HomeMy WebLinkAboutBuilding Miscellaneous 1992-5-5
SEWAGE DISPOSAL SITE EVALUATION P2-~t:J77
#' ./""' /? S,I, #
TRS,TI /7-.tP3-ZZ ./~4/.? Job Location 3345" &?~~;~/~# c..!/At:::;??h~'ZLJ
Written Directions r.. F. 0101 I3EL7'-IIo1E f/IK-T /-:") ';=/2.E"wAY - RIGH' DAJ
&rr 1'1 t= f7/R 1'1 R iJ.
; WATER SUPPLY 1# E L. L
i?U.f)EK- /J-'T !/o11t:" E XCA I//rT/lf/G- Phone b~3 -~rf8f
(rll.-I /379 SWN)' /)/(. El/6 7710 <f Phone 6!f8 tt. '7'75"
PROPOSED USE OF PROPERTY liUJ1 J/AI-IP !?E>T 1:0""'.5
:3 5/-10""':06 /~7QlLF"lS
I hereby certify that the above statements are true and accurate, and that I have the following legal interest in the property: _owner of record; _contract purchaser; ~tential b~er;
:;c/'W liV'sf~l'~CfhLlurther c~ thaI (if not the ow~ I am authorized to act for the owner of record, and thaI said own~r i,a~ approvesJ!.lhis ~ctir' / 2.. -fS> E:.IT }~ce5
"TEST HOLES READY.kb-/7".........7Y /~..d Signature V//; i2.-/~ _Date '1'-3-7';;>...
. '" '" "'.. '" '" "',., '" '" '" '" '" '" "',., '" '" '" '" '" '" '" '" "'.. '" '" '" '" '" '" '" '" '" '" '" '" .*. "'.. '" '" '" '" *. '" OFFICE USE ONLY BELOW THIS LINE'" '" *.*.*..
'" '" *. '" .... '" '" ** '" "'.. '" '" '" '" ** *. '" '" '" "'.* '" '" '" '" '" '" '" '" '" '"
Subdivision:
Ln,t
Bloc~
APPLICANT'S NAME AND ADDRESS Vie
/20'1
OWNER'S NAME AND ADDRES~
STRUCTURES NOW ON THE PROPERTY
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
.
Ap,OreJr/ed ~r 5ub-s~ 'S~e
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Ci.. c./e..fd..//i!!<V ~ - 9V -sea....fc... A){O'E;
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f'Co; .,uG ~D/FCoT7C7#?_
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Partitioning #
LAND USE COMPLIANCE
.l\creage or Lot SizE'
(lOTAL)
fJarcel#
) Completed
) Pending
COMMENT""
il...EC.; _CP~hf?J-(/)
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~~N~~D. SEE REV.:;t; SIDE~
C/ A~6RIZED SiGNATURE - ' , ~%
LANE COUNTY ENVIRONMENTAL HEALTH, 125 EAST 8TH AVENUE, EUGENE, OREGON 97401 (687-4051)
C55-32
o Floodway
All or part of this site may be in a flood hazard
area for which 100 year flood levels have not
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
arBa 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 fl~ level at any point.
MEMO
TO: APPLICANT
FROM: LANE COUNTY ENVIRONMENTAL HEALTH
SUBJECT: CONDITIONS OF SITE APPROVAL
kme county
-
.
Any alteration of the natural conditions in the area approved for the on-site system or replacement area may void this approval.
This approval is given on the basis that the lot or parcei described above will not be further partitioned or subdivided and that conditions
on subject or adjacent properties have not been altered in any manner which would prohitiit issuance of a permit in accordance with
O,R.S, 454,605 through 454,755 and Administrative Rules of the Environmental Quality Commission. Any such subdivision,
partitioning or alteration may void this report,
WARNING: This document is a technical report for on-site sewage disposal only, It may be converted to a permit only if, at the time of
application, the parcel has been found to be compatible with applicable LCDC.acknowledged local comprehensive land
use plans and implementing measures or the Statewide Planning Goals. The Statement of Compatibility may be made on
the attached form or its equivalent. Authorized Agent approval is required before a construction permit can be issued,
This report is valid until an on.site sewage system is installed pursuant to a construction permit obtained from Lane County, or until
earlier cancellation, pursuant to Commission rules, with written notice thereof by the Department of Environmental Quality to the
owners according to Department records or the County tax records, Subject to the foregoing, this report runs with the land and will
automatically benefit subsequent owners,
Only persons having a valid license issued by the Department of Environmental Quality under ORS 454,695 to install subsurface
sewage disposal systems or an owner or contract purchaser or his regular employees may install subsurface sewage disposal systems.
A certificate 01 satisfactory completion will not be issued if persons other than the above perform the installation,
.
.
.
srn: EV ALU^no:' fIELD WORKSHEET S. I . #
Cj:;). -0 77
LIf/'/~b.ka-n'c
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Parcell fUL'
W~ter SUPP1Y@0lIt1ltmitY Public
Tax Rer.,..,n<:e J '7 -0-7 - 2- 7. ,
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Texture
Soil ~Atrix Color ~ MOttling (Notacion)~ \Coarse F~agmencs~ P.oots.
Struc~e. Layer Limiting Effective Soil Depth. etc.
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Other Site Note:s
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=n:H SPECIF.lColTIONS
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92-<J 77
:SiL1AGE DISPOSAL
PLOT PLAN APPROVED
A permit is required
prior to ;!aJ1i p construction,
DATF. ~7.t;. %.
BY
nvironmental Health Services
125 East 8th Avenue
Eugene, Orc:;tln 97401,
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W: 3 L.ANE ~;DLJNTY D1;:PJRE~.V7t1G,TI,JF![CI':IF::-.i, 5i 9".>0(.)77 ])ATE 040:'.2
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