HomeMy WebLinkAboutPermit Septic Tank 1983-9-12
FOR OFFICE USE ONLY
APP1~catio~~~ ,j1~
Perm~t .# /-'0 7U-OV
DTWO copies~f 'Plans
o Three Cop'ies -of Plot J?lans
DMech(Plumbi~g Checklist
DLegal Inter~st '[)~c:~ent
BLOCK 0
'7. ,/J /~' _' Plan Check Info Sheet
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I HAVE CAREF~Y EXAMINED THE COMPLETED APPLICATION.FOR PERMIT, and do hereby certify that all information hereon is true and correct, and'that I
'have the. following 1~galint~re5t ~n the property: []owner of record; []c~ntract purchaser~thorized agent wtth evidence of ,authority. attached.
,I f~rther certify that any and all work performed shall be done in accordance with the Ordi~of Lane County and the Laws of the State of Oregon
,pertaining 'to the work described herein, and that NO OCCUPANCY will be made of any structure without the permission of. the Building Division, I fur-
.ther ce~~ify that registration wit~ the B~lder'5 Board is in full force and effect-as required by ORS 701~055, that if. exempt the basis for exemptionl
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. c::!T} NAME (p~ttt~'" pnnt'f . ,. . /fiIGNATURE ' # ~ DATE"
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17
SJBDIVISIONjPAR1ITION (if applicable)
DECLARED $ VALUE
READ THIS SECTION CAREFULLY. YOUR AU~HORIZATION HAS BEEN BASED ON THE,FOLLOWING.CONDITIONS!
o PLANNING/ZONING:. Zone #A- Partition' # Parcel #, Parcel Size A / .A-
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)(:lillITA'tION~. ,. 1. .. B. R. ~ ~~~il'''OO "'~ord ",ood' 0 'eo 0 NO
. . Installation Gallon 'J 1-0 Lineal Feet sbjlt~w_ Maximum Depth
Specifications: "Tank .. '" . ~'f . of Drainfield CL~' pn,<;:e;; rl2L.(lpf Trenches .'
~OMNENTS: ~~ r .sepUC CCA..nK ~ ~.s:-Scv-y~ /nsYsz-f /
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.' . 'Date: 9//.>' ?'~
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o PLANS' EXAMINATION: Type
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Group
Use
COMl>lENTS:' '
Date:
n
TOTAL VALUATION $
CONSTRUCTION AUTHORIZED BY THIS PERMIT
~ Fixed Feel Floodplain Fee $
, . . De c_.'riPti~. n " Sq. Ft. Unit Cost. $
Su'bsurfa6e Fe~~
/".- ..... Building Eee $
r; ~~' ~ _ ;7::~R:::kF::e :
~ State Surcharge $
~ - . ~ DEQ Surcharge . $ -"A' - .?f"
,(/ /' - TOTAL FEE $$~'.-.v
RBAArT ARR~%{~~~i(l)) .. \ ~~S ,f.r.- 5
LANE COONTY DEPARTMENT OF PUBLIC WORKS LAND MANAGEMENT DIVISI( lN, 687.4061
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
SEE REVERSE FOR INSPECTION INFORMATION
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SETBACKS 'AND OTHER CONDITIONS OF- APP~OVAL MUST BE ST~ICTLY OBSE~VED. ,VIOLAT~ON CA~ RESULT IN REVO-
CATION OF THIS PERMIT, ,CITAT,IOt'l pNDER"PROVTS'IONS OF ,LA~lE. COUNTy.... S JNFRACTI,ON ORDINANCE, AND/OR OTHER
REMEDIES ALLOWED BY LAW. ' '. " :..' ~ -,t-,. '-'''~_';'''''' ,'- ,',- -. ,'. - . " , . ;. '.. ';. '
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WHEN READY FOR INSPECTION, CALL 687'-~0,65 .:AMINIMUM" OF~ AT LEAST, 24: HOURS ADVANCE :NOTICE FOR INSPEC-
TION ,REQUESTS MUST BE GIVEN. Have ~,th~ ;o,l;lbwing inf?rmation ready:; p~rmi t 'number, job address; type
of inspection, whe'n it will be 'ready, your' name and phone number ,and .any' special directions to' site.
BUILDING 'DIVisION:
...
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REQUIRED INSPECTIONS:-~ ;
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.Foundation Inspection: To be made after trenches are ~xc~vated and forms erected andcwhen ill
m,a ter ials tor the founda tiqI]. are d.elivered on the job." Wh.e_re'. concrete from a .centraL mixing.
plant (commonly termed "~ransi,t mixed") is to be used, materials need flot be, pn Uie"jbb. ..
.... ..... -.... .... . ," 'to. . . 'l. .. "" ,
.Concret'e; Slab or Under-F.loor Inspect-ion: To be made-a'fter'. a'l'l in-slab or under""f loor building"
service equipment, conduit, piping accessories, and other ancillary equipm~nt items are in
place but b~fore any concr~te is poured of fl?or she~thing insta~led~,incl~?i~~'t~~pubF~OQ~~_
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3. Framing ~ Insula tion Inspec.tion~: To be made ,.after ,the roof" all fr,aming, :',f ire ,blocking, and ,
bracing a.re, in place and all:; "pipes , :f~replaces". chimneys,.and vents .,are:c9mplete and.all r:o).lgh
electrical and plumbing~are approved. All wall i:nsulatiori and vapor :barrier are il'1: place~'
. : . , '" .....,.. '. ' .. . ... '. :' '....'': .2::::....." .
I ' 4 -i ,"Lath !'lnd/or"'Gypsum Board' Ins'p'ection.: To"be'made afte'j:' all lathing' alid :gyps1.i.ri\''''}?o~rd, inter:i;o"r
. and "exterior, is" in place but, befqre any plaste,ripg is ?IPplied and before gypsum, board joints
~', ,and fasteners are,tapedand'finished..., ,..... " . "'. ' , ,
.~ :_ ......... ,'_ "_;';.... .. 4'~ .... .. '- -' -.. .. ~-- .. ':\ '. _.~. ..;~ '~__'j'.._'"
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'~.' ,Final. Inspect.ion: 'T? be made' 'after the building ,~s complete and before occup~n,cy. ,
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APPROVAL'REQUIRED', No work shall be done on any par't. of the ,bui'lding or, structure beyorid' the. point.
indic<?-tE:'!d ~n each successive i'nspection- without first obtai,ning',the ,appx:oval 'of the buildin-g',of'ficia),.
, Suth' approval shall be given only after' an inspectio'n" shal'l'-have been mace of each successl.ve step'
in the construction as indicated by each of the inspections required.
NOTE: All building permits require:..tnspections"for the work authorized, such as but not limited to:
. ." "". :.. .
A. Block Wal~: To be made afte~ r~inforcing 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; i "
,B;. Wood Stove':, To,be'made after comp.let~onof'masonry (if applicable) anq when instalia'tion is
cqmple',te. I,hstal.latjol1 shall be' ~if accordan,ce', with ~napproved, pationally reco.gnized testing:
agency; and the manufacturer I sinstal'lation. instructions. ~..~.
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Mobile Home: . An insp~ct~on ,is required after the~ob~le home is conne~t~d to an approvep
sewe~ or septic s~stem for setback requirements, blocking, footing connection, tiedowns,
skirting, and plUmbing connections. '" '
, ~
1. . Footings and piers to comply with State foundation requi~ements for mobile homes or as
recommended by the manufacturer. ' ,,.,,.
.2.. -t:1obile home'mi!:limum finish floor elevation '~hall be certified when required by a flood-
'.plain ~anagement.le~ter. .,..., ": .,.,,": ' " '..' ,
_ .......,..'.... ,'" .... _'\._ _ ~~.... . ..~ ...... .4_...._.._ . _ _.. ....... _ .,._._ _
3. Mobile home'tiedowns~ when'required, and skirting shall,be'installed and ready for inspec-
tion wi thin at least 30 da:(s .after occ~pancy., Tied~wns and. sk~:fting ~hall be installed
per enc'losure. '"~ . ..
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Swimming ,Pool:, Below grade 'when steel is 'in place' and before 'concrete is poured.' Abpve grade
when pool is .installed.
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APPROVED PLANS MUST BE ON THE JQB SITE AT ALL TIMES DURING WORKING HOURS. THIS PERMIT WILL EXPIRE
IF WORK DOES NOT BEGIN WITHIN 180,DAYS, OR If WORK IS ?USPENDED OR ABANDONED FOR MORE THAN 180 DAYS.,
SUSPENSION OR REVOCATION MAY OCCUR.",IF "THIS PERMiT WAS 'ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS";
INFORMATION. ' . , .. "." .,
ANYONE PROCEEDING' PAST,THE\POINi 'or REQUIRED INSPECTIONS'WLLD DO SO AT THEIR OWN.RISK.
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SUBSURFACE 'A~D, ALTERNATIYE ,SEWAGE DISPOSAL SYSTEMS: ' r "",... , " ; /:',,' ;'~ ,
, L per;i ts shan be"eq.e~t~::e.:f.?r '.~ne' ye,ar from the ..,da ~~ "<?~" -is,suanc~1", \ ~..... ' :. ",\: ,,', ,'.
. .. ... ... .._.... ;.......~' '.. ~.: J ~ 0- --'0. ~ " j 'r .,""' \. \. I..' _...' , ." " " ~. e )
2. - Upon completing" the construct~on for wh'ich a permit has.... be,en issue'd';: tne permit. holder sha'll
noti'fy the Lane'.County Depa:r:tment of Planning and Community Development by submitting the
inst~ilat,ion "j:"~c.ord 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-
lationof ORS 454.605 to.454.745 and.this rule.-
Setbacks
Subsurface Sewage
Disposal
'Septic
,,'10' I
10 I.
5 I,
56 '
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Tank
Drainfield
.10 I.
10'
10'
100'
From:
Interior property lines
Edge of road right-of-way
.Building~foundation
Wells"other water sources
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PERMIT AREA '
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ACTIVITY INFORMATION SHEET
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COMPLETE THIS SECTION. INCOMPLETE FORMS WILL BE REJECTED!
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PERSO~ MAKING REQUEST
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MAILING ADDRESS
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'CITY STATE
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PROPERTY OWNER
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MAILING ADDRESS
:3361
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ZIP CODE
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CITY
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STATE
ZI P CODE
7~" 5~-S'-( .
BUSINESS TELEPHONE # HOME TELEPHONE #
2" PROPERTY ADDRESS
(IF DIFFERENT FROM MAILING ADDRESS)
7dt,~73S?
BUSINESS TELEPHONE # HOME TELEPHONE #
. .
3 MAP & PARCEL NUMBER (from tax maps in Department of Assessment and Taxation '
(REQUIRED INFORt~ATION) or from tax statement) -
/7 03 23 ~~~_ UJ!;
TOWNSHIP RANGE SECTION TAX 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 SUBDIVISION (if applicable) LOT .Bl~)c.K ,
5 REQUES1j0tate exactly what you plan to do) . S'-e~c' ?e,;t)fl/~ - ~[ilJL/""
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6 DIRECTIONS TO SITE:
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** FOR STAFF USE ONLY **
NUMBER
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ZONE/LAND USE:
BY: DATE:
TIME IN: OUT:
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LAND MANAGEMENT DIVISION / 125 E. 8th AVE., EUGENE, OR 97401 / 687-4061
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159083 DATE,091283
. AD DR 3361 BALDY VItW, SPRINGFIELD, OREGON -l'
LOT BLK
~BLD&S 001 PHONE 726 7357
APPLICANT GIVEN,
'TLt 1703230000500 .
.~EW BLDG TYPE
OWNER NME'
CODE APPL NO ' ACTION DESCRIPTION '
_W
, :BP.
>BP
.IF'
SP
JOHN
SUBDIV
USE R BDRMS 3 UNiTS ,001 STORIES
AD DR
SQ FT UNIT COST VALUATION
FEE
DAYS
TOTAL FEE**
,25.00
,IL NO. FIXTUHES: NO. CONNECTORS: 15.00 EACH -
MECH MECHANICAL FEE
SUR STATE SURCHAf<GE 4%
'CK PLAN CHECK FEE 65%
SDS' LC 159083 SDSR 25.00
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~ATG: APP RA
SEQ,U : 0
tAKEN BY'RL.H
FP SDS SI PCK
1
EST. COMPLETION DATE
OTH ISS
2