HomeMy WebLinkAboutPermit Septic Tank 1983-1-10
~
CONSTRUCTION/PLACE~ ENT
PERMIT J~ VIO
PLEASE USE BLACK INK AND PRINT.
FOR OF?ICS CSE OKLY
A~Q V_ P?
permlt~/ 0 p 0 ....../
COMPLETE THIS BLOCK.
DTwo Copic",. of Plans
o Two Copies of Plot Plans
D~lechanical Checklist
D Plumbin(1 Checklist
DPlan Ched Info Sheet
TOi'iNSHIP /7 . RANGE 0 3 SECTIO~ "- ~ _ :~t:? ~OUT Of'
:::UBDIVISION/PARTITION (~f applicable) (LOT/PARCEL - BLtJCK
/? _~ ? 1/7 /?
321~R?j b~g//~4 ~~
~~"M'~OH7"~ -- ~ / _
D~'-~YOF 0 .DIi~ORV-. .- // ~7 $ VALUE
~ ~ .~~4/a ~~ _ /~d/~-/,;4~?)
-<0'-" oc,~ 0,'0 -/P//i; /"!ll/~'MP7>> ~# / WATER SUP~~ . - aE%~~~~ -
~s NAME A'D~ / . . ~ TELEPllONlO NU11BER
C/o. ~ /~.,{/- . t ~, . _ ;i}/4
CO.F. 0.'" NA>~ 0 0' , ,dtP6a/9~~ ~6';}?:-;;;7..:_~7
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I, HAVE CAREFULLY E .D THE COMPLETED APPL1CATION. FOR PERMIT, an~ do hr:rdr/. '~I_'rt_i fy th.-1t: ,1] 1 infnrpntioll Iv-'u"Jtl i~; trw"' .1nd ';.4orn'~tITlrj I fl.Ht, !vr
certify that any and aI work performed shall be done 1n accordance w1th the ()rdulC)'1C('S of Larl0 COUllt.y i.111d til0 L~T."":; of t-~lf' SLit!? (If ~_Il("l"ll 1'~11]llln'~
to the work described herein, and that NO OCCUPANCY will be made of any structuro: '..Jjthout the permission of the Bljlldillg Divi::;ion. I f',-Htll'~r (' r'~ify
that registration with the Builder's Board is in full force and effect as requir0d by OR~; 701.055, that if cy'l:'mpt the basis for cxcml,ti<,rl i~- n()~,'d
hereon, and that only subcontractors and employees who are in compliance with ORS 701.055 will be uS0d on this project. I HAllE READ AIJD CIIEC}:.FD T!lI.S
APPLICATION THOROUGHLY.
ZIP
PROPOSED US!... UF Ft\ui-'ERTY
o Residential
Dlndustrial
D Commercial
Dpublic
,,<)Udl7,*"/,f.t?J!:,/lJ/JIeK ;< /~~ ~
o PLANNING/ZONING: Zone; 19t:: /" Partition ~ Parcel ~
0:-""'"'.
/h~L ~~...,.~.......
7 ~,CJ_ 0 ? ~L,.d~. "".
[J.. L 0 A<?C!lt
l'arcel slzeL6Y K.57b I
Nl.nlmUm Setbacks: CL, fr8nt .--,
.//3l.4 comment. c--SV.S "L
L Y/~~ h
- - .;",..
o FLOODPL N: In flood hazard area?
o RURAL ADDRESSING: GRID COORDI~An:
W SP.NITATION: s. 1.
'2?//~;;Faz~ ~ ~
/ Date: /-/d-d ~
" 0
[] No [] Yes, see attached sheet. Date:
D
N
E . Date:
# ~ ~tallation Record
Issued? [] Yes [] No
B. P.
-:z /. · _ I Maximwl1 Depth
~1O J nG.l'1e..Sof Tren"he~
lJbw ~WaBe ~ s.y.s~ -to l:::e 1~17. lIed
[If'-Y ~{)ved FloC pfh-, t91d ~G tzA.nk i;b k R~
Date: ,/13/2'5 ~
o PLANS EXAMINATION: Type Group Use I
Ins1:allation
Specifications:
l{){)o
Gallon
Tank
15"0
Lineal Feet
of Drainfield
Comments:
Comments:
Date:
o
CONSTRUCTION AUTHORIZED BY THIS PERMIT
State Surcharge
,-~
Qt ..
$S~V~
FEESB:~ID~~
Date~ ///-/d-~S
(/ '//3!g-.=s
I , DATE
$ ~A' h:?
$ O?/'_.'-
$
$
$
$
$
$
~ri/;on
j/J~
Ft.
Fixed Fee/
Unit Cost
Floodplain Fee
Subsurface Fees
Building Fee
Sewer/Storm Drain/Water
Plumbing Fixtures
Mechanical
Plans Check Fee
TOTAL FEE
$
LANE COUNTY DEPARTMENT OF PLANNING & C01-l!>lUNITY CEVELOPHENT / 125 EAST EIGHTH AVENUE, EUGENE, OREGON 97401
SEE REVERSE FOR INSPECTION INFOR~\TION
.
SETBACKS AND OTHER CONDITIONS OF APPROVAL MUST BE STRICTLY OBSERVED. VIOLATION CAN RESULT IN REVOCATION OF THIS PERMIT,
CITATION UNDER PROVISIONS OF LANE COUNTY'S INFRACTION ORDINANCE, AND/OR OTHER REMEDIES ALLOWED BY LAW.
WHEN READY FOR INSPECTION CALL 687-4065. A MINIMUM OF AT LEAST 24 HOUR ADVANCE NOTICE FOR INSPECTION REQUEST MUST BE
GIVEN. Have the following information ready: Permit number; job address, type of inspection, when it will be ready,
your name and phone number, and any special directions to site.
BUILDING DIVISION:
REQUIRED INSPECTIONS
1) FOUNDATION 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 central mixing plant (commonly termed "transit mixed") is to be used,
materials need not be on the job.
2) CONCRETE SLAB OR UNDER-FLOOR INSPECTION: To be made after all in-slab or under-floor buildin.g service equipment,
conduit, piping accessories and other ancillary equipment items are in place but before any concrete is' poured
or flo?r sheathing installed, including the subfloor.
3) FRAMING & INSULATION INSPECTIONS: To be made after the roof, all. framing, fire blocking and bracing are in place and
all pipes, fireplaces and 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 GYPSUM BOARD INSPECTION: To be made after all lathing and gypsu~ board, interior and exterior, is in place
but before any plastering is applied.or before gypsum board joints and fasteners are taped and finished.
5) FINAL INSPECTION: To be made after the b'uilding is complete and before occupancy.
APPROVAL REQUIRED. Nu 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.
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 before 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 masonrv (if applicable) and when installatioQ is comolete.
Installation shall be in accordance with an approved nationally recognized testlng agency arid the manu-
facturer's installation instru!=tions. .'
C.
f40BILE HOME:
sys tem for:
connections.
(1) Footings and piers to comply with State foundation requirements for mobile homes or as recommended
by the manufacturer.
(2) Mobile home minimum finish floor elevation shall be certified when required by a floodplain
management letter. .
(3) Mobile home tiedowns, when required, and skirting shall be installed and ready for inspection
within at least 30 days after occupancy. Tiedowns and skirting shall be installed per enclosure.
....
An inspection is required after the mobile home is connected to an approved sewer or septic
setback requirements, blocking, footing connection, tiedo~ns, skirting, and plumbing
D. SWIMMING POOL: Below grade when steel is in place and before concrete is poured. Above grade when pool
is ins ta 11 ed.
APPROVED PLANS MUST BE ON THE JOB SITE AT AL~ TIMES DURING WORKING HOURS. THIS PERMIT WILL EXPIRE IF WORK DOES NOT BEG~N
WITHIN 180 DAYS, OR IF WORK IS SUSPENDED OR ABANDONED FOR MORE THAN 180 DAYS. SUSPENSION OR REVOCATION MAY OCCUR IF THIS
PERMIT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS INFOR~ATION.
ANYONE PROCEEDING PA'ST THE POINT OF REQU,IRED INSPECTIONS WILL DO SO AT HIS OWN RISK
. .
S~BSURFACE ANp ALTERNATIVE SEWAGE. D~SPOSAL 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 permi~ holder shall notify. the
Department by submitting the installation record form. The Department shall lnspect ~he constructlon ~o
determine if it complies with the rules contained in this division. If the constructlon does comply ~Ilth
such rules, the Department shall issue a certificate of satisfactory completion. to the permit holder. If ~he
construction does not comply with such rules, the Department shall notify the permit holder and shall requlre
satisfactory completion before issuing the certificate. Failure to meet the requirements fo~ satisfactory
completion within a reasonable time constitutes a violation of ORS 454.605 to 454.745 and thlS rule.
Setbacks - Subsurface Sewaqe Disposal
From: Interior property lines
Edge of road right-of-way
Building foundation
Wells, other water sources
Septic Tank
10'
10'
5'
50'
Drainfield
10'
10'
10'
100'
.'
r
. ...ANNING & COMMUNITY DEVELOPMENT
ACTIVITY INFORMATION SHEET
....-_.~..."
kme county
COMPLETE THIS SECTION. INCOMPLETE FORMS WILL BE REJECTED!', .__.__......_...._..... -
f:J'v)~LI] E )<"Cl'\V ~'1i IJ~ '''''c- t
~ERSON MAKING REQUEST
.20<0(') BR.o~(Jl~ <), ,
MALLING ADDRESS
_B01~ (~EP,o""'4~ (~e (
. PROPERTY OWNER
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MAL LI NG ADDRESS
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CITY
c1">(L
STATE
9)40~
ZIP CODE
CITY
STATE
ZIP CODE
~8<1. -0' S 7
BUSINESS TELEPHONE # HOME TELEPHONE # BUSINESS TELEPHONE #
2.. PROPERTY ADDRESS ~ 4- '2, SA L.O\ V, ~ h"-' #
(IF DIFFERENT FROM MAILING ADDRESS)
HOME TELEPHONE #
(1 0'3 '2 '3 .
TOWNSHIP RANGE SECTION
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(from' tax maps in Department of Assessment and Taxation,'
or from tax statement)
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TAX LOT(S) OR PARCEL #
ZONI NG
3 MAP- & PARCEL NUMBER
(REQUIRED INFORMATION)
TOWNSHIP RANGE SECTION
TAX LOT(S) OR PARCEL # _ ZONING
TOWNSHIP RANGE SECTION
TAX LOT(S) OR PARCEL # ZONING
(\ S- ACRES
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP:
4 SUBDIVISION (if applicable)
LOT
BLOCK
5 REQUEST (state exactly what you plan ,to do) f2.e-PL-A-C€: E~'l~rl t-J<J
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6 DIRECTIONS TO SITE: Ccow"T'1 ~ ~ _ T;:; O~YVtMAJrCJ ~~ ~ ~
R M- D '1 () I c=-tAJ L t--O..
. .
** FOR STAFF USE ONLY **
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NUMBER-
DATE
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(,/)
ZONE/LAND USE:
BY: DATE:
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TIME IN:
OUT:
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LANE COUNTY
APPLICANT .EMERALP, EXCAVATING .
TLO 1703230000300 SUBDIV
NE~J BI..1)<;; TYPE .USE R BDRMS 2 UNITS (~0'1 'STORIES
OWNER NME ADDR
CODE APPLNO ACTION DESCRIPTION . SQ FT UNIT COST VALUATION
BP .
BF'
BP.
BF'
, ,BP
DEPT.ENV MGT RECEIPT . 2883 DATE 011083
ADDR 2060 BROADVIEW, EUGENE, OREGON
LOT BLI<
OBLDGS 001 PHONE 689 0757
FEE
DAYS
?L NO. FIXTURES:
MECH
SUF~
,:'CK
SDS
SUR
'NO. CONNECTORS:
MECHANICAL FEE
ST A n~ SURCHARGE;:
PLAN CHECI< FEE.
1 :> . 00 EACH ."
4%
65%
LC
28B3 SDSC
50.00
5.00
.! J
CATG: APP F~A FP SDS . SI PCI< OTI-I ISS'
, l I SEQU : '0 1 '') 9.
,:,.
TAKEN BY I:;:LH EST. COMPLETION DATE TOTAL FEE** 55.00 CK
~
PLANNING & COMMUNITY DEVELOPMENT
ACTIVITY INFORMATION SHEET
idne cOunty
COMPLETE THIS SECTION. INCOMPLETE FORMS WILL BE. REJECTED!
rot \2~ J- )y 0 I'),
.',;; PERSON MAKING REQUEST
MAILING ADDRESS.
'".........
PROPERTY OWNER
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(from tax maps in Department of Assessment and Taxation'j:
or from tax statement). . .
a{; /3 (1':J. 3 I-/I? lj
RANGE SEcflON TAX LOT(S) OR PARCEL # ZONINg .,
o 6 13 . ,1) 'I Pill
RANGE SECTION TAX LOT( S) OR PARCEL # . ZONING
MAILING ADDRESS
CITY
STATE
BUSINESS TELEPHONE #
HOME TELEPHONE #
BUSINESS TELEPHONE #
HOME TELEPHONE #
~ 3 MAP & PARCEL NUMBER
. (REQUIRED INFORMATION)
/h
TOWNSHIP
10
TOWNSHIP
TOWNSHIP RANGE SECTION
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP:
TAX LOT(S} OR PARCEL #
1'1, ;l
ZONING-
ACRES
"
; 4 SUBDIVISION (if applicable) LOT BLOCK
i 5 REQUEST (state e~~ctl: what y. o. U pl an t~) C 6A~ - (AQ./4( (}>.f r& ~ ?-t.-<::---I-
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~IRECTIONS TO SITE:
** FOR STAFF USE ONLY **
NUMBER.
DATE
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ZONE/LAND USE:
BY: DATE:
~
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TIME IN:
OUT:
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