HomeMy WebLinkAboutPermit Septic Tank 1993-5-5
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,
, REQUEST
FOR:
SEPTIC SYSTEN VERI~!CATION
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'17 0327.'5:1" "'1'19 ''-'''''''''''''''''"''''
LOCATlOO AODRESS
1664 W. QUINALT AVENUE, SPRINGFIELD,
-STRUCTURES NOW 00 PROPERTY
EXISTING SINGLE FAMILY DWELLING
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OREGON
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RAINSOil
NO.OFSTORES
NO. Of EMPlOYEES
cx::NSTllUCTQ.I COSTNAUE
PR IVATE USE
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SEPTIC SYSTEH VERIFICATION
DIRECTIONS TO srr" FROIr.l NEAREST MAIN HTERSECTlCH
CENTENNIAL BLVD., WEST ON ASPERN, NORTH ON TAMARACK, WEST ON QUINALT AVE.
APPUCANT NAME & ADDRESS
--LAR~,( ~ ,:=~II"1TrK. SA~!:= AS THF ,JOB ADDRESS ABOVE
C/IMIIERS NAME & ADDRESS
PHONE
461-0989
PHONE
SAllE
PHONE
_SAU,LJ\ S THE A B 0 y_~__
CONTAACTOAIINSTALLEW9UILDER NAME CCI:I.
~j A
) MAIL PERMIT
LARRY E.
,....,
,
TO:
BENEDICK,
338 HOWARD AVENUE, EUGENE, OREGON
97404
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STREET
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PANT KAME
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sides of this ap~" I a d here y certify that all Information
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FEES DUE: $
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APPROVED
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DATE
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(CALL FOR INSPECTIONS (SEE BACK OF FORM F~ INSTRUCTIONS) 687-4065
SEPTIC permits are good for one yeer. ALL a/her permits expire ef/er 180 deys unless Inspecllons ere current.
:
lMD 040 Rev. 6192
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VIOLA nONS
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SBTBACKS AND onmR ........_.........jo OP APPR.QV AI.. MUST BB snuC1l. Y OBSERVED. VIOLATION CAN RBSULT IN RBVOCAll0N OPnn5 PBRMJT.
CITATIONS MAYBE ISSUBD UNDER TIm PROVISIONS OF LANE COUNTY'S INPRAcnON ORDINANCIl: AND/OR OTHER RBMIIDIBS AlLOWED BY LAW.
A MINIMUM OF AT LEAST 24 HOURS AnV ANCE 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 OWIClAL RIGln-TO TRESPASS ON PRIVATE PROPERTY OKS ns.oso
POWER TO BNTP.R UPON LAND. 1HB COMMISSION, AND ANY OP ITS MBMBERS, OPFICER.S AND EMPLOYES, IN1HBPBRPORMANCB OP TI-IBIR PUNcnONS, MAY
ENrnR UPON ANY LAND AND MAKB BXAMINATIONS AND SURVBYS AND PLACB AND MAINTAIN nIB NECESSARY MONUMENTS AND MARKERS nmREON.
REQUIRED INSPECTIONS
FOUNDATION INSPECTION: To be made after excavations for footings are complete and any required reinfon:ing 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 equipmen~ condui~ 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 INSPECTION: To be made after the all framing, fire blocking, bracing and roof are in place and all pipes, chimneys and vents are complete
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 reinfon:ing is in place, but before any grout is poured. The inspection is required for each bond beam pour, There
will be no approval until the plumbing and electrical inspections have been made and approved.
FINAL MECHANICAL INSPECTION: To be made just prior to the structure or remodeled area being occupied and prior to operating any equipment
FINAL PLUMBING INSPECTION: To be made just prior to the building, structure or remodeled area being occupied.
FINAL BUILDING INSPECTION: To be mad<, after finish grading and the building, structure or remodeled area is completed and ready for occupancy,
MOBILE/MANUFACfURED HOMES: An inspection is required after the mobile home is connected to an approved 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 fOlmdation 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 approval 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 TIlE IOB SITE AT ALL TIMES DURJNG WORKING HOURS.
TIllS PERMIT'W1LL EXPIRE IF WORK DOES NOT BEGIN wrrnIN 180 DAYS. OR IF WORK IS STOPPED OR ABANDONED FOR MORE TIlAN 180 DAYS.
SUSPENSION OR REVOCATION MAY OCCUR IF TIllS PERMIT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRO~EOUS INFORMATION.
ANYONE PROCEEDING PAST THE POINT OF REQUIRED ~SPECTIONS WILL DC! SO AT THEIR OWN RISK.
Your signature on the front of this form verifies the following: I HAVE CAREFULLY EXAMINED TillS COMPLETED APPUCATION, and do
hereby certify that all information 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 "",,"'Y_A..I' 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
arc in compliance with ORS 701.005 will be used on the job.
SUBSURFACE & ALTERNATIVE SEW AGE DISPOSAL SYSTEMS:
When subsurface construction is complete, the pennit holder shall notify the County Land Management Division by submitting the installation record
fonn. An inspection will be made by a qualified sanitarian. If consbUction complies with all rules a certificate of completion will be issued to the pennit
holder. If construction doeS not comply with rules, the pennit 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 alloned time constitutes a violation of ORS 454.605 to 454.745 and this rule.
SUBSURFACE SEW AGE DISPOSAL SETBACKS SEPTIC TANK
From: Interior Y'_Y_'" lines 10'
Edge of road right-<Jf,way 10'
Building foundation 5'
Wells or other water sources 50'
DRAINFIELD
10'
10'
10'
100'
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LARR.'-I E. "8~e/) Ic..e(.
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OWNER OF PROPERTY (II not same as .Dovel
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OWNERS ADDRESS (If nol ..me .. ebow)
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MAP, PARCEL NUMBER
(Found on tu mapa In the Aaana~nt~.llon Depl)
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PLAIN
TOWMhlp ""Ri;;;;- ~ 1/4 &ectlon Tu Lot
lownsnlp ~ _lion 114 uecuon IU LOt
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'MAIL PERMIT TO:
LA-~R...\I t:. SGt..H='DIC.!L.
NAME \\ _
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:~..:<.. t:~G~ Ofl.. '17404
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STAFF EVALUATION)
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Land Managamant Div. stall can
not ba held responsible for
avelualions or recommendelions
based on false, inaccurate or
lMO '41. 2192 Incomplete
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1'114-68 02/92
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UtCIIlMAGOI1NT D1V1101
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ExIstIng BuildIngs or
Improvements on
Property
cz( House
c::I Bam
c::I Garage
c::I Mobile. Home
c::I Shed
pEPTIC INSTALLED
C!!!1 Yes
c::I No
Water District
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DIrections to site from
nearest maIn Intersection
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For Mobile Home
Placement Only
Brand
Year
Size
No. 01 Bedrms
Ucense #
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Home to:
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Water
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W: 5 3 LANE COUNTY DEPT ENV MGT RECEIPT I 151093 DATE 050493
APPLICANT ElENEDICK. LAF~RY ADDR 338 HOWAI~D AVE., EUGENE, OI~EGON .
TLI 1705273200119 SUElDIV LOT ElLK,
NEW ElLDG TYPE USE R ElDRMS 0 UNITS 001 STORIES IElLDGS 001 PHONE 461 09~~
OWNER NME ElENED I CK, LARF~Y ADDF( 338 HOWAF~D AVE., EUGENE, OF(EGON e
CODI'.: APPL NO ACTION DESCRIPTION SQ FT UNIT COST VALUATION FEE lI'AY~
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W: 5 3 LANE COUNTY DEPT ENV MGT RECEIPT . 151093 DATE 050493
APPLICANT BENEDICK, LARRY ADDR 338 HOWARD AVE., EUGENE, OREGON .
TL~ 1705273200119 SUBDIV LOT BLI(,,,,~
NEW BLDG TYPE USE R BDRMS 0 UNITS 001 STORIES IBLDGS 001 PHONE 461 09~:
OWNER NME BENEDICK, LARRY ADDR 338 HOWARD AVE., EUGENE, OREGON .
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