HomeMy WebLinkAboutSpecial Inspection Septic Tank 1985-5-24
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Lane County Authorization for:
Evaluation of existing Sewage Disposal System
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FOR OFFICE USE ONLY
Appl~,cation/ /Jq / c:::l~
Perm~ t # , r...Jt'V- '- n- 1
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17 03
SJBDIVISION/PARTIT~QN (if applicable)
Garden Grove
LOCATION ADDRESS STREET
221
D6Uf'OF
L
.. TOWNSHIp.
"-RANGE 'n
....SECTioN
34.2.2
TAX LOT
LOT/PARCEL
7
BLOCK
3
PROPOSED USE OF PROPERTY
D Residential D Industrial
D Commercial 0 Public.
CITY ZIP
885 ASQ.en Street. Sprinqfield~ Oregon 97477
: STRUCTURES CURRENTLY ON PROPERTY
...filitioqSinale Familv Dwellinq
DIRECTIONS TO SITE
Centennial Blvd., south on Aspen to
site at 885 Aspen Street
~2SCRIPTION OF PROPOSED WORK - BE SPECIFIC
Evaluation of existing sewage disposal system
OF BEDROOMS # OF STORIES # OF E~lPLOYEES
DECLARED $ VALUE
I
4
1
none
loJATER SUPPLY
public
::J Proposed
I Existing
-- - ...
TELEPHONE NUMBER
, O;,NER' S NAJoIE AND ADDRESS
Mr and Mrs. Richard Gall
CONTRACTOR'S NAME AND OSR #
Steve Shear c/o Pacific First Federal Bank, 1100 Willamette, Eugene
, ?2R/olIT TO BE MAILED TO (NAME AND ADDRESS)
P~~ific Ffftit/ First Federa!.. Bank above
TELEPHON~ rYMBER
342-1/81
TEL!:.i"MuNE NUl'",!:'"
I HAVE CAREFULLY EXAMINED THE COMPLETED APPLICATION ];'OR PERMIT, and do hereby ce rtify that all infonnation hereon is true and correct, and that I
:have the following legal interest in the property: Downer of record; 0 contract. purchaser i 0 authorized agent with evidence of authority attached.
. I Lcrther certify that a~y and. all work performed shall be done in accordance. wi th th" Ordinances of Lane County and the Laws of the State of Oregon
pertaining to the work described herein, and tha:t NO OCCUPANCY will be made of ar.)' st.rncture 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 AN'LICATION THOROUGHLY. '
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, SIGNATURE
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DATE
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READ THIS SECTION CAREFULLY. YOUR AUTHORIZATION ~AS BEEN BASED ON THE FOLLOWING CONDITIONS!
[] PLANNING/ZONING:
Zone
Partition #
Parcel #
Parcel Size
Minimum Setbacks:
C
L, front
CL, side
interior
rear
COMMENTS: NO special planning action required. For loan review purposes only.
Date:
n
o SANITATION: S. 1. #
B. P. # Installation Record Issued? 0 Yes 0 No
Lineal Feet Maximum Depth
of Drainfield of Trenches
~I~ ~M--fM~4"~--~ cd!-
Date (J S:-02 t( - fr j' ..~
Ins talla tion Gallon
Specifications: Tank
COMHENTS: '\..,.J( f) - ~...:....;t::;r' rYJC
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[] PLANS EXAMINATION: Type
Group
Use
COMl-1ENTS :
Date:
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(oer ORS 456.805(1))
S-~y-fJ
DATE
PARTMENT OF PUBLIC WORKS LAND MANAGEMENT DIVISION, 687-4061,
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
SEE REVERSE FOR INSPECTION INFORMATION
C 14-25 RB4-
SETBt,CKS A~D OTHER CO~DITIO~:S OF APPROVAL !'-WST BE STRICTLY OBSERVED. VIOLATION CA:J RESULT IN REVQ-
C';:- IO~ OF ':'liIS PI:RN!T, CITATIO:J UNDER PRQVrS 10:1S OF LANE COr.;:-:TY I.) INFRACTIO:1 ORDI~:.;NCE. A~D/OR OTHER
RE~EDIES ALLOWED BY LAW.
WHEN RE.;OY FOR I~SPECTIO:1, CAL:' 687-4065. A i'-lINIi.m:-l OF AT LEAST 24 HOURS t\DVA!:CE NOTICE FOR INSPEC-
1'10::1 REQCES7S :':0ST 8E GIVE~~13ve the following informa tian ready: permi t number-, job address, type
of inspection, when it wLll be ready, your name and phonc number, and any special cirections to site.
BUILDI~G DIVISIO~:
REQUIRED I~SPECTIO~S:
1. Foundation InspectLon: To be made after trenches are excavated and forms erected and when all
materials for the toundation are delivered on the job. Where concrete from a central mixing
plant (commonly termed "transit mixed") is to be used, materials need not be on the job.
.
2. Concrete Slab or Under-?laor Inspection: To be made after all in-slab or under-floor building
servi~e e~uipmentr conduLt, ?iping accessories, 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 ?lace 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. La th and/or Gvpsum Board Inspection: To be made af ter all la thing and gypsum board, ~.nterior
and exterior, LS 1n place but before any plastering is applied and before gypsum board joints
and fasteners are taped and finished.
5. Final Insoection: 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 befo=e 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,
skirting, and plumbing connections.
1. Footings and piers to comply with 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. ~obile 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. 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 TIMES DURING WORKING HOURS. THIS PERMIT WILL EXPIRE
IF WORK DOES NOT BEGI~ WITHIN 180 DAYS, OR IF WORK IS SUSPENDED OR ABANDONED FOR HORE THAN 180 DAYS.
SUSPENSION OR REVOCATION :1AY OCCUR IF THIS PER}IIT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS
INFOR}lATION.
ANYONE PROCEEDING PAST THE POINT or REQUIRED INSPECTIONS WILL DO SO AT THEIR OWN RISK.
SUBSURFACE AND ALTER~ATIVE SEWAGE DISPOSAL SYSTEMS:
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. 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 permit, holder.
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 ORS 454.605 to 454.745 and this rule.
Setbacks - Subsurface Sewaqe Disposal
Septic Tank
Drainfield
From: I~tcrior property Ilncs
Edge of road rlqht-of-way
Buildinq foundation
Wells, other water sources
10 '
10'
5 .
50'
10'
la'
10'
100'
"
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ACTIVITY I~F~~~~;oN~~EtT
Idhe'county ,.
COMPLETE THIS SECTION,. INCOMPLETE FORMS WILL BE REJECTED!
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1 JlCi+t cT;;" s + f- -€-cl (3 evv)C
/ PERSON MAKING REQUEST
/ / IJ 0 W; / / tLn1 e:CLe
MAILING ADDRESS
EtI...a e ne Ot€. 9 7 LfD /
(J1ITY STATE ZIP CODE
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BUSINESS TELEPHONE #
HOME TELEPHONE #
/lj)JY) B~krd G?LLL
I PROPERTY OWNER
'3 gS- 4;Sp-f: yV ~7J I
MAILING ADDRESS
8;pr/ 'n q-P/'e-/c/ 0/2 97'177
f/ CITY J I / STATE . ZIP CODE. '
.747-7335"
BUSINESS TELEPHONE.# HOME TELEPHONE #
2 PROPERTY ADDRESS
(IF DIFFERENT FROM MAILING ADDRESS)
3 MAP & PARCEL NUMBER
(REQUIRED INFORMATION)
(from tax maps in Department of Assessment and Taxation
or from tax statement)
TOWNSHIP RANGE SECTION
( 7 03.;1 ~i--< OO.l..:l.1 _ R
lAX LOT(S) OR PARCEL # ZONING
TOWNSHIP RANGE SECTION
TAX LOT(S) OR PARCEL # ZONING
TOWNSHIP RANGE SECTION
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP:
TAX LOT(S) OR PARCEL # ZONING
ACRES
4 SYBDIVISION (if applicable) LOT BLOCK
5 REQUEST (<;tate exactly what you pl an to do) Wa..fL,f _L!:L~tf2fz...c-I-;D J( v-P
..:!3W+'t-l Gvt3/eYYL cct s> <6'5 R",-';4J-eJG rS.-t "''\10;'/ -0Q-h./~/cP
V u.. - -~ --. II . ... J V J I
fret C/rcdi2rfo . !yIqJ<~ .rnvcbj~Cj~ )oa.vu nil 06111fe.
6 DIRECTIONS TO SITE: eenl-e^-Yl fCLl 4/!/d.)'~ ;Sou._;+f~ ,
to ~ A-~ KJ e ,f\ :s-t;
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** FOR STAFF USE ONLY ** .
NUMBER
DATE
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ZONE/LAND USE:
BY: DATE:
TIME IN:
OUT:
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LAND MANAGEMENT DIVISION/ 125 E. 8th ME., EUGENE, OR 97401 / 687-4061
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,;)'([ TO BE COMPLETED BY INSTAllER:
PERMIT ISSUED TO:
Nam!> Z1 ("~"'t'___ '.
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Mailing addree:e: 6' r
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Record of Individual Sewage 'Disposal System
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'} Installer's name t, , i
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:,;.~-"V~ [ AT Building permit number
I,,'., J _~,' 1,',1 " .. - 1'1 - P t dd ('j ? l
V r. ,:-'-""Y~ roper y a res!; C _J .;
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Total number: living unite: Bedroome: 'I Baths 3r~.~~:Basement: Yes 0 No1t1
Water supply by: Public system L.,--- Individual system ~ Community system '
" Septic tank: Distance from well Feet. MateriaLiJ~~ . No. of compartmente: /
) Total liquid capacit'y /"...,......., gal. Inside length g -I.:l_ft. Inside width ..;-:- ft.
,~Diameter ft. Liquid depth 5" '. .'-..LJft.
':.'.'. 'f", Tile disposal field: Distribut),o~box? Yes [21 No 0 Other
, ,Length each line I .~ c. ft.
Total length / I l,' ft.
Width of trench ft.:;..
Total square footage ,(?' 0 ft."
Distance between lines :;' ft.
Type of filter material: Gravel' ,/ - Other
Depth of filter material over tile, L inches.
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SKETCH (See instructions):
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Distance from:
Well.-
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N.earest
..~,~t hn,e: Front 0 Side 0 Rear ~J
Foundation /7 feet.
Depth of filter material beneath tile.
feet.
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Sy'st~~ .,~pp~:;,ntly will i3 will ,not 0 ;.,~~nction s~tis!1toriIY/a~d is therefore oppr,~~ed for occu~ancy '~
Remarks:. .. . '"\
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