HomeMy WebLinkAboutPermit Septic Tank 1991-10-17
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A,UTHORllATION FORM"", '~/~4-9/
Managament Olvlalon 125 E.: 8th Ave. Eugene, .OR 97401 "
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REQUEST
FOR:
SEPTIC VERIFICATION FOR LOAN REVIEW
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NEW}
~ TOWNSHIP
17 03
LOCATION ADDRESS
2295 ROSE BLOSSOM DR.. SPRI~GFIELD 97477
"'iTiiiiCi\JRE8 NOW (ltII PROPERTY
. HOUSE; GARMi,Ej SHED
'"0POSED USI SEPnc INSTALLED WAtER INSTALLED
PPJVATF Y.fS
IlESCRlPTlOH Clt' PNOPOBlD WONK
VFRIFICATION Of EXISTING SEPTIC SYSTEM FOR LOAN REVIEW
DIRECTIONS TO alTI '110M COUATN0l.18&
HAYDFN BRIDGF RD. FAST OF 5TH: TURN SOUTH ON ROSE BLOSSOM
I FFT AROIJT FIVE HOUSES FROM HAYDEN BR IDGE
APPLICANT NAWE .. ADDRESS
S r~F IJ JnNGFW~. nfi3 L YIll..C.K \4AY. EUGENE 97401
aWNEIl. HA...8 . ADDRUS
2863 LYDICK WAY, EUGENE 97401
oaR UCDlSE ,
RANGE
SECTION
26
1/4 SECTION
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3zb"6
aU.DlV~ I '.....nTlON
LOT f 'ARCEL BLOCK
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NO. CI' BTORI...
NO. OF Ol.I'LOYEES
CONBTRUCT1DN COSTIY"WI
NO. 01' BEDRDOIIa
DR. ;
HOUSE ON
RfTrv 1'1. .1 ON G FtIARll,
COit\,,,.C',OH ""oWli
PHON.
686-9714
PMOfilll
686-9714
PHONE
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~ NAMe
I have cerefully reed BOTH
HILLIE D. GLOYNE
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AT 686-9714
ADDll~Ra
, PRlM"NAUli
sides of this application and hereby certlfy~nformatlon
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Is true end correct
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tSANITATlON
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FEES DUE: $
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APPROVED BY:~:/'~.L><t
DATE
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CALL FOR INSPECTIONS (SEE BACK OF
. SEPTIC permlls are good for one year. ALL other par
RM FOR INSTRUCTIONS) 687-4065
lis explra after 180 deys unless Inspections are current.
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VIOLATIONS
SETBACKS AND 0lHBIl CONDmONS OP APl'ROV ALMUST DB SmCIL Y OBSBRVED. VIOLATION CAN RESULT IN REVOCATION OFTInS PERMIT.
CITATIONS MAY DB ISSUED UNDER nIB PROVISIONS OF LANE COUNTY'S INPRAcnON ORDINANCB AND/OR 01liER RBMEDms AlLOWED BY LAW.
A MINIMUM OF AT LEAST 24 HOURS ADVANCE NOTICE MUST BE GIVEN FOR INSPECTION REQUESTS
Have the following information ready when you call: 687-4065
Permit number - Job address - Type of inspection required When it will be ready
Your name and phone munber - Any special directions to the site
PUBLIC OFFICIAL lUGIn'TO TIlESPASS ON PRIVATE PROPERTYORS Ds.oao
POWER TO BNIl!R UPON LAND. nIB COMMISSION. AND ANY OP rrs MEMBERS, 0WIc:mlS AND BMPLOYBS, IN"ffiBPERPORMANCB OP 1HBIR. PUNcnONS. MAY
ENTER UPON ANY LAND AND MAKB EXAMINATIONS AND SURVBYS AND PLACE AND MAOO'AIN nIB NBCBSSARY MONUMENTS AND MARKERS 1lIEREON.
REQUIRED INSPECTIONS
FOUNDATION INSPECTION: To be made after excavations for footings are complete and any required reinforcing steel is in place.
UNDERGROUND PIPING INSPECTION: To be made after all underground piping has been installed, prior to any backfill.
CONCRETE SLAB OR UNDER-FLOOR INSPECTION: To be made after all in-slab or under-floc! 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 INSPECTION: To be made after all ducting and gas piping has been installed and prior to being covered.
ROUGH PLUMBING INSPECTION: 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 INSPECTION: To be made after all insulation and vapor barriers are in place, prior to covering.
LATH AND/OR GYPSUM BOARD INSPECTION: 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 INSPECfIONS 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 INSPECTION: To be made just prior: to the structure or remodeled area being occupied and prior to operating any equipment
FINAL PLUMBING INSPECTION: To be made just prior to die building, structure or remodeled area being occupied,
FINAL BUILDING INSPECTION: To be made after fmish grading and the building, structure or remodeled area is completed and ready for occupancy.
MOBILE/MANUFAcruRED 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 COIUlections.
Footings and piers to comply with State fOlDldation requirements for mobile homes or as recommended by the manufacturer.
Minimum finished 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.
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APPROVED PLANS ~ST BE ON TIlE JOB SITE AT ALL TIMES DURING WORKING HOURS.
TIllS PERMIT WILL EXPIRE IF WORK DOES NOT BEGIN WI11IIN 180 DAYS, OR IF WORK IS S lVrreu OR ABANDONED FOR MORE TIlAN 180 DAYS.
SUSPENSION OR REVOCATION MAY OCCUR IF TIllS PERMIT WAS ISSUED ON TIlE BASIS OF INCOMPLETE OR ERRONEOUS INFORM A TION.
ANYONE PROCEEDING PAST THE POINT OF REQUIRED INSPECfIONS WILL DO SO AT THEIR OWN RISK.
Your signature on the front of this form verifIes the following:. I HAVE 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 property as owner of record or authorized agent. I
further certify that any and all 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 property, my registration with the Builders Board is in full force
and effect as required by ORS 701.055, and that if exempt the 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 submitting 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 correctj.ons 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 SEWAGE DISPOSAL SETBACKS SEPTIC TANK
From: Interior property lines 10'
Edge of road right-of-way 10'
Building foundation 5'
Wells or other water sources 50'
DRAlNFIELD
10'
10'
W
100'
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OWNERS ADDRESS (il not ..me .. above)
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Land Management Dlv. staff can
not be held responsible for
evaluations or recommendations
based on falso, Inaccurate or
- Incomplete Information ""~C,,',^d,,.
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Existing Buildings or
Improvements on
Property
~House
CI Barn
!1:ti Garage
CI Mobile. Home
uz:(Shed
pEPTIC INSTALLED
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Directions to site
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. APPLICANT JONGEWARD, S.L~~YLCOUNTY D~bbRE~~6~Gly~y8RIWAY,~EO~~~t1 DATE 1011i1
TL~ 1703261103206 SUBDIV LOT BLK
NEW BLDG TYPE USE R BDRMS 0 UNITS 001 STORIES ~BLDGS 001 PHONE 686 9714
. OWNER NME JONGEWARD. BETTY ADDR 2863 LYDICK WAY, EUGENE .
CODE APPL NO ACTION DESCRIPTION SQ FT UNIT COST VALUATION FEE q~y~
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MECHANICAL FEE
STATE SURCHARGE
PLAN CHECK FEE
FT. RAIN:
5r.
257.
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CATG: PLN
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TAKEN BY MLC
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EST. COMPLETION D.ATE DEPOSIT **
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LANE COUNTY DEPT ENV MGT RECEIPT . 314691 PATr 101rr'
AI"'I"'LICANT -!ONGEWMW, S. NEIL ,"'DDJ~ 3B.o,3 L.YDICI( ~)'W. EUGlcNE . .:. . ..'
TLO 170326110320.0, SUBDIV LOT BLI(
NEW Bl.DG TYPE USE R BDRMS 0 UNITS 001 STORIES ~BLDGS 001 PHONE 686 9714
O~JNEf< NME -![)NGEWAF<D, BETTY ADDR 2B63 L YDICI< Win, EUGENE .
B~ODE APPL NO ACTION DESCRIPTION SQ FT UNIT COST VALUATION FEE ~laf
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