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Home My WebLink AboutPermit Plumbing 1973-8-7 " , .J' ~'~~I^ . ..;..-:.____~> J.' .... it ,,' .,:.:' 'i..' ~-! ,. .' --. , -'~\ (:''/.- V "; ::.<,..,,:, ('.-.,.-:' .. .. ':'1-:~.t /r ~~;:t:..'~,~-(;~ J ~ ..-\:'.~-f, _.~_~ ,". ~i\.'::'-~',~~' '~~)1 ) ......._.. . /;: ~, .~'G' . -P~~ ~ ~;ii I ~: LANE COUNT, BUILDING l~J ~UILDING PERMIT, .Q,R MOBILE HOME USE PERMIT /..~'i./} -,/~_~i' MH 0 PERMIT NO, t0u;r""t3 MAILING ADDRESS PHONE PROPERTY OWNER !'la::G~:J ~ Cd hilg .t.' ~. CONTRACTOR SC::lO .' MAILING ADD.RE,SS ~ "j4'lo:JSJ71 .' ::1., PHONE PROPERTY LOCATION - INCLUDE POST OFFICE Our U:':~ri:~)l1 Ave. PROPERTY LEGAL DESCRIPTION - METES, BOUNDS F i rs'l: tk.M CGlntorbll(l'Y Vo n ~~o tote ~ [3 Uoctt 2 U~!!D.50 COUNTY BUILDING & SANITATION SPECIFICATIONS DRAIN FiElD REQUIRED i5t'J TWP RANGE SECTION nl 0) 24, tj.{ APPl. t'JC5j;;<wor t~ij'j5'i:. NAME & 2~t5SJ t~:)rtV1 ~5rc~ P~ClCO MAILING ADDRESS Svd flgVi oUd, @rQgGlI FOR MOBILE HOME PERMITS ONLY No. of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT [kJU n 1 U UDg ljorogo me\!:. llfH';. i[J~i:OUU ::-JGt;JWrJU i'JIl~IPS::;C.J1 ~Y;'l\.\:m 1 ~IUD~fog FYntures SEWAGE DISPOSAL PUBLIC 0 BUILDING WASTE DISPOSAL PLUMBING PLAN REVIEW PARK TRAILER SEPTIC TANK 0 OTHERD G2.@Q 2(()' tWO 2~.SO c TOTAL c MIN, SEPTIC TANK CAPACITY WITH DIST, BOX: GAL 750 noof arClinG ~iOl sfCroGl'Q:. TYPE OF STRUCTURE VCJ BLDG. SETBACKS h FT. FROM CTR. OF ROAD RIGHT OF WAY FRONT l;:.,~ I SIDE INT, ;;; I. SIDE EXT. AUTHORIZED SIGNATURE - DATE IrJ .tl::o Ooc~ ~y CbrcUock BLDG. PERMIT - WHITE OFFICE COpy - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENROD TAX LOT NO. CODE CENSUS TRACT .Ji 30;;?r 2@-Uf~C EXISTING STRUCTURES ON PROPERTY CJ061 0 . LEGAL ACCESS TO PROPERTY. 8n.lrui~g~oo Avo. PROPERTY. SIZE - FT, WIDTH DEPTH AREA Connect to Existing Sewage System 0 TYPE CONSTRUCTION SQ: FT. # BDRMS 1 HS ? U 2 {2} "'A~ ,.r:-. t'J') ~V~ -":'" ,oJ New System 0 VALUATION ~t)~D(~O n r~n u ,..{!.". U~;;;~:j' FEES PLUMBING INSTALLED BY OWNER 0 OTHER: NAME WATER SUPPLY PUBLIC ~. o OTHER lIN, FT TRENCH WIDTH FT, 2 ~GJ, OR SQ. FT, OCCUPANCY ZONE R- a PUBLIC UTll. EASEMENT USE CLASSIFICATION REAR 7' John CruSckg~c~~, R.S. DATE 00{""7:3 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) ~"" ft c"" LANE COUNTY, BLDG. & SAN, DIY" COURT HOUSE, EUGENE, OREGON 97401 . -..-., . " ,'~ jj'.}~,~ /~f J'~ .-L'7;... ,15:) c9j ...,,:' LO,( . CENSIJS TRACT ,~/'.. . .\~-- ~ ~ ~~LAAA, .. ~:~I~~~~,:a~;c{-b ADDRESS C/o ~~~ / ~. PHONE DATE ... ,\',/ Yd'U;; ding Perm i t App I i cat ion No. () Site Inspection /J;7'~.~J () Pre-Permit Investigation ""..--.--." .... ...-.. LANE COUNTY PLANNING DEPARTMENT I. Zoning Ordiriance Compl iance (Zone.zJ ) Subdivision Ordinance Compl iance NOT app I icab I e () () ( ) ( ) ( ) () NO YES NAME DATE 3. Required Access ( ) ( ) ( ) ( ) (~ (-r' .. ()'" (~ ( ) c..fJ- ~b3 2. 4. Building Site (Area, Width, Frontage, Setback) 5.. Other (see comments) COMMENTS: BUILDING INSPECTION SECTION NOT NO YES NAME DATE app I icab I e '-Lu, 1W7~.~j}~1, 6. PI ans Subm i tted. ( ) ( ) r g ...,:.. ::>~ 7. Soi I Stab i I ity (.foot i ngs) ( ) ( ) 8. Flood Plain ( ) ( ) ( ) 9. o t he r (see Comments) ( ) ( ) ~( ) COMMENTS: I TO APPLI CANT: ~,o r Building Permit / Site' Inspection/il ( . Can be app roved. cf - 7- 731f!:!/. Cannot be approved at this time as indicated on item NO. above. Questions and further information on items 1, through 5 contact th~ Lane- COUNTY PLANNING DEPARTMENT. Questions and further information on items 6 through 13 contact the lane County Building and Sanitation Division. () Wil I be held in this office until you can resolve the probl~ms indicated. () Is being returned. () Your building permit appl ication fee i~ being returned under separate cover. LAN[ COUNTY PLANNING DEPARTMENT IV, Sixth Ih'enue [ast, Euqellf>, Orequn97401 -I'IIIINI: 1/1/-1.\11 IXI. ?',I LANE COUNTY BUILDING & SANITATION DIVISION 135 Sixth Avenue East, Eugene, O,.egon 97401 PHONE: 342-1311 EXL 411 ~ . . -- -. -. .. ...--..-- - -- --. .-----------.-.. -'...-..~---" -. ... . . .. -. ._._.._-.~~ . -.-. , 0..:. ~ :~ .:} ?~ l' r 5 p"!! .~ ; --, ...T'..' . \ \ \ t " , I ..L ~!C(V l~U(J i'rt8~~ .~</~ r----- - J I I i \ _: - .-Y< -- -- --- ~ 'l.1~ --__'2,,::f1 7 1: \ : N...... ~:J ~Ql M. . 1- I ; I i I I r ~ - -.i ~ , ., , - 1" , ,\ ,. , t, ~ 'J ,:,? ~ ~. .. .Date 1. , Permit No. CURB CUT PERMIT IN THE BOARD OIF COUNTY COMMISSIONERS OF LANE COUNTY WHEREAS, the attached application has been fully considered by the Board of County Com- missioners 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 '-1' , . for placing, building or constructing the following facility: ! _,' ("~; ,.: :\' ',' '~: \' 't..' - cr:<:.;_;,_ \.>-~_~<'~,,:. < ' . ...i ~ ~ " " .: - \~., ~':~~ :<:,' ,- upon the right-of-way of County Road No. , Mile Post , in strict conformity to the exhibits attached hereto, and subject to all terms, conditions, agreements, stipulations and provisions contained in the appl ication and permit, the Rules and Regulations Gov- erning Facilities to be Permitted upon County Road Rights-of-Way, as set forth by the Lane Man- ual 50.190(2) any amendments thereto, and any other applicable regulations, law or ordinance. Special Provisions: 1. Driveway will be constructed in accordance with the attached driveway approach specifica- tions (Drawing M98-50). 2. Permittee will be responsible for the immediate removal of all mud, dirt and debris from the roadway and right of way caused by his 0 peration, leaving the roadway and area in a neat, acceptable condition. 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 be- fore ,,' ,':' fl,.. \, , 19' Expires ; 19 Inspected and Approved Approved by Board of County Commissioners By Date By Director of Public Works ~ WHITE - OFFICE FILE GREEN - RESIDENT ENGINEER PINK - PERMITTEE BLUE - ROAD SUPERVISOR ORANGE - BUILDING & SANITATION DEPT, YELLOW - REAL ESTATE c98-79 FHA r;ORM NO, 2573 Rev, 10/70 , U,S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT Form Approved FEDERAL HOUSING ADM'NISTRATION !"':::-.. Budget Bureau No, 63-R0296 HEALTH AUTHORITY APPROVAL je} It INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM ' "./ I?iJ ~ ,:11 ((f)~ lL...- P PART I -TO BE COMPLETED BY FHA ~ II 11// ~ . I FHA Case No. NO V !'..~~ /jj) # II]. ' f) l7ir//_ 0 oj.... / / Mortgagor or Sponsor: I )1',- I- ( - 1i:t/...'7 /:J . Westover Construction--co;>;" builder . ,..: ~ J1Vh, Erling HanseQ.p'urchaser 'YH/:... -'""Ii.. rll Property Address: Ii] 2781 Burlington D[p( Springfield. Oregon 97477 . .:. Insuring Office Mortgagee - Name, Address and Zip Code r- First National Bank 18th & Oak Branch P.O. Box 1315 Eugene, Oregon 97401 of Oregon I Subdivision: Lot No. L -1 Block 2 Canterbury Village 1st Addition 6 SC' New Installation Can Attic or other Area be made into additionaf ~-1 bedrooms? (If yes, how many?) T9.TAL NUMBER , TVTNI1 UNIT!':' BEDROOMS ---BAIlJ!': BASEMENT 1 3 WATER SUPPLY BY: ~ Pu blic System SEWAGE DISPOSAL BY: D Public System 1 DYes [i] No DYes 0 No SYSTEM DESIGNED FOR o Community System o Individual No, of Bedrooms Garbage Disposal o Communi ty System ~ Individual DYes o No. PART II. - TO BE COMPLETED BY HEALTH DEPARl:MENT HEALTH DE PARTMENT INS PECTOR'S SKETCH / BLDG. PERMIT 1517-73 ~- 1--- ----- 1- I -----=~---=========---=======~--_F====== --------------- r------ -----====---========---F=======-------------- I ---- ------- I -- -,== ===== ====Ft====- --== := :== --=---=------4--- := 1-- c= ========= ~-- [ r- r------ :,== -- ==$:'----= ==--- '1- 1== --_F= ===== '__ ,======:1 1-- -- ----------- ,- I I c= ~=========== C L_ -=---== :== ---== ----t ===== =*== =ffi :==1 i= ==+- ::=-----::::::::::::::. ==___C c: -Ett=-=F~ ~~~ _===t,m~~~~~~m~~~~=::tF::W=1~ - - -+= =:: = ~ = =:::: tl = = =::: +::::: ~ 'c - rl.:: - t It is the opinionofthe D State D County Local Department of Health that this individual water-supply syst~m D is D is not satisfactory as a domestic water supply for the subject property. -----=] 1- c: I ,-= ====~- ,-- ------ ,-- ----- ----- 1-- ----- ----- ,-- ----- ----- 1-- ----- --:---- 1-- ===== ===== c= ----I: =:=:: ,==- c- --- --j--- I -=== ---f= ,-- ---- I-- I 1---- ,--------- It is the opinion of the 0 State [] County 0 Local Department of Health that this individual sewage-disposal system with proper maintenance: [X] Can be expected to function satisfactorily, and 0 Cannot be expected to function satisfactorily . . is not likely to create an insanitary condition DA TE SIGNA TURE TITLE 11-19-73 RICHARD A. KIRBY, R.S., SU~ERVISING S^NITARI~N NOTE: The health authority should complete the appropriate opnion statement above and affix date, signature and title in the: spaces provided. . . . . Use of the ab,?ve grid for Health Department Inspector's sketch as well as use of the back of this form is ~t the opinion of the health auth.ority. ' PART III. FOR USE OF FHA OFFICE TO THE CHIEF UNDERWRITER: I have. reviewed the foregoing and the pertinent FHA Compliance Inspection Report, and recommend that the I~dividual water-supply system be considered D Acceptable [J Not Acceptable Sewage disposal be considered D Acceptdble D Not Acceptable. DATE SIGNATURE o CHIEF ARCHITECT o DEPUTY FOR CHIEF ARCHITECT HEALTH AU'THORITY APPROVAL , INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM FHA FORM NO. 2573 Rev. 10/70 J"" \~ REPORT OF INSPECTION-INDIVIDUAL .SEWAGE.DISPOSAL SYSTEM PRIMARY TREATMENT consists of Dl Septic tank. 0 Cesspool. S.ptk Tank: feeL Inside width 4~ CONCRETE Kallons. Capacity inlet compartplvnr leet, Liquid depth, 4:;- Number of compartments Distance from well, Total liquid capaci~ Inside length 7?' Ce..,_I: Distance from: Well, feet; foundation, Inside diameter, feeL Depth SECONDARY TREATMENT consists of ~ Tile disposal field. feet, Material 1000 gallons, feet, _ feet; nearest lot line at 0 front, 0 side, 0 rea~, feet. Liquid. capacity, gallons, Lining material o Seepage pits. Other feet, Tile. DI.pa.al Field: Distance from: Well, Total len~h of tile lines,_ Trench width i6 Length of each line, 60-60 Type of filter material: KJ Gravel. 0 Broken stone. Depth of filter material beneath tile" 6 feet; foundation, 10 feet; nearest lot line at 0 from, KI side, 0 rear,--L(l 120 feet, Number of lines 2 Distance between lines, 1 n inches. Total, effective absorption area in bottom of trenches, ~60. - feet. Depth, top of tile to finish grad.. Other feet, feet, ~quare feet, inches, inches. Depth of filter material over tilp 2 inches. , Seepage Pit.: Number of pits__. . Outside diameter feet, Distance from: Well, feet; building foundation In.pectlon mode by: 0 State. XI County, 0 Local Health Depth, feeL Lining material feet; nearest lot line at 0 front, 0 side, Authority. Orear feet. Inspected b) /.,,/ .I.D1-IN rRlllrK~I:!ANK, R ~ SANITAR.t.AN ( TITLE) Date of inspectioll SEOT(MBER 27 ,19 73 REPORT OF INSPECTION-INDIVIDUAL WATER.SUPPLY SYSTEM Distance to nearest puhlic water main, _. feet, Size of main inches, Individual wells 0 are 0 are. not customary in neighh9rhood. Give most recent rl'Cord of failure of wells in immediate vicinity to furnish adequate supply of water Properties in I!eighhorhood 0 are 0 are not beillg developed with both individual water.supply and sewaKe-disposal systems. Lot size: feet wide,__ feet deep, Dwelling set hack from front property line, feet. Individual water supply from: 0 Drilled well. 0 Driven well, 0 Dug well, 0 Bored well. D1.ta.nce of well from: -' BuildinK foundation cast iron sewer, seepage pit, Well con.trvctlon: feet; nearest lot line at 0 front, 0 side, 0 rear, leet; septic tank feet; disposal feet; other sources oi possible pollution, field, feet, feet, feet; feet; tile sewer, feet; cesspool, Diameter inches. Total depth, feet, Type of casiny Depth of casing, feet, Approximate depth to pumping level of water in well, feet, Approximate yield, gallons per minute, Sealed watertight to depth of feet, Exterior space around casing sealed with: 0 Cement grouL 0 Puddled clay, 0 Ordinary backfill. Well cover: 0 Concrete, 0 Wood, 0 Metal. Openings in well cover watertight: 0 Yes, 0 No, Pump: 0 Shallow well. 0 Deep well. Len~h of drop pipe, feet, . Pump capacity, gallons per minute, Located in: 0 Basement, 0 Pumproom off basement. 0 Pumphouse ahove ground, 0 Pump pit, Pumproom properly drained: 0 Yes, 0 No, Pump mounting watertight: 0 Yes, 0 No, Type of stOrage: 0 Pressure, 0 Gravity, Capacity, gallons, Has bacteriological examination of water been made? 0 Yes, 0 No, If answer 'is "yes," give date Quality 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: O.State. 0 County, 0 1.<><:al Health Authority, I nspected by 19_ Date of inspection 19_ (TITLE) GPO 900.682 .. ,~~ , . r; .f::'\, LANE COUN1 BUILDING D JUILDING MH D MAILING ADDRESS PERMIT OR MOBILE HO"fI&: USE PERMIT PERMIT NO, PROPERTY OWNER PHONE 1J.?9? C /...J' l:!!~ f /) ~ . 11 /.../ r" J J Y1t3 -10 IA "7 PHONE / 'Sf- hou ~~ CONTRACTOR MAILING ADDRESS 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 D TYPE CONSTRUCTION SQ. FT. # BDRMS New System D VALUATION SEWAGE DISPOSAL PUBLIC D BUILDING WASTE DISPOSAL PLUMBING PLAN REVIEW PARK TRAILER ot. FEES PLUMBING INSTAllED BY OWNER D OTHER: NAME WATER SUPPLY SEPTIC TANK D OTHERD PUBLIC 0 D OTHER TOTAL ot. MIN, SEPTIC TANK CAPACITY WITH DIST, BOX: GAL COUNTY BUILDING & SANITATION SPECIFICATIONS DRAIN FiElD REQUIRED L1N, FT TRENCH WIDTH FT, OR SQ. FT. TYPE OF STRUCTURE OCCUPANCY ZONE PUBLIC UTIL EASEMENT BLDG. SETBACKS __ FT. FROM CTR. OF ROAD RIGHT OF WAY USE CLASSIFICATION FRONT SIDE INT, SIDE EXT, AUTHORIZED SIGNATURE - DATE REAR DATE BLDG. PERMIT - WH ITE 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 COUNTY, BLDG. & SAN, DIY., COURT HOUSE, EUGENE, OREGON 97401 FORMitC55-13 eP/< - ~ SLAB FLOOR -1-15-7:3- PLUMBING GROUNDWORK ApPROVED I / DISAPPROVED I REMARKS GAS PIPING GROUNDWORK ApPROVED I I DISAPPROVED / REMARKS ROUGH PLUMBING ApPROVED /~ I DISAPPROVED / REMARKS ROUGH GAS PIPING ApPROVED / I DISAPPROVED I REMARKS FINAL PLUMBING ... ' ApPROVED LXI DISAPPROVED / REMARKS FINAL GAS PIPING ApPROVED / I DISAPPROVED / REMARKS CERTIFICATE OF OCCUPANCY READY TO ISSUE I I DATE I DATE / DATE 9-)"- ? J I DATE INSPECTOR INSPECTOR '. INSPECTOR~ ~ (/ INSPECTOR I DATE ItJ-~ J-):1 INSPECTOR dt:::/r - , / DATE I NOT READY TO ISSUE / REMARKS I DA TE INSPECTOR INSPECTOR . c .. ~ f,. 'NDIVIDUAL SEWAGE DISPOSAL SYST.,.... RECORD installer: Complete top part ~ .orm to signature and return both copies to Lane County Building Sanitation Department. Property Address Burl i noton Ave. 'tr7X/ Basement Water ~u~ply Yes 0 No ~ PublicW' Other-List Feet from ~~!! _____Foundation Lot Line Front Total sq.Ft.between Fillr9tLz, ft.3t,o lines /0 TYP~ /. , 'I () Signature ff/~ Jt -t/ ~~ /)J-/j Iz&ller's Name ~ No.LivingUnits Bedrooms Baths . I 7/. I Septic Tank: Ft. from well Steelu Ins~C1e DlIllens~ons: ,t't:. Length :7. ~-Width t/rJ'- ~pplicant I c/o E. Hanson Name Westover Const. Concrete' ~ No. Compartments Diameter Depth '/, J- Mailing Address 2SR~ N. ~5~h Pl~~e ~r~in7fi~lrt nrA~nn Leygth/of Lines - Ft. Trench l.{pq2h()3. 4. 5. 6. Width.3 Sketch (See instructions): N .,.LJ, 'L // f" l , .. ~ ".. ,...01 ):l31 ,~ 1':- J~ I. J- ...~ ':ir?(j ~,;tB ">S -0 I to_I' ~br ~ /.. ...,...... ....;oPO .~/...,.",... l_ to . Date 9- Z V ~/tJ7 ~ . For Sanitarian Use Only: ~APproved: System Installation . 0 Disapproved: Does Not Conform Remarks: 4' i . .. . . P.RMIT NoJ~}7-73 J.e. 1 Gal. Capaci ty./ () t!J 0 Tile Disposal Field: Distribution Box:Yes d( No 0 Other Distribution- T~Je Id Side I CJ Rear' Filler depthF~~~er deptfi above below I i:i!e .7---. !!h.....tile Co iTJ.... \ I ~J LJ .-* I . . ~~ \;~., ~ f2. 1r-. \'I ~ \ri D. ~.\\!l\C'I\, ,. .l) \.1\--' S EP 21 1973 . '-- t..ANE COUt'lTI HEALTH mm " (l . I?A~ iI~ Date, 9A--frs 91L ./f? Conforms to Current Standards to Current Standards ~ " ",., , . .' Lane County Building & Sanitation ~~ / '1.J ..) / Sanita ian's Signature Dept. .. . ":"Y-~ LANE COUNl BUILDING D "OILDING MH D MAILING ADDRESS PERMIT OR MOBILE HOlVu: USE PERMIT PERMIT NO, PROPERTY OWNER .' 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 \~ ,..': ..", -,:,\ \ EXISTING STRUCTURES ON PROPERTY ..!~-"*","& MAILING ADDRESS FOR MOBILE HOME PERMITS ONLY No, of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT ,. ~ \' _ -\ \ _ \J .LEGAL ACCESS TO PROPERTY \ ;, '. ~ . \ ,'. r:: \'P,RORERT-Y SIIE~-';..F.;j"::"':"~t,.,-,,: "",~..i \, '_ I .... \j .....'4~...:J .......... '..,.> "- ..'0' ''''-l~ WIDTH DEPTH \'. AREA .J \~ ..\- . ,.,~.-'. \ '\ : i,11 \'to,i;1,!1ect to Existing TYPE '€'ONSTRUCTION .:':, \' \ '.:' 1\ " \..... '.. Sewage System D SQ. FT. # BDRMS New System D . VALUATION " , " , \ :~ \' .....,~.:. '. ~ ~ - ~ \ -- ~\J . '" ' ,:;. 't~ '- ~\~ ~ \ '~~ \~~~~ , , '\ ~-s:\..~\" \:~.~,'t\x'~~<\~ \,~" \k ,~~.'\ .' ! PLUMBING INSTALLED BY SEWAGE DISPOSAL PUBLIC D BUILDING WASTE DISPOSAL PLUMBING PLAN REVIEW PARK TRAILER SEPTIC TANK D OTHERD ~ FEES OWNER D OTHER: NAME WATER SUPPLY PUB~IC(' 6 '. - D' OTHER \ I " TOT AL $ MIN, SEPTIC TANK CAPACITY WITH DIST. BOX: GAL COUNTY BUILDING & SANITATION SPECIFICATIONS DRAIN FIELD REQUIRED ~ " \ ---~ ' ~ TRENCH WIDTH FT, OR SQ, FT. " ~,\. '. , ~~, \\ TYPE OF STRUCTIJRE" OCCUPANCY ZONE PUBLIC UTIl. EASEMENT BLDG. SETBACKS __ FT. FROM CTR. OF ROAD RIGHT OF WAY USE CLASSIFICATION FRONT SIDE INT, SIDE EXT, AUTHORIZED SIGNATURE - DATE REAR DATE 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 COUNTY, BLDG. & SAN, DIV., COURT HOUSE, EUGENE, OREGON 97401 ~ FORM ='rl\r:;_l1. SITE INSPECTION ApPROVED / / DISAPPROVED / / DATE . INSPECTOR REMARKS FOUNDA T I ON I NS7T I ON . APPROVED,LL/ . DISAPPROVED / / DATE ~/--U REMARKS.~ ~ f1,J'3~<7:3 . ,7/ u INSPECTOR FRAMING INSPECTION ApPROVED / / DISAPPROVED / / DATE. INSPECTOR ~. ~.~/Ab- C}-i'1..,'t; A 11 / A' (J~_-.() .. - ~"7U{~qft, / p ~/!/ ~?3 x LATH OR SHEETROCK INSPECTION ApPROVED / / DISAPPROVED / / DATE INSPECTOR REMARKS FINAL I NSPECT 10/ ApPROVED /L'~ DISAPPROVED REMARKS d~~ I()..;/P Ii / / DATE /1-- Y-73 INSPECTOR -73;) ~/()~L3 "'71 CERTIFICATE OF OCCUPANCY READY TO ISSUE / / NOT READY TO ISSUE / ./ DATE REMARKS . /;/ ~- ~~ /~/.. t( / 'I/f/f/-l:,.;~ -- - (j loil;-7~ ~VI~ Vf~k.:>/f' :2?fi"/ r -.-- (/ ~,*,! '~- .' cIv /~ INSPECTOR ;(o-~OO ~ "'\ r LANE COUNT) llLDING PERMIT OR MOBILE HOM1\!~USE APPLICATION PERMIT TYPE - BUILDING ~ MOBILE H~Mt[JOSC REG. # PERMIT :# PR~P9TY OWNER .. l 1 MAILING ADDRESS . ~~~ ~A~~ . CO'NTRACTOR ./ ~.. trAjLlNG ADDRESS ~/~~~.A-/A-~ f'~~.GGP~P.~P9 PH-O-PERTY CATION fNCLUDE POST OFFICE. . , O~~ - PROPERTY LEGAL DESCRI6!oN J ,a/;, ~ /./ A c:~. }~. b?' L/ L L ./ ./ dMETES BOUNDS 0 YES LOT - BLOCK - SUBDIV, ~ {~ ~_ ~~ ~ (P <..JL,iAA ACHED 0 NO ;:J ~~. ~c.' TAX LOT. (ODE d. ~U:'T~~jY~ . AP'PLlCANT . r // DESCRIBE EXISTING STRUCTURES ON PROPERTY IF ANY NAME ~/.?~/AJ &-~ I 77~_ AND ~ L~:ESS TO RO;eRTY:,..ROAD N~-",~t> MAILING PROPERTY SIZE-WIDTH . DEPTH- AREA ~ .J6/j-;7.;L PHONE PHONE . :>>~~~ .!~/-~?, ADDRESS FOR ,MOBILE HOME PERMIT ONLY Number of Bedrooms ST~~U. RES TO BE ~ILT THIS PERMIT ~L/~~- L ._-aLl/-7/./Y?~~1 , V Connect to Existing TYPE CONSTRUCTION Sewage System D or New System Req, D SQ, FT. # ~EDROOMS VALUATION ;I,J75@J/,~~~) /iI~O ~~ ~&PJ.E /5/rr/ - '/~~ / t'" SEWAGE DIS.POSAL PLUM~ING INSTAllED BY TOTAL /010 I 5cJ OTHER 0 FEES WATER SUPPLY #~ PUBLIC 16 OTHER PLUMBING \FEESc::e"H f?i ~ IJ FJXTURES Ai. I, J!-(} CASH 0 S~ CHECK ~NNECTION FEE c:< ~ eJI-i) PUBLIC WATER J. CONNECTION FEE _!) C) . ,. OWNER 0, . OTHER 0 NAME PLANS FUR.NISHED FACILITY PERMIT YE~ 'i1' . No' 0 YES ~ NO. 0 ;J;!:J? 'E't)::x.........-S" f?- d ~'; ~ FEE RECEIVED BY DATE ~ffi~ _ (~.-7~ PERMIT # /.1{ /'/- 7~ PUBLIC 0 BLDG. WASTE DIS,' PLUMBI.NG PLAN REVI.EW PARK TRLR, SEPTIC TANK 0 $~ .:2.... ~ . ,~~ If) Q ,~~.6l) COUNTY BUILDING & SANITATION SPECIFICATIONS MIN" SEPTIC TANK CAPACITY DRAIN FIELD REQUIRED 1~ UN, FT,./6-o TRENCH WIDTH FT, .2.- r?ooFc/ml J"iS Tn stn::d" OR SQUARE FEET ,. 300 WITH DIST. BOX: GAL. a,H.r;,>~ v- / a' eu"," U~'NT .J ,j..., r Iv Yt1 MJ'J. ~. C (t, S;;,,?..>> REAR YARD TYPE OF STRUCTURE OCCUPANCY ZONE 77-1 REAR 7 J . BLDG. INSP. USE CLASSIFICATION UN / BLDG, SETBACKS - FT, FROM CTR, OF ROAD RIGHT OF WAY" FRONT 4t;' SIDE INT, 5 l SIDE EXT, I PD:NL- Dale ~'~'3 Dale Directions to Find Property: COPY 1 - OFFICE COPY 2 - JOURNAL COPY 3 - AUDIT Form # C 55.12