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HomeMy WebLinkAboutPermit Septic Tank 1976-11-9 ~. 1 "~:..:~:~:.:~.. <~(!.. ..~~:,~..'.., " ." , ,; .;'.,~>':.'~:~',> ,~ ,CA,~'r'C6UNTYPERMlt. FQ~': , \. ~'.: CONST:8UCTION J','j' ~ b'w~e'r. :i~*fl~~~' .$i:.~,'.' iL~,1' .,' , NAME""'!"'''' J '.. . D Contract'pr :". ' j. , C8ANGE OF OCCUPANCY [ ] {'..... fi-,.","",V':' ~,,~1,'!f"' . , .11' t' .'" " 'N. ,y,,;f :, .1!:~'4:"i'i\;j-'. ~'''i, ,.,."':t.iI!l 1/" .d PHONE ,.~."' " . . .:! ~..:. . ':Nf,i,ME 'AD'DRESS , CITY ZIP CODE PHONE , ,. ,.O.S:Reg.'#: 1;,'"""'1; ',Twp.4:;,:,1 Range" :~":. . :€ 'Subd'ivision ,~tltt. -. ;. .,~,;,,~~jl.~I'Tax Lot .' . ; ~,'" " :,' . .. , Ab:eagp i~~s ,~;;;~".~ ,;t,Width :.... . '-;~ . , Depth . ,10' '. _'.J " .~:...,.~ '.'"' . , : , Existing Structures on ." .;:~ - - ~ " . :.. '. . ~..: ," ',' .;~".;~tk;." '~~~fl5~~s;j~t;jJ:ii1l, :,~~~7: PLUMB'iNG INST~lLED"i3y:' . ";()ylt" . i,';!'''' . OWNER ~ ] ,OTHER [] NAMF BCJl;46/~G.< .' ..... . '\ .'.~ ,," . ..p.. . ".",PLU,~B;IJ"G,";. ," '~~j%. ~URCf;LA,RGE= , :.."iVI0BllEHO'l\IIF. :; "'WASTEQI$P.O~A:~ >. .:P LANR Evi!=\Nf" : ,'WATERSUPP,LY: PROPOSED [,'] EXISJING [] '[~]C;~..' [ ] COMMUNITY, NAME, ["J PR IVATE.WELL [ ] OTHER - SPECIFY: '. ':.'). :,::,~,~{~,,:. . ;\ '. TOTAL: .,t~' , '_ " .,' , . c, '-: ';;1IJt;;;: :;fi:,'f: ,.;;' '?, ;-., .. icbi\iSTRUCTION PERMITS& I~SPECTr()f\JS'~l)IpWATER j:>6L.L.OTION'CONTF{()L'S~Epf!t:l~ATIONS .,Mlr:L.$Ep.T1C;;t~NK'CAPACITY:' " . ':GALS. ',' :1f.~f.f!!:t~'.1V1IN. DB'AINFIELD :::: ': :,',~,;~1;~t!.,: .,/4~"'~~~~~;,~:~i?,t~~> ";'~i'i~, ';1: ,'"J',jj, :~ 'TYPE'OFrCO~'STR'U~'~f10N~~~;T~, "G ROUP '.' . .",. ., .' -. '. . '. :: . j'/' ~- , ,:....", MAX. TRENCH@D;EpTH INCHES ,Iii!", ,/')i! ,,;:,..1;. . ,,~.\.:~.Ad. ;,." ii, ,'J< ,&....;...,. l0r&:'~1;:;:;f~~~.. ,.;.;, "Jf'4~'Jl1~,J:~~'~,w..'t-,~~.., .:~'\'i;':~'1.?JiI . "~tf[~~,w.r,;;~' !ii~" Iuif~t.~.J.;~.;~:i '/~:t~o', FRO MAL LWE L~S ' FIRE ZONr: USE CLASsiF. -. ~: / -'R .>;i", 1, :S'ETBACKS ' :~:; ,. f-~O f':JT" k,J'''_" ' '. ",' l' f,'" -. i "CTR, OF r/W: J SIDE EXT. " FT, FROM PRG!P.: L,;'INE:P E I NT >'1. '., R E R SI D , _h"-,~i.iI.',' " ': ' A r-t~:-~," , i~ ZONF\. :(/:~':\",' ,~'<",.. .4, ',^.' ,1,;. ~ . . ""';', " , ! .~ ...~:~:n~;-' . ~f::~': ;g~ BLDGi)p.~M{r;"':'vYHI'TE, ' ,'OFFICE G~Y,;" WHITE. COUNTY 'FAI''''+~8INK,' " :PLlJMS'ING:'::>MNARX BUILDING - GREEf\h., .' SANITATION - ,GOlDENRO\l..' .-'~~<" ) AlJJ';'H~OR iZEQ'SI,GNATUcF~ """f~i."'~ },~~~:! ;f2:~,,,,' "~ J~{; II\II~q'R:TANT:, ' "~""'< ., ,~~;:,.. Calr687,4065.to scliedule all required construction Inspections C'all 687-4061 to requl'rea '. septic system Inspections All construction shall comply With the State BUldllng Code, D E Q standards for,.subS~ri?ce,'sewage disposal and the State Plumbing Code, All buildings ,require a certificate. of .. 'occ~pa~,~v.,~Qefor~ being occupied, '" . (See Deta; Is on Reverse Side) .,,. .i~ ': ~ -,:.'",:\'.:', . ~', .:.~:: ' ~ ,~.t ,.., .;... ~<' . 0", ~ l', ,.'" ""':', :..~;{f>dst THISPERMfT::ON MAIN BLDG. AT SITE) ..' C55.13. .".. ,<. , ." J "~:dc.ANE COUNTY. PEPT'OI: ENVIRONMENTAL MANAGEMENT 'COUR1f-19M~.E~~N~EX,,'13:, E~ST 6th: EUqENE,OREGON 97401,:' ~:'. .~"., )".~"I&>1.t:~7',.,,,:;" . ." < , 'OJ SITE INSPECTION ApPROVED I I DISAPPROVED I REMARKS ~. . FOUNDATION INSPECTION ApPROVED I I DISAPPROVED I REMARKS FRAMING INSPECTION ApPROVED I I DISAPPROVED I REMARKS, LATH OR SHEETROCK INSPECTION ApPROVED I I DISAPPROVED I REMARKS FINAL INSPECTION CERTIFICATE OF OCCUPANCY READY TO ISSUE I I DATE I DATE I DATE I DATE, INSPECTOR INSPECTOR INSPECTOR INSPECTOR I DATE I-It:) -; 7 INSPECTOR REMARKS I NOT READY TO ISSUE I I DATE ~~.- -=" ~ INSPECTOR ::/ '~ .~ NAME-: , SEE: C55-08 .c::ROSS REFERENCE . ,.., , ' ,BUILDING PERMIT '~cttP:.@~ ~ / ~,~03~d-3f -:r'L- 6 0 33rr ~J7 ~oY~ ~. NOo(o/j/'~ ?c?- '7 G C3 ' , ,,/ 'l.~ , " :. , " ~.J C,;", PROP.oSEDSEWAGE'DISPO'SAL SYSTEM RECORD. ~~.~ :. LNSTAL:LER: 'Complete top p.;lr~'of formtosignatureand submit bo~h coPieswithapP,l!~~pon.' ...;,' \ RA~DALI.. ' ~~AN.T ~ ~ t;;,5 ~AI..J\VV(E;LJ,' PERMIT NO.IVHi' 51,g 7~ I NST,ALLER I S NAME ' ,PROPERT'{ ADORE~S . ~ ,.. . .Jfd, No. Liv1ng Units Bed40o~s Baths ' "7,\/1 ' I, " Basement Yes " No 1/', W~ter Supply ,'~ Pub 1 i c !>(.Other-Li s t Septic Tan,k: "II. Ft. from wel1p'/A: Steel 0 c~ncre.t~~r N,o., compa,.rtm~nts I, Inside Dimensions:.Ft.I,;'(,_+, ,',,' ",' Tile Disposal Field: Lenqth '[I~'\Width'4~t;t'l Di'ameter"~' ',1' Depth5'L.lt" Distribution Box: Yes/ No OWNER 'R' . .. . , Other' Distribution-Type NAME L . I /? P AJJ.T ' , , Feet from , MAILING 3-:< yq RALJS.'( VIEW ' "WEll1>u~w(., tVATER. Founda,t ion 10 I !vttN" ADDRESS. .1 LotLi ne ,T2:,.U 1?~J..1E:.. e:;1l.e.. Cf., '-to/Front'S i de l \ I Rear Le~th of Lines-Ft. T~enchTotal Sq. Ft. Between F!l1er ..hIFi ller Depth ... Fi1'ler Below 1"32.1123.\%64... 5. 6. "Wldth~ Ft. ,\~D Lines I~ fY\,IM TVDeIV1.~Above Tile 1.- in.Tile ~'in. Plot Plan (see 'instruc~ionV: '1 ,~\..... / \' ''Z/Cet 1.0$ " ' r Gal. Capa~ity ',I 800 bAJ- ~ ,/ , \J'l .;:s '~.. ': _ L.., ,.116') ,Y,I'4J"" ::: - -----1 - I \' i .: ~r--~---.~~?'.'-<.,.,\ ~k .:. ..b ....-..- -,-,/-,2 _ . \ ~,~. ... : /? ,,-..... " - 1'..''"'''' I' .t:: . t ...~ ,. ....J, ~:t< ~,L ,:::. .. ',f- ' ~J~_,~M,~" ,,~_;4 <j .~' , 3' , ,(; . ~~,,:1, .J: vJ, " 'it: Jblj Fe' , ' ,f1Th,.t'~ iCE m ijll r ~ ,~ ." 'r:.; u, WI rr .~ &1 ... ..... .,..., " . , Il;a 1i1..9 - - ~ ~ I' ~ 1#'JV/~~~t.~2UNTY " I'HAl- MGMT. II .. .. : r%.'-:t'~ .p <>.:~-011 LI (( 2-d. ""N " ' . \ ~ . . 1 j .", 'JJI~'"" j Date I i 1- ~ I 'Ii Si q[lature r":1 :/~ i< /~;;r " I" '1 t ~ERTIFICATE OF SATlSFACT, ORYCOMPLETrON ".', "~,,,." For SanitarianUse'On,ly: ,,' ,oate:,f--.$/-77 In accordance with 1973 Oregon .LawsChapter 835, Section 214 this certificate, ,is issued . . as evidence of.' satisfactory completion of a subsurfac;~ sewage disposal system at the above' . 1.oca~'APpr.~ved:: System I~~tallation,conf~rms to 'current standard~ , I l 0 i s'appr'oved:, Dc;>es not conform to' current standard~ ReiT!arks: STATE'OF OREGON DEPARTMENT OF '" "f ~ ",.L../-.., " '~,{.~ . SanitarTan'ls Sign~re ' ,LANE CpUNTY , " ' " . ' EN~ I RONMENTAL 'QUAL !TY,_ ; C55-11