HomeMy WebLinkAboutPermit Septic Tank 1988-4-14
..
'f 6-t3-St;f
Lane County Authorization
.
for:
FOR OFFICE USE ONLY
~~~;f~aiion/ R9gr- 71
7
~UC INSl'J:A:uON FOR Im\N REVIEW
'I\J~SHIP
17
RANGE
03
SECTION
27.3.3
I TAX 11T 70 /?OUT OF
LOT/PARCEL I BLOCK
PROpOSED USE OF PROPERTY
~ Residential D Industr ial
o Co~ercial D Public.
~~~~.,~jION/PARTITION (if applicable)
LOCATION ADDRESS STREET
1581 SEQUOIA AVE.. SPRINGFIELD. OREGON
9747'7TY
ZIP
STRUCTURES CURRENTLY ON PROPERTY
EXISTING SINGLE FAMILY DWELLING. GARAGE
Vl~~TlONS TO SIT~
EAST ON CENTENNIAL OVER 1-5. LEFT ON ANDESON LANE. RIGHT ON COTTON WOOD. RIGHl C
ON SEQUOIA
u~SCRIPTION OF PROPOSED WORK - BE SPECIFIC
SEPTIC il~=,,^-,dON FOR Im\N REVIEW
" OF BEDROOMS J n OF STORIES I It OF EMPLOYEES I WATER SUPPLY
NA NA NA PUBLIC
o~~ER'S NAME AND ADDRESS
RONALD J. MIDDLETON. SAME AS THE JOB ADDRESS ABOVE
DECLARED S VALUE
o pr<?po~ed
~EX.lstJ.ng
7~'t"~'l!'6 4'~BER
C0NTRACTOR'S NAME AND OSR #
~MKX~SXX"KX~B3K SAME AS THE ABOVE
P':;RfoI.IT TO BE MAILED TO (NAME AND ADDRESS)
SAME AS THE ABOVE
TELEPHONE NUMBER
SAME
TELEPHONE NUMBER
SAME
I HAVE CAREFULLY EXAMINED THE COMPLETED APPLICATION FOR PERMIT, and do hereby cer~ify that all information hereon i8 truQ and correct, and that I
have the following legal interest in the property:KJowner of record l 0 contt:dct purchaser f Oauthorized agent,
I f~rther certify that any and all work performed shall be done in accordance with thu Ordinances of Lane County and tho Laws of tho Stato of Orogon
pertaining to the work described herein, and that NO OCCUpANCY will bu made of any structure without the permission of ~he Duildinq Division. I fur-
ther certify that rcgl.stration with the Builder's Board .is in~UII __ ~~ii~ct as required by ORS 70LOSS, the.t If exempt the basi. for oxemption
~:E~~d:~~~~~7T~\~~~~::~:c~r. ~d empl~.e. Wh~ 'n :;;:~7#tl~?Ojeet. :;VEI/ ;/
NAME (please pnnt) ~ ~.... 'S;pRATURE DATE ,
READ THIS SECTION CAREFULLY. YOUR AUTHORIZATION ~AS BEEN BASED ON THE FOLLOWING CONDITIONS!
[] PLANNING/ZONING:
Zone
NA
parti ticn #I
Parcel #I
Parcel Size N A
Minimum Setbacks: CL, front
CL, side
interior
rear
COMHENTS:
NO SPECIAL PLANNING ACl'ICN ~IRED.
Date:
4-12-89
RLH II
[] SANITATION:
S. I. #I
B. P. #I
Installation
Record Issued? 0 Yes 0 No
Maximum Depth
of Trenches
Installation Gallon
Specifications: Tank
C"""ENTS~ l2{...Q - ~~ -:: .\"h.\_
~-1ih.J--j;;;;~ - J flAM ~,
[] PLANS &XAMINATI09Type .~. GrOllO
Lineal Feet
of Drainfield
{~
~./Jo.L L..r../~ ~
()~~/s/_Pf .~
Date;
Use
COM?-1ENTS ;
Date:
II
1
~) _..= _ _ --- ~--7~ .ff'
~I~ROVED BY 9U.r1:IDlNG OF (Der ORS 456.805 (1)) DATE
~ LANE COUNTY DEPAR T OF PUBLIC WORKS LAND MANAGEMENT DIVISION, 687-4061,
1 EAST 8TH AVENUE, EUGENE, OREGON 97401
SEE REVERSE FOR INSPECTION INFORMATION C 14-25 R84-
.
.
SETB1\CI\S "':.10 OTHER CO:;DITIO~S OF APPROVAL ~lUST BE STRICTLY OBSERVED. VIOLATION CA~ RESULT IN REVO-
CATIO~ Of TBIS PERHlT, CITATIO:l UNDER PROVISIONS OF LA};E COUXTY'3 INFRACTION ORDI:;;'NCE, AND/OR OTHER
REHEDIES ALLOWED BY- LAW.
WilEN READY FOR INSPECTION, CALL 687-4065. A ~lINHlU~l OF' AT LEAST 24 IlOURS ADVM:CE NOTICE FOR INSPEC-
TID;'! HI::Ql,;ESTS ~jUl)T BE GIVEN. Have the tollowing information :-eady: permit number, job address, type
of inspection, when it will be ready, your name and phone number, and any special directions to site.
BUILDING DIVISION:
REQUIRED INSPECTIONS:
1. Foundation Inspection: To be made after trenches are excavated and forms erected and when all
materlals tor the toundation are delivered on the Job. Where concrete from a central mixing
plant (co~~nly termed -transit mixed") is to be used, materials need not be on the job.
2. Concrete Slab or Under-Floor Insr.ection: To be made after all in-slab or under-floor building
servIce equTpment, condult, plplng accessories, and other ancillary equipment items are in
place but before any concrete is poured or floor sheathing installed, including the subfloor.
3. Framing' Insulation Inspections: To be made after the roof, all framing, fire blocking, and
braCIng are In place ~ all pIpes, fireplaces, chimneys, and vents arc complete and all rough
electrical ~nd plumbing arc approved. All wall insulation and vapor barrier are in place.
4. Lath and/or Gypsum Board Inspection: To be made after all lathing and gypsum board, ~nterior
ana-exterIOr, lS In place but before any plastering is applied and before gypsum board joints
and fasteners are taped and finished.
S. Final Inspection: TO be made after the building is complete and before occupancy.
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.
NOTE: All building permits require inspections for the work authorized, such as but not limited to:
A. Block Wall: To be made after reinforcing is in place, but before any grout is poured. This
rnspection is required for each bond beam pour. There will be no approval until the plumbing
and electrical inspections have been made and approved.
B. Wood Stove: To be made after completion of masonry (if applicable) and when installation is
cornpl~ Installation shall be in accordance with an approved, nationally recognized testing
agency and the manufacturer's installation instructions.
C. Mobile Home: An inspection is required after the mobile home is connected to an approved
sew;r-or septic system for setback requirements, blocking, footing connection, tiedowns,
s~irting, and plumbing connections.
1. Footings and piers to comply with State foundation requirements for mobile homes or as
recommended by the manufacturer.
2. Mobile home minimum finish floor elevation shall be certified when required by a flood-
plain. management ~Qtter.
3. Mobile home tiedowns, when required, and skirting shall be installed and ready for inspec-
tion within at least 30 days after occupancy. Tiedowns and skirting shall be installed
per enclosure.
D. SwimminQ Pool: Below grade when steel is in place and before concrete is poured. Above grade
when poo1l'5"installed.
APPROVED PLANS }lUST BE O:l TilE JOB SITE AT ALL TIMES DURING WORKING !IOURS. TillS PERMIT WILL EXPIRE
IF WOR~ DOES NOT BEGIN WITHIN 180 DAYS, OR IF WORK IS SUSPENDED OR ABANDONED FOR MORE THAN 180 DAYS.
SUSPENSION OR REVOCATION ;.1AY OCCUR IF THIS PERMIT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS
JNFORMATION.
ANYONE PROCEEDING PAST TilE POWT or REQUIRED INSPECTIONS WILL DO SO AT THEIR OWN RISK.
SUBSURFACE ~ ALTERNATIVE ~ DISPOSAL ~:
1. Permits shall,bQ effective for one year from the date of issuance.
2. Upon completing the construction for which a permit has been issued, the permit holder shall
notify the Lane County Department of Planning and Community Development by submitting the
installation record form. The Department shall inspect the construction to determine if it
complies with the rules contained in this division. If the cOnstruction does comply with such
rules, the Department shall issue a certificate of satisfactory completion to the permitlholder.
If the construction does not comply with such rules, the Department shall notify the permit
holder and shall require satisfactory completion before issuing the certificate. Failure to
meet the requirements for satisfactory completion within a reasonable time constitutes a vio-
latiOn of ORS454.605 to 454.745 and this rule.
Setbacks - Subsurface Sewaqe Disposal
Septic ~
Drainficld
From: Interior property lines
Edge of road riqht-of-way
Building foundation
Wells. other ~atcr sources
10'
10'
5'
50'
10'
10'
10'
100'
-
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E:8th' OR.97401
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Directions to site
from Courthouse
f:Ac::r rfA I ('"A'.J..~
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Jltv ~p__<~., L """,y-
tm.'II1Y"'P ,.AJ-Iv /)/Jc;.v
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.
Please complete all lines Inside white boxes,
~ J /J1/dt'lle-AAJ
yout {?o:{r/ <~c:=~
cln Sf TUJ..Ll ~/__tl / cShr
If possible.
~/I/ 1J-l7
VAIl:. f
Zt~U?~
97~77
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,
OWNER OF PROPERTY (il nol ..m.. .. above)
"HONt;
OWNERS ADDRESS ,I' nol ..me .. above)
ZIP
CONTHACIOH
L,cen.. .
MAP, PARCEL NUMBER
(F7 on "(;3 ';2,A7'33 T....7,J"oa
Town.' ~ ::t.Cllon 1/4 ~ci,on (ax ~OI
Townahlp ~ Seellon 1/4 Secllon T.. Lot
lownN\'p ""Ir.'rige l:Iiec:llon 1/4 ti4cllon lall LOI
,
.
SITE ADDRESS
'/,5KJ
-;:)p 1-"./ J) UJ
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MAIL PERMIT TO:
<"' Kn A. ) A-!.f) ;I}/j I riA /-p-J, A')
NAMI;.
J ~ C::;:/r / ~ C:;<9 lI;)...,/ ./J /-/1
AUUH".. _"..;0 -P I ,() ,?I f"!1tr .s::
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OJ 7)/77
ZIP
CIlY
,
STAFF EVALIiA , ,
, Inhirmatlon" Request"
....y..,'..,'..
TRS Verified
Allowed Use
, t=JVes
r::=:JVes
.
.
land Management Dlv. staff ean
not be held responsible for
evaluations or recommendations
based on falso, Inaccurate or
Incomplete Information
.'.,' :.
''''":'.'
.:.,'....-,
.. ,
Existing Buildings or
Improvements on
Property
l:i2rfiOuse
c::JB n -
~age
c:J Mobile. Home
c:J Shed
~TIC INSTAllED
ll2IY os
c:J No
w~ District h
"-' ..... tT70lJ
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.
,
q7t/77
ZIP
,
~
For Mobile Home
Placement Only
Brand
Year
Size
No. of lip-outs
No. of Bodrmo
License #
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