The URL can be used to link to this page

Home My WebLink AboutPermit Septic Tank 1992-5-14 (2) REQUEST FOR: IUSTALL SEPTIC SYSTEM ",.."" lADD~ESS'Nl:l; .... .. .... ..... ......... .. ... . . h... . .... .... .... .......... .......... .. .. .. ..... . ....... .. ....... ........... . .. .. . .......... . ...... . .", . .. . , , :D.TI:::.....:: :", : '"'::"::"::'" ............... ," ," , TOWNSHIP 17 RANGE 0 3 SECTION 2 2 1/4 SECTION TAX LOT 1 000 SUIIIlIYISION I ......nT1ON LOT IPAI'CEL aLOQl LO~~ ,-#'OOAESS ))4) GAME FARM ROAD, SPRINGFIELD, OREGON "1iiiiiJCTURES NOW OH PROPERTY EXISTING SINGLE FAMILY DWELLLING, AG BUILDING PflOPOSED un. 8~nc lNaTA-LUIl PRIVATE USE WATEJIl "STAUED NO.OI'IITORlEB NO. QI' DlPLOTEElI COfGTRUCTlON COBTIVAWE IlESCIUI'TlOH 01' PROPOSED WOM!l; ~Wl Hd.p{....-'V~~!f~~.v<? TO GAME FARM ROAD, RIGHT, 1/4 MILE, LEFT INSTALL SEPTIC SYSTEM DillECTlON8 TO ani ,.ROM COUATMOUSE EAST ON BELTLINE, PAST GATEWAY, INTO DRIVE~/AY. APPUCANT NAME" ADDRESS VIC RUDEK, OWiiEii'i'HAUE .. ADDfIESS 13 7 9 ROY GRAY, PHONI SUNNY DRIVE, EUGENE, OREGON 683..2884 '.OH' 688 -6 7 9 5 C:OfHAACTOA NAME AT HOME EXCAVATING ) M~tl1ttJMd~ If: 84823 f1CB ETH ROAD. oaR UCENlI. . PHOHI ~ EUGENE, OREGON 97405 t N.....E ADDRESS · I hava carefully raad BOTH sIdes of thIs aictlllc'\t1ifn.!1!! herw ~rtlfy Jhat all VIC RUDEK 1/~ (C/aufd.. PRlNTNAME ~ - 0'''' ) Information Is true and correct t . FEES DUE: $ t READ CAREFULL VI APPROVED s:l.EfLq 2- 1 CALL FOR INSPECTIONS (SEE t!dlCK OF FORM FOR INSTRUCTIONS) 687-4065 SEPTIC permits are good for one year. ALL other permits expIre after 180 days unless InspectIons aTe current. ~ VIOLA nONS SlttBACKS AND onmR __.'_.. ._..J OF APPROVAL MUST BB STRlCI1.. Y OBSFRVED. VIOLATION CANRBSULT IN RBVOCAll0N OFTIfiS PERMIT, CITATIONS MAY BB ISSUED UNDER TIm PROVISIONS OP LANB COUNTY'S INFRAC110N ORDINANCE AND/OR onmR. REMBDIBS AlLOWED BY LAW. . . . .~ / A MINIMUM OF AT LEAST 24 HOURS ADVANCE NOTICE MUST BE GIVEN FOR INSPECTION REQUESTS Have the following infonnation ready when you call: 687-4065 Permit number - Job address - Type of inspection required When it will be ready Your name and phone number - Any special directions to the site PUBLIC omClAL RIGHT TO TRESPASS ON PRIVATE PROPERTY ORS n!.Oao POWER TO ENI'ER UPON LAND. nIB COMMISSION, AND ANY OF ITS MEMBERS, OFFIa:.RS AND EMPLOYES, INntB PERPORMANCB OPTHBIRFUNC110NS, MAY I!NJ'ER UPON ANY LAND AND MAKE BXAMINATIONS AND SURVEYS AND PLACE AND MAINTAIN TIm NECESSARY MONUMBNl'S AND MARKERS . '~". REQUIRED INSPECrIONS FOUNDATION INSPECrION: To be made after excavations for footings are complete and any required reinforcing steel is in place, UNDERGROUND PIPING INSPECrION: To be made after all underground piping has been installed, prior to any backfill. CONCRETE SLAB OR UNDER.FLOOR INSPECrION: To be made after all in.slab or under.floor building service equipmen~ condui~ piping accessories and other ancillary equipment items are in place but before any concrete is placed or floor sheathing installed, including the subfloor. ROUGH MECHANICAL INSPECrION: To be made after all ducting and gas piping has been installed and prior to being covered. ROUGH PLUMBING INSPECrION: To be made after all plumbing rough.in is in place, prior to being covered. FRAMING INSPECTION: To be made after the all framing, fIre blocking, bracing and roof are in place and all pipes, chimneys and vents are complete and the rough electrical, plumbing, and mechanical inspections have been made and approved. INSULATION INSPECrION: To be made after all insulation and vapor barriers are in place, prior to covering. LATH AND/OR GYPSUM BOARD INSPECrION: To be made after all lathing and gypsum board, interior and exterior, is in place but before any plastering is applied or before gypsum board joints and fasteners are taped and fmished. ADDITIONAL INSPECflONS MAY BE REQUIRED, such as but not limited to; BLOCK WALL: To be made after reinforcing is in place, but before any grout is poured. The inspection is required for each bond beam pour. There will be no approval until the plumbing and electrical inspections have been made and approved. FINAL MECHANICAL INSPECrION: To be made just prior to the sb'UCture or remodeled area being occupied and prior to operating anyequipmenL FINAL PLUMBING INSPECrION: To be made just prior to the building, structure or remodeled area being occupied. FINAL BUILDING INSPECrION: To be made after finish grading and the building, structure or remodeled area is completed and ready for occupancy. MOBILEjMANUFACI1JRED HOMES: An inspection is required after the mobile home is connected to an approved sewer or septic system, prior to covering sewer or water lines, for setback requirements, blocking, tiedowns and plumbing connections. Footings and piers to comply with State fO\D1dation requirements for mobile homes or as recommended by the manufacturer. Minimum fmished floor elevation shall be certified when required by Floodplain Management Tiedowns, if required, shall be installed and ready for inspection within 30 days after occupancy. Tiedowns shall be installed per enclosure. APPROVAL REQUIRED No work shall be done on any part of the building or structure beyond the point indicated in each successive inspection without first obtaining the approval of the building official. Such approval shall be given only after an inspection shall have been made of each successive step in the construction as indicated by each of the inspections required. APPROVED PLANS MUST BE ON TIlE JOB SITE AT ALL TIMES DURING WORKING HOURS. TInS PERMIT WILL EXPIRE IF WORK DOES NOT BEGIN WTI1IIN 180 DAYS, OR IF WORK IS >lvrreD OR ABANDONED FOR MORE TIlAN 180 DAYS, SUSPENSION OR REVOCA nON MAY OCCUR IF TIllS PERMIT WAS ISSUED ON TIlE BASIS OF INCOMPLETE OR ERRONEOUS INFORM A nON, ANYONE PROCEEDING PAST THE POINT OF REQUIRED INSPECflONS WILL DO SO AT THEIR OWN RISK. Your signature on the front of this form verifIes the following: I HA VE CAREFULLY EXAMINED TillS COMPLETED APPLICATION, and do hereby certify that all information hereon is true and correct, and that I have a legal interest in the ..................J as owner of record or authorized agent. I further certify that any and an work performed shall be done in accordance with the Ordinances of Lane County and the laws of the State of Oregon per- taining to the work described herein. I further certify that if I am not the owner of the ............_..,;, my registration with the Builders Board is in full force and effect as required by ORS 701.055, and that if exempllhe basis for the exemption is noted hereon, and that only subcontractors and employees who are in compliance with ORS 701.005 will be used on the job, SUBSURFACE & ALTERNATIVE SEW AGE DISPOSAL SYSTEMS: When subsurface construction is complete. the permit holder shall notify the County Land Management Division by sllbmitting the installation record form. An inspection will be made by a qualified sanitarian. If construction complies with all rules a certificate of completion will be issued to the permit holder. If construction does not comply with rules, the permit holder will be notified, and all corrections shall be made before a certificate of completion will be issued. Failure to meet satisfactory completion within the allotted time constitutes a violation of ORS 454.605 to 454.745 and this rule. SUBSURFACE SEW AGE DISPOSAL SETBACKS SEPTIC TANK From: Interior l-'Iuy......j' lines 10' Edge of road right-of.way 10' Building foundation 5' Wells or other water sources 50' DRAINFIELD 10' 10' 10' 100' ~/WC . 5::l' 02. ~, "'< ~ lu 1:- ~ rJl' -- :ORtVtF 'WAf' ,. o c (tI ,01 " '\ Cr-rjjJf14.or \ ) JAdU~ft~/ ~ !' 60# ~L-D ,o--::::==D ~ G-,!-ouE or fI/C. TIC E'C s. /{fD /00, /' <.. ~' St:fT1'- - / rflfol~ jbO;C " . 93~S G-ItHE J7:,RI1 /Co. S''I ~ ?;).-oo77 1 ~r (<::J I) " /\ ;, 1'j3/)~}J..j... i+;'/VJHL. 'i SO ,,/ I'1v!rrr r . ) A S'u i \ tea. I Q't.{) - & ~r;tt-J tlOiJ>~ --- ~o - }O vJEa o . .... .... .... ..............,... ~ ,".-4. Plea,e complete all lines Inside white boxes, If possible. tile... 12UtJE JL //}-'/ ./-J1)/1~ Elfe/! U 5hh.:2-. '.",un ...la... / UAII; I '?uH'I!:.:~ 1-1<- AE7f1 ;2;). /;:!..3-~J''I., . /3 t/&E /J/E, 0 r2 CITY / R.o'/ tJ../C/rf oW~E307~ERTY 5:;; ~ ""t7 ,e EO G- OWNERS ADDRES8 (If not ArM .. sbo.,.) t.w1r. fi.(l.!!.~'H.tH 1fC' flllhT/ i/{;... '77 '10 )" ZIP 6?& -{,79S PtUJNIt 'l7,/of ZIP UC'nM . MAP, PARCEL NUMBER (Found on I.. maps In 1M ......msnt . T...l1on D.pl) ~ RIlr:.3 wcl?n':J-.'~lI<<uon /C:~LOC: Tow..hlp ~ 8teUOn 114 8tc1lon T.. Lot Township '1Iiiiii"" II<<lIon ~/4 atcllOft ,.. LOl , I SITE ADDRESS ':? ~t/5" 6-/l-/"1F !7J--,e/1 KO. , 'MAIL PERMIT TO: ir 1?tJtJE ~/} ....J N'.nII?~.f,). '3 7J/ ~ ./C/ .uUH.l. ~ j /L i 7 '10 <) ellY 0 / ZIP , .. ....... ... .. . ......... ... ........ ....... . ........................................ . "..""......, ..,....,.., 'i(:' Land Managament Dlv, staff can not be held responsible for .......................... ........'.; ;.;;...;.;.,.,.,... evaluation. or recommendations '" ",..", ,..",..',',,', bs.ed on lal.e, Inaccurete or ...':...",':,:::'",'''",..,''''''''''''''' ,MIl ".. .... Incomplete Inlormatlon ,', ' .. ~ ~;~. MI4-68 02/92 , Existing Buildings or Improvemenls on Property do House ~Bam c:::J Garage c:::J Mobile. Home c:::J Shed SEPTIC INSTAllED c:::J Ves c:::J No Waler District .; " ,.. '. , , Directions to site from nearest main Intersection Efts T C> tv' &&~d /- Z:;-(~;J 1 ~~f:: 1', ZIP ~ I,":.:"~ , r Mobile Home P ement Only nd Ve /' Size " /' No, 01 B~ Ucense ~ :.~ (' '/' / . . , " '. . \1\11 . . . . . r ~ H . ,. , " . , .- . <I ~ ~ . . e~ III " e~ J' ~ w et: r ~11r. .~ ~ , . .~ " . ~ j .. i ",,1111 , ,", 0 .~ . .~ . . . ',:\1' ~_. . / . \.1: :1 LANE COUNTY D[T'T E:NV rlGT F::ECEIPT .r.. 1 :):";'192 DfY'i'E 0:)1 i.''''? APF'LICANT GI,AY, F(OY ADDF( :\:',4:) GAME:' F(iF(M F(D., SF'F:TNGI~IELD" OJ'\,,, TLI i70322000i000 SUBDIV . LOT BLK . N[I;J [<LDG TYF'E:. USE R ElDF(MS 0 UNITS 001 STClfU[S" .::.Bt"DGS 00i PHONE:' 6flB 67'1'" DWNEI:( NME C;f((.W. FWY ,ttl)DI:( ~n45 GMiE F (.:1 Fa'i \'(0", S"F'FnNGFIELD. Ol':e CODE APPL NO ACTION DESCRIPTION SQ FT UNIT COST VALUATIOK FE:E D~!~ Ell'" J... BP Ell'" . I~P Ell" . 'I" I :' . . Pl.. ~:'FIX/F.'ATH; MECH SUF~ . PCK SDS LC 155992. SDSS I", SDEQ Ff'T SDS S . SWR: FT. WTR: MECHANICAL. FEE STATE SURCHARGE Pl"AN CHECI< FEE FT. RAIN: FT . :;~{, 25i~ i00.00 i () .00 . , "i! ~ . . CATG: F'I...N SEQU: TAKni BY Hl..H F(tl ' SDS ELE F'CK ISS 2 / SI DTF( i EST. COMPLE:TION DATE DEPOSIT JH' eff i i 0.00 CI< ; r e~ ~ ; .~ < . .