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10512765
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Last modified
6/29/2021 9:39:24 AM
Creation date
6/25/2021 2:20:28 PM
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Permits
Permit Address
10025 NORTH FORK LN SE
Permit City
LYONS
Permit Number
555-20-009346-PRMT-01
Parcel Number
093E02DC01100
Permit Type
Septic
Permit Doc Type
Permit Document
Status
Ready to Film
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Septic Permit 555-20-009346-PRMT-01 Page 2 of 2 <br /> .+QY O f� 19Y 'y��`�- 'r r-T .-r-na � f�'s <br /> 14 .. •I .wa,�,.* ' " •.fit.-,�M b' fit. t �k ° g" <br /> ry t5 t d o�° m c.°art X'y 'S:tit _ oa•or'`i. :3 i,.45 <br /> MI/W. fl l� X {�f�r'6'.'.";' °} °. o f a�w .oh, °°:;gyp 86 <br /> a u51d <br /> ., . h.a�.���.,... " ""° R `,t"' ' •�x�Sai..��..;.�:.1t�u°±...r.a t2 ,._+.n•• - <br /> 1 •' dr t ',` 8+i 4 y L ° +' "� wr-z 6.T..- ,i� Y 4 ,� _.. a P <br /> € s <br /> Installation of this onsite wastewater treatment system has been determined to comply with the applicable requirements in <br /> Oregon Administrative Rules Chapter 340,Divisions 071 and 073 and the Conditions of Approval above. <br /> 1. In accordance with Oregon Revised Statute 454,665,this Certificate of Satisfactory Completion is issued as evidence of <br /> satisfactory completion of an onsite wastewater treatment system at the location identified above. <br /> 2.Issuance of this Certificate does not constitute a warranty or guarantee that this onsite wastewater treatment system will • <br /> function indefinitely without failure.Conditions imposed as permit requirements continue for the life of the system. <br /> 3.The area of the initial and the identified replacement area must not be subjected to activity that is likely to adversely <br /> affect the soil or the functioning of the system.Such activities may include,but are not limited to,vehicular traffic, livestock, <br /> covering the area with asphalt or concrete,filling,cutting,or other soil modification activities. <br /> 4.This onsite wastewater treatment system that be connected to the facility referenced herein within 5 years of the <br /> issuance of this Certificate of Satisfactory Completion(CSC)or rules for authorization notices,alteration permits,or <br /> construction-installation-permits as outlined in OAR 340-071-0160,340-071-0205,or 340-071-0210 apply,including <br /> payment of an additional fee. <br /> 5.This system must operate in compliance with OAR Chapter 340,Division 071 and must not create a public health hazard <br /> or pollute public waters. <br /> 6.Unless otherwise required by the agent,the system installer must backfill(cover)this system within 10 days after the <br /> issuance of this Certificate of Satisfactory Completion. <br /> +•, x `..+ c^A+'1 cn°b" Qn� t <br /> Sr *Aga"; ! 7r- i►ia{�� l� ,30Fy�.t, s i " ' fit •}u.� , <br /> d <br /> .,. d " <br /> ' 2:',r v. :s 4° t <br /> System Inspection: Yes Operation of Law-7 Days Notice: No Pre-Cover Inspection Waived Per 340-071: No <br /> Comments: N/A <br /> 5� '+�%,s s „+.'�' i. x 3a '.�^..' <� -.��u,,..a. ..,,, .v AA 'a•"J!'i .. ..'4`?�` °` ?'" `7;tr R ;,. 1 <br /> Inspector Inspection Inspection Date Inspection Result <br /> Robert Goodwin 7999 Final Septic 06/14/2021 Approved <br /> Robert Goodwin 7270 Tank Water Tightness 06/14/2021 Approved <br /> Robert Goodwin 7450 Drainfield 06/14/2021 Approved <br /> Robert Goodwin 7350 Pressure or Effluent Line 06/14/2021 Approved <br /> • <br /> Rob;- oodwin Onsite Wastewater Specialist 2 <br /> •i <br /> / / CALL BEFORE YOU DIG...ITS THE LAW <br /> ATTENTION:Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center.Those rules are set forth by Oregon Administration Rules.You may obtain copies <br /> of the rules by calling the center.(Note:The telephone number for the Oregon Utility Notification Center is 1-800-332-2344.) <br /> 6/15/21:3:52:12PM Page 2 of 2 ONS_OnsiteCSCj r <br />
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