HomeMy WebLinkAboutPermit Building 1978-6-29
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TRS~TI 11-o3-~3.3- ~-o7ou Job Location [urd:::2 8tcclCS' ;(3y4t./21/s/ /Jr-.I6/I;'fidYl
Written Directions (~<).?: IS/ ./jt J::r;7 /J)() CC / ~~i~~~IJf'JJ /0(Lq q '7 C)? ?
I~ORMATION S~ET '
J--HfUilding Permit
) Site Feasibility Study for Septic Tank. Number of sites
Acreage or Lot Si7<> Test hol~ will be ready
Partitioning # - ( ) Completed Subdivision K () tf4'cillU 'i- \ <;~ ~~d t \''-(iV'---
( ) Pending , '
APPLICANT'S NAME AND ADDRESS <--..TOJ-hr.) 111 rCflrl"?/".
OWNER'S NAME AND ADDRESS, if different fr~m applicant's S,~ " J
CONTRACTOR'S NAME AND ADDRESS
Mail permit or results of site feasibility study to ~Applicant (' ) Owner ( ) Contractor.
) Prefer to pick up. Call (owner, etc. ) when ready.
STRUCTURES NOW ON THE PROPERTY e~ 1~~/1C~ -r-~/ff:'/) r'fJ97V:16>'
. / -
PROPOSED USE (this permit) rt'JY7<"~~c~ /p",r ,;2s/'" u/7c::.2'7rY"A/4(?~//;#?,"'))
" -O';j/J', t;3~L:;&- '/'" .
WATER SUPPLY -------- I~ ' (existing or proposed well, etc. If public, name of system)
SEWAGE DISPOSAL ~ s/ IiJrS: (existing or proposed septic tank, etc.) S.I.:;:
( (;/
Lot ;;22- Blocl< ~
C(rrZI r:c; \' 3G 3 f3iuMnp...2 Phonp 2//7-~S-3s-
Phonp
Phonp
Contractors o. s. #
~ ~r.aa:ns '----
PLUMBING BY
Address
) PROPERTY IS WITHIN ONE MILE OF CITY (
-
******************************************* OFFICE USE ONLY BELOW THIS LINE ************,****************************'***
) NWd~S NecessCjry c () Facility Permit Necessary
JE---,~ .- SETBACKS: Front Side Facing Street
(FROM CENTERLINE OF ROAD)
) Special Permit Area.
Minimum Elevation:
Interior Side Yard ,-5 _ Rear S-
(FROM PROPERTY LINES)
To: Planning/Bui Iding Inspector/San itarian/Surveyor.
This applicant appears to have a problem with
Your assistance will be appreciated.
By
Permit Processing Section
Response:
C55-12
By
DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
Permit Processing Section
125 East 8th Avenue
687-4394
Division
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DESCRIPnON: )
First Addition
Book 32. Page
Records.
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certify that tJ
overlap.s on thl
propsrty and to:
the true and eI
June 2). 1965
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PACIFIC fIRS
P. O. Box 89
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TRS, T!
vJJA~~(1J
LANE COUNTY PERMIT
Acreage or Lot Sj7P
Contractor's O.S. #
, ,(-+-
Partjtioning #
) Completed
Subdivision
Lot
Block
APPLICANT'S NAME AND ADDRES~
OWNER'S NAME AND ADDRESS
CONTRACTOR'S NAME AND ADDRF<:;<:;
Mail permit to ( ) Applicant ( ) Owner
) Contractor. ( ) Prefer to pick up. 'Call
Phon"
Phone
Phonp
(owner, etc.) when ready.
STRUCTURES NOW ON THE PROPERTY
"HIS PERMIT IS FOR
# BEDROOMS
# PLUMBING CONNECTIONS
WATER SUPPLY
SEWAGE DISPOSAL
S.I. #
THIS PROPERTY IS WITHIN ONE MI LE OF THE CITY OF
. PLUMBING BY
I hereby certify that the above statements are true and accurate, and that I have the following legal interest in the property: owner of record;
contract purchaser; . potential buyer; realtor or agent. I further certify that (if not the owner) I am authorized to act for the owner of
record, and that said owner is aware and approves of this action. I hereby agree to comply with all applicable Codes relating to this permit.
Fee Paid $
) NEW ADDRESS
SANITATION
Signature.
) FACILITY PERMIT TO TRANSPORTATION DEPT..
Date
) SPECIAL PMT. AREA. MIN. ELEVATION:
Minimum Septic Tank Capacity (Gallons)
Drainfield Required - Lineal Feet
Maximum Depth
BUILDING
Type of Construction
Use Classification
Group
Fire Zone
Comments:
'omments:
..... ~I
By: Date: By:
PLANNING REQUIREMENTS SATISFIED. By:.< ,_
ZONE: SETBACKS: FRONT.t(~~;t"f'.- SIDE FACING STREET
,..<:' Date:
Date: _J Date Issued:
(FROM C/U INT. SIDE YARD': REAR
(FROM P/U
. .... . 7-'
LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE.,.-EUGENE, OREGON 97401
POST THIS PERMIT ON MAIN BUILDING AT SITE
PHONE: 687.4394
C55-13
BLDG. PERMIT - WHITE; BUILDING - GREEN; PLUMBING - CANARY; SANITATION - GOLDENROD; OFFICE COPY - WHITE
J
/
SITE INSPECTIO~,
ApPROVED / /j DISAPPROVED.I
/
DATE /;'~2-7- 7~NSPECTOR (~
C/
REMARKS
ApPROVED /
REMARKS ~ ~
FOUNDATION INSPECTION
"../
/' I DISAPPROVED
I I Om $-li=-t2INSPECTO~ .
() j(' ~ ~ In_ - 2-Cf- 7 r! ~_
v
FRAMING INSPECTION
ApPROVED / /j 01 SAPPROVED / / DATE 5? -I c./. 1t INSPECTOR Q. rR..
REMARKS~ ~; : ~.1 ~ :;:2- UI~ ~ ,,~~ <?-/Y~7g~
J . 0
LATH OR SHEETROCK INSPECTION
AP.PROVED /
REMARKSt~ '"
/ DISAPPROVED j
/Jj a,
j DATE
INSPECTOR
FINAL INSPECTION
Aep,o"o LL/O'''''"o"o I I O'TE 2-6-~1. '''''CTM~~
REMARKS
CERTIFICATE OF OCCUPANCY
READY TO ISSUE
/
/
NOT READY TO ISSUE
I
,
/ ,DATE
INSPECTOR
REMARKS