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HomeMy WebLinkAboutPermit Septic Tank 1977-9-1 ~. ' 'P' /0 ;.cf TRS, Tl 1'7-,3- 2.2\001 .,. G. Plat Plan '.\, \ ~, t'.....LJ.J ~ 'i\, t ~ 0 0 ~ ri ~ ~ I t' 'I:) <3' :~ ~ I. vJ '2 'if) ':> 0 cq: (j V> '!) tJ V> ..j, (U .... ea \}J lU -a -a ~ Cl ,<( . 0 ,() OJ \f) .~ c: ~ t .~ co " ~ \:0 ~ 't-- - i..~ (U ~~ It) \ E co 2 '2 C z W ~ u) t'-- .V> ~ a;~. +-' ,~ ,\0 ~ c: \f) co <r T j (.), co Q; '-.J .'\t- 4J :ij: +-' V> > Q; c.. c: co <(, co ~ Job Location (Street, mile post) 5306 BAL...D'Y "\i:.~w LA.N~ ~Ubdivision l.i~1';t ~\ " . Lot Block FOR SANITARIAN'S USE ON L Y: L$l:SystemApproved . 0 System Disapproved [J Needs Correction COMMENTS: 'Signature: '~ '~.du-'1 ,., ,/ . /( /'" ~ C Fi.ller Depth Below Ti~e rp-- Lv 1'/1 e;- -'~, " from drainfield ' / t) IJ I Date: 9' J.J. 77 '''' FOR INSTALLER'S USE: Trench Depth Tank Capacity q ()" Manufacturer Measured distance to well from tank' / (;10 I tfJ It.f10-'77 " \l ~I (]i, ~"'. ~I ,C) NE CC1"'h~7 ;.'~I ~ ~ .... .,l i " ~ _i-q;- .0/ ' '0 ',II r . - - .., , .,,~ <(~ fd/~ j,;V P. ~ t)J o , ' " . ,1/' /,-H4- Q. ~ f::..g~PP"v, I 7. fa"''' " , i., f) E' ~ 'E' 1 \1 ~ n r\' ~ ,I VI !b.. i:.,j - P/u'W\. ' By S E POI 1977 . Scale: LANE COUNTY ENVIRONMENTAL MGMT. INSTALLATION RECORD AND CERTIFICATE OF SATISFACTORY COMPLETION When signed by the County Sanitarian, thiscertificate is evidence as per ORS 454.665 of sat, isfactory completion of a subsurface sewage disposal system at the above location. . N Return'this form to: Permit Processing Section, Department of Environmental Management, Public Service Building, 125 East 8th Avenue, Eugene 97401 C55.11 I I f '~" ,~ ,'() , f \ I \ i I~ !t}I (- I / , /, j , , /f I / I i / / i I i / / / / / ! .Zf~ NJ' 6',-t>, . . W tJ/I/o.J OO~ - ~l J I I I l / .I ; i I /, I i / I I j I 1i i .' ~, : ~( '\' <'v <>y _.----------------.1" . ";.. 2.. \ "2.;,.. , I I j -. -- J I \<1 I V ~ K... I I J' I 1 ~r:>.. .:. ",' Ij~ :-'::':, - ~ : "-=">-- ,/ I -- "~~t~/~~~:, .... /, · I <I'.~~~ \, II "J' I 01' ,"~" ""'j7;~'0..^,' '(;.;. .,' / . ~.:::- -, >,,): ' .' , ,..- -, - '''\ - - ' _. I ~\.c - - - _ ", 80'+-- v "". ~ ~ . '?j r. EJ " " 7"1 \,J \~ ! I I I "':~ ~~~"".tf . . IJ/'~\ I -.------ I ... J / J .I JI.;./ , I I I I r I -l:\V\ ....,N ~...., " ''f;' +'JJ .0: (TJ I I I I / , .' I / ,f _' f-...~~ i i 0 ", .' I \\-- "';:: , "'-' <: -'e .hI':- ~ I\,.- .:: ,I i \ \ . \ >,. I', j') " i, ,I , I' ,~ , \ \ \ \ \ ,."f' ~, t ,Ir; /" I' r;;~< I '( L '0 'N H - ............- ........, -............. "~.. ..~, --~ '--....,., -~ !<J I I (I: ~'; I 1 -" i t!>-- [ I I ) 1 ,. ,/ I I I I ~... 0.1 At;> "1- '1}. ,... _ s~'.../ :Y:' ....... ~l, .t ." ;t; -~ r ,f , ~' -;"- ;;0::-,1 'c., "~" ;' ,/ / .' / t ~, t ~ ,~ i SLAB FLOOR PLUMBING GROUNDWORK ApPROVED I I DISAPPROVED I REMARKS GAS PIPING GROUNDWORK ApPROVED II DISAPPROVED I REMARKS ROUGH PLUMBING ,ApPROVED I VI DISAPPROVED I REMARKS ROUGH GAS PIPING ApPROVED I I DISAPPROVED I REMARKS FINAL PLUMBING ApPROVED I~I DISAPPROVED I REMARKS FINAL GAS PIPING ApPROVED I I DISAPPROVED I REMARKS CfRTIFICATE OF OCCUPANCY READY TO ISSUE / I DATE I DATE INSPECTOR INSPECTOR I DATE ~;I/st~~~ INSPECTOR f' I DATE INSPECTOR I DATE / /-'.).0-7/1 NSPECTOR I DATE INSPECTOR I NOT READY TO ISSUE I I DA TE REMARKS f" I?k R;J- INSPECTOR '< f. TRS, T' /, . ---'-I a I~ #, / )'. ,~ERJIT # /<;r l. ," /'J L"')/tL /1'/,< ( ./ ,I....&tr j ht:J~?;:JZ_ ' , /7 v j LANE COUNTY PERMIT 1//1 ..., ..., r 0/ /1 /'~- Acreage or Lot SizE' d r7~ .X 3 fA Partitioning #. ( ) Completed Subdivision ./) , ' Contractor's O.S. # I.. ,,,\ Q II Lot, Block,- - :/02.-- APPLICANT'S NAME AND ADDRES~, rtb,,,4~c,1).jf~fJ s tit! ,q<lt:J tltJfi/ td/ilf/t,P _)a~~1P':::("f6'-9~?7 ,'. OWNER'S NAME AND ADDRESS~(J/I./U'h Jl.J/A'/1j'~~~~ .Et(c--IIJP>>'-(....:iJ;:,{:/6 ~;~ ?:?"7V/J/ ......, Phonp "7t./7-<;;:-</~7 CONTRACTO'R'S NAME AND ADDRES~ ((fILO~.A\J /..Cja,tJ oS ~ / ""....... -/j, -- Phonp Mail permit 1'0 ( ) Applicant ( ) Own,er (w) Contractor. (j.....)..Prefer to pick up. Call h6 6- /' f5:....';/ I (owner, etc.) when ready. STRUCTURES NOW ON ~HEOP-RIQ'PERTY ..0 ...- " /~ ~ _~ }- ~ I ~ b .yo f 7-.';;)'~ ~~)HIS PERMIT IS FOR_ S Ff),.$ DS\ ~.J ~#~BEDROOMS , - ., /) / / () - WATER SUPPLY u.J ~ SEWAGE DISPOSAl <;; _, f',. THIS PROPERTY IS WITHIN ONE MI LEOF THE CITY OF PLUMHING BY .. , ! .. I hereby certify that the above statements are true and accurate, anq that I have the following legpl interest in the property': owner of record; contract purchaser; potential buyer; . realtor or agen( "1 further certify that (if not'the owner) I, am authorized to act for the owner of .record, and that said owner is aware and approves of this action. I hereby' agree to comply' with all a~ca,I;>I,e Codes relating to this permit. Fee Paid $ ;J Od- I {o , ", '''Signature- M~Jl ~" , Datp ( ) NEW AD,DHESS ( ) FACILITY PEJ~MI,!, TO TRANSPORTATION DEPT. ( !.-)...SPECIAL PMT. AREA. MIN. ELEVATION: SANITAJj~,~ ~ COUNTY SPE~[JAJj,),RRMITrAREA _~ =,.-.- ,/ .... Minimum Septic Tank Capacity (Gallons) ~ A/Type oJ Constructio,n -'" -JGroup~) Fire Zone ,,) ,;$> D Drainfield Required, Lineal Feet' g~ I A /,# A~Use Classification " , ":30(1 '. - 6':'~"(.f.-'(.,."~o'.'-7 C. -. MaXimum Dep~,h /. , .' Comments: .J~ments:, {,t?;,1.~~t ci~r.~~iJ' ~ .t~ 11:J'~u?J c.,p~ r:-', , . " .r; "-1,' 11 I'. 1/, If ",1,1 :;:J' / /J .'t",,-, -l1k1/, ,.I..<-O-~,' (~< dC-{{4-I-..!:::wA<fI..-' t1Z_vr;./ rrf r<h.~jdi~ ,'" ''1''''1,.! ...;' , #h" _..../.'?l IF ..A~1L~ ,4~~~...-l4...--I'I'.tA"'_P' :t .A"..&.<8~ "c~1 <.{/~~: (ftt). "-:.- " {;II '1 LI. <::f '-- :v.~~~'0~1 L'v12f:.ic;t'1 Io/~- '0 ^!f/..a~,,~./ ~eG- .\\.; /,.tio/'-, c,vV':-</YL~ljl lhA ./!'f..L.. /~~;:;'1. 7f.t...1.....",,,g' r, . \ -, ~, '/' '/ I ;.-: --.1 / /2 ,-' / (I"' /1 1 / '7 -? By: 4 /~~1 Date: (;; "',.2D/77 By: \~t.:> (/-:)~ !.J!....e.~ ")4D/'~Date: f{e:>" ,'1- j! - . / PLANNING REQUIREM'ENTS SATISFIED. By: " Date: I ~ Date)ss_ued: !~- 27-77 ZONE: 1x4-C jSETBACKS: FRONT -Sl) I SIDE FACING STREET (FROM CILl INT. SIDE YARD I-)'REAR o?O(FROM-P/L) ; r7-3-27- IDOl JOB LOCATION '-""r/;f 0~:':;' "S I ~' --; ~..,..r-\........I' .' \~ X ,Q ./ ." '-?' f ,,/ ; / ~ -~. , .... ~~', ...... f /cJ PLUMBING CONNECTIONS S.1. # 7 t,- (; IS- ur/ .~ "''J,t 7-,,),..] }" O?/" ~ i>' LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE., EUGENE, OREGON 97401 POST THIS PERMIT ON MAIN BUILDING AT SITE PHONE: 687-4394 C55-13 BLDG. PERMIT - WHITE; BUILDING - GREEN; PLUMBING - CANARY; SANITATION - GOLDENROD; OFFICE COPY - WHITE ~ .,.,~ .:it, '\ ,.. L :... r.' SITE I NSPECT I ON ~ ApPROVED / r I DISAPPROVED / REMARKS FOUNDATION INSPECTION /' ApPROVED /- /' 1 DISAPPROVED / REMARKS ~ tJ k LATH OR SHEETRO~NSPECTION ApPROVED.! /! DISAPPROVED .I REMARKS , FINAL IN~PECTI~/ ApPROVED 1/1' DISAPPROVED I , REMARKS CERTIFICATE OF OCCUPANCY' I DATE~/~72 INSPECTOR ~~ ~ I DATE $-/~- ?? INSPECTOR 9-4. ~ ~ 7- rIP,?'" ~ f O"E ~ ''';-77'",PECTOO ~ I DATr/2;..:? 3 - 7 71 NSPECTOR ~ I ' , , REMARKS I NOT READY TO ISSUE / / DATE INSPECTOR READY TO ISSUE / ...' , . ~'~::' J _, ~J !- / ")RS Tl , '/J ' ), PER~IT#/L/-;o-77 ba!('~ ( / .u~}Cf2.,z.P . . LANE COUNTY PERMIT , /7 / 4- Acreage or Lot Size d ;;;.s;'L9{, J Partitioning :# ( " ) Completed Subdivision / tI ./ Contractor's O.S. # . v. I , " / I 'Lot Block . yq"7 APPLICANT'S NAME ~ND ADDRESS ~/~&~ 8tl9c/{_;J If(l/f/fJ/)n ~ )(}~~?r:~e0ff':7'3-7 / OWNER'S NAME AND ADDRESsc::;4cI4h-{h LJ(U:J I A./_~ ;P//I) B~~~t.1 /5 ~ 'z?7Y() / ' PhonE' 7u7--0f/c'Y / CONTRACTOR'S NAME AND ADDRESS .!IIl{Jxid//I'-" /c:1b4-,<:::;' / -~ ~(J _ ,Phone Mail permit to ( ) Applicant ( ) Owner r) Contractor. (~fer to pick up. Call ~ 5- '7 A7 / (owner, etc.) when ready. /") ?TRUCTURES NOW 0)'l3~6~ERTY \. ~ 'THIS PERMIT IS FOR ~ F .0) .s; ns) WATER SUPPLY uJ d /1- 3~~;; ?- I /OUJ JOB l,OCATION. '1' :;S'~ Q(}/) ) o '/ /_ ,'P--BEDROOMS fa PLUMBING CONNECTIONS S.I. # 71-,- 0 IS- SEWAGE DISPOSAl THIS PROPERTY IS WITHIN ONE MI LE OF THE CITY OF PLUMBING BY LA:NE ,comITY SPEC~L!fJ:mR11lT"AREi'\ Minimum Septic Tank Capacity (Gallons) Type of Construction Drainfield Required - Lineal Feet Use Classification Maximum Depth Group Fire Zone Comments: Comments: ,FLcX)(L ELE.U, TO isE I A Iv.. (rJ 4 3B oR. AJo g\..t()[Cf., r/-fA-,u -:t.f c..) LOVJE.fL rl+~~ Tt+E:. tS'f.-(C;\(kJ~ (~USE TO T(+E: 6....JE: S ( -w... ~ By: Date: PLANNING REQUIREMENTS SATISFIED. By: ZONE: SETBACKS: 'FRONT By: Date: Date: Date Issued: SIDE FACING STREET (FROM CILl INT. SIDE YARD REAR (;-: ROM PIll LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE., EUGENE, OREGON 97401', POST THIS PERMIT QN MAIN BUILDING AT SITE PHON E: 687-4394 C55,13 BLDG, PERMIT - WHITE; BIJILDING- GREEl\i'; PLUMBING - CANARY; SANITATION - GOLDENROD; OFFICE COpy.. WHITE , r r .~ ; i ~TR~,T,j 17--0?'-22-_~... J,OOI Written Directions /k/'f SDc/t}i END c?3o h .&q;e-?/ 7-% i - Job Location {&:- 10 B~ ~~ ( 'B €J~.~ ~(g{;}-;J q,7<-!O! o F Jj A t../J ~ Vl~ <.IV /.. ~ A/ E' INFORMATION SHEET - ~ /1 (~) Building Permit ) Site Feasibility Study for Septic Tank. Number of sites Acreage or Lot Siz~ 2.,'41"" X ~,<'(, 1?. + Test holes will be ready Partitioning # (X) Completed Subdivision ( ) Pending , ' APPLICANT'S NAME AND ADDRESS ~ASs'E'Al '6~~. lSvtl..bf'te$ qcf6J....IIA.:VrIJr;~lJ.vtT E'U&t~~ q7~oL OWNER'S NAME AND ADDRESS, if different from applicant's J.iA~I1.PJI!,;/,.wr:: te:t-IO ,&91(~f,D EVt,cNC 97</'(;)( ~ONTRACTOR'S NAME AND ADDRESS ,t...qS5~N Zit,Ps. '"BV.I '-i>.ge-s t./~62- HlIwrllO~~ €'~ q:7ifP:l- ail permit or results of site feasibility study to ('X) Applicant (, ) Owner, ( ) Contractor, \ xr) Prefer to pick up. Call lfJ~~--q, ~7,7 (owner, etc.) when ready. Lot Block Phone f!:J8.~-er J 7 '/ Phone 7~7- .!S~&7 Phone Contr~a.ctors o. S. # S Z. 7 9' STRUCTURES NOW ON THE PROPERTY V'I)N'-( :I! ~<=>r'1Y'rx:ms. ~ frlJJo) " PROPOSED USE (this permit) 51 IV4'-C ?Ahli-..F ~t ()cll.l"r/Il '- 5-0'\ WATER SUPPLY ~/S1/1f.14 tA/ E t.-I- (existing or proposed well:etc. If public, name of system) (existing or pr~~sePtic tank, etc.) S.1. #7to-~I\ . A~~~'bM_A/" . -::/, J ) PROPERTY IS WITHIN ONE MILE OF CITY ( ....f''\~v ***** ** ********,*************** ******* ***** * OFFICE USE ON L Y BE Lg~ LI N E *** ******* *** ** * *** ** ****,** ** ** ** ** *,* ** ** **' ) New ~~'essary ( ) Facility Permit Necessary . ~~<\."1,.( , ) Special Permit Area. Minimu~ E~~: ' ' LJNE--'f<f~ SETBACKS: Front. Sid:~~reet . Interior Side Yard -". ~ar (FROM CE!;;!T~~l: OF ROAD) (FROM PRS.~~tINES) V ' ~'t>s;' To:, Planning/Building Inspector/Sanitarian/Surveyor. 'f-..'<. ' This applicant appears to haile a problem with ....r'\.r>V Your assistance will be appreciated. <o~t>- By ..t\.~ ' '''\~ ~\.) ,'1~ ~(~ DEPARTMENT OF ENVIRONMENTAL MANAGEMENT Permit Processing Section 125 East 8th Avenue 687-4394 SEWAGE DISPOSAl 5CPTrG fApK A; ,e ps P4-(/~ (J/~ PLUMB I NG BY lOt(, A-'l...~,c.:r PI. i/,NtO/v'f Permit Processing Section Response: nivision C55-12 For Office r Use On I y ,,-_J,( .i..4fiaJ ,Received bv S.I,.:#;7~-~/~ Yes i/ No . Urbanizinq Area 1/ -c;CI 1.dU2~ C'ode ' C.T. Number Soec;'ll--Permit Area v THIS IS A PRELIMINARY REPORT WHICH DOES NOT INSURE THE ISSUANCE OF A FUTURE BUILDING PLANS OR EXPENDITURES MADE IN_REI:.-IANc-E....,UPON THIS REPORT ARE AT YOUR OWN RISK. .---- '''-.., , ' /// ._/~p L f'4 S E P R I N T If Subdivision - Name: ,.. 1 Lot # / 0/ (}-UCt:~- / -DS 3cJ/2..4.- 1000 / YJl.S Yes)( No :ownship Rang~/ Secti~n Tax Lot No. //Owne'r of,propert?' Owner's Consent H l1 rry .A ? u..c II d1J:C:. ,_._./ No. of Sites "I $ ?.:;;: dO Name ~. " , { 1<(J"tq )/) -"6dVJ ?~/p.I-....13 No. of Acres i'; 5' Mail ing Address' ; ~.. /: ~, O~,c...--rJ, <rZJ7Lf-D {{ Total 74-~ ..--s;?G, (;> ;3 I. ~ _ Ji . _}-ash ~~'3-J,*9'~ X;)..;/. ._' ('?'\ 7 U-n.n...-..o K-v l ~Check Telephone # S i g'hatu1 of App I icant Da}i; jV Proposed Use € J Appl icant's Interest Buyer of Property: J? p = I P'42 ": ~ in ProPi~rty: Other (Specify): -, - - dr .6 A C~ tSc.<f/' &lu i/t.euJ Lq/'IL-<:L iAj ~ Property Size Legal ~cess - Roao Name ExistFng Structures on Property /.i f 'Is Property Within One Mile of CiJ;.:i? /J /Prop"osed Water Supply Yes ~' What City? Sr...'n.,.,....J,./,@ fJ-, Publ;ic District: No . /' .. Sp,rfng _: ~Jell \( _ ~ther 5~cify):. ,I r , .1 ~ A~" /...,.". ) iJ.;iC;;) O/;-/y.) c: f) 0 lLa.-' I f"I L /In Property Location (Directions)i'1J;~~ -;f ~/f1A~t'_ ....~1, C:a~<>- ~ ",/'I R:j,-~, -h-> ;0 J ~-v\ ~~~ h r n v; ;;2.Jt ; - 12"-1 ( 'R I;; t-6) /~ -f2. " j~~" ~~ J ~ h~_ R rL --6 -73~_~-ij~A' Vb'(?~' /5 e4~ S~11L~ ~"" ~ /jri 1/)~~.->.~~i4- RJr^'b When Wi I 11 Tes t Ho I es ~e Ready? / \~~J?:.-J ..fA .A J ,~ MARK TEST HOLES WITH OUR FLAGS \ '(Dare)./ Locat ion of Test Holes on propertY:t ~~ 6:/ ~JZ--1Jb " Draw,di?9,ram o~ I?roperty,,~shOWin9\I,oJ.atio/ of /j,y Vlandmark~ antrelati~nShip' of test holes to ~Z? /~eselllandmarksL: .' '\ \' [ , , Vq (<1y' , ,/f?' <t..... ~,,,-<:1' " ~. '..' ,.", , ,'. '..~ .'-,....,. f..:...-..$,-----+-..~rK-\--.. ':..'-- --i"" .',. / -:- \ r . , ~. -t4~'-'" --. ., ' )/t. \,- '-1LV~' j. f Af. ill ~ ' '" t...\..() . ;; -z;d-~ 5e~' c.1!fq.c6~ 3~74 . ~EQUEST FOR SITE FEASIBILITY STUDY G. $ $ 7~ IJV Owner (~ . ( " ., ~~' , ~ , ~ .... ;' PERMIT. -, -I--J (i) Block # ;;oW t: Vlf'0 rv -1- /'""\) '*~ - Seller Realtor ;" r " ~' .::,. " k .. J \,r.. , I' \' \l \ , MAKE CHECK PAYABLE TO: ENVIRONMENTAL MANAGEMENT Phone: 687-4065 MAIL TO: LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 135 E. 6th Ave., Eugene, Ore. C55-55 APPROVED X NOT APPROVED tP~wd for 5db.?vrf~ ~~ di.y>o>c,) C I 'I:' , _4 \ JOt diU:? CIVIle/if 1J I YI CA-fea..o-r-te~ J1<Jh7-._ ,Xl, puT G..{- 11 t', dm-.'hf/erd /5 '-f::p k I ~ .tJ, e )(Jt-J 6-.%tl). ~ if.::>> t;t,~ S&uth 0t-1.d ~si- Ol1il1o jX'-.Jt (.~ 10 k c/~ thtU? (;ph~ h~wd retlJ -fi-c<f; 'to y'/ue/ b::z,n/( _ L--_.. (}~l~.&(?/~O ~,j ~~.?Ju hor,zed Signature ' ? q 7/:7.h f - I Date 0- r ~r . ,.. . LOCATION: TWP. ZONING: SECTION 2-7- TAX LOT # ~b~.p J:- ~~f- SITE EVALUATION WORKSHEET )7 RANGE 03 PROPOSED USE: SIZE OF PROPERTY: ,s-; UL:r~C? ( WATER SUPPLY: '. 1_",. ' 7~-blS- /0&/ COMMUNITY n AMOUNT USABLE AREA: PUBLIC I I INDIVIDUAL ,'Xl '- '-.. IF SITE MEETS S}'ANDARDS FILL OUT: Type of'structure and approximate sewage flow: Single Family MUlti-family gpd Industrial Commercial gpd Institutional ( , . .."j. - ~' MINIMUM DESIGN RE9U!REMENTS: Jp~ f; Length of disposal trench required ,/ Distribution Method: Equal 00 Curtain Other: Serial l I /' drain required: -/-Yes U No },/ I VL>r>h (J~ crf SUA.J~ ~-, S/Jr/~ '~~-C ~I I()()' .-hv~ v/~AJ~ %V /150 gal. evnJ} SPECIAL SITE CONSIDERATIONS OR VARIANCE OPTIONS OR OTHER ALTERNATIVES: NAME'~~ /};U~ C74-l26 DATE OF EVALUATION: gpd gpd gpd # 1 T E S T L E # 2 T - S T H 0 L E' PERCHED WATER PROFILE PREDICTED WATER PROFILE Predicted in. Inch Predicted in. Inch Observed in. Observed in. Date Date 12 - 12 - SATURATED ZONE SATURATED ZONE Predicted in. 24- Predicted in, 24 - Observed in. Observed in, Date Date 36 - 36 - Restrictive Layer in. Restrictive Layer in Impervious Layer in. 48 - Impervious Layer in 48 - Mottling in. Mo tt ling in, 60 - 60 - SITE DOES c=J DOES NOT ~ MEET MINIMUM STANDARDS. ADMINISTRATIVE RULES REQUIRE !:. MINIMUM DEPTH OF: 0 36 inches to an impermeable layer 0 30 inches to a restrictive layer 0 60 inches to a permanent water table 0 24 inches to a temporarily perched water table OTHER REASONS FOR DENIAL ON YOUR PROPERTY THE DEPTH WAS: inches inches inches inches PLOT PLAN: Stream .-- ~ Drainage or pond ",.~",."""" Road - .- Test Hole (I) '\. 10 Slope Cut Bank ;,it" Fence ~ 'X )( ~ , ' , i I 7~~'/~- PUVViM e ~ ~W " ~U ' \ e ~ -------....."'~~ "~J} J;?' :>S" r~:2.?,I( /tJ()O ~l~ ~!,~I\ ~ ~ ~~~~t . f1 dl[ MpO #bJc / ~ ~ , /I'}) iJ J , I : I ffi jrfJ , I PJ 100 ( \ 'f)t \' """~-, \1 ~{1' i \ i i i \ , , I , , I : ! , I , I , I : I Section 22 T.175. R3WWM. 17 03 22 "'" fHIS MAP IS TO ASSIST LOCAnN~ INDEX ..- ,,\ OPERTY. THE COMPANY ASSUMES NO LIABILITY FOR 'NACCURAClES, rv r;.; . -... '7' " (',1')4 : Z' 'J ' 15 ~~ ,.. - 200 -. --D-'+ \, \ ~. ,:~ : ~.- ;J: ,. 22 , ~ \ .. ... ..,!,...: ~ ':, Il~ J(:'- ....~.. t &. ''700';1/ -:,.: ': ,I 'Go 0 I ';~ ". I: ... .... ..~ '. ! .~ ' '\' o~' ;;. \ ~ : t/, '900 _N I i: '1 ~~, : ~ t r M"H'ft" : · :\,.00 ~~ i ,I, I ~ 1 1 .~ J,....'!~ -~~..~~. LANE COlllTY . l.~ ' '" n 'J:.:-, .__~fI1 ,F'.... /i;'. ? ~ \,./ .~ J*' !! ~~j~~l~itl"'" \ W~ ~:l!"" #~ "".~ ~ 'y! [ _..,>-:~" "'t., ~.,. \.~.'" ~N Rru.LJIn. ~n'l_""~ '" -'. ~'\'\Y~:" l. ".-.," . ~ C /~ ,~,..,:r-,' . '\, ~irI'R~-:, ~)I I. -...~:~L><;O~O 46 ''''''')lilii,~ ...... ",y,;:';- '11: . '~". ~008.1..~' .. ';;'''ii~__ ~.. ~!' ,f/ . ~I 15 104 - 2,) . ",'~::" '90' \ " ~ ~'.- ~ !'I'( '0 1'1____....__ ...~~~:---~~ "r~~;1 ~ . 0<1':" 004-241 -" r- "'" ... c,~, '....\~, _,~~ .w'... .0- _' ~~ t ~"LT .. I " I L loJh ......'~ I , -';..- ,O:Z ~;;::.' . ;), ~-_._- a;5: '.-...... ~~'T'1f -o6I7.W"22j ---" ---"-_ o~--;:?'~.~ - {~I801 ~ 0-,,"8' ~',~,-'\,:' I' ''''', -p.. ...'....:;..,.....~,;' --- ';,.7~.._..... ~~ 004-23 d., " )u.,_.....~~, ,~, I I \ ;.~<.", A--:-::7.'~~i'"l..~lil.~~ "','<,','900 :j;~~ ~ ~ _', ~ ~,~~ d ,1 1917 "kj-;:tl~-~a ~:-;~. l~~''''''. ,.. ~ f~~ -~t.. oJ :>>.,' I "l!' .~ ~~I~'3,~ij.-;:""'~ "> ...::,. ....i lll1~JNI"" ~ '\.'..,..~. I :II:"~-~ _4_ .;. ,.-- ,'2';}4' .g<. ~~----"~._... i !~ <b.' '''''',7; ""p;:, I . """:IT.' " ~ '.~;-".:i 1901' "- " ''jl 5:JIJ;. .,' '41~ Pf'~' t ~ .--d{ ~ 2001 ..:; ~/'i" I .... t '.,.. SEE MAP 17 03 22 I 2 ',f ~' ',....-\~: I P/ .AP::.;.I'f i; .;~~t. ~-i'l ,.)IF.;. .. '''ll ." .. _',\ q.... " 4""!' '\'- !~;:,. '", ~ 'T""~" ,;' , ;';'[' ~" "I r I "'-\ ;'\'\'~.'~ ; 1918 i~ I , r' ,}f"1'. v4 '.,~ >"""'.. ~~ ':o......\~ ~ ~ ,," hI: .~, ,.. I '-, · ....1f'~ ~. '; , ,~ .Y ""'- . ....~" -0 ;t;' i I I ' ..F ....~. '''~ I 2';"'.:::,':'....... 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'~~.~-: ~~~.. .~'~t_...~ BUILQIMG SITE EVALUATION cG T / ~ ~ {) 3, 5 SUBD IVI ~,...JN: LOT: (/001) &-cvfc:J Z--"2-j AX LOT J (}-1T7) -- ( ) ~ BU I LD ING PERMIT APPLI CATION NO. BLOCK:; SiTE INSPECTION '16,-blS- APPLICANT DATE PLANNING DIVISION u. Not Applicable No Yes CK'D BY: ~'/7 ~,76, 1. Zoning Ordinance Compl iance: Zone "fl'f:)'o () ,() () 6. Setbacks from cll of road:' 2. Subdivision Ordinance Compl iance - () () ( ) Front 6U 3. Requ i red Access , () () ( ) S Ldp ~'(tPrj o~ 4. Bui1.ding Site (Area, Width, Frontag'e) () () ( t Setbacks from interior lines: 5. Other (see comments) () () '-M-- Side ,h) COMME~S: rL- IvQI ~ ~/>~ ~~A-/' /L Ri6-.t< d . ~ 1J-u,/ /1/-p(~/A-.4'..:' Q' .:J?i.r7i._}f~ !M?;~i ~~/1..t~~ ~ Ii jJ~ II . ~, A;L~ / ~(~.~ /..g, ~~,_,..,'~ ~ ,~~/-r~. " .. . PLANNING D I V I S loff'AciloN'''P'END'fNi:;-:-'YES ( 'J " NoCr'APPLltATI ()N# .: BUtLDING INSPECTION DIVISION Not A.pp 1 icab 1 e ( ) ( ) ( ) ( ) No Yes () (.) ( ) ( ) ( ) () () ( ) CK'D BY: 7~ Plans Submitted 8. Soil Stability (footings), 9. 'Flood Plain 10. Other (see comments) DATE COMMENTS: WATER POLUTION CONTROL Not, App 1 icab 1 e ( ) ( ) No Yes () J4 ( ) () CK'D By(l~i~ r DATE 11. Meets Department of Environmental Quality Standards. 12. Other (see comments) COMMENTS: TO APPLICANT: YouyBuilding I Site Inspection: , ,1 P (,If Can be app roved. ' eV'~ Ii () Cannot be approved at this time as indicated on item NO. above. , Sf- Questions and further information on items 1 through 6 contact the LANE- COUNTY PLANNING DIVISION. Questions and further information on items 7 through 12 contact the LANE COUNTY BUILDING AND SANITATION DIVISION. ( ) Will be held in this office until you can resolve the problems indicated. ( ) Is being returned. , ( ) Your building'permit aepli~,~.!j,2Q.Jee is being returned':"'..~J:)~:.r: seoarate cov.!:.!:.., DEPARTMENT OF ENVIRONMENTAL MANAGEMENT 135 Sixth Avenue East Eugene Oregon 97401 PHONE: 687-4065 LANE COUNTY PLANNING DIVISION PHONE: 687-4186 C55-28 , I ! ' i I I i I f / i I I / / / ,. ~' ,-{>.. '(:r , I I.,r... !tP ~ ( - J I I I j I (, I ' I I / ! I I I I, I ; / i . I I . If" i, r{{:~ oy. \ 1+ '1-\_ 1___------'---..1----- , I I f' r I 2. \ "2... I 1<1 , V t:. K... / / I ! , I I' I 1 , ~/Cb N " 6' .t... U:~ co! . fl I I /[ ~ / oJ, d'~"~ --:~ t: ~f.>, .. /'-')': / / I. l( t:-;..." " "",' I '0' / i~'\ . ~.s'>.-~,' '-+'-.' ; I . ~;:--- ' /;;' . - , , ,..- -~ ' - j '~; -___ ".. ,,8o't.-- 'c... - '" -. .. ~ . - "'of,. ",f-,,") .to, G" l5 \0 1"'1> 1+ / \ . I I "'; ~~~"/>, -.-...""""---...-........... ~.... "., .--h........ -... ........ ...r / I I , .' I / , ,J .c;' t... ~(' , I ! 0 "V .' I \\.- ::.., , "Yl! .... -e I .Dr:. ~/l,..- .:: ~}' Fr 1 ~. , .1 ! I ~'" . '0 0.1 "'..,. ~ "I" ". I "'J.S~.......':!<' I /1 :. ~~~ I I 1 "..... I / I .-d '.;" " '1. i ~ 11 .... J .j J , I ~"'l .........., dl" " i .. , \ \ , i . \: i'? I:. o c, , \ \ J / i \ \ -{\(I) _N I..... €' 0. \l +VI .OJ {~ 1 ' , I I f I I I I I I I y P-:?' [ Iv , {:, ~ '-( f ',.., . J H 1 I ,/ I L "..- .--.-- ~7 '--..-.~ '-, / .' { f f , q' ,/ ,,- ; pll.llZ'virll~ Surname 7 Twp. 3 Range 2~ Section Olllt of JWOO Tax Lot '16=615 ,..=04 Code Census Tract Receipt No. Date Owner Owners Consent Yes No REQUEST FOR SITE FEASIBILITY STUDY THIS IS A PRELIMINARY REPORT WHICH DOES NOT INSURE THE ISSUANCE OF A FUTURE BUILDING PERMIT. ANY PLANS OR EXPENDITURES MADE IN RELIANCE UPON THIS REPORT ARE AT YOUR OWN RISK~ Name H@,Z'K'V fA .. P~~'l.ntrm$J 1 $ 75.00 and No. Sites Address RIQlt1!1t~ 10. ,. Bo~ 261 ~ B $ No. Acres IE: ug<Zl@G! ~ OZ'~Q 97401 TOTAL $ 75.010 Telephone No. App 1 i cants Interest in Property . Proposed Use of Property Property Size 5 ~Clf~8 Existing Structures N@ne Proposed Water Supply Publ ic District Legal Access - Road Name Special Permit Area !~lclv Vi~w Lilln~ Yes No Is Property Within One Mile What City? Other Specify Urbanizing Area Yes No of a City? Yes No Sprinq Well .Property Locat i on: (D i rect ions) APPROVED J~ NOT APPROVED A~pZ'~w~d f~E ~wb~u~f~~~ sew~ge &iapo$@l for O~~ d~elli~g i~ a~GS oi ta8~ ~'MJlefJ 0 w@ ph8,1.C't: of thtB clrG.iIrllfiold j.8 ~~ btn ~lU t1h1<.e lqj,w ~K'188 ~1Ql the @~)U~r\i: &t<.'11,cl ~:Je8)'t ~ll1l@ Q{;J p&.!'t ie to be ~loe€i1:t' lch2lIT1 ont:a h.t]n.dl'~d f@Gl'IC t@ 1.'C'i\'7~:f b'€I.;'~\:. OAR Chapter 340 Divlsion 7 Section 72-020 (6). Thi s report shall remain in effect unti 1 issuance of a permit to construct, unless in the meantime conditions on this or adjacent properties have been altered in any manner which would prohibit issuance of a permit in which case this evaluation report shall be considered null and void. Technical rule changes will not invalidate any evaluation report issued pursuant to this section. BEFORE CONSTRUCTION IS STARTED bring this form to the Department of Environmental Management and make application for a building permit. If the property is a por- tion only of a tax lot, a metes and bounds description of the parcel must be fur- nished. Exact specifications for the sewage disposal system will appear on the building permit. Two sets of building plans and a plot plan will be required. LANE COUNTY DEPT. OF ENVIRONMENTAL MANAGEMENT 135 EAST SIXTH AVENUE, EUGENE, OREGON 97401 J ann CTuiL(':lX.;,~ ~El:::iJk ,~~.:. Authorized Signature ~)=c;C'>7(6 C55-32 B Date