HomeMy WebLinkAboutPermit Building 1979-12-10
..':':
POST THIS PERMIT ON MAIN BUILDING AT SITE
. ,~,
.~,OB-<-ADDRESS: 2764. Burlington Spfd
.CONSTRUCTION PERMIT #
LC-1912-79
TRS, TL:
17-03-24.4.1 II. 3020
Subdivision: Cantebury Village Lot 11,. Block 1
. . .
This permit for the referenced property is hereby CANCELLED. . Setbacks and other conditions of approval must be strictly observed. Violation can
result in revocation of this permit, citation under provisions of Lane County's Infraction Ordinance, and/or other remedies allowed bylaw.
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Applicant/Address:PBDl V. Crouse, 2764 J,lru1inton Ave, Spfd, Oregon
Owner/Address: J same
Contractor/Address: same
Contractor's OS # /
. /
- 'nstruction' apprcoved by this permit:
Water Supply:
Total.Construction Value:
Teleph~ne: 747-8710/747-4501
Telephone:
T.eJephone:
building for storage@ 16 x 16 Greenhouse (plants and garden tools)
# Bedrooms: 3
# Plumbing Fixtur.es: na
# Employees:
PLANNING DIVISION
Rainbow Water
WATER POLLUTION
CONTROL DIVISION
Setbacks
- erior property.lines
...dge of rQ~d right-of-way. ,_
Building foundation"., .'
Wells, other water sources'
CONSTRUCTION
PERMITS/INSPECTION
DIVISION
Directions to Site:
NA
12-10-79
Date Issued:
C55-13
Zoning: R":'l 'Partitioning # na . Parcel # na
Minimum required structural setbacks, from: centerline of road; front: 45'
side exterior: na ; interior propertY lines: 5 ';rear property line: 5 '
Special Instructions: na
Parcel Size:
; centerline of road,
89' x 115'
For information call 687-4394,
Roger Hollis
Site Inspection # . na . Installation specificationsna gal. min. .septic tank capacity;
na lineal feet of dra-infield required; max. depth of trenches: na
Special I nstructionsPERMIT CANCELLED PER BUILDING DEPARTMENT
Septic Tank
10'
10'
5'
50'
~
..
Drainfield
10'
.~' 10"
. 10~
100'
.-.
For information call NA
Type of Construction: 5-N j:Jr:.oJ!P:
I . / )
nstructlons: PERMIT. CANCELLED.-.-.-;~~
Fire Zone:
Use Classification:
Greenhouse
3
11
For plans information call NA between 8:00 a.m. and 9:00 a.m.,
For inspections (see back of this permit) call 687-4065 between 8:00 a.m. and 5:00 p,m.
bne county
~
DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
COURTHOUSE I PUBLIC SERVICE BUILDING
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
By:
Kara Adams/lky
-,~
~~,,>:., L- c;.
~ CANCELLATION/RE~D AUTHORIZATION Pennit # /7/'..:<'-/7'
Name (please print) /' ~~ z;( /%~._ /7 .-.
Address ~ 764. - ~/~2!!f:;/, ~/~__~~ /~~~
APPlicant(t(l /owner,()-'- COl'lt~to:()/~/--&_ " (....-"' 7'77Y77
Re~Qn7f~~.elliW~~~(~~ ~/~
/~,/~~ ~~~~~~ .
P' - -. r;;L c--- l/ r
SignaturV Date ~-~-79
Fees paid for waste disposal systems (site inspections and/or applications to install the
septic tank and drainfield) are ordinarily nonrefundable. Some refund may be made on the
building and plumbing portions according to the amount of the permit processed.
CONSTRUCTION PERMITS & INSPECTIONS
Authorization for possible refund:
(OFFICE USE ONLY)
qa % Building permit fee $
% Mobile home fee $
% Plumbing permit fee $
,
-0 -- % Pl an check fee . $
IbO~"'% State surcharge fee $ .Cay
TOTAL AMOUNT $ , IS'. 0 if
Date / ~-/7-7 9'
/4.'10
Signature
Q/LJ c,cO, ~
/1
f./
v
Pll.u1 V n Crouse
2764 Bu~l1ngton~ Springfield~ O~sgon 97477
~~~~~~ Date /2_/?-::19
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DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
COURTHOUSE/PUBLIC SERVICE BUILDING
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
WATER POLLUTION CONTROL
Authorization for possible refund:
Signature
TO: DEPARTMENT OF FINANCE
Building permit refund $
State surcharge refund $
Septic disp. syst. refund $
Site inspection refund $
TOTAL TO BE REFUNDED $
14.40
I> 1ifJ;\
15004
PLEASE MAKE CHECK PAYABLE TO:
Name
- ,
Address
S'; gnature
.--'~
";;-'
.....
, ito
l(';';~'
--J.' .
'~' \
_' _, ",pl
... _ f.i'l
, -'.\' ~~1
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,~~\ 'ii,€ 74.::::.Jj:7 9
,
% Septic disposal system $
% Site i nspecti on fee $ ..
TOTAL AMOUNT $
Date
. ::;:'.: ,.:\.~ ~~'. ..',
24-08-24/Acct 46960/Prog 021
24-08-24/Acct 46960/Prog 021
24-08-25/Acct 42133/Prog 011
24-08-25/Acct 42134/Prog 012
Receipt #
Receipt #
Receipt #
Receipt #
68142
68142
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,
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CANCELLATION/REF~ AUTHORIZATION Permit #.~~~~--~~
Name (please print) .&~ ~ ,~
Address /2 7~ L'L /.- _/.?~ _ / _ /. .,~ ~2~/
Appl ieant VJ ~ner () ~-->< eto: ( ). .r:: %.,,:1',",,,, ,." / tZ--y '77Y77
. Re~s ~oI:C.a a el~ing . It j1l~:'Y('~ ~ /~ .
/'::?&:.4 . /~ /~47-6--~';?'>'~""A'~
r:gnatu~(7- ~ /' . - ' , Date/~~ -79
Fees paid for waste disposal systems (site inspections and/or applications to install the
septic tank and drainfield) are ordinarily nonrefundable. Some refund may be made on the
building and plumbing portions according to the amount of the permit processed.
(OFFICE USE ONLY)
CONSTRUCTION PERMITS & INSPECTIONS
Authorization for possible refund:
~ %
%
%
-0- %
/00--%
Signature
.~~.~
/7"
(/
v
WATER POLLUTION CONTROL
Authorization for possible refund:
Signature
Building permit fee $
Mobile home fee $
Plumbing permit fee $
Plan check fe~ $
State surcharge fee $
TOTAL AMOUNT $
Date I ~-t""'-7?
/ 4. vO
.~'-I
IS'. 0 'f
% Septic disposal sys tern $
OL Site inspection fee $
,0
TOT AL Af-10UNT $
Date
TO: DEPARTMENT OF FINANCE
Building permit refu~d $ 14~{Ul 24-08-24/Acct 46960/Prog 021 Receipt # 68142
State surcharge refund $ .6~ 24-08-24/Acct 46960/Prog 021 Receipt # 68142
Septic disp. syst. refund $ 24-08-25/Acct 42133/Prog 011 Receipt #
Site inspection refund $ 24-08-25/Acct 42134/Prog 012 Receipt #
TOTAL TO BE REFUNDED $ 15.04
PLEASE MAKE CHECK PAYABLE TO:
Name
Address
Signature
Paul V. Crouse
2764 Burlington. Springfield, Oregon 97477
~,<<~d~--/ Date ,//._/,9---/'9
,. 'c::/ - ;EPAR~MENT OF ENVIRONMENTAL MANAGEMENT
COURTHOUSE/PUBLIC SERVICE BUILDING
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
C74-}~79
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If this application is for an agricultural building it will be used for purposes allowed by the State Building Code and
Lane County Code Chapter 10 (zonjAg) and for no other purpose. I have the following legal interest in the property:
owner of record; ~ contract purchaser; lessee; holder of an exclusive option to purchase;
duly authoriz~act/jo)'the~wner, who is knowledgeable of thi~ application.
Signature/Address _ /'~--L/t~ -'~ ___. :2. 71 r {ftLV'-l, JIlc; /'oJ? flu.e S/,d)a! Of'f' (zip) 7'7177
Telephone 7t/7-P7/0 or 7V7-'-/Jb/.e)(fJ...Ct>7'.Dat; ;;. -2.~....", 79" ' ..
When permit is ready notify: XI App1 icant () Owner CI Contractor ~: i;{ mail'> CI phone
Owner Pf1111. c..r()'t~.}. ~<nLE. (zip) Phone
Contractor l~f'::~:l~) (zip) Phone
Contractor's OSR# Plumbing by
DEPARH1ENT OF ENVIRONr~ENTAL t1ANAGEr~ENT
PSB, 125 EAST 8TH AVENUE
EUGENE, OREGON 97401
LCm
If Commerc i a 1 :j~fj~l;t~il'
Residential :~&fI4~.r~
SI test holes ready
DO NOT WRITE BELOW THIS LINE
# of emp 1 oyees:':@t':4n~;,J / "L 4'/1_.- ? ;?
iij$.l CI Existing, BP # T /V ,?-7
I~I Proposed, SI #
'6'
l~~"~~~~~~ il:l'l Valuation
.. d /? $
_'~'UJ\LLlJ-IOHO~) I:5ttttrhnt>< ~/ ~/ $~\
,~x IG, fr.oOF(,hnusR. (~i1i'-P~dO/y) "1r-d2V}
"' ~~~~.? ~ ,~J:z~ $
. ~ .
L dl!t
~~~~~..... ~ J / / t7J~~;U
I-~'~F.K~~ ~ /' :/VV'
eceived by;l~~
~ 4% State surcharge
Plans check fee
Water supp;: . ~~~~
Proposed Existing )<' Change of Occupancy
,
Year Installed
OOt~;{~UtiM
Fee
Total Valuation: $
i'~~I~~~~i~l~ :: :
each
$
$
$
$
$
$
$
$ ;(1, 1:,4:
each
Subtota 1
TOTAL
. .
Zone R - / Part. # . /1/ /,.,? ?rce1 #.ff //;'
1., front ' 7t~~ I ; 1., rlde /; into
i .
~~.-LLJ~~_ ~.QA4~ ~~- ~ ~ - .
~"~W --- ~. - /
r v . By /7~) fL Date ~ -/f-?~
Group fY\.. Fire Zone ~ VUse r~ificat1on QQ.~ l-\oU~
~.r\" C~-o "
Parcel Size ~ )( //S-/
S/ ;~ rear SI'
PERMIT PROCESSING
Minimum setbacks:
Comment
CP&I Type ~ --'N
To be typed on permit
I
.L ~
By y- 0JlQ \.
Da te l1.,. -- ~ .....1.9--
Phone -B ') (p ,~
,~ tJJ in?! VYl ~o "'
CJ1 ~~ ~~ (r() rYJ9
Date Date to
Comp 1 eted PCC
For.plans information call (area inspector) .
~ctions to site 0J\~ \..;\~~. l ~"~ ~ ~7ffi r
'OJ..riln~t9"NJ U ~-t-, " l~~~ ~
I-I -;IFO . ~~ns to: CP&I set(~)- - . Date Hold S
- WPC set (s ) Requ i red to pce
~CP&I
;g, WPC
'LI.P1anning
CI Public Works
. "I.!. Elevation CI n/a
ICi Address
CI Facil ity Permit
I~I Environmental Health
17/~
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7/_3
.
FOR INFOR~~TION about progress of your application call:
C74-171
Permit Control Center
687-HELP (687-4357)
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DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
PSG, 125 EAST-8TH AVENUE
EUGENE, 5~t~bN 97401
Application # ~
LC-,I~~~-?7
Assigned Numbers
Job Address ~ I" (;, d (~I ! It-~' I J".....'~:/A-l""'rV"\ City ~::;),O,>rri.
Township, Range, Section, Tax LoP ii7~~~;:::)d, A t .:i:S=. ~{-{'1r'l
SubdiViSiOn(/>>''''''':''.>~~:;>'''''J'''' /'/J/~~.<I"'-:- -. i ~,LO\ // -Glo~nk~~' I
APPli~ationlf6'rv.'~\." ~;;'~~<;"'rC~ '~'AV ."'", je> I V'li+ II t R <;.p
Structures now ontthe-p~p'e;ty '1-;:';-:;'~ 't-1';,..:""", Vil7::;"~~' In .,-
_ --- ....,...--......- n _f ) r ~..__w_
Proposed use of property: LI,Residential LI"'Commercial CI Industrial LI Publ ic
Affidavit: I, a.. I {(br-"..,.. ,&7 ' , hereby certify that this information is true and accurate.
v "'......'".~. -. "([il"ease print)
If this application i.s for an agricultural building it vlill be used for purposes allowed by the State Building Code and
Lane County Code Chapter 10 (zoning) and for no other purpose. I have the following legal interest in the property:
owner of record; . ~contract purchaser; lessee; holder of an exclusive option to purchase;
duly authorized tOj'ac'f.for the. owner, who is knowledgeable of this application.
. .... /' ~ 7 , ~J J
Signature/Address ,A{::"", , '/~7.{.....7/1 1'/1'(/ 1(', .., I.t.r 7,." /],;" ~." /".1 ()n.
" r ~.....-.... ..-... ... ,--;..r,.-y~~ . ~..., ....'--' I' < /--." """-.. r'"' --.
Telephone '1f/7,07/f! or 7U'..,.(,Jrr..,/...al.1.)r"pate /.?C<7t7'
_ ' r' \I t f ~p _, .# _ \y
When permit is ready notify: "/1// Appl icant L/ Owner L/ Contractor Qt.: /~Vmai1 /~ phone
/' 1\
Owner O.-n. . 0 n"...--. ;~D ^u-.:L~ r:;; (zip) Phone
I ~4-~.., -" r ""....... -"-" J ,- "0......
Contractor . '^ I,') _./"" r"? } (zip)
Contractor's OSR# \..' . ' )\,,/ '" -/ Plumbing by'
(zi p)
~:' :;;";1 ') 7
Phone
If Commercial: # of stories
Residential: # of bedrooms ~
SI test holes ready
DO NOT WRITE BELOW THIS LINE
# of employees # of
SDS:
un its
LI Existing, BP #
/~/ Proposed, SI #
.I'1.7?J-Z7
Fee
Code
Description
Sq, Ft. or
# of Sites
Unit
Cost
Valuation
Fee
----....
...,C"~J..r.,,;~,4J=d.,.j...~ ~ '\." n ~ .,
......,...~."......~:). --, \._l'-"----...~,.. ~Kn~v
/'
""
,4
(~, . : J An;"..".... t:::.A J ~/~AZL7....
irl'"\......... .t'i\;';;:;:)~ ',Q c..':":;4~~.r;-~k , ~1 ~l'"l.AJ(lA"\
. "" I.........,..~ ~Ja..oo'f" ..,,-,,:, J 'v '~c,J"'-:lJ \).',." -~ · ~"'-'i~~y"
.. "" ~ r.;I /1":7/ / ~p? .
<:P'I "-" __. L...--'" """ I r-
Total Valuation: $
Plumbing fixtures at $
Sewer/water conn. at $
NI)/
, v/;1-
j"
$
$ "
-b~:,y'\"{) )
.'. ',,,,, ''$''''
$
each $
each $
"(::-i: ~:~".,
;][~;!~t!:
sf
1-/ Cash
-=- \!r
Lf\~heck #
Received by ~
.. .o/' // "
Y /..v) .?' 4) 1"
Water Supply ;{--:!::-~,;';f!~,;::.} /a~
Proposed Existing V
Year Installed /'''
Subtotal
$
$
$
$
$ ;')tJ 1,,4-
(. ~ ,
4% State surcharge
Plans check fee
Change of Occupancy
'---
TOTAL
PERMIT PROCESSING
Zone
p--/
Pa rt. #
/1///7
.
. /
)("Q V //~
V '~/I
; rea r _ <r I
Parcel # uJ h Parcel Size
r ".. / r . - r ., j . '" /' ,
Minimum setbacks: 1., front L,{ tf"'", 1., s)'oe J4J /..4. /; into . <:"'" /
~ - I 1"'1"
comment~ro~- /' J. _,R...:/) .~ .~ '" _. , ~ -?:: ~ A... . /.
To be tyiftjl'pe~'~.v;:;:;f..~Yv-",-,-, :;r'V64/'4//(/ '/V" <Y : ~~)- ./,//
, By // ..,.......;,.-., _ _ oU Date
,t/f~/l/'
WATER POLLUTION CONTROL tI." _ , / y
Installation specifications: 1<' -':.\ c?.M: gal, ta~~;':' , '1..'- I , !S'.Iof drainfield; max, depth of trenches:
. To be-2p~d on permit \lb /1)0/ dL~ tM.J.f.t.. ~ ~tJ .~ ~ .
a/tM rvL tP?u1~, Y~a.-/J'~d.o aI~pT /",O'P p~ 6t/nI/!/Y~47&.
:O/J~ .;a%d,(/I' ~40R',#~O//JcI/ ~~J-M /Y-a/;1f',(}-#Jn-:P~ aU~~~~' I ~
~ -,:-, :-~>//
~J / /. I' ' .o~""''''',(,/~
BY~/. Cllr"d~~ "'-uatt!' .~.~./9'IJ~
! i"I \'1- A-l.... :::r7+f:.. G n ",t", I t"'\ 6~ ~-,' t -.1 .......:,,<::,./ r '\.'{. ~
) _ "-,___."",, ..-- v ~ - ~ - -.....,..)"...~.-11 "" ~.~ ",....,U I J ...... ~--1'
IA I"'l11 ~ CR f 0 '\':f ~ fA ~; ~:~ i1'l ~ ..:-_~ ,'* J-~ t'\1r\, 1/'"1'1 i I:,,;
j u "'-"'~ v......., ''', ,,_'{j[$':"'-~-' f II 0' ~.. II __ . ~ ...." .........o' II II ,.)t.)'e.~
Date Hold Sl:i~'i. Date Date to
Requ i red to PCC-'-' Comp 1 eted pec
~ __'7/,,: #"??
DirS'ctions to site f""'\{/ ('"
!.:l.~ I rr-t I,^<",Y",;:;:():')
" 1'Itr"_....... ,-." t .. ,." .\."-' Ii ~ 0)
l~f~siFO (~Plans to:
Telephone
\.. \ ,....1 rr"'......A rl
.~j'-'Ii7'.\};+:--
CP&I \."",et('si'
WPC set(s)
I'/.' CP&I
'. ,"\
!\I" WPC
L\
LI Pl.anning
() Publ ic Works
'~P/ Elevation I~/ n/a
J~
F'/ Address
rei Fac i 1 i ty Permi t
L/ Environmental Health
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FOR INFORr'IATION about progress of your appl ication call:
Permit Control Center
687-HELP
(687 -435 7)
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FLOOD PLAIN MANAGEMENT
Department of Public Works
125 East 8th Avenue
Eugene, Oregon
687-4195
TO:
PERMIT PROCESSING
PERt~IT NUMBER
PLArmING
PARTITION NUMBER
PUBLIC WORKS
SUBDIVISION
OTHER
SITE ADDRESS
PERMIT VALUE IS A SUBSTANTIAL IMPROVEMENT.
YES
NO
SITE IN FLOOD HAZARD AREA
YES
NO
SITE LOCATION IS WITHIN A FLOOD HAZARD APPROXIMATE STUDY AREA, EXTRA
PRECAUTIONS MAY BE APPROPRIATE TO ASSURE THAT THE BUILDING SITE WILL
BE REASONABLY SAFE FROM FLOODING. MOBILE HOME TIE DOWNS REQUIRED.
SITE LOCATION IS WITHIN A FLOOD HAZARD DETAIL STUDY AREA.
1. MINIMUM FIRST FLOOR ELEVATION OF (M.S.L.) REQUIRED.
2. MINIMUM FOUNDATION ELEVATION OF (M.S.L.) REQUIRED.
3. MOBILE HOME TIE DOWNS REQUIRED IF GROUND ELEVATION THAT MOBILE HOME
WILL BE PLACED ON IS BELOW THE REQUIRED MINIMUM FIRST FLOOR ELEVATION.
4. SITE LOCATED WITHIN A DESIGNATED FLOODWAY CHANNEL, BUILDING PROHIBITED.
RECOMMENDATIONS:
-".
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DATE
BY
C99-21
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.
BOLD
SLIP
lane county
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APPLICATION # L(- \C\ \'~1-1~
V ~lilL u' C \2..0 I ) L,;E..
L 1 (0 4 v~ ,),\2.L \ ~c '\ [) "-\
'j?Q.\~C F\~LD rJQE.
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-:(1411
Zi P Code
Name
Address
The above application is being held by the Permit Processing Section for the following
reasons: n \tlE. Pi~"(2.... I:JU~1)O\)\- /.:::;'f'j,Et'-\ '\2.EQ.I,) 1\-\(.. 1~"0"-\:?O\Jr\L- A,N."P
Ij\i\t"'.? or- Ai'\. f.:NC,It-.\\SER ULI;: \\.\ jS1::> \ t--\ "'\\\C ..~\ i\\'E- o~ O\2'S<: 01-..\
'C..)R '\ \-\ \ ") <DE..- S l t, N, .
C1 t\~ AUE\2.Nf\T\t,j(:;. 'SOLu'rIO,,\ It;) !\V\;::S?...\ ~\t=='D::K f~()UI\..\\Y\\\()N.
'PLG I-V)S cLJ.\-i2JF.>...(.
-;-;; ~ ~
Division: h\ hL\)\"\C 1~ \'\.\,:;\?ECf\(l~ \)€~-\.
. ,
Signature: JI. ("t I\n. (lflCL'\{\\~ Date ~-:l(1.19
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A*~
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II 1 ,. ....., ~
...~. C-)
Di vi s ion : ~~,QJ"'\ \'\" ~i~o( ii::.",")';) \ \'..\C
c: I I
Si gnature: -H=:<'"R(,,\ \\ uN.WcL CL.lf.QC Date (..,_. '](1-1(1
This application will be held until 9 -'J-.q-lq . If the information
required above has not been furnished by that date your application will be cancelled.
Fees paid for waste disposal systems (site inspections and/or applications to install
the septic tank and drainfield) are nonrefundable. Some refund may be made on the
building and plumbing portion of your application if cancellation is necessary.
In the event a Planning or some other long-term problem exists over which you have
no control we will hold the permit until the problem is resolved and we receive word
from you as to whether to proceed with permit issuance or process a cancellation.
PERMIT PROCESSING SECTION - 687-4394
C74-139
q
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lane county
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APPLI CATION # u:. -\di l '1.-1 '(
~
~~L.- G~Of ~ Name
::Ll~ ~~~ Address
~lN4 Fua..:D~Z"" c d'~
.' P 0 e
The above app 1; ea ti on is r; n9 held for the fa 11 owi ng reasons:
'\~\c:.) ~':> '\"() N.D\\;~ '"tOu ~ "\?C>\JE \"E.~\'\
~\W ~~ GP\~C~€.-"9 l~ m"E.. 12.~Q.JJ'6-':>\ 't::-~
\~~Pt(\b~ '\0 ~?ue~ '~~ CJe\~~ l~
~'\ ~"Bt'\\\\'E.1? "Vb~ V'l__ to.. -1" .
1 ?Q.c\j~'O~ "f\e.1Z- ~0~~ . ~'1~\G~ ~~
~~~~u,,>e..t "-'I ~~J\L..... 13'"( ~e.,~~\~
~c.,U~ ^~~L....-'i ~\.~.
o
This application will be held until
or a response, has not been received
Con SFtr et i on Permits & I nspeet; on 0 i v; s; on
. ~ Date \\-(5-71
.If the above information,
by that date your application will be cancelled.
The CP & I Division has not received approval to issue your permit from the divisions
indicated below:'
( ) Water Pollution Control ( ) Elevation ( ) Address ( ) Env. Health ( )
RETURN THIS HOLD SLIP WITH THE REQUIRED INFORMATION
For the status of your Qermit,. contact
~..~~
687-4394.
~
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,
LANE COUNTY DEPT ENV MGT RECEIPT . 191279
, ~PPLICANT CROUSE PAUL AD DR 2764 BURLINGTON,
Tll 1703244103020 SUBDIV CANTEBERRY VILLAGE
," NEW BLDG TYPE ACC USE R NO BDRMS 00 NO UNITS 001
U],tt CODE APPL NO ACTION DESCRIPTION SQ FT UNIT
,BP STORAGE BUILDING 256
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APPLICATION II _L~j~lLk~77 ~ 4"Il!lJ1'
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f2u.<1 CICt1J. tS0. Name - *~te,. -2-2 ::.,
--!~~~.~ ''^ittJ.'~:W~Q;:l.' 2Address :l.~ i::::o;:;""::l~;!!:9 A"&.( ,
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.The Lane County Water Pollution Control Division cannot proceed
VJith pr~ing your application because:
~ Incomplete application (items deficient).
Address and/or directions to application site.
Proposed Number of bedrooms in dwelling.
2.
erification of existing system required (memorandum
explaining this procedure attached).
3. Two test holes (2'X4'X5'deep) required for expansion
or repair of existing sewage disposal system in the
area of the proposed drainfie1ds.
provable plot plan ~::.~~-,-:.",,~
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Notification of date test holes will be ready.
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l~ATEH POLLUTION CONTROl DIVIS ION . ~' [N'vll~ON ".'TAL i~MIAGn1HIT DEPARH1f-NT
1.25 EAST 8th AVDIUE / Pi C SEr\VICE BUILDING--.---;....-/tu, .::, OREGON 97401 687-~061
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APPLICATION #
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Name
Address
Zip Code
The Lane County Water Pollution Control Division cannot proceed
with processing your application because:
1. Incomplete application (items deficient).
2.
3.
4.
M74-181
WATER POLLUTION C
125"EAST 8th AVENUE /
Address and/or directions to application site.
Proposed Number of bedrooms in dwelling.
/\ oLU>>eJ 7~2 ilh/ / 71
Approva6Te plot pfan ts"Elattachment).
Notification of date test holes will be ready.
Verification of existing system required (memorandum
explaining this procedure attached).
Two test holes (2'X4'X5'deep) required for expansion
or repair of existing sewage disposal system in the
area of the proposed drainfields.
Othe r:
, I
~OL DIVISION /
pUBLIC SERVICE BUILDING
ENV
/
iMENTAL MANAGEMENT DEPARTMENT
_JGENE, OREGOM 97401 687-4061
6ne county
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JOB ADDRESS:
TRS, TL:
POST THIS PERMIT ON MAIN BUILDING AT SITE
CONSTRUCTION PERMIT #
Subdivision:
This permit for the referenced property is hereby Setbacks and other conditions of approval must be strictly observed, Violation can
result in revocation of this permit, citation under provisions of Lane County's I nfraction Ordinance, and/or other remedies allowed by law.
Applicant/Address:
Owner/ Address:
Contractor/ Address:
Contractor's OS #
Total Construction Value:
Telephone:
Telephone:
Telephone:
I"'')nstruction approved by this permit:
Water Supply:
PLANNING DIVISION
WATER POLLUTION
CONTROL DIVISION
Setbacks
- 'rior property lines
, .de of road right-of-way
Building foundation
Wells, other water sources
......
CONSTRUCTION
PE RM ITS/I NSPECTION
DIVISION
Directions to Site:
Date Issued:
C55-13
# Bedrooms:
# Plumbing Fixtures:
# Employees:
Zoning: Partitioning # Parcel #
Minimum required structural setbacks, from: centerline of road, front:
side exterior: ; interior property lines: ;rear property line:
Special Instructions:
Parcel Size:
; centerline of road,
For information call 687-4394,
Site Inspection # I nstallation specifications:
lineal feet of drainfieid required; max, depth of trenches:
Special Instructions:
gal. min. septic tank capacity;
Septic Tank
10'
10'
5'
50'
Drai nfield
10'
10'
10'
100'
For information call
between 8:00 - 9:00 a.m.,
Type of Construction:
Instructions:
Group:
\,~--
Fire Zone:
Use Classification:
For plans information call between 8:00 a.m. and 9:00 a,m.,
For inspections (see back of this permit) call 687-4065 between 8:00 a.m. and 5:00 p.m.
DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
COURTHOUSE I PUBLIC SERVICE BUILDING
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
By:
bne county
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SITE INSPECTION
ApPROVED /
REMARKS
/
DISAPPROVED /
ApPROVED /
FOUNDATION INSPECTION
/ DISAPPROVED /
REMARKS
ApPROVED /
FRAMING INSPECTION
/ DISAPPROVED /
REMARKS
ApPROVED /
LATH OR SHEETROCK INSPECTION
/ DISAPPROVED /
REMARKS
FiNAL INSPECTION
ApPROVED /
REMARKS
/ DISAPPROVED /
CERTIFICATE OF OCCUPANCY
REMARKS
READY TO ISSUE /
/ NOT READY TO ISSUE
/ DATE
/ DATE
/ DATE
/ DATE
/ DATE
/.
1
!
DATE
INSPECTOR
INSPECTOR
INSPECTOR
INSPECTOR
INSPECTOR
,
INSPECTOR