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HomeMy WebLinkAboutPermit Septic Tank 1993-12-15 }> 01 '-.J ~ ;:t)..(\O~ \: "(j"'- ~ ""J - ~ . ~ (fl- ...... -r z ...- b III -h ~ ~! '-:b }> f{) ffi ~ ~ s:::~ ~ ~ , c (fl (}M~~ '} ~ .' . l.) () .-'\ \:) ~ \J .~ ; ~I,~ er i :J CD ' (Q ; ~H ~ o .~ ::E S' :J ~ ~ '< T 1 r a;l 2' ro :J -0 (fl ::T CD 0 :J ~ CD h- ~~, ~ .c. ~ }- .~~~ ) ~ +:. { j ~i ~ ~ ~ i\ "" ~ ~ v ~ r I ~ CD C).... ~ '~ -'1 ~ ~ ~ ~~ ~ ~ . :J (fl er ro "" o III ro VICINI. i MAP . N ,! e ~ ~A1u/,G / Rf(:;('N-'i...- ,,----~, v t:lJ DEe 151993 i==Nv I LANE COUNTY tre II t"JQ 7 - RONMENTAl HEALTH r'""I ,~ ~ 5 ; I't: ,j ~ --J ./1 1 7S(' 9 ~ MUST BE IN BLACK Il-JK Permit No, 7~ I U - ~ Twnshp, --L7 Range 6J.3 _ Section 39 I). .2 Standard System 0 Alternative System [] (Specify Type) K~I>t:lJ.'1' r\ Job location (Street Address) tcr 7 ItSfe" sl; Sfi'1 t1,,,flJpJ&I Supdivision/Partition # Parcel 'v lot /fOJ'~~'ll Tax lot Cf tl'U Block DETAIL SYSTEM PLOT PLAN AS CONSTRUCTED Scale -'-- " = l.J () {)'vo I ~ -e. '.4-J ~ '1 ...,; ..-- . 1/ N :t: ~ ,,"'SCII ~ 1fI1( r .:%AJsTA-(led- y-j, e S'f"S re-1. S J../?)~~ h-e....e IJ.AJd ~+,?':~ 7X..r ;'1"" t!6~.(_~ /D "TAe... I? ~ Je..s (!r"fZ. G ~ Q 3~O P,"vi:Jlo-......- 71 ;r ~l 1. "- J", " '- ' ~' -' -- . _ """ '"'< ~)("''''''.r...o_ ..~ JI: >~ ~ tI\ ~ ~ ~- ~ ,~ ~ ---.:. ' .~ \~ , Ig ""I~ ) . ... ~i?~ 11.-10-93 .l' , ,.. .. J ~ " Ii' 1-., ;~. 5' .~:- ~ ,e ~ (, k I1'i \ T I~ ~ ..~ ,"" -, :;v , USE BLACK INK ONLY , FOR INSTAllER'S USE: Trench Depth :; y. 'I' Gravel Depth Belowlile ,'" Tank Capacity Jt'J(JO Manufacturer f1' 6 ra TeV( Measured Distance from Well to Tank, - From Drainfield, - Total length of Lines /SO" COMPLETE THE FOllOWING IF A PUMP WAS USED ON THIS INSTAllATION: I (installer's name) certify that a (Mfg.) (Model No.) Pump and Mercury Float Switch (Mfg, and No.) have been installed with this sewage installation, Signature Date, FOR SANITARIAN'S US,E ONLY ~te: Appr~ved Ji2J Syst~m Dis\lIlproved 0 Ne~~~n CO~MENTS:... A"~'~ j' ~,,'7J-- r~ ~ -a,. ?d... ~ A~_JJ_A, ~ ~O.A'k.._ " 'lr ,'-- o System Corrected Date, System Capacity 4/.5b gal./day Signature _~ ~_ Date /.:2-IS- 'i..3 INSTAllATION RECORD & CERTIFICATE OF SATISFACTORY COMPLETION When SignedU'the County Sanitarian, this certificate is evi, dence as per ORS 454,665 of satisfactory completion of a subsurface sewage disposal system at the above location, To request inspection. return all three (3) copies of this form to: lane County Environmental Health Services, located in the basement of the Public Service Building. 125 E, 8th Avenue. Eugene, OR 97401,