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Home My WebLink AboutSpecial Inspection Septic Tank 1986-1-28 17 (!~/ IPdV l(Qi~f RUSf-f ' Lane County Authorization for: N~~~XXI~~KXIWXIA~~XIX~ SEPTIC DISPOSAL SYSTEM IN~PtLIIUN ~UK LN. ~EV. TAX LOT OOUT OF ,.. G-G- /--Q'I FOR OFFICE USE ONLY fa Appl~cation/ ~ uG! ~/- Perm~t # ~ r, -c:r- 6 TOWNSHip SJBDIVISION/PARTITION (if applicable.) LOT/PARCEL BWCK PROPOSED USE OF PROPERTY [Xl Residential 0 Industr ial o Commercial D Public, RANGE SECTION 03 23.3.3 3500 LOCATION ADDRESS 174 A 11 en STREET CITY ZIP Eugene STRUCTURES CURRENTLY ON PROPERTY SFD "'Diru::l..uu,;STO SITE' Harlow East to Castle;Nofth to Allen,West to 174 u~SCRIPTION OF PROPOSED WORK - BE SPEGIFIC SEPTIC INSPECTION FOR LN. " OF BEDROOMS # OF STORIES DECLARED $ VALUE CONKLIN, Bernard CONTRACTOR'S NAME AND OSR # 101 E. 14th.',E'llopnp q74n1 o Proposed fl Existing TELEPHONE NUMBER 344 4451 TELEPHONE' Nilli~M3lr~ : 2 I, ,# OF EHPLOYEES \-IATER SUPPLY 'O;VNER I S NAME AND ADDRESS LEWANDOWSKI, Tom same P~RNIT TO BE MAILED TO (NAME AND ADDRESS) Conklin TELEPHONE NUMBER I HAVE CAREFULLY EXAMINED THE COMPLETED APPLICATION !-'OR PERMIT, and ,]0 hcrelJY ce rtify that all infol'1nation hereon is true and correct I and that I have the following legal interest in the property: Downer of record; D contract. purchaserj (Z]authorized agent. I f-..:rther certify that any and all work performed shall be done in accordance ,wi th the Ordinances of Lane' County and the Laws of the State of Oregon pertaining to the work described herein I and that NO OCCUPANCY will be made of afiY st.rllcture without the permission of the' ,Building Division. I fur- ther certify that registration with the Builder's Board is in full force and effect 'as "required by ORS'701.055, that if 'exempt the basis for exemption is noted hereon, and that only subcontractors and employees who are in compliance with ORS 701.055 will be used on this project.' I HAVE READ AND CHECKED THIS APPLICATION THOROUGHLY,. BpyytfJ vA Co", k:.U J NAME (please print) YLf~~ /- ZK'- K6 SIGNATURE DATE READ THIS SECTION CAREFULLY. YOUR AUTHORIZATION gAS BEEN BASED ON THE FOLLOWING CONDITIONS! [] PLANNING/ZONING: Zone Partition ,# Parcel # Parcel Size Minimum Setbacks: ,C L, front CL, side interior rear COMHENTS: FOR LN. 'REVIEW PURPOSES ONLY. NO SPEWI PI ANNTNG Ar.TTON R~nlilBED ~~. Date: 'l-2R-R~ ,/JA4I o SANITATION: Installation'Re,cord Issued? 0 Yes 0 No Maximum Depth ud:~o~ ~';-~'~~;:f~ '. ' ' , ~ DA,k<. ~~tV . /-.1~ -f't. (J ~/' I (J ." ~I PLANS EXAMINATION: Type Group S. 1. # B. P. # Installation Specifications: COMJ.lENTS:~ Gallon Lineal Feet ~~ o Use COMHENTS: Date: n "-. ~~,!~~. ~w$,":'N" Coo, OR' 456.805(1)1 . I-J()D'fl , LANE COUNTY ~RTMENT OF PUBLIC WORKS LAND MANAGEMENT DIVISION, 687-4061, 125 EAST 8TH AVENUE, EUGENE, OREGON 97401 SEE REVERSE FOR INSPECTION INFORMATION J r.llo..,?'\ Q$:ld. ;-' 4 ., SETBI,CKS A:-JD OTHER CC:;DITIO:;S OF APPROVAL ~lUST BE STRICTLY OBSERVED. VIOLATIO:-J CA:-J RESULT IN REVO- CA':'IO~ OF ':'HIS PER~lI':', CITATIO:; lCNDER PROVIS IO~S OF LA:-;E ::OC:-;TY':; I:-JFRACTION OR::>r:-;A:-;CE, A:-;D/OR OTHER REMEDIES ALLOWED BY LAW, WHEN READY FOR INSPEC':'ION, CA~~ 687-4065. A MI:-;IMUM OF AT LEAST 24 HOURS ADVA~CE :-;OTICE FOR INSPEC- i:O~ REQ~ES7S ~iCST BE G:VE~. Have the following information ready: rermit number, job address, type of inspection, when it w111 be ready, your name and phOr.0 number, and any special circctions to site. BUILDI:-;G DIVISION: REQUIRED I:-;SPECTIONS: 1. Foundation Inspection: ~o be made after trenches are excavated and forms erected and when all mater1als for the toundation are delivered on the job. Where concrete from a ce~tral mixing plant (com....nonly termed "transit ffi1xedll) is to be used, materials need not be on the job. 2. Concrete Slab or Under-Floor Inspection: To be made after all in-slab or under-floor building serVl~e equipment, concu~t, p~ping accessor~es, and other ancillary equipment items are in place but before any concrete is poured or floor sheathing installed, including the subfloor. 3. Framinq & Insulation Inspections: To be made after the roof, all framing, fire blocking, and bracing are in 21ace and all pipes, fireplaces, chimneys, and vents are complete and all rough electrical and plumbing are 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 and extcr~or, ~s 1n place but before any plastering is applied and before gypsum board joints and fasteners are taped and finished. 5. Final Inspection: TO be made after the building is complete and before occupancy. APPROVAL REQUIRED. ~o 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 b~ 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 inspection 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 complete. 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 sewer or septic system for setback requirements, blocking, footing connection, tiedowns, skirt1ng, and plumb~ng 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 letter. 3. Mobile home ticdowns, 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. Swimming Pool: Below grade when steel is in place and before concrete is poured. Above grade when pool-rs-installed. APPROVED PLANS MUST BE ON THE JOB SITE AT ALL TI~ES DURING WORKING HOURS. THIS PE~~IT WILL EXPIRE IF WORK DOES NOT BEGIN WITHIN 180 DAYS, OR IF WORK IS SUSPENDED OR ABA:-JDONED FOR ~:ORE THAN 180 DAYS. SUSPENSION OR REVOCATION :'~Y OCCUR IF THIS PERHIT WAS ISSUED ON THE BASIS OF INCOHPLETE OR ERRONEOUS INFORHATION. ANYONE PROCEEDING PAST THE POI:IT or REQUIRED INSPECTIONS WILL DO SO AT THEIR OWN RISK. SCBSURFACE AND ALTER~ATI'/E SE\,AGE DISPOSAL SYSTEHS: 1. Permits shall be 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. ~he 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 permit, holder. If the construction does not comply with such rules, the Department shall notify the permit holder and shall requ~re satisfactory completion before issuing the certificate. Failure to meet the requirements for satisfactory completion w~thin a reasonable time constitutes a vio- lation of ORS 454.605 to 45_,745 anu this rule, Setbacks - Sub5urface Sewaqc Disposal F~om: Interior property lines Edge of road rl~ht-of-way BuilJinq foundation wells. other water sources Septic Tank 10 ' 10' 5' 50' Dra.infield 10 ' 10' 10' 100' \ ' j,1 . -.' u " ' ,I n 11 ' '\ t: 11 W: 5 LANE COUNTY DEPT ENV MGT RECEI~r APPLICANT CONKLIN. BERNARD ADDR 101 E 14TH ST., l'L_~ 1703233303500 SlJBI)IV "",! E V.! BL'D,G T',{PE I...I;;,;:E F;: E::OFd~L';.' () OWNER NME LEWANDOWSKI', TOM" CODE APPL NO ACTION DESCRIPTION .JI. '1)' ::!> 4 "i t~{:') II i r ,1 I'i I' \' I ' Di:~ITE 01 :?Bi3(, L.OT ' BLK E!...iGENE l.JN):l'S 001 S'rOR]:E~S :~BI_.DGS 001 F'f'1()NI~~ 344 AD DR 174 ALLEN-ST., EUGtNE SQ FT UNIT COST VALUATION ):~ t:) .dP IlP OP ",:lP "," I w"PL ~FIX/BATH: SWR: FT. WTR: j"1I::: CH(:lN I [(11... FEE '.S,""j'i:)TE SI...iF;:CH(lRGE PLi\N CHECI< FEE ....)':::11.... :... .... ,on .'1ECI--! F'T. F:t!IN: S!)F;~ 1:)[:1< ~ ..,' .-t.{ I~l '''' :... 'E,. l.. C~ .:3.4 i {~ll~) S' D S \l C;(lTG: S':!: F'CK OTH' !::lPP FF:S , r;:t1 . ;~;DSI ,,~:EQU: 'i r "I "I:{.:,I< E 1',,1 B Y G T ~.~~ EST., COMPLETION DATE ISIS' "y .'::1 TOTi:~!1... FEE'j(''Jl: .4 l~. => 'J FEe Dtl\'S '1' D I~ l: , f: I F'"j' (:) (:) ~ () () i 0 60.,00 CK C \. I ACTIVITY INFORMATION "HEET Idne county COMPLETE THIS SECTION. INCOMPLETE FORMS WILL BE REJECTED! .... ",,- I. 1 Vg~J~~~:./ ~ / ' PERSON MAKING REQUEST j I t 1 1 /o! ~, /~ MA I LI NG ADORE SS cJ~ ri~/ PROPERTY" bWNER / () / C, / LJ~ MAILING ADDRESS fj4l~" ' Or-e- 17'-10 J I CITY STATE ZIP tOOE j<-!t/_L/l-jSl 013-'-113"2-- BUSINESS TELEPHONE # HOME TELEPHONE # ;)<PROPERTY ADDRESS '/1"1 I!~ (IF DIFFERENT FROM MAILING ADDRESS) ?:.tA1'" .A(...L-- CITY STATE ZIP CODE . ' BUSINESS TELEPHONE # HOME TELEPHONE # j 3 MAP & PARCEL NUMBER, (REQUIRED INFORMATION) )< /7 . TOWNSH I P (from tax maps in Department of Assessment and Taxation: or from tax statement) : 03 ~3r5(3 ~~6 cJ RANGE SECTION TAX LOT(S) OR PARCEL # ZONING TOWNSHIP RANGE SECTION TAX LOT(S) OR PARCEL # ZONING TOWNSHIP RANGE SECTION TAX LOT(S) OR PARCEL # ZONING ACRES TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP: ; 4 SUBDIVISION (if applicable) : 5 REQUEST (state exactly what you plan to do) LOT BLOCK _ SD5 ~/(f. Xl6 DIRECTIONS TO SITE: , N~, +Jcu"/ov./ Ecz..d- t;; Cad:te../ t; AtLpAt./ lJ~ 1;; /71 J ** FOR STAFF USE ONLY ** NUMBER DATE , " ...,,,,,,, -l ;;0 (/) ZONE/LAND USE: BY: DATE: .. -l "r-: TIME IN: OUT: LAND MANAGEMENT DIVISION / 125 E. 8th AVE., EUGENE, OR 97401 / 687-4061