HomeMy WebLinkAboutPermit Septic Tank 1993-2-9
UGB/SPRINGFIELD
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SUeOMSIc:t.l1 PARllTION
LOT I PARCEL' BLocK
LOCATION ADDRESS
570 ASPEN ST., SPRINGFIELD
STRUCTURES NON ON PROPERTY
NONE (HOUSE BURNT DOWN)
PROPOSED USE SEPTIC NSTALLED WATER INSTALlED NO,OFSTORIES NO, OF EMPLOYEES CONSTIlUCTION COSTNALUE
-.E.R I V ATE Y (.S R 81'1 BOHAll R
DESCRIPTION CF I'RClPCSED WORK
SEPTIC AUTHORIZATION
DIRECTIONS TO SITE FROM NEAREST MAIN INTERSECTION
CENTENNIAL; SOUTH ON ASPEN TO 570; RIGHT-HAND SIDE.
NO, CF BEDFlClCMS
APPLICANT NAME & ADDRESS
KEVIN B. McKoFKA,
OWNERS NAME & ADDRESS
gEVIN B. ~CKOFKA,
CONTRACTOR IINST ALLEf\I BUILDER NAME
555 ASPEN ST.,
555 ASPEN ST.,
SPRINGFIELD
SPRINGFIELD
97477
97477
PHONE
747,-8188
PHONE
747--8188
cce.
PHONE
) MAIL PERMIT TO:
--K.E V I N Ii. IYi c K n F K A J S S S ~ N ST. J S P R I N r, F I Fin q 7 ~. 7 7
) NAME ., STREET " aTY
, ~;~eBJ&d~:+Hd:.Of thl. ep(firJNl!J:f1~et ell informetion i.
;, r 'R'EA'D"""'CA'R'E'FU'LLY'!''''''~~'~'~' Authorization Is Based
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FEES DUE: $ APPROVED BY;~ ..-\..-;~ DATE :L-7-1J
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~" .. CALL' FOR INSPECTIONS (SEE BACK OF FORM F& INSTRUCTIONS) 687-4065 ' ,
SEPTIC permits are good for one year. ALL other permits expire after 180 days unless Inspections are
~
LMD 040 Rev, 6/92
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current.
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VIOLATIONS
SETBACKS AND OTIIER CONDmONS OF APPROVAL MUST BE STIUCn. Y OBSERVED. VIOLATION CAN RESffi. TIN REVOCA nON OF TInS PERMIT, 0
CITATIONS MAYBE ISSUED UNDER 1HB PROVISIONS OF LANE COUNfY'S INFRACTION ORDINANCE AND/OR OTIIER REMEDIES AlLOWED BY LAW.
A'MlNIMUM OF AT LEAST 24 HOURS ADVANCE NOTICE MUST BE GIVEN FOR INSPECTION REQUESTS
Have the following infonnation ready when you call: 687-4065
Permit number - Job address - Type of inspection required When it will be ready
Your name and phone number - Any special directions to the site
PUBLIC OFFICIAL RIGHT TO TRESPASS ON PRIVATE PROPERTY ORS 215.080
POWER TO ENTIlR UPON LAND. 1HB COMMISSION, AND ANY OF ITS MEMBERS, OPPlCERS AND EMPLOYES. IN 1HB PERFORMANCE OF 1HBIR PUNCTIONS, MAY
ENTER UPON ANY LAND AND MAKE EXAMINATIONS AND SURVEYS AND PLACE AND MAINTAIN 1HB NECESSARY MONUMENTS AND MARKERS THEREON.
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-floor building service equipment, conduit. 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 INSPEcrtON: To be made after the all framing, fire blocking, bracing and roof are in place and all pipes, chimneys and vents are coll,?-plete
: 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 INSPECTIONS 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 M no approv:d ~ntil the' plumbing and electrical inspections have been made and approved. '
FINAL MECHANICAL'INSPECTION: To be made just Pr!o:r to ilJe ~tructure Qr r~od~led area being occupied and priQrto. operating anyequipritent
FINAL PLUMBING INSPECTION: To be made just prior to,the building, struct\iie or remodeled area being occupied. . '
FINAL BUILI)~GINSPECTION: To be'ma,de after fmishgr~ing and the building, slructure or remodeled area is completed and ready for occupancy.
MOBIL~/MANlJF ACfURED HOMES: ' An inspection is required after the mobile home is connected to an "t't',u..ed sewer or septic,
system, prior to covering sewer or water lines, for setback requirements, blocking, tiedowns and plumbing connections.
Footings and piers to comply with State foundation requirements for mobile homes or as recommended by the manufacturer.
Minimum fmished 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 al'l'ov..al 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. "
, '
APPROVED PLANS MUST BE ON THE JOB SITE AT ALL TIMES DURlNG WORKING HOURS.
THIS PERMIT WILL EXPIRE IF WORK DOES NOT BEGIN WITHIN 180 DAYS, OR IF WORK IS STOPPED OR ABANDONED FOR MORE THAN 180 DAYS.
SUSPENSION OR REVOCATION MAY OCCUR IF tHIS PERMIT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS INFORMA nON.
ANYONE PROCEEDING PAST THE POINT OF REQUIRED INSPECTIONS ~LL DO SO AT THEIR OWN RISK.
, Your ~ignature on the front of this form verifies the following: I HA VE CAREFULLY EXAMINED THIS COMPLETED APPLICATION, and do
hereby certify that allmrormation 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 corrections shall be made before a certificate of completion
will be issued. Failure to meet satisfactory completion within the allotted time constitutes a violation ofORS 454.605 to 454.745 and this rule.
SUBSURFACE SEWAGE DISPOSALSETBACKS, SEPTic TANK
, ..' From: Interior pi'operty)ine~ " ~ 0'
,Edge ofi'ba<:i,right-of-way "10'
'BuildiTIg foundation' . 5'
Wells or other ~ater sources 50'
'DRAINFIELD
10'
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100'
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A p~rmit is required \
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.REQUESTFQRi.ASSlsrANCE
LandMahagemehtDlv.125J:. "8th Ave....Eugerae.OR 97401
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LAND MANAGEMENT DIVISION
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Please complete all lines inside
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white boxes, if possible.
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OWNER OF PROPERTY (If not .em. a. abov.)
OWNERS ADDRESS (If not ..m. .. above)
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Requesffor:, ~/C!- ~h;~l~'
1-
I
MAP, PARCEL NUMBER
(Found on t8ll map. In the AlI....m.nt .. T8llatlon D.PLl
! 1_ 03 ,~y -2.3 5"00
lowntln,p Hange llecllon 1/4 llectlon 18ll LOI
"
ZONE
FLOOD PLAIN
Townahlp Range Section 1/4 Section T8ll Lot
lown.hlp Hang. llecllon 1/4 llecllon 18ll LOI
'\I
I' , ,
, SITE ADDRESS
-r
'\I
1
7- MAIL PER"!"T TO:
KE:\J I ~ \3 I\ll c Ie 0 .[ r:~
NAME ;J
S~~ lA~De
AUU"l:li~ 'D-Fd.. I CY(' e_
CII Y
#f
S7tJ
mJ?!;:/U J~
/
OfU '77
ZIP
,.
STAFF EVALUATION
Information RequesfOnl)' t::J
TRS Verified
AI/owed Use
CJYes t-,loCJ
c:::JYes Nc)c::l
Partltlonl Subdlvl.slon Lot & Block
COMMENTS I FOLLOW-UP
, 4-
\I
Existing Buildings or )
Improvements on O#w
Property~ f/jV!f'
o9..Housll-' ' ?A ~ &
c:J Bam /v t-
O Garage
o Mobile. Home
o Shed
SEPTIC INSTALLED
DYes
c::J No
Water District
, fwrr... b h ...J....!,.lfLi'"o 'lr
~
4-
, -l.. Directions to site from
nearest main Intersect/on
Le...n .j.. I e >"l: oJ.... - So \.,.~+~
(YY\ o.b D~ +0 57D
e I (} VI +- h Vdl& tS 'j J) e:..
.....J
~
J
J;J? r:- L/
ZIP
J
\1
r Mobile Home
P cement Only
rand
11 r I
,:'. I I (~
1?ls~e from "4!.oblle
~e to: ""
Water S.,).,er/Septic
11 ~~ ~
\
.,.
,
,
Land Management Div. staff can
not be held responsible for
evaluations or recommendations
based on false. inaccurate or
LMD 149.2/92 incomplete information
.
4-
M14-68 02/92
,/