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~t~~J.~Gf DiSPOSAL
rLOT PLAN APPROVED
A permit is required
prior to st :i, constru,tion,
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BY
nvironmentil Health Services
125 East 8th Avenue
Eugene,0"2" 97401,
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