HomeMy WebLinkAboutPermit Septic Tank 1979-6-29
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Job location (Street, rT)ile post)
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lot Block
FOR SANITARIAN'S USE ONLY: ~ System Approved 0 System Disapproved ibfNeeds Correction
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COMMENTS: "-'<(J'Z~ ~~ CNU.J., ., ". l~t'l-LI '1'f/<w/,(,v
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FOR INSTAllER'S USE: Trench Depth c:2.Lf14. Filler Depth Below Tile"-6' " I J
Tank Capacity 7 S"O~ Manufacturer '1)ouf"'ed. ih t::VtIJ~
Measured distance to well from tanl< 5;r::::;1 from d~infiel~ S-c /
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INSTAllATION RECORD AND CERTIFICATE OF SATISFACTORy~,PJ:.FflOJ\i~;
When signed by the County Sanitarian, this certificate is evidence as per 0 RS"45~~.665:&f~
isfactory completion of a subsurface sewage disposal system at the above location,
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Return this form to: Permit Processing Section, Department of Environmental Management,
Public Service Building, 125 East 8th Avenue, Eugene 97401 C55-11
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JOB ADDRESS:
TRS, TL:
POST THIS PERMIT ON MAIN BUILDING AT SITE
CONSTRUCTION PERMIT #
Subdivision:
This permit for the referenced property is hereby 0 Setbacks and other conditions of approval must be strictly observed. Violation can
result in revocation of this permit, citation under provisions of Lane County's Infraction Ordinance, and/or other remedies allowed by law.
Applicant/Address:
Owner/ Address:
Contractor/ Address:
Contractor's OS #
Total Construction Value:
Telephone:
Telephone:
Telephone:
Construction approved by this permit:
Water Supply:
PLANNING DIVISION
WATER POLLUTION
CONTROL DIVISION
Setbacks
Interior property lines
C:dge of road right-of-way
.Juilding foundation
Wells, other water sources
CONSTRUCTION
PE RM ITS/I NSPECTION
DIVISION
Directions to Site:
Date Issued:
C55-13
# Bedrooms:
# Plumbing Fixtures:
# Employees:
Zoning: Partitioning # Parcel #
Minimum required structural setbacks, from: centerline of road, front:
side exterior: ; interior property lines: ;rear property line:
Special Instructions:
Parcel Size:
; centerline of road,
For information call 687-4394,
Site Inspection # Installation specifications:
lineal feet of drainfield required; max. depth of trenches:
Special Instructions:
gal. min. septic tank capacity;
Septic Tank
10'
10'
5'
50'
Drainfield
10'
10'
10'
100'
For information call
between 8:00 - 9:00 a.m.,
Type of Construction:
Instructions:
Group:
Fire Zone:
Use Classification:
For plans information call between 8:00 a.m. and 9:00 a.m.,
For inspections (see back of this permit) call 687-4065 between 8:00 a.m. and 5:00 p.m.
DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
COURTHOUSE I PUBLIC SERVICE BUILDING
125 EAST 8TH AVENUE. EUGENE. OREGON 97401
By:
bne county
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