HomeMy WebLinkAboutSpecial Inspection Septic Tank 1988-7-19
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C]fio/ ().G 6
Lane County Authorization for:
SEPTIC INSPECTION FOR LOAN REVIFW
FOR OFFICE USE ONLY
Appl~cation/ "/1~ f\~
Perm1t I ~ ~ '
- TOWNSHIP'
RANGE
SECTION
~,~
I Tm~uur OF
LOT/PARCE'" BLOCK
2ROPOSED USE OF PROPERTY
~ Residential 0 Industr ial
o Cc>nun~rcial D Public,
/ '7 (/3
SJBDIVISION/PARTITION (if applicable)
LOCATION ADDRESS
STREET
CI','Y
ZIP
1210 Anderson Ln.,
STRUCTURES CURRENTLY ON PROPERTY
Eug~e 97477~7607
SFD
DIRECTIONS TO SITE
Off N side of Centennial Blvd., just- over the 1-5 over pass
"
Q2SCRIPTION OF PROPOSED WORK - BE SPECIFIC
SEPTIC INSPECTION FOR LOAN REVIEW
;; OF BEDROOMS
# OF STOR;J:ES
# OF ENPLOYEES
\"'ATER SUPPLY
I' DECLARED S VALUE
:J Proposed
XlExisting
I TE~t850N857UMBER
o;mER'S NAME AND ADDRESS
PAlMER, Karen,
CONTRACTOR'S NAME AND OSR #
site
--_. -
TELEPHONE NUMBER
P:ORl-IIT TO BE MAILED TO (NAME AND ADDRESS) gK ' ,
HARRISON, Tam 1210 Anderson Ln", ~00fit,97477-7Q.iF
I TELEPHONE NUMBER
747 6552
I HAVE 'CAREFULLY EXAMINED THE COMPLETED APPLICATION ,'OR PERMIT. ar,d ']0 hcore!JY ce tt.lfy t,hat all infOl:mation hereon is true and correct, and that I
have the following legal interest" in the property': Downer of record; 0 CCH1:1:"act. pl1rchaser; o authorized agent~.
I f:..:.rther certify that any and all work performed shall be done in aC't:Ol.'d~~lC':::: ,^!i th 'th\;; Ocdinances of Lane COW1ty and the Laws. of the State of Oregon
pertaining 'to the \o?ork described herein, and 'that NO OCCUPANCY will b~ made of ar.)' st:.rl1cture without the permission of 'the Building Division. I fur-
ther certify that registration wi.th the Builder's Board is in full force i'md effect. as r'e'1.uired 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
CHECKE~S ~::::::THOROUGHLY. ' \-., } \\, , ' ______...,'' 7-19-88
,~~. -
NAME (please print) ,', SIGNATURE DATE
READ THIS SECTION CAREFULLY. YOUR AUTHORIZATION qAS BEEN:'BASED ON THE FOLLOWING CONDITIONS:
o PLANNING/ZONING: ,Zone
Partition #
Parc~l #
Parcel Size
Minimum Setbacks: CL" front
CL, side
interior
rear
COMJolENTS:
SEPTIC INSPECTION FOR LOAN REVIEW--NOSPECIAL PLANNING ACTION REOUIRED
7-19-88
Date:
Installation
Specifications:
, COMHENTS : ~1 /. () _
~~
[]I'PLA~ EXAMINA~N:
Gallon
Tank
Lineal Feet
of l1rilinfleld
J1
y#
Installation Record Issued? DYes D No
Maximum Depth
of 'Trenches
o SANITATION:
S. 1. #
B. p, #
, .~ q~ ~~.~ ~).il,\ -'~A
~~~ _ /f, '
~4j
~~,,/~
V,7-,2/-p?tt
D
Date:
Type
Group
Use
COMl-IENTS:
Dale:
n
~6?tll~y
LANE COUNTY DEPAR M T OF PUBLIC WORKS LAND MANAGEMENT DIVISION, 687-4061,
12 AST 8TH AVENUE, EUGENE, OREGON 97401
SEE REVERSE FOR INSPECTION INFORMATION
---Rs
AL/DESIGNEE (Der
7~2/-P
ORS 456.805 (1))
DATE
C 14-25 RB4-
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...
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SETB:\CKS A:';O OT;!I:R CC::DITIO::S OF APPROV:\L ~.iUST BE STRIC:-:"'':' DESERVED. VIOLATIO:-J CA~ RESULT IN REVQ-
C~7IO~ OF 7!ilS r~RMIT, CIT~TIO:; U~DSR PROVISIO~S OF L~~E CaC~TY'3 INFRACTION ORDI:;A~CEf AND/OR OT!JER
REMeDIES ALLOWED B, LAW.
"""HEN RE.';OY fOR I:~SPCCTION, c.:...:":" 687-~065. A :-lI:Jr,n;:.l OF AT LS,\ST 24 !I0t.;RS ,;OV:\:;CE :\'OT1CE FOR INSPEC-
TIO:J REQt;t:S';:'s :.j:';ST BE GIV'E::~a'...e the following in:o:::-:na ticn :ready: ;,ermi t number, job address, type
of inspection, when it will be ready, your name anc p~o~c :lu~ber, and any s?ccial directions to site.
BUILDI~G DIVISIO~:
RSQUIRED I~SPECTIONS:
1. FoundatioIl Inspection: To be made after trenches are excavated and forms erected and when all
materials for the foundation are delivered on the job. Where concrete from a ce~tral mixing
plant (coffi.!lIonly termed "transit mixed") is to be used, l":'Iaterials need not be on the job.
2. Concrete Slab or Under-?loor Insnection: To be made after all in-slab or under-floor building
servi~e e~uipment, conduit, piping accessories, and other ancillary equipment items are in
place but beiore 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 ?lace a~d 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 Gvpsum Board Inspection: To be made after all lathing and gypsum board, ~onterior
and exterior, lS In place but before any plastering is applied and be:ore 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. No work shall be done on any part of the building or structure beyond the point
indicated in each successive inspection without fir5~obtaining the a?proval 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 th~ins?ections required.
NOTE: All building permits require inspections for the work authorized, such as but not limited to:
A. Block '~all: To be made after reinforcing is in place, but befo~e any grout is poured. This
~nspection 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 instaliation is
com?lete. Installation shall be in accordance with an a?proved, nationally recognized testing
agency and the manufacturer's installation instructions.
C. Hobile Home: An inspection is required after the mobile home is connected to an approved
sewer or septic system for setback requirements, blocking, ~ooting connection, tiedowns,
skirting, and plumbing connections.
1. Footings and piers to comply wit~ State foundation requirements for mobile homes or as
recommended by the manufacturer. .,.. -- .
2. ~obile home minimum finish floor elevation shall be certified when required by a flood-
plain management letter.
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. Swimmin9 Pool: Below grade when steel is in place and before concrete is poured. Above grade
when pool-rs-installed.
;\PPROVED PLA~S :,IUST BE ON THE JOB SITE AT ALL TIMES DURING WORKING HOURS. THIS PERI'IIT WILL EXPIRE
IF WORK DOES NOT BEGIN WITHIN 180 DAYS, OR IF WORK IS SUSPENDED OR ABANDONED FOR ~IORE THAN 180 DAYS,
SUSPENSION OR REVOCATION :,IAY OCCUR IF THIS PERHIT WAS ISSUED ON THE BASIS OF INCOHPLETE OR ERRONEOUS
INFORHATION,
ANYONE PROCEEDING P/\ST THE POI:a or REQUIRED INSPECTIONS WILL DO SO AT THEIR OWN RISK.
SUBSURFACE AND ALTERNATIVE SEWAGE 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 Co~munity 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 permiti ~older.
If 'the construction d6es not comply witho'sucrr rufes, the O-epartment shall notify' the permit
holder and shall require satisfactory completion before issuing the certific~te. Failure to
meet the requirements for satisfactory completion ~1thin a reasonable time ~onstitutes a vio-
I~tion of ORS' 454,605 to 454,745 and this rule. '
Setbacks - Subsurface S~waqe Dlsposal
Septic Tank.
From: Interior property Ilncs
Edge ot road rlqilt-of-way
Bllildina founrlation
~clls, other ~atcr sources
10 '
10'
5'
50'
Drainfield
10'
10'
101
100'
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<.Please pom~ete all lines
'WUIctrv' ~ J'" vlt l k:> 1\ )
Yo~lCLs ~ Jc-\~t~ ~l
CITY sfP- \1
k4(~O PA} ,VltleV'
OWNER OF PROPERTY
inside white boxes, if possible.
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f"lV'
EXISTING BUILDINGS
ON PROPERTY
c::J House
c::J Sarn
c::J Garage
c::J Mobile. Home
c::J Shed
Other
1 ,1'0
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MAP, PARCEL NUMBER (Found on lax mapB In the AueBBmant & Tsxatlon Dept.)
If
Directions to site
from Courthouse
X'" h s;,c ll~ v-..l""
(:~': \ ~,.Q ~ ~
( tJ;:.', k:J\\ (~f<J\A L t-s Lut
\1 AG ~~
'-1"f~t "T, <;. () \.) (,\
~
OWNERS ADDRESS ZIP
CONlflAl,;IOfl t.leense II
r ownshlp
Hange
t)ecttOn
1/4 l;:;ectlon
lax t.ot
~,As.. ~
Township
Range
Section
1/4 Section
Tsx Lot
lownsnlp
Hange t)echon
(i \\ elL C \ \";"(i'."."./ Lf\
~/
7d:;~ello{::1'7 4' 7 .,;~~t7C:fJ7 ",:,;
d ......' '\ LII' J.
./ FOR MOBILE HOME
PLACEMENT ONL Y
J
\210
SITE ADDRESS
,
MAIL PERMIT TO:
NAMI;;
Model
Year
Size
No. of Tip-outs
No. of Sedrms
License #
AUUHI;;SS
\;11 Y
ZIP
I
Land Management Div. ataff can not
be held responsible for evaluatlona or
recommendations based on false,
Inaccurate or Incomplete Information
~,