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HomeMy WebLinkAboutPermit Building 1973-3-28 f~.. . #l~iJ;? [r( e!-;.~/W, r:.::::/1 ~ . : J "'''''. " LANE COUNty BUI~DING PERMIT OR MOBILE BUILDING D MH -D MAILING ADDRESS -', . .4. . .,\ (1 \'1 ~'~t t., ...,.' "~ " . :/_' /' ~~~ -,. Hb~E1{JSE PER~IT Y:';f''1~~01'3''1 '(; PERMIT NO, 48&c";~ -> PHONE PROPERTY OWNER "" l,~'10C. -r,.n\lC'\ ~ CO NfRACTOR f'''''Me: 1'1' : . t':n. .?c;RQ t\L ~C:;th 1?1.. ~f1}'fd.. MAILING ADDfESS " . 1l6'j",~~7~ 'P'HONE. PROPERTY LOCATION - INCLUDE POST OFFICE 2732 8urt inClton PROPERTY LEGAL DESCRIPTION - METES, BOUNDS Canterburv vnnaoe.. istAdd.. B. L L. -B-2 TWP , RANGE .11): SECTlo.N. 11 3 24 r 4, I TAX Lo.T NO.. # 610/9 CODE ., CENSUS TRACT APPL. NAME & MAILING l,~. 20.. EIiH 1;0 EXISTING STRUCTURES ON PROPERTY M~stovcr Constr~ CO. I~one LEGAL ACCESS TO PROPERTY Bu r.1 t naton PROPERTY SIZE - FT, 2589 t~. 35th PI. ADDRESS S~)f i naf ie 1 d. 0 r . FOR MOBilE HOME PERMITS ONLY No.. of Bedroo.ms STRUCTURES TO. BE BUILT THIS PERMIT WI[)TH , DEPTH AREA ,.') Co.nnect to. Existing Sewage System 0 TYPE Co.NSTRUCTlo.N SQ. FT. # BDRMS New System 0 VALUATlo.N ,l}t'Je.1l i na Hood ! s85 @) I 2 3 i c}. 020 <<DClraCll'i:i co iilU:. '" QIS !led. Cove.red porch 1)06 @ 3.'i0 72 @ 2 I . 77 U llW ~O_~~i:; SEWAGE DISPOSAL PUBLIC D SEPTIC TANK D BUILDING. '1;. WASTE DISPOSAL PLUMBING PLAN REVIEW PARK TRAILER OTHERD. 77.0n 'n.nn 1':t.t:n FEES . PLUMBING INSTALLED BY OWNER D OTHER: NAME WATER SUPPLY PUBLIC D D OTHER TOTAL t 130.50 . COUNTY BUilDING & SANITATION SPECIFICATIONS DRAIN FIELD REQUIRED L1N, FT 150 !m TRENCH. WIDTH FT, ..3 OR SQ, FT, 450 MIN, SEPTIC TANK CAPACITY WITH DIST, BOX: GAL. goo Roof and footinadrains to str12et. TYPE OF STRUCTURE OCCUPANCY ZONE PUBLIC UTll. EASEMENT i;M t 8- .J BLDG. SETBACKS _ FT. FROM CTR. OF ROAD RIGHT.OF WAY USE CLASSIFICATION FRONT 45 REAR 7 SIDE INT, 5 SIDE EXT, AUTHORIZED SIGNATURE - DATE ./sl' 005S bv Harbt'!lRloh DATE John t~ulckshan~~ n.s. ~",2a..1~ BLDG, PERMIT - WH ITE OFFICE COpy - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOlDENROD Constructio.n to.. co.mply with uniform building co.de and co.unty regulatio.ns co.vering plumbing and sewage disposal. . All buildings require a certificate , of occupancy b~fore being o.ccupied, (See Statement. on Reverse Side) (POST THIS PERMIT ON MAIN, BLDG. AT. SITE) LANE COUNTY, BLDG, & SAN, DIV., COURT HOUSE, EUGENE, OREGON 97401 FORM # C55 .13 . ,:~\ - ~ No. I/J:L~ T / 7 R 03s:; L/ TAX LOT e~'~US T~ACT ~o :'-~/5c- 'WdJ/ A'~fu;t ~~;~/~. NAM~~.~B~/ ADDRESS BUILDING SITE EVALUATION .. ~ Building Permit Appl ication 1(; Site Inspection LANE COUNTY PLANNING DEPARTMENT NO PHONE DATE _ r.;>~ ::2s~ 7.,3. NAME DATE () Pre-Permit Investigation I. Zoning Ordinance Compliance (Zone t.C: \ ) Subdivision Ordinance Compl' ance NOT app I icab I e () () ( ) ( ) ( ) ( ) YES 3. 4. Required Access ( ) ( ) ( ) ( ) (~~~ (~ ~ u.----- ( ) =' -2..~-7L 2. Building Site (Area, Width, Frontage, Setback) Other (see comments) 5. COMM ENTS : BU I LD I'NG INSPECTION SECTION NOT NO YES NAME DATE app I icab I e ( ))1 6. P 1 ansSubm i tted ( ) 7. Soi I Stabil ity (footings) t><{ ( ) ( ) 11 " 8. Flood Plain 2): ( ) ( ) >/~ ~ '1 .,.51 ~#/.3 9. Ot he r (see Comments) ( k ( ) ( ) , <- ,.(1 ~ / COMMENTS: SANITATION SECTION NOT NO YES NAME DATE app 1 icab I e yf 10. Sewage Disposal ( ) () 11. Usable Area ( ) ( ) (4 Q(VhU~ .~bf) ~ pi .. t.. , - N- 12. Water Supply ( ) ( ) 13. o t he r (see Comments) ( , ( ) ( ) COMMENTS: TO APPLICANT: Your B~ilding Permit / Sb~ ~n~e:t~ (y,..-fan be approved. f;2~. 7~ () Cannot be approved at t 'is time as indicated on item NO. above. . Quest ions and further informat ion on items] through 5 contact the Lane- COUNTY PLANNING DEPARTMENT. Questions and further information on items 6 through 13 contact the Lane County Buildinq and Sanitation Division; () Will be held in this office until you can resolve the problems Jndicated. () Is being returned. . () Your building permit appl ication fee is being returned under separate cover. U\NE COUNTY PLANN I NG DEPARTMENT ITe; Sixth !\venue East. Ell~lelle. Oreqon 97401 l'llONl' \1".'-1 \ II I XI. n I LANE COUNTY BUILDING & SANITATION DIVISION 135 Sixth Avenue East, Eugene,Oregon 97401 PHONE: 342-1311 . EXl. 411 p ~llari..un J.'J.cl(;;,dJL1 / -/ _ -=: -.:J </ Jlrl-?3 _ .~HA FbRM NO, 2573. At'. /o-#G~PARTMENT OF HOUSING'ANLJ U'R'SAN DEVELOPMENT. Form AP'pr;~~d .- , eY, 10/70 "'1J... NO. ~ FEDERAL HOUSING ADMINISTRATION Budget Bureou No. 63-R0296 Of";\;: ..r,.-/~::.J.:::t- ~,:?.. ___ .L_ HEALTH AUTHORITY APPROVAL 'D\I..\.E~ No. ~ WATER SUPPL Y AND SEWAGE DISPOSAL SYSTEM O~'\: I _____ PART I -TO BE COMPLETED BY FHA InsurlniP&tj.j~ Portland, Oregon ,F>< ~ .' FHA 43i NiZ1203' 2[; ff.~ r;~ '/ \:P ~ -. ". . II t:::J i , I WESTOVER CONSTRUCTION COo J,q "V !"!.l \ ! ,-. 1:173 /.:: Mortgagee - Name, Address and Zip Code I 40035~735 FIRST NATIONAL BANK OF OREGON Real Estate Loan Division P. O. Box 1786 Eugene, Oregon Mortgagor or Sponsor: 97401 Property Address: 278: Bu::1ington Street .': .'-: ;",:~,:,I'\1 'l!:,r, -L ........ Sprmgheld, Oregon 97477 -~~," I r,_,..LI,1 Or.? I Subdivision: L .J FIRST ADDITION TO CANTERBURY VILLAGE Block 1 Lot No. 12 TpTA~ t1V.~BER .L'V'Nr. TTIDIS.. RFOR('I.oMS R....:r.HS BASEMENT Qg. New Installation Can Attic or other Area be made into additional bedrooms? (If yes. how many?) DYes [FJ No SYSTEM DESIGNED FOR 1 3 2 DYes QNo WATER SUPPLY BY: [Jg Pu blic Sy stem SEWAGE DISPOSAL BY: o Public System o Community System o Individual No. of Bedrooms Garbage Disposal o Community System Qgqndividual 3 DYes D No. PART II. - TO BE COMPLETED BY HEALTH DEPARTMENT HEALTH DE PARTMENT INS PECTOR'S SKETCH B.P. 484-73 I I I , I I I I I \ I I I I I I ~ ~ , I I I' I I I ~--'- - - -- _.~ .+__J I 1_- I .. ~ = ::C: =:: ~ =:::::::: =:: :1::::::: _ _ =:::: =::::::: _ _ _ _ _ _ _ _ __11 I-I I I ! I I -----------------------------------------~- I i ___________=============================================--. =F i !: ::::: - ---- --f:: ::::: ::::: :::::::::: ::::: ::::: ::::: ::::: =::::===~ ii_Ii I I ::::~~~~~~~~:~~~~~:~::~~:~~~::=~~=;=~~~;:~=~:::~~=~:~~~~:~::==~~~~~==r~ . - - - - - = = - - - - -I I I ______ ________. L_ ' __ qJ -- _ r: __1-___ _____ ____====== =_~_ ___~_ _____ _____ _____ ---1_- ----t ---r--------r---t------------Ii-J-----r---------------------- , _~ - __ __ I It i~r;n;""~ Q St.a.tp n C0unty LoC~l Deoartment of Hf'Alth th.ai.ib.i" in~11f11 ;1'f1tpr-sl~prly sv~tem ----------------------------------------------- -------------------------------------------------- -------------------------------------------------~-----. ------------------------------------------------..- Gl-;" D:~ ~c\ci~f(:tL;luL) ;.:S cJ t,~~~.__~~:_..... 'w'.'~L..: ~~rr~.i ~"o't-tL.::. J.;:.:.~~....-~1 ;::Eperty. It is the opinion of the D State ~ County D Local Department of Health that this individual sewage-disposal system with proper maintenance: [XX Can be expected to function satisfactorily, and 0 Cannot be expected to function satisfactorily is not likely to creat n ins nitary condition~ DA TE Slct-:- URE R TITLE 5-10-73 , Rt HARO, K_ Y:I. '_ .RVIS ING SAN ITARIAN NOTE: The health authority should complete the appropriate opnion statement above and affix date, signature and title in the spaces provided. Use of the above grid for Health o.tment Inspector's sketch as well as use of th.k of this form is at the opinion of the hea Ith a uthori ty. PART III. FOR USE OF FHA OFFICE TO THE CHIEF UNDERWRITER: I have reviewed the foregoing and the pertinent Fl-IA Compliance Inspection Report, and recommend that the Individual water-supply system be considered 0 Acceptable D Not Acceptable Sewage disposal be considered 0 Acceptable. D Not Acceptable. DATE SIGNA TUR E o CflIEF ARCHITECT o DEPUTY FOR Ciil EF ARCflITECT j HEAL ~'ji AU".:-'iORITY AP PROV AL INDIVIDUAl. WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM FHA FORM NO. 2573 Re\'. 10/70 , b~ .r> ~~ REPORT.Of INSPIECTlON-INDIV8DUALSEWAGEmD!SPOSAL ~YSTEM PRIMARY TREATMENT wnsists of ~ Septic tank, 0 Cesspool. 50ptk Tank: Distance from well, Total liquid capaciry Inside length, ? C; CC!IIIlIpool: Distance from: Well, feel. Material, 1000 CQncrete ,Io:allons, Capacity i~let compartment 4. C; leel. Liquid depth, 4 C; Number of compartments ft:el. Inside width gallons. feet, feet; foundation, - feet; nearest lot line at 0 front, 0 side, 0 rear, fc'et. Liquid capacity, gallons, Linin,lo: material o Seepage pits, Other feet, Inside diameter, feet. Dcpth SECONDARY TREATMENT consists of !?;l Tile disposal field. TlkI.DI.po.al flold: Distance from: Wdl. NO Total length of tile lines, Trench width 36 Length of each line, 75 -' 75 Type of tilter material: tJ Gravel. 0 Broken stone. Depth of filter material beneath tile h IJ-ElL feet; foundation, to feet; nearest lot line at 0 frone, ~ side, f9 rear,~ 0 1 50 feet. Number of lines, 2 Distance between lines, 7.5 inches. Total effenive absorption area in bonom of trenches 450 ~ . 4 . feet. Depth, top of tile to finish gradf' Other feet, feet, ~quare feet, inches. inches, Depth of filter material over til.. 2 inches. SeGpage Pit.: Number of pits__, . Outside diameter feet. Depth, feel. Lining material Distance from: Well, feet; building foundation feet; nearest lot line at 0 front, 0 side, 0 rear In.pectlon made by: 0 State. l&J County, 0 Local Health Authoriry. feet. Inspected b} .John Cru i ckshank. &....s.. Sanitarian (TITLE) Date of inspenion _.5~1d1. ,19_ REPORT OF INSPECTION-INDIVIDUAL WATER-SUPPLY SYSTEM Distance to nearest public water main, _, feet, Size of main inches. Individual wells 0 at(: 0 are not customary in neighh9rhood. Give most recent ((:cord of failure of wells in immediate vicinity to furnish adequate supply of water Properties in nei,lo:hborhood 0 are 0 are not being developed with both individual water. supply and sewa,lo:e.disposal. systems, Lot size: feet wide, feet deep. Dwelling set back from front property line, feet, InJividual water supply from: 0 DrilleJ well. 0 Driven well. 0 Dug well, 0 Bored well, DI.tance of wall from: Bu ildinJo: foundation, cast iron sewcr foet; nearest lot line at 0 front, 0 side, 0 rear, feet; septic tank, feet; disposal feet; other sources or possible pollution field, feet, feer, feet; seepage pi' Well con.tructlon: feet; tile sewer, feet; cess pool Diameter inches. Total depth, feet, Type of casing Deprh of casing, feet. Approximate depth (0 pumping level of water in well, feet, Approximate yield, gallons per minute. Sealed watertight to depth of feet, Exterior spac.e around casing sealed with: 0 Cement groul. 0 Puddled clay. 0 Ordinary backfill, Well cover: 0 Conlfete. 0 Wood, 0 Metal. Openings in well cover watertight: 0 Yes, 0 No, Pump: 0 Shallow well. 0 Deep well. Length of drop pipe, feet, Pump capacity, gallons per minut~, L.ocated in: 0 Basement, 0 Pumproom off basement. 0 Pumphouse above ground, 0 Pump pit, Pumproom properly drained: 0 Yes, 0 No, Pump mO\,lnti!lg watertight: 0 Yes. 0 No. Type of storage: 0 Pressure, 0 Graviry, Capacity, gallons.. Has bacterioloJ.(ical examination of water been made? 0 Yes, 0 No. If answer "is "yes," give dare 19_ Qualiry of water 0 is 0 is not satisfactory for human consumption. Installation 0 does 0 does not comply with approved exhibits, if any. Inspection mAde by: 0 State, 0 County, 0 uKal Health Authority, Inspected by Date of inspection 19_ (TITlE) - e GPO 900.682 . . .{ " ....:... "I ~ (/,- ? 3 c .: I . .. ",' "'.. Date No. .~$!t..?$ ;'y:L., ~ PERMIT IN THE BOARD OF COUNTY COMMISSIONERS OF LANE COUNTY WHEREAS, the attached application has been fully considered by the Board of County Commissioners of Lane County, and it is the opinion and judgment of the Board that the said application should be granted, and that a permit should be issued, now, therefore, it is hereby ORDERED, that a permit be and is hereby issued to for the placing, building and constructing of the following facility: ! :: -;, ,,~ ' i i 1--:' '"i upon the right-of-way of County Road No. , in strict conformity to the exhibits attached thereto, and subject to all terms, conditions, agreements, stipulations and pro- visions contained in the application and permit, the Rules and Regulations Governing Facilities to be Permitted upon County Road Rights-of-Way, dated March 31, 1960 and any amendments thereto, and any other applicable regulation, law or ordinance. Special Provisions: ;~' Ul . -n .. -~.~ t',. i ~ ~ '!~-" (: t ~. ,; ~ ". .~. ~; ; This permit is revocable at any time, and will be strictly adhered to and no work other than that specifically mentioned above is hereby authorized. This permit shall be void unless the work herein contemplated shall have been completed before , 19 Expires , 19 Inspected and Approved Approved by Board of Commissioners By Date By Director of Public Works WHITE - OFFICE FILE PINK ~"RMITTEE ORANGE - BUILDING & SANITATION DEPT. GREEN - RESIDENT ENGINEER BLUE 6.D SUPERVISOR YELLOW - SURVEYOR 08-52 "\..' . L /Date :, ... ,..~ , i . _ ',~ ,., . .4 ... " rfl APPLICATIDN FOR 'FACILI. ~ PERMIT IN THE BOA,RDOF COUNTY COMMISSIONERS OF LANE COUNTY " ~,: . . j "..; ." . . Your applicant, hereby makes application under Rules and Regulations Governing Facilities to be Per- mitted Upon County Road Rights-of-Way, to construct the following facility: Upon the right-of-way of County Road No. "J ; , at the following location: I~I: ! - . ~'. . as shown on the exhibits which are attached hereto, in strict 'c.onformity to the. state- ments of the exact nature and amount of work to be done, and to the description of the facilities contained in said exhibits. Your applicant will be the beneficial owner of the facility as constructed, or otherwise primarily liable and responsible to members of the public for its proper maintenance, repair, operation and use. Your applicant accepts all terms, conditions, agreements, stipulations and provisions, in Rules and Regulations Governing Facilities to be Permitted Upon County Road Rights-of-Way, dated March 31, 1960, and any amendments thereto, and any other applicable regulation, law or ord'inance. . j , ' ,,:. 't -,', :.f ..: -{'- Signature Address WHITE. OFFICE FILE GREEN. RESIDENT ENGINEER PINK. PERMITTEE BLUE. ROAD SUPERVISOR ORANGE. BUILDING AND SANITATION DEPT. YELLOW. SURVEYOR Phone No. .'" /) .' .( . "J ..,'.\ -. .- PROPERTY OWNER LANE COUNTY BUILDING PERMIT OR MOBILE BUILDING 0 MH 0 MAILING ADDRESS HOME USE PERMIT PERMIT NO, PHONE CONTRACTOR MAILING ADDRESS PHONE PROPERTY LOCATION - INCLUDE POST OFFICE PROPERTY LEGAL DESCRIPTION - METES, BOUNDS TWP RANGE SECTION TAX LOT NO. CODE CENSUS TRACT APPL NAME & MAILING ADDRESS FOR MOBILE HOME PERMITS ONLY No, of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT EXISTING STRUCTURES ON PROPERTY LEGAL ACCESS TO PROPERTY PROPERTY SIZE - FT, WIDTH DEPTH AREA Connect to Existing Sewage System 0 TYPE CONSTRUCTION SQ. FT. # BDRMS New System 0 VALUATION 'i: FEES PLUMBING INSTAllED BY OWNER D OTHER: NAME WATER SUPPLY SEWAGE DISPOSAL PUBLIC D BUILDING WASTE DISPOSAL PLUMBING PLAN REVIEW PARK TRAILER SEPTIC TANK D OTHERD PUBLIC D D OTHER TOTAL ~. MIN, SEPTIC TANK CAPACITY WITH DIST, BOX: GAL COUNTY BUILDING & SANITATION SPECIFICATIONS DRAIN FiElD REQUIRED lIN, FT '; l' t~ i TRENCH WIDTH FT, OR SQ, FT, TYPE OF STRUCTURE OCCUPANCY ZONE PUBLIC UTlL EASEMENT BLDG, SETBACKS _ FT. FROM CTR. OF ROAD RIGHT OF WAY USE CLASSIFICATION FRONT SIDE INT, SIDE EXT, AUTHORIZED SIGNATURE - DATE REAR DATE d, '. . , BLDG. PERMIT - WHITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOlDENROD Construction to comply with uniform building code and county regulations covering plumbing and sewage disposal. All buildings require a certificate of occupancy before being occupied, (See Statement on Reverse Side) (POST THIS PERMIT ON MAIN BLDG. AT SITE) LANE COU~!Y, BLDG, & SAN. DIV" COURT HOUSE, EUGENE, ORES;ON 97401 FORM=C55-13 ~. . ~ lit! ~~l ;i,' l\ . .. '. SLAB FLOOR PLUMBING GROUNDWORK ApPROVED / / DISAPPROVED / REMARKS / DATE -'L.A.../ U1M,' ,F:; 6 b l- dJ)/) GAS PIPING GROUNDWORK .. S'/ll/c ~ ('.1.16-"'7 ApPROVED / / DISAPPROVED / REMARKS ROUGH PLUMBING ApPROVED /-,1... / DISAPPROVED I " REMARKS ROUGH GAS PIPING ApPROVED / I DISAPPROVED / CI REMARKS FINAL PLUMBING ApPROVED 1)(' / 01 SAPPROVED / REMARKS FINAL GAS PIPING ApPROVED I / DISAPPROVED / REMARKS CERTIFICATE OF OCCUPANCY READY TO JSSUE I / DATE (:> /c.. / DATE1j~ /1-.V / DATE / DATE/-/-;?5 / DATE / NOT READY TO ISSUE / REMARKS / DA TE INSPECTOR /I'lI,?.J ~{j~ INSPECTOR' INSPECTOR, ..... 4./ f./ INSPECTOR INSPECTOR ..-4'l.-./ 1- . rl INSPECTOR INSPECTOR . .. t.\~. ,") 4,... ....' . ,~ ,!', ..' .. . ~. 7~ PROPERTY OWNER LANE COUNTY BUILDING BUILDING 0 MH 0 MAILING ADDRESS PERMIT OR MOBILE' HOME USE PERMIT PERMIT NO, . ~.gLi'_] 3 -I' ,;', CONTRACTOR '~\;lr..~t. ; '. "..~ l _ ...,~\q .~:. ;':.th )>>1.. Sohh MAILING ADDRESS 'II PHONE 741-9" 1 ! PHONE PROPERTY LOCATION - INCLUDE POST OFFICE i: ) PlI.-1 j nnlon PROPERTY LEGAL DESCRIPTION - METES, BOUNDS ., ,;t.d.\i"V V!1141(,e. 1st rl\:H t.. i. L. 12 TWP RANGE SECTION '\ \", .i l TAX LOT .NO. CODE CENSUS TRACT J ZL, - \, C" 01\ \> :Iv-LOiSe EXISTING STRUCTURES ON PROPERTY If, I Ill. LEGAL ACCESS TO PROPERTY Bu r j i n y t un PROPERTY SIZE - FT, APPl. NAME & MAILING ADDRESS \;~5tov'~r L,)t1St,. ).~\ ;\:}<':;I :,. J}t h P j . r \." ,j. ~~H i r:H~ jc- 1 d . ": .. WIDTH DEPTH AREA FOR MOBILE HOME PERMITS ONLY No. of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT Connect to Existing Sewage System 0 TYPE CONSTRUCTION SQ. FT. # BDRMS New System 0 VALUATION \ ..' 1 i ; n,' ~;U()t I ~~;.: 12 1). !11(: ~~'t ". I' '901' - ".t t. - at~.)!id \ :i'.' .'..r,'".: DI_.rc.~ ~. \.\ :..-". .. \ \... " .... ~ ;;06 ~" 3.';0 12 (. ') j .t/l litl, 20.'));) t OTHERD j / . liO ;:~ C:. Of; FEES PLUMBING INSTALLED BY OWNER D OTHER: NAME WATER SUPPLY SEWAGE DISPOSAL PUBLIC D BUILDING WASTE DISPOSAL PLUMBING PLAN REVIEW PARK TRAILER SEPTIC TANK D PUBLIC D D OTHER ';; ~< . ;;u . TOTAL t I>J.'IU MIN, SEPTIC TANK CAPACITY WITH DIST, BOX: GAL '00 COUNTY BUILDING & SANITATION SPECIFICATIONS DRAIN FIELD REQUIRED 15(\ 'I UN, FT \J TRENCH WIDTH FT, J OR SQ, FT, !,50 ",y:.,; ;I'{;~ foot fng dr~fM to street. , \'. \ .'\ .... ,:' ';- -\. , ,,\~.~ '\. . ' ~\ 'I -. \ \\ ~. ~~':;" " " 'J \..1, ''"''. TYPE OF STRUCTURE OCCUPANCY J So J \' ZONE PUBLIC UTIL. EASEMEJH BLDG. SETBACKS __ FT, FROM CTR. OF ROAD RIGHT OF WAY USE CLASSIFICATION I. ..J REAR ., I FRONT " SIDE INT, ;. SIDE EXT, AUTHORIZED SIGNATURE - DATE j\)~~\ b\' l10rbaugn John CnJid~!>h';tHk. "',.S. DATE }..'/.&.1'3 /<;.i BLDG, PERMIT - WHITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUMBING -CANARY BUILDING - GREEN SANITATION - 90LDENROD Construction to comply with uniform building code and county regulations covering plumbing and sewage disposal. All buildings require a certificate of occupancy before being occupied, (See Statement on Reverse Side) (POST THIS PERMIT ON MAIN BLDG. AT SITE) FORM:!:i:C55-13 LANE COUNTY, BLDG, & SAN, DIV" COURT HOUSE, EUGENE, OREGON 97401 ,~ r~ / ~___~...' . r. .~.;::;... .0; I I 'Co' SITE INSPECTION ApPROVED / / DISAPPROVED / / DATE ~ r~i"/-If'.7' INSPECTOR REMARKS FOUNDATION INSPECTION I NSPECTOR a ...--- ApPROVED / ~/ DISAPPROVED / I DATE t/_I f1".~7 J REMARKS FRAMING INSPECTION ApPROVED / 1/1 01 SAPPROVED / I DATE i/ ~/~.... 7.] INSPECTOR REMARKS LATH OR SHEETROCK INSPECTION ApPROVED / I DISAPPROVED / I DATE INSPECTOR REMARKS FINAL INSPECTION ApPROHO /; 7D" ,"PROV(O / / /1''' ( G -,;l 6'-73. I NJ,'" nOR REMARKS~~~~f"'J U..- ~12.r"2f-'l) lW- #' /l. 11 A IJ /) /J /) ~~"JL . c;!f~.P;1 ~ -' 1.7" ?;-J hf&. CERTIFICATE OF OCCUPANCY READY TO ISSUE / I NOT READY TO ISSUE / I DATE -/l r{ /1/J ~* .~4~ ~ ///A ~,{ V (...../ I l/ ..... Ij 8'11...93 1/J~273'2 g~~.iiJd: -.-' '7 /1'- , Wlp~ ~"A. REMARKS vi ~ INSPECTOR ~, . ~ t4I --.. ..'~ ~ . . . . ~INDIVIDUAL SEWAGE DISPOSAL SYSTEM RECORD Installer: Complete top part of'form to signature and return both copies to Lane County Building Sanitation Department. '1. ) tP . , ... :? :'" m L I~erls Name~ . PF'RMIT No. 484-73 JC No.Livingupits Bedrooms Baths I ."J / Septic Tank: Ft. from well Steel 0 Ins~C1e D.unens~ons: .t't. Length 'J,S- Width ~,J- !\pplicant Name Property Address 2782 Burl inqton Basement Water Sypply Yes 0 No ~ Public ~ Other-List Concrete M No. Compartments / I I I I i ",....-- ~- Gal. Capaci tYl d" (!J Tile Disposal Field: -~ Distribution Box:Yes ~ No 0 Other Distribution- Type (7 Feet trjom /J f wellNO IA.f~I"-1Foundation I () Lot Line Front Side i () Rear I d Total sq,Ft.between Fil~r~~ F~ller deDth'F~ller~d eptfi L1"" , 7 (- above below it V~ () hnes /Iv Typ A-d,...~ tile "Z-- in. tile il'4 " . '~\ ~~,~,j I ~ . l ~ ~<r - ~~ I.~ <~ ~. ~,. ~t;) J~~ ,"~ ~ ~I /~ ~~ ~~ \' "Z~. ~~~ \ .ni~ ,~. I ~zr' I . . . Q 't/ji- it . w ,\ \ vV)'! i J ~,j \6-11~ V 1 Depth .,1. J- Diameter Westover Constr. Co. Mailing 2589 N. 35th PI. Address Springfield, Or. Length of Lines - Ft. Trench l7'J"2y1J3. 4. 5. 6. Width 0' Ske~h (See in~truction~): i J \ I t- I _.J AI I i j~ -, :1(/ 7f' I I I I I I 1___., Signature {J }l /1/1l ~J" Conforms to Current st~dards Date, ~Jf7jLr~ to Current Standards~ /: (J1JI, ~f/) - Date 1.-- 27-- It! 1 i - - For sanitarian ule'only: ~APproved: System Installation o Disapproved: Does Not Conform Remarks: " ~)&ft)7-1~ ) t/ Sanitar~an's~ignature Lan?unty Building & Sanitation De ('~~ -11 , LANE COUNTY BUILDING PERMIT ,0 R MOBILE HOME USE APPLICATION i' (tpERMIT TYPE '- BUiLDING ~ MOBILE HOME Dose REG. # PERMIT # <<F~ - 7...:::1 PR~~~~/7~-_ ::..~ ":AI~::DDRE.Ss,,:~.'._a,~: . . ~ .. j:l"ONE ~/A L~ (V__ -L;J-t2, I /1" 3.~ ~~ ) , A7~/ ~ CONTRACTOR . ,. . MAILING ADDRESS .. './. . /P~NE '7~'7-997/ n PROPERTY LOCATION -INCLUDE POST OFFICE . 2fJ/:? ~~v/~/:~ 'I. ." ~. 'PROPERTY LEGAL DESCRIP.TION n~c:T.. , / {/< ~/1.. L '/:' 1 / ./2'/ -/ /.' ., . METES & BOUNDS. 0 YES LOT -BLOCK - SUBDIV. (~. - /..d4" ~ 0 -:- ~ - <><--- ATTACHED JZfNO TWP RANGE . . .. SEc./. // 1 TAX LOT #. CODE: .: CENSUS TRACT ,/ ./7 03 . '".(?L-.. ..,. , ~o .-ed /:50 ( DESCRIBE EXISTING STRUCTURES ON PROPERTY IF ANY, . ~.. LEG:bACCESS.;;.p ~ROPERTY -", ROAD~AME OR #, ~0g../'P-La~ . PROPERTY ~IZE-WIDTp.. DEPTH APPLICANT NAME ' AND, ~~~ MAILING . . , AREA ADDRESS - - FOR MOBILE HOME ,PERMIT, ONLY Number, of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT ~~ ~/44A r??, ~ -ad -tUIY LPf . &~~hJ C?L,X/'!) (k~~ ~/tk:/ '- SEWAGE DISPOSAL PUBLIC 0 SEPT.!.S...TANK ,kf BLDG. ~. I'Z rl" FEES WASTE DIS. ...2...P. P-i:> ,f3;6d Connect to Existing. .~L/. Sewage System D or New System Req. D '. .SQ, FT, # BEDROOM}--- VALUf'TION /5J?.5 (B /d/ (J )/'~O~I!) , . - ./ ~'h 413. ~ ) '11/ '.:.7~e.-<. ___/,4~ , '..<.#Y'3S TOTAL /3tJ..$o PUBLIC WATER CONNECTION FEE eX: .~ ).50 PLUMBING INSTALLED BY OWNER 0 ' OTHER 0 NAME / PLANS FURNISHED .. / ... FACILITY PERMIT YES V NO 0 A YES.M" NO 0 StCH-ATUR:-8f APi' ICANT ' ~~ .. ~CEIVED BY I tLIdA / ~IT#,/ .. 4P.L/-A3 DATE PLUMBING OTHER 0 WATER SUPPLY PUBLIC )( OTHE~ PLUMBIMG ~EES e!..,3 tJ-(J ,/0 FIXTURES J-o ..~ ~. CASH 0 S ' CHECK ONNECTION FEE PLAN REVIEW PARK TRLR. f2eC)T ~cl. CJeo -rn"t~ COUNTY BUILDING & SANITATION SPECIFIC,~TIONS DRAIN FIELD REQUIRED . I L1N. FT. IS'O TRENCH WIDTH FT, ./..5' OR SQUARE FEET. 6160 - - MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GAL. cJYlLi'h~ 'in .r;:ty~-t, ./ -; UN' REAR .Y ARD PUBLIC UTIL. EASEMENT .~ . OCCUPANCY , ~ IV . 1-rT-;r" BLDG, SETBACKS - FT, FRO~CTR, of! ROAD RIGHT OF WAY USE CLASSIFICATION FRONT .4-e:s . SIDE INT, . S SlL>t tA:, REAR 1 . _. ^- tteARIAiIA ~ .. . D... PLANNING D... BLD't. l~sP.a5 If r/Jt)., F .... r;(~MkJ!.l::{#Y /14."3> 3-2~1~ 'JMD>1I'rbI ,..,f.l-(;g)t:..,J ,,:{~:'9:J ~;'e't;on' '0 F;nd .,ope,'( .... . . .... . (/ "( \ !>Y 1 - OFFICE 'If 2 - JOURNAL \~ - AUDIT .---,c' C55 - 12 ~ ~ TYPE OF STRUCTURE .- I I f \' ,-V i r X / < I \7 1 -~1L_, / ).. 7 ., ~ -.--. - .... ' '1 _ "7<' · ~ 7,,4 .----,-- ~?l{s1- - 13~~~ \'''' .... -- - " ..... <"- . . .