HomeMy WebLinkAboutPermit Miscellaneous 1975-8-5 (2)
31.74
REQUEST FOR SITE FEASIBILITY STUDY
c33S-S-
S.I.# /5-730
..
For Off i ce
Use Only
{6~
Received by
l/-o/
Code
;2/jo-fo
C.T. Number
ve3>
Specia1 Permit Area
Yes No ----
Urbanizinq Area
/7 3
Township Range
i/(tU/5 RIJNlJA-LL [?RA/JT No. of Sites
Name
(?r 10 Rox ?S 1
Mail ing Address
C:-U(~PIJr= ()1r.E;:'/~olv 97401 Total
74h(4q4~ xfJ (JLM~lLlJ J<"J ~ ~~::k
Telephone # s-fgnature of Applicant D~j:el-
t'/SI 7.>
Appl icant's Interest Buyer
in Property: Other (Specify):
THIS IS A PRELIMINARY REPORT WHICH DOES NOT INSURE THE ISSUANCE OF A FUTURE BUILDING PERMIT.
PLANS OR EXPENDfTURES MADE IN RELIANCE UPON THIS REPORT ARE AT YOUR OWN RISK.
PLEASE PRINT ......
If Subdivision - Name: l.ois .1;'3 o.j.\ Ptlrhf.oll 1?1 JlJ-7.5 Lot #
2- 3> (,Oo g/p,4jJ T
Section Tax Lot No.
-i
Block #
Owner of Property
Yes
Owner's
No
Consent
;0
L.,
$
c.n
No. of Acres
$
$
-i
r
~
Owner rx
Sel I er
Proposed ~se, f)
of Property:tut=LL IlJb
1,t.Q D .
() o/J.Lb~)' J./JJ.JE
Prope~ty',Size Legal Access - Rq~d Name
Rea I tor
NO
Existing Structures on Property
lis Property Within One Mile of City?
Yes !X'" What City? 5PRILJ(~F:{{tl,j)
No
Proposed Water Supply
Publ ic X District:
"'" Sp ring We 11
Property Location (Directions):
Other (Specify):
/'
f7ls I EJl [) IS EtT LIIV IE - i-EFI AJ9."" t= Ff:J.t<.".,
F~v R~,-Rl&Hr BAn\( VIG::U..J.LAAJ6'_
I /
~ ~.~) ~lle.
- /J~ ?~~ If/~
and relationship of test ho! s to
R>I b- i-+ 'I j) f2AIj M..o J..j O>s
LEFT .150}<' Z.G"7
When Will Test Holes Be Ready? alS/7S-
MARK TEST HOLES WITH OUR FLAGS ' (Date)
Location of Test Holes on Property: ~~
......
Draw diagram of property showing location of any
the,e I an, ma'j , f.
~- ---b
I~ ~ '!~, I Lon ~fi
~. ../-
, . I~
M~I(EN z,
~
--
f' i/If(
~TH-
------
~
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
r "
I
/
APPROVED
/"
('
NOT APPROVED
.~
()q ;J~:;g~"uce
Date
<;
'~'. '
" 'Si^te' Inspection # '
"
. t: '~.. .
'r' .
. ,-;
EVALUATION'
"
,FOR" ~ETERMIN:r~,G ~I~~ :9UI~I~ITY
FOR DEV~~OPMENt UTILIZING
"SUBS.u:RFAqE SEWAGE,: PISPOSAL METHODS
LOCATION:
.SEC.
TAX LOT;'f
TWP.
RANGE.
Are p\jblic s~wers available,or nearby? (Distance)
Are there zoning or environmental considerations?
Size of property:
Amount useable areq
Are other systems in area known ;to be,malfunct'{oning?
Is there room for future expansion?
SURFACE FEATURE CONSIDERATIONS: (Explain)
Slope: (1', /1'00 r) , r'> .(%) ·
p
Flood plain: ,
PJants: ,
Ro~ks :
Low Cirea:
Drainageway:
Streams :
Cut ,bank or slope:
WATER,..SUPPL~~u.nLlnE. oS:
~ity ~ No, ",' 0' Proposed ~
Individual Water: Existing ~
75'- 730
~
(SKETCH IN PLOT PLAN)
Water lines:
Exisqng U
Pr~p~sed U
Gas lines:
Exi sting' L.J
Pr~p6sed LJ
Wells on adjacent "ExistingU )?roposedU'
properties:
! I'
,~
#1 T E S T H 0 L E #2 T E S T H 0 L E I-
Perched Water PROFILE Perched Water PROFILE
Predicted in. Inch Pr,edicted Inch
in.
Observed in. Observed in.
Date Date
12 -, 12 -
Saturated Zone 24- S: L Saturated Zone
24 ~
Predicted Predicted
Observed Observed S:lL
Date Date
36 - 36 -
,
Res,tric.tive Layer ( in. L.[6 .
I Restrictive Layer in
I
Impervious Layer ,. in. 48. Impervious Layer , in 48 -
i (OlA.i"s-"" I
Mottling / in. 5...,...d Mottling / in
{v b ~ fe.r /
60. 60 -
.' "-'"
Sit~ Does..{C Site Does Not Meet miniIIn.1m standards for individual
waste disposal.
IF SITE DOES NOT MEET STANDARDS SPECIFY BASIS OF DENIAL:
- Administrative Rules Require -
- Your property found to be Deficient -
--
IF SITE MEETS STANDARDS FILL OUT:
Type of structure and approximate sewage flow: Single Family,
GPD
Industrial
Institutional
GPD
GPD
Multi-family
Commercial
GPD
,
r,PD
NOTE: Soil absorbtion area in square feet
Area necessary for sewage disposal systems
ARE ALTERNATIVE SITE LOCATION, DESIGN OR MODIFICATION AVAILABLE, DESCRIBE:
~~
. DATE OF FIELD EVALUATION"
'?s/;~I ? If
\
:sS>;t1f-
() BUILDING PERMIT APPLICATlq~ NO.
(~TE INSPECTION 7.j--73 0
.
BUILD,ING SITE EVALUATION
.
PLANNING DIVISION
1.
2.
3.
4.
5.
Zon i ng 0 rd i nance Comp 1 i ance: " Zone
Subdivision Ordinance Compliance
Required Access
Building Site (Area, Width, Frontage)
Other (see comments)
COMMENTS:
f4/
T ! 7 R 03 S .:23 TAX lOT (; (!) 0
SUBDIVISION:
LOT: BLOCK:)
APPL I CANT
DATE
PLANNING DIVISION ACTION PENDING: YESt ) NOt ) APPlICATION#
Not
Applicable No Yes
J!(;--r () () () 6.
() (J.-'()
() () ( )
() () ( )
() () ( )
;f~M fl~
J' " IJ 1/
BUilDING INSPECTION DIVISION
Not
APD 1 icab 1 e
( )
( )
( )
( )
7. Plans Submitted
8. Soil Stability (footings)
9. Flood Plain
10. Other (see comments)
COMMENTS:
WATER POlUTION CONTROL
Not
App 1 icab 1 e
( )
( )
11. Meets Department of Environmental
Quality Standards.
12. Other (see comments)
COMMENTS:
No Yes
T') ( )
( ) ( )
( ) ( )
( ) ( )
No ~e
T') ,
( ) ( )
8m4i\
~. S-~-7S-
of road:
CK'D BY:
Setbacks from ell
Front
Side Exterior
Setbacks from interior lines:
Side
Rear
CK'D BY:
DATE
A::'By~;~h>
a... I DATE
TO APPLICANT:
mYour Building I Site Inspection:
2 Can be approved. ,~
/1 ~ ~annot be approved at this time as indicated on item NO.. ~ above.
, \0/ \ 7' Ci,uestions and further information on items 1 through 6 contact the lANE-
, '\" ~ COUNTY PLANNING DIVISION. Questions and further information on items 7
"Atl through 12 contact the LANE COUNTY BUilDING AND SANITATION DIVISION.
~ ( ) Will be held in this office until you can resolve ~he problems indicated.
( ) Is being returned.
( ) Your building permit appli..s!'.!~L9!'_.~~,~...Ls_!?einq returned un~~separ~te cover.
DEPARTMENT OF ENV I RONMENTAL MANAGEMENT-
135 Sixth Avenue East Eugene Oreg0n 97401
PHONE: 687-4065
lANE COUNTY PLANNING DIVISION PHONE: 687-4186
~'\ ',; C55-28