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';"'.:::,':'....... ''HItII'i:.''':::...,!! ..-'<J"".....___, 004-62
..,,:~; ", 'I~! ,~. ;.1 ~..-J....<';'A.CSt.vens ~;2!i.O_ t_: 2102 II' V''\.,
., .~-.",.,.~,/'-<- ! IT ,1< OLC_45 ~.~~~' :) "-, ~ CARDINAL 'II;;'''
i .." 1'"~' '" .,', ~ '~'\.', \,
p_'..n"~ ,:l It,' 12100' ".~,~.. n... -".' i 2111'~ :n. 11, : _ r"~ '
I f" I' .......1 ~~'
__,-,,:,-.1 ;,; .~__. i ":.. ~ "" "p,,;-~ - ~ :\1 ~
-." LOT 1~.88 I; ,:' ~l. ._w _ ~ ~
: ~ :lil!,i~;::'I,l.~1051~::2~t:- ~ ~ SEE MA~~' 3 221 ~c I
t: i 'i 1)1 :)ii ';I;'~ i', TlMA""" 4.~ ~I.
" I " , ..\ ~'\I400
I : I.,., M:-:..'~ ,"<:''-_ ~__' i ,'''Oll< \:~.
J >- Ilii 2101 "I 4.',r,l ~- MALL..A_D ~'I '"
~~ ~4 eo. '1 i " Ii ~I' ~-.
~...z:.il' ~ _-------J~ :,/< !,Ii I "00
JI..':~ " ~,r..,-",s_-.. _ .....~ .... . " --1 \
... , 1"-~~:"'::"-1t: i ''''~,;,.,u .*:!.sI... /\."""IHr.n t.vfNUf ... .l~ .~\\
g .~ 2' 09 . I < --- . '"
Z214 ~,l~::: [',,;,;~~: .:,- ~ Ii ..,. ;,,, :f' r;;;;-' ",,:. I';::;. !'.~- \
; ~ : : lit,' 19-0C \' ,',._,., -....,,;;; ~ \~ q
'" · ,,~: ~" ~~ : II " " "::;~~ \ \~ ~
:__.~"i~_~l-u~"~:m_j ~::'~:,..\\~Q~i~'\~~(\ .---
=. ,2300 II 10, , ) \. ~
\ I · ' I ;'-f
. ,,;' cO 1 ~ I l\1!l" . -l,\
. . : , 2700 n <
~ ; . ! ~,.~ \' i -f.." - ~~;::. I': i I,' ~ ;.' " '''17: ~
i~ 1 .r;~':r;'~W~: ~ .~' I ~:(~ ~~ 22~ J: ;~,~:~;:}~~,']", ,J~ u 'l'll&r~-r
I ,'r ..' ,~. . ,.." , _,v~.... . l'/ ,\\ l
t"" .. ~I"..." '" I'" _' - --- ---.... - L,""",..L:h---:i-4-".f-"'..t_ I
.. I ,.' \..:"i:'=i'~" :..?,-~~-.:~~.__cou..ty~"'..n. '<I.-S~. .. 11IO 4:1." .
i I 23;5~"~.:"m--4 ",.;~;~::,:~,.:<~t' ",: 2'&X,;!;"!-~3000"'W f.:J 22I,~'l#.St:-_:'-' ~~I' OI9-0('~ ~(--~
t \ I ..~;~ ..~;:; .;r..,., -" ;'.'O'"~' '.-;"~4. J'" l.Dt" ~~ Hs I'" Cor .~ - , ~ 23
121 I 22 'X ..;-,;:. "!/!~"'''.I.""~,l~~,,, 124, " +/ .,.. ", \'" -l 1- 215
Jln.r....,n~,\'~":ti::...;... "...~,.~"'-". .;;'" ,.2;.,'\. "I, "ood ~
.:! -r-....J..-.,- u~....~-.~ _ -._ ,iii'''' . ;t. l ....~ _:..;;V t" r---~
28 27 'if \\~~~I ,. - I Nf COQ
- ...,:-...... ;: I r. nAY
'-.4001
-'-
Seo Mop ,7 03 15
019-00
1/4 Cor-
-V
!V6".'" ...
(t'G>;r,4""J
'..II'lllt..
00'" - 2 3
I
1
,
I
I
,J,
,
,
..
004-0~. ~~ .'
.,/ ""
\ '
IL ~-
,~.
\
....
,.,
<II
\
~
~
Q. ; ;:;:~~;... y
~ ~ ::~a. :;.::
. 'M'._IIIT ...,.
!: '" /......JW _.
US : ~-ffi !!
.. ~-..--~. ...".
~ tr=~~ :Z~.
; :f.~:~~.:'~. .~f'
........ ~ . ., H
,. ..-..-___ ..... ..-41 ,......
;: ;'-::.~.:.'~ :~. I.'.. :::.
.. ~."'r''''',,,,, ,,,,_..
of....' 'H'"
" ..,.,. ~ ~ .~_..r .... ""
... ............ .....
= .....;~...~;":. :;~
,. "'''''-....0".. .....
~ f.-;:;: ~:' .;~:
.... Lo'. ........~ ".
.-...... . ....
r .."_ .,... ....... ','"
A..;'" u., "
,. ~.,,",.. ~ ,,-
. .. ......... .~
: :I~:...1:-i:.:.".
~ ;::: ::-:.
.. .......- ~
. ... -,,,." ...
..:;'."'-:':"'.
.. ,. ..... ,
.. .......".
....,....,..... ...
...."..It,IlI.. ..'
~ :::~~.,t7:'
., .. ....... 1">-
..:,. '~~.~-: ~~~.. .~'~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