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HomeMy WebLinkAboutPermit Building 1973-8-16 ':.-,'_.-....,..:~>,..;-...~^-.......~...,.J,.'-.-~'"';.~.,...--- .""'-...~.-:: ~..----.'.....--"'-.,-' ,>-:e........__ .--.,.;;.~..:::-;q..::":."";'~_.,;.. .,..,'-...-.:':.';..7"""'.:' ~""'(~.~_:'''.C-: ~-,......---,. J"--~-"-- ~ ..~: . . ..' , 'i^J 'i:..~.; :"'C} lANE COUNl") BUILDING [i] '" ks~~~~,'"..r ,,';i:/'c&~ " JllDING~' PERMlt-<OR, MOBilE" HO'fv._ USE. PERMIT, ,. ' .. .-.~':~~ ".,";" . 'MH 0" ' .'. PERMI'T NO. 'MAILING ADDRESS'> , ",!j~ ',' . -"'. "~,.-"..",-".-" :7' .,.-n,'. ...-. r ~~....- . ,'.--.' '-r.'. ____/. ,C-.r-J/"_ (;;?-J-O--;7"-. \ ~.'.. , 'I!c:D~-73' '!:3 " . ii' ", < ,;~;..;r), ..",'{; ..'IV '_~'{"~' , 'r,'i:~:' .. . . j. J'$OO"':73 '" ~R~~ERTY OWNER ttG:l5S I dt.' Garv CONTR.:-CTOR " HB~t(:n"C1I1'. ttGmes' P'ROPERTY LOCATION - INCLUDE POST OFFICE ;'-l_ PHONE .' .,. " ' MAILING ADDRESS 2589 Nerth;,,35ti, Plece . ,'. ,r'~it~ ",;~,~ii~~; " Spl""i'n9f't'.e~dt: OrGgon' ,:,""":1,1 " PHONE ," -1~7...997:l ~ '. 27j7.~h,;r:l inllltClm ,PROPERTY LEGAl. DESCR,IPTION - METES, BOUNDS' U:St Add ;,~, Cef1terbur~ V ill Cllfile 'l6t, 3 TWP- " "'flANGE SECTION' " Block 2 :1: :!. ~ 1:7 3 24 ' L{ J TAX LOT NO,' ~J6;;;{~ ,CODE " .1, .~ '11 EXISTING STRUCTURES ON PROPERTY , Nenel ' " , ' ~tJ LEGAL AECESS TO PROPERTY . b~t. Bur;1 i n9t(j)I'H~"~. :' PROPERTY SIZE - FT, CENSUS, TRACT ',I 20-300 , APPl. NAME & MAILING ....-'!, )-. , " ADDRESS , WIDTH DEPTH AREA FOR MOBilE, HOME PERMITS ONLY No, of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT Dl>1G 111,11/1)} t.1m im G<Jlra~~'unc. Connect to' Existing TYPE CONSTRUCTION Frame, Sewage System' D , SQ, FT, # BDRMS, l494 @r 1-2' (~) ,Ob, '(al ' j New System' [j VALUATION l7.928 j . ~.IO 19;446 I " I i ( ..t~ l.. 'instlll a'~AS-;'D ~s. i 0 P'l umb i nill f i.~tures " SE~A9E,. [) ISP,?SAL PUBLIC.. 0 SEPTIC TANK lID BUILDING <t. WASTE DISPOSAL PLUMBING PLAN REVIEW PARK TRAILER OTHERD ,74.00 20.00 33.50 FEES PLUMBING INSTALLED BY OWNER' 0 OTHE~: .NAME WATER SUPPLY' '" 't1l:fiilys ~1 UrJD i ng PUBLIC ~ o OTHER TOTAL $ .,\-27.50 COUNTY BUilDING & SANITATION SPECIFICATIONS DRAIN ,FIELD REQUIRED UN. FT, 225 TRENCH WIDTH '=.T. ~. 9~ ~Q, FT. Tight..Hnli?"~requl reCl WIUlIn ~an Tee" ,OT UW\d1 VHI!:). 450' MIN', SEPTIC TANK CAPACITY WITH DIST, BOX: GAl. 900 Roof, drc'ns :to' street .T. . ~, :-' ,~ :. ;. TYPE OF STRUCTURE 5 N, BlDG,' SETBACKS __ FT, FROM. CTR, OF ROAD RIGHT OF WAY, OCCUPANCY '1' &. J ZONE Rl: PUBLIC UTll. EASEMENT " USE CLASSIFICATION 7' P.U.E. FRONT ~5 SIDE'INT, S', SIDE EXT. ..... AUTHORIZED SIGNATURE - DATE REAR DATE Is/,;'J,.'E~., BGs,s. by .Marbau~h' , , J~hn' C.r~l'I,ckshaVlko fr~S. 3~16"7l t.,,' BLDG, PERMIT-WHITE re, ,OFFICE,COPY-'-WHITE ';-"i-(OUNTY TAX ...,.,pINK :: ::,:. ,PLUMBING _'CANARY :":~':~liullDING;":' GREEN.. " , 'S~~ITATION -~OlDENROD Construction to 'comply with'~uniform building code ~~d', county r,egulations covering' plumbing and sewage disposal. All buildings re,quire a certifiwte of occupancy before being ,?ccupied. (See Statement on Reverse Side) ,I. '~'h , , ' ,(POST THIS PERMIT ON'- MAIN BLDG. AT SITE) ~~. . :.\1 ' [:, ,,'i<:~, ,,' ,. ' , "., . LANE,C,()UN!Y ~ BLDc:;:, ~ SAN',PIY:, <:O~RT,~P~S~, EUGENE, O.~EGON, 97~Ol ~~;:~~'::1;~;;-I~~~~~',,{:;'v.i;r(\\i7~';"~"":;:"" t'~~:' ~\,"" '.~~~"'.I'.' ., ,,", ,: :"'~:":"",(-~:>:"" ',','" ,"'''': c,"',," , :" \'. .~ -'- ~\ t' ~ L. ;...~ .~ .. '\~'!. .. .. lit T /7 R 03 S ,;;l. r/ TAX LOT CEN" .TRACT ' '. :/.p ~'~7/.1/L-/^'~~ APPLlC1~: ~_.- -----t;=;?, L--3 NME~~~ J ADDRESS ~_ ~...u:l~~ ~ PHONE DATE f?-/ !3 -'^~ 1'1 ' BUILDING SITE EVALUATION . . .' )>4 Bu i I d j ng Perm i t App I i cat ion No.a&A:J ~ rru () Site Inspection () Pre-Permit Investigation LANE COUNTY PLANNING DEPARTMENT NOT NO YES appl icable NAM,E 0Ji... - DiHE J. Zoning Ordinance compl~e L- ( ) ( ) ( (Zone ---) 2. Subdivision Ordinance Compl~ance ( ) ( ) ~ 3. Required Access ( ) ( ) , ) 4. Building Site (Area, Width, ( ) ( ) 1) Frontage, Setback) 5. Ot her (see comments) ( ) ( ) \) COMMENTS: ~ r)....'-"Y:S BUILDING INSPECTION SECTION 6. Plans Submitted NOT NO app 1 icab I e () () 5rV () ~ ;; ! YES NAME DATE 7. Soil Stabil ity (footings) ,y{( I ( ') ( ') ( ) (f, '1'~tfPL PJ~/"~?J; . '" r 8. Flood Plain 9. Other (see Comments) COMMENTS: SANITATION SECTION NOT NO YES NAME DATE app I icab I e , 10. Sewage D i spos a 1 ( ) ( ) ~ d;&17Y 11. Usable Area ( ) ( ) D4 ~ t 12. Water Supply ( ) ( ) 13. o t he r (see Comments) ( , ( ) ( ) COMMENTS: TO APPLICANT: ( ) ( ) ( ) Building Permit / Site Inspection:~ Can be app roved. /'...-/6 -'1 ~ Cannot be approved at this time as indicated on item NO. above. Questions and further information on items I 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. Wil I be held in this office until you can resolve the problems indicated. Is ,being returned. ' Your building permit application fee is being returned under separate cuver. ~ I LANE COUNTY PU\NN ING DEPARTMENT 135' SI)Cth Avenue E"~t. Eugelle, Oregon 97401 FtlONE: 342.,1311 EX I. 231 lANE COUNTY BUILDING & SANITATION DIVISION 135' Sixth ~veTlue East, EU~lenc. Dlegon 97/~Ol l'UOWl: .. 3l,2-1 J II [Xl. 10 I . - . . ~ . .~ -.-. '. .,'-'.. .... . . . . ., ..,. . ... .--....,.--.- -.-,-.----.-- M<;<;-')~ \j ...... "'";...-.1....-:"'.~..,..~..'..J.....,."'---~~~t.......~.,....- ,-';"-'" .~~..-r-r'_." ... ,....:~~,._;;..,,"..""":-...w'::" .....-:'.~.,.c'7,"';":;.'l,."r~~ ,~. ..~ ..,..,-,.. ,:-",1 . . 1_ ... jt .",.' ~ . / '1' ~4' (,. ~-":, ........:"S;~~~'~,:':~.,>~- JllOING PERMIT OR MOBilE MH D MAILING AD!:?RESS .' ..r .:;::;'\.~ 1-10"'._ CfSE P'ERMIT PERMIT NO.. '/~~, ~~,V .f { lANE COUNT) BUILDING [i! '- .. PROPERTY OWNER ~on6 U oU' n &n~, CONTRACTOR t106}0;(J;Id0U1~!l}:SOS -.,,;~. ;\~"""., PROPERTY LOCATION - INCLUDE POST OFFICE 'a(fp(1)@=)~ " PHONE MAILING ADDRESS, , . ,2~~9 ~~r.~~ 3;th Pi@@o BLorr-lnS;1~GQJM~ @ll'Qgen.' " . '. , PHONE, 1P4"~';;fi/~, li15J1 '8tlf'UD~!f!goo PROPERTY LEGAL D.~SCRJP.T!ON - iv\E,.ES, BOUNDS "'itsG;'~Gd.,t~~ort~~rfi \HHQ~~ ~t. ~ah!lclt a., TWP-' R-'\t>lGE SECTION TAX,LOT NO, CODE CENSUS TRACT u '~ 2~ a~~{!:!1l .- :'.. APPL. NAME & MAILING ADDRESS FOR MOBILE HGME PERMITS ONLY, , ,No. of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT EXISTING ST,RUCTURES ON PROPERTY 00000 " . ,LEGAL ACCESS TO PROPERTY @tj~ll~fj~,@n A~oo PROPERTY SIZE - FT, I." ,. WIDTH DEPTH' AREA, " Ot<JOUhllf:J ~~U~ Gmraso l\.ti\)i5..; qnntoU S..uo $,. ~@PhcmM~~ V'h~~~1foS C6rinectto' Existing TYPE CONSTRUCTION rr~~ Sewage Sy'stem D SQ: FT, # BDRMS t~rl ~ 16t' (Sb )::J3 <kl 't;:I , .;,1, ".', New Syste'm. VALUATION n7J1;~~i3 ' '"' <":7.';;,(,"\ UQc;.,Qvw ~lib-'-\~ PJ9t~ 0" . ..; ,~ [- '{' :~:, ';. . FEES ,PLUMBING INSTALLED BY OWNER D OTHER: NAME WATER SUPPLY t10UY,$ ~h;:~~nq@:, ~,. SEWAGE DISPOSAL , .;. ',' , i,PUBLic cr',.,..", ;''<. B~0lDING ~ WASTE DISPOSAL PLUMBING PLAN REVIEW PARK TRA)LER SEPTIC 1ANK EJ $ OTHERD , 1~ .,ti,~U '- 2m:,. tiC ~:S,,5@ .-1" .- ...... It..-1- P,UBlIC LJ D OTHER , ,~.:, TOT AL' t .. 1 ~7o -s&.t COUNTY BUILDING & SANITATION SPECIFICATIONS , ' MIN, SEPTIC TANK CAPACITY DRAIN FiElD REQUIRED 225, ,2, ,!I,I:'l, FT .. , T~!:Hc'i ~!!?T!l ti-L_^ _11 A~~QR.J ~9:^FT. 'lI.-O~If'V~\~VU-fJlVJ ""'U~f4'V.ld~ ~'~IHlf'n 'i/$,"'Oi.O"l.t:\i:..;~'l",J ~f,j'. ~~V. ,"'.YY.VCJ ~~ ' :,.;, WITH DIST, BOX: GAl. S@.tp '~~OO'a' (lW~Qcrua. ~I>ifQ~O:'OlJlI>. ' ':.: '~\. : 'r TYPE OF STRUCTURE \, ~ t~ OCCUPANCY fr,t.). J ZONE' ~ B ' PUBLIC UTIL. EASEMEi'!T BLDG, SETBACKS __ FT, FROM CTR, OF ROAD RIGHT OF wAy FRONT 4!li SIDE INT, S' SIDE EX'r, , ""0 AUTHORIZED SIGNATURE - DATE ,1'01 J.~.. (j@lJ{1 by .~CW'bct.rvSiJ REAR USE CLASSIFICATION 1.8 V "U. E4'. Jcll~.&m.t:~Q,h~ltl!l,'tl.~.. . .' \''- ,~~1~~7~ ' DATE;-'i~l~Y:~;, BLDG, PERMIT- WHITE, OFFICE COpy - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENROD ,i '. ' ., ,Construction to ~omply with uniform building code and county reg'q,!QFons' covering plumbing and sewage disposal., All buildings require' a certifi'Cafe of occupancy before being occupied. ,,~:1',' ..,'." (See Statement on ,Reverse Side) FORM..: c.55 --13 : ;if', ,(POST', II"II,SPERMIT ON MAIN: BLDG. AT SITE)' - .:.)~~.~:.{.~. .' .' ". . LANE COU~T~t:.~LDG>& SAN, DIV" COURT HOUSE, EUGENE, OREGON 97401 ,.,,':2~~~~!\ ., ,:" " " '. " ' .'!-<!', .~ '1.:..'(''::: " ,~: :, SLAB FLOOR PLUMBING GROUNDWORK ApPROVED '/ / DISAPPROVED / REMARKS GAS P I PI NG GROUNDWORK ApPROVED / I DISAPPROVED / REMARKS ROUGH PLUMBING ApPROVED ~IP( / DISAPPROVED / REMARKS ROUGH GAS PIPING - ApPROVED JK I 01 SAPPROVED / REMARKS ~'r+ ~ "=:! I FINAL PLUMBING ApPROVED . / / DISAPPROVED / REMARKS FINAL GAS PIPING ApPROVED / / DISAPPROVED / REMARKS CERTIFICATE OF OCCUPANCY I DATE / DATE / DAT(l~/'I.;;J fI. .,. , I ~ I ,'<~ I I " ;, I'l I, ,jj'i 'I I INSPECTOR INSPECTOR I"""O'~~ (I / 0",//-d.7:J l"."m~~ II -/ J,;' c>' 'j, 4~ - , - ~#-- / DATE / DATE READY TO ISSUE / '/ 'NOT READY TO ISSUE / / DA TE REMARKS INSPECTOR. INSPECTOR INSPECTOR "~,, "", , '. ,_ f ~/ 1~/ . FHA' FO, RM NO. 2573...\ ' ~ /U.S. D ARTMENT OF HOUSING AND URBAN DEVELOPMENT Rev. ~0/70, \,' ,....0. ~1.10 . FEDERAL HOUSING ADMINISTRATION 1>-1c 0 'J. HEAL TH AUTHORITY APPROVAL ~~\.\.~Q /, /.(7113--~o' INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM Op..~ II~ PART I-TO BE COMPLETED BY FHA 1Y>~rlng d;nie '. .ft e-/ Form Approved Budget Bureou No. 63-R0296 Mortgagee - Name, Address and Zip Code 'FIRST NATIONAL BANK OF OREGON Springfield9Branch 665 Main Street Springfield, Oregon 97477 I -Mortgagor or Sponsor: ~.\ Gary M. Kessl'er F'D)ca~~' ~ ~ W ~ p ,~ OOT 24 19i3 Properly Address: L 2737. Burlingtl~rf{t'6l1~JTY HEALTH DEPT. SpT'n~fipln OTP~nn Q7u77 Subdivision: .. -- Lot 3, Block 2, Canterbury Village Firs t Addi Hon Lot No. ~ 3 TPTA t-_1Hllj'lRRR I IVING UNITS RRQB.Q.QMS RATHS BASEMENT IXXl New Installation Can Attic or other Area be made into addition81- bedrooms? (If yes, how many?) 1 3 2 D Yes IX>> No o Yes [UNo SYSTEM DESIGNED FOR WATER SUPPLY BY: ~ Public System SEWAGE DISPOSAL BY: o Public System D Community System D Individual No. of Bedrooms Garbage Disposal D Community System ~ Individual 3 PART II. - TO BE COMPLETED BY HEALTH DEPARTMENT o Yes ~ No. HEALTH DE PARTMENT INS PECTOR'S SKETCH BLDG. PERMIT 1600~ 13 _1_______ I I ,I fL ';- -- -'- I ___ ;;; ~ ~ ~ i ~ = ~ ~ ~~ ~ ~ ~ ~: ~ = ~~ ~ ~~ ~ ~ ~ ~ ~ ~ I'~ ~ ~ ~ ~ ~ ~: = -:: ~ J ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ - - ;;;;; ~ ~ ~~ = I 1 ~.: ~ ~,: ~ ~~.: ~::=: ~ ~: ~ - ~ ~ ~ ~ ~ t= ~ ~,= ~; ~ = = ~ ~ ~: ~ ~ ~ ~,~ ~ ~~ -; ~ ~ - - --- I 1-- 1--- c:::- ~ ~ ~ ~ ~ ~ f ~ - - -':: ~ ~'~ ~: ~ ~ ~ ~: - - ~ ~ ~ ~ ~ ~: t ~ ~: I~ ~ ~ - =.: ~,~:: =F': ~ ~~: ~~ ~ :: ::: ------~--- ,- ,--- ---- ------- --- ,-------- ====-- 1-=== -f= :==== =-=c: -=====1 F===:::== "It is !.he,_opiniop,QUp~ ,,0 State r- County Local Department of Health that this individual ~a!er,:,supply system ~' -=--,......-_. G is D IS not satIstactory as a domestIc water slIplliyrnr:rhe, suoJect property. It is the opinion of the D State '. 09 County with proper maintenance: fXXl Can be expeCted to function satisfactorily, and is not likely to create an insanitary condition DATE SIGV~ ro., D ~1\,: JL 10-24;'73 ~'\ICHARD~RBYJ R:5: I D 'Local Department of Health that this individual sewage-disposal system o Cannot b~ e'xpected to function satisfactorily TITLE SUPERVISING SANITARIAN NOTE;, The health authority should complete the appropriate opnion statement above and a~fi,x date, l!ignature and title in the s po ces provide~. , :.. .. " U.se of the above grid for Health Department Inspector's sketch as well as use of the back ofthi's form is at the opinion of the health authority. 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 0 Acceptable [J_ Not Acceptable Sewage disposal be cons'idered D Acceptable D Not Acceptable. -. .'~.. ~~ .~~ DATE 'SIGNATURE D CHIEF ARCHITECT D DEPUTY FOR CHIEF ARCH/TECT HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM FHA FORM NO. 2573 Rev. 10/70 REPORT OF INSPECTION-INDIVIDUAL 'SEWAGE-DISPOSAL SYStEM '~, PRIMARY TREATMENT consists of iJ Septic tank, 0 Cesspool. Septk Tank: Distance from well, Total liquid capacity Inside ,length,-1* C...pool: Distance from: Well. feel. Material 1000 feel. Inside width 4i CONCRETE Number of compartments "allons, Capacity inlet compart4~nt feet, Liljuid depth, ~ gallons, feet, feet; foundation, _ feet; nearest lot line at 0 front, 0 side, 0 rear. feel. Liquid' capacity, gallons, Lining material o Seepage pits, Other feet, Inside diameter, fecI. Depth, SECONDARY TREATMENT consists ofXJ Tile disposal field, TIIe'Dlapoaal fl.ld: Distance from: Well, feet; foundation, 10 fee~; nearest lot line at 0 from, ~ side,'K1 rear,_10 feet, Total length of tile',I~<.-:-_,-:} 1)0 _ fee,t,-,Number ,oUines, - ' ? . Distance ,between fines, ,to 'feer, -'-Trench wiJth, .:9 ,inches, : Tot~l effective absorption area, in bottom of trenches, , P::;O sljuare feet, , length of each line,'" 71::i-7r:; feet, Depth, top of tile to finish grad~' ":,, 'nches, Type of tilter material: 1KI Gravel. 0 Broken stone,' Othf' " Depth of filter material beneath tile" 6 inches, Depth of filter material over tile, 2 inches, Seepoge Pita: Number of pits__, ,Outside diameter feet, Distance from: Well, feet; building foundation Depth feet. lining material feet; nearest lot line at 0 front, 0 side, 0, rear feet. Date of inspection OCTOBER 14 0, Local Health Authority Inspected b: Inapectlon made by: 0 State,' 1XI County, 19.11 /s/ JOHN CRUICKSHANK, R.S. SAN IT ARI AN (TITLE) REPORT OF INSPECTION-INDIVIDUAL WATER-SUPPLY SYSTEM Distaole to nearest puhlic water main. _, ~eel. Size of main, inches, Individual wells 0 ~re 0 are not customaty in neighbprhood, Give most recent r('Cord of failure 'of wells in immediate vicinity to furnish adequate supply of water Properties in neighhorhood 0 are 0 are not being developed with both individual water, supply and sewage,disposal systems, lot size: feet wide feet deep, Dwelling set back from front property lin.. feet, Individual' water supply from: 0 Drilled well. 0 Driven well. 0 Dug well, 0 Bored well. D1atanc. of well from: Buildinj.( foundation feet; nearest lot line at 0 front, 0 side, 0 rear' feet; tile sewer feet; septic tank feet; disposal field feet; cesspool feet; other sources or possible pollution, feet, feet, feet; cast Iron sewer seepage pit, Well conatructlon: Diameter, inches, Total depth, feet, , Approximate depth to pumping level of water in well, Sealed watertight to depth of feet, Exterior space around casing sealed with: 0 Cement groUI. 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. length of drop pipe, feet, Pump capacity, located in: 0 Basement, 0 Pumproom off basement, 0 Pumphouse ahove ground, 0 Pump pit, Pumproom properly drained: 0 Yes, 0 No, Pump ,moun~ing',:,atertight: l:J Yes, EJ No. Type of storage: 0 Pressure, 0 Gravity, Capacityg'allons:' - 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 satisfaaory for human consumption, Installation 0 does 0 does not comply with approved exhibits, if any, Inspection made by: 0 State, 0 County. 0 Local Health Authority, Inspected by Type of casiny feet, Approxiri13te yield, Depth of casing, gallons per minute. feet, gallons per minute, ,19_ Date of inspection 19_ (TITLE) GPO 900.682 .I '. , ,~ ..~ " . -~~'''i'''''~,' '-',- r;:;-{':f.;.~""i.: ,.-.' 'f, -"',,, . I u ~ I \ ,r i:.:T PROPERTY ~ER 'I ..~, 'cONTRACTOR 'I' . c.' , ,t~Z:J0 ~ROPERTY'LO,,(.ATlO~ -,IN,CLU,P, E POST _?~FICE I. .' "P O;\lr;(;;@l7'J, , PROPERTY LE<?AL DE'SCRIPTION -METES, BOUNDS' , !. .: J..'~..I CbfllUOJrfill1,~1J"6 \1finUq;3 t..gg ~OtGC8. a TWP,' RANGE SECTION TAX LOT NO" , ',," "~ g2~ I , APPl. ,- ,,1 , r~ ," _' ~ --; t ,.--,- "-: . . . ....'; '1'. ..,. " HOh...- USE P"E~'Mlr PERMIT NO. '/;/ / J /,"4', '--' ~ lANE, COUNT. BUILDING rn ,U1lDIN,S:; PERMIT OR MOBILE MH 6.:' ' "'.'} ;,;: MAILING ADDRESS , . 1 .1\;, ,.- _'t ~ ',\I,-, , t ,,' :;c <:>'i ,......,,'1 It ar;{0r",9'", u '(.-,..... ~,;.r-.' -l,hdJ ",PHONE '" ..,., 'l.,,' , '.,,-1,, .MAllING'ADDRESS '~,.t~;\.\Iti~:",,,:\ : 5"e~', i'^~>?r;.~;; m 1':1">1.-;) , n'i~"i" ;., ,( ~.1 ~. ~J~inf...-h' l,-")f~ -t>ftv i!}~n,lt:..., \,t'V';...J~""'; 1 , J , PHONE , 'JtYZ1~%i7.7U ," .- ',-", ,:'1~ tit ~f. 1 0C):?6V"J;J~a6~d!~ @O>C:f%:JiJ, '.! COD!" t .~-"" CENSUS TRAS_K;; , '...,.~:.z&>.:l~e' . lfL~>,."" t./ NAME 8. , I 'MAllING I ADDRESS I F9R~~~c~JME No. of, Bedrooms f'"_,'"",-,, ' ~. '..~\. '''- ~. '~ EXISTING STRUCTURES ON PROPERTY t~~,~o i -. ''t'\ " ~\,~ : LEGAL ACCESS TO PROPERTY ~ " , !1k:.:rU UCVD~elY [':tiJ9o' PROPERTY SIZE - FT. ... WIDTH ,DEPTH AREA .', PERMITS ONLY 'SEWe.GE DISPOSAL, ~~:PUBlIC D ; ~~ ' SEPTIC 'TANK' 'E] Sewage System D New System D ' SQ, FT, :# BDRMS VALUATION... U~~),_ Q, ~2 <<D>> U? C'$:f!O r"-.....,~,'.. J-I.,'..--:~-t... f1' r"'I~I~" ~~ .....,. ~~. ... ' ~.;.::~\f~~;;.:': __~L;\'~0-,-L~ " \ ",..." .',"~'.i'.: U(~~(V, '...\.. ~... i "~~'.' ,'. .t{<.". ' ';';0' .....,,,..... - , '"",' '~{', ".'..:Y" ~~'-c. \~~~"'~'\ ~", :\ ~ '" .~ , '. ':::.. ~,.~\'\ '\,. . P.LUMBi~G"'INSTArLED BY' " ~,'...' "", , "'"~t,\ '" \".\'~ ~ \ ~~, ~\~~,~~,...j-~.~ ~\"'1-:-""-T;\jO'\\\1H"IQ, OT.t!,EREI.~' '-), ' ...J~ ;'3' )OWNER D OTHER, N:AME'" Hif i?n\:.~>;~Unfj il.L')..L~;; FEES WATER SUPPLY ~~",'1jt') PUBLIC' 5 Connect to, Existing TYPE C,ONS:rRUCTI9N C"trC3. , STRUC;:Tl,)RES TO BE BUlL,] THIS"PERMIT u':.'O~ UOt~ ~~,6p .~~ "." \,"-",'0 . "..",r? '~' ,..:Jy0(~\J"""" ~,..ll~Q ~...Ul..; . , , , " " , , ..... ... - ...' '~~ ----'- li1JD\$<..JU u tl.l!l.O..' U0vnt::,~fffila 17~~eJI1'00 , '..' ~~ \ ~. ,",~" .t'\:~~~)\" . \ \ , ' .:. ~;;,..... . " BUILDING" ., WASTE DI~POSAL PLUMBING PLAN REVIEW P.ARK TRAILER $ D OTHER .,s)~ ~ \;At'! .' TOTAL $ u u t' ,,>)~~ ~, MIN, SEPTIC TANK CAPACITY WITH ,[),r~T.:.,BO!<,;..G.~.L;,_ ~~\~~lr.; l,./U WV \iJ.!..~ ~\';.:J , COUNTY BUILDING 8: SANITATION SPECIFICATIONS DRAIN 'FIELD REQU,IRED , 5:D~ , e:lJ~ "''''''';__^ <:>n ~,"-../'. tL!'~~jT ~~~~IJ ...~A ,,",rrR.E~.\=t:t'<<!D.,T!i bT,~ ,..0 r",~9~ \~9..~FT. i...J'u.;~~:'U,Q"'- .~J V'tJ"'YU~-,-q",>I""''-i:~ .v .......~~....\O..,'v~. VVl.l ..,..,..,...v...", .""_...... . t" ~ ('. -- \ ,\" . ;\;,~ \~\,,;', .;~~,~~., .~\"'.))~,~> ~'S~ ~~~~~t~;~~~~ .' ~ \ """",, ," \J.i\ V, \\,C,\" ,~',J'''.',; ',','.\' " ':, ,\'t~j~..~"'" \~\~:\\ \ \~~~~.~-'~"" ~\."'~~~';\A,... - '%. .. .\\" ,- '-ZONE \I PUBLIC UTI!.. EASEMENT r;~u ' 2 c~;:;@ .,.,............'..'.. ..H..W.... TYPE OF STRUCTURE , !j lJ ' OCCUPANCY H [;. 49 BLDG, SETBACKS ~_ FT, FROM CTR, OF ROAD RIGHT OF WAY, ~~ 0 ~o FRONT SIDE INT, ,SIDE EXT, AUTHORIZED SIGNATURE - DATE toJ J)..(io GenG .~~f~c:Ji)&'GO:Jeh'v ' . . ,REAR ~(I F}l:fu;,ltoSSIFICATION <l),lZD~fu1 C~~'OcltD~C;;i~;to W'l~. 11' i\(' .',",1 'W:?v _;.cJIc':; DATE BLDG, PERMIT - WHITE OFFICE COpy _ WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITATION":" GOLDENROD Con'~truction to co'mply with uniform' building code and county regul;ti~ns covering plumbing and ,sewage disposal. ,All buildings, require a certificate of occupancy befo~_e .peing R\ccupied, '/ ' . .~ " .~~:; .~~ - ''':~,.~"::. ~,~ J " l..... :(See St9tement on Reverse Side) -" ~ \ ' , ~~.') (". ' "y', .); :'~~-...<~. <., .. ., \ \ '~.~~.~-+ ~'tt , I - " '\ ;. ... l~ , . \. . .~.....~~.~', r ~, I' (POST THis PERMIT ON MAIN B~PQ;" AT" Sn:E) , '.' :' . ,\" ~~__J ...: '~:,'" ~ ,.~.... ....~ ..\ LANE COUNTY, BLDG,. & SAN, DIV" COURT HOUSE, EUGENE, OREGON 97401 FORM :tt'rt;t;~ 11., .,.. :0; , 4 SITE INSPECTION ApPROVED / / ,DISAPPROVED I / DATE: INSPECTOR REMARKS FOUNDATION INSPECTION /' ApPROVED / V / DISAPPROVED / / DATE q:,,/:z '" 17 INSPECTORM REMARKS FRAMING INSPEC~ /7 ApPROVED I Y I DISAPPROVED / / DATE.;...tJ.../P'7':J INSPECTOR!:C... REMARKS~~9"'1;)' ",,& f LATH OR SHEETROCK INSPECTION ApPROVED / / DISAPPROVED / I DATE INSPECTOR REMARKS / , /' FINAL INSPECTI~ ~ ApPROVED / j/ / 01 SAPPROVED / I DATE / 1- ~ 73 INSPECTOR ~JfKS ~~A,~~~_d./J/IJ-~J~~1~,~Uhlv~ Q;;o~f ~ ::I J(U ;e;;:;;:, ;"TI~ I 1- CERTIFICATE OF OCCUPANCY READY TO ISSUE / / NOT READY TO ISSUE / / DATE INSPECTOR REMARKS A fJ //// f,~/fJ /tptJO-i3 I~( ;?r;8I'Jtl~ W~, ':V' p- , ' l.t\ It;., ,0/" " ,<a:.'. \ ! ~\ ;;z 0.- 30ZJ . ..,. .. __ -'.'la ,. , ~A/Jl/1 Ins[;Jler I s Name ~ / No.LivingUnits Bedrooms Baths I \3 I Septic Tank: Ft. from well Steel 0 Ins~C1e D:unens~ons: .t.t. Length ;{...r-' Width V;J'- Diameter \pplicant Gary Kessler Name c/oWestover Homes 2589 North 35th Place ~pringfield~ OreaRn INDIVIDUAL SEWAGE DISPOSALSYSTF.M}RECC~ Installer: Complecetop part form to signature and return both copicQ to Lane County Building Sanitation Department. .. ''- pro:eerty Address 2737 Burlington Basement ~ Water S~ply Yes 0 NO~' Public ~ Other-List PI"RMIT NQ_ 1600-73 J.e. Concrete ~' No. Compartments --- Depth "I~ -J- I Gal. Capacity, 10 0(7 Tile Disposal Field:~ Distribution Box:Yes ~ No 0 Other Distribution- Type L, \,,':"'/ ',J ..~;;c,., Feet 1. om Well/b Lot Line Front Side I (J Rear 10 FilJ!e\-.p. V F.iller depth Filler depth lJ.d above be low J TY~fV;u.. , ' !.il~ V in. tile C!J .:iJ4 (. J \ i)-i"'-'-\~l, ~ \S\ ~ n ~~ m 'iU), U ' I c.. .'" L. ' I \ "" " ',- LIt ,-- c C 1 19 1973 ' .. ItJ Mailing Address Length of Lines - Ft. 1.7.[2.713. 4. : 5. 6. Sketch, (See'instructions): AI Trench Total, sq,Ft.between Width dft.;jtlJ lines 10 I '10 ~ I LAi'1E (iOU\~n HEAL1H UMI1 lJ f ~~' ;t~J 31 J ' 'f ~ ,I.:;- fC<--" l' " , I~~ j'lr' II~ _1/ : I~"") t1- f \)wV'J" .J ' 1.-, " f ~7S ' ! , '- 'lJ,1 I I i I Date / () ~ / g' ,- / ~l7~ .. For sanitarian Use Only: '~Approved: System Installation b-Disapproved: Does Not Conform Remarks: .olIIIIl ~J lANE COUNTY P liNG PERMIT 0 R MOBilE HOME APFLlCA TION PERMIT TYPE -' BUILDING ~ MOBilE HOME Dose REG. # PROp, ErsJ7RT OWNER ,11./ '.. MAILING ADDRESS K ..P~~, , '1:7~ / {ONT~A~TOR /J-- /, ~ rJ-' MAILING ADDRESS. ' ' .," -' ~ qC (JJ~;9.'ev ^~ c:J,c:r 99' ,~.b:, S- PROPERTY LOCATION - INCLUDE POST :FFICE 02 '7 .3 7. ~ ' f ~ ~ ~ .W"p~" '_, ,It PROPERTY LEGAL DESCRIPTION.3 ~ LOT - BLOCK - SUBDIV, .,,-- TW) '7 R]E Sc.e/' TAX LOT # <:,ODE ./ ~~ PERMIT # /6 CJt?-:z? PHONE PHONE 70-.97~ NAME CENSUS TRAC -<0 - d c;? C7 DESCRI,BE EXISTING STRUCTURES ON PROPERTY IF ANY =--:b~ LEG4 ~S TO PRO,PERTY - ROAD NAME OR # '~~L~_~ ~. PRQl>{RTY SIZE~WIDTH ...e-,. ~EPTH '" MET~~ ATTACHED 0 NO APPLICANT AND MAILING ADDRESS FOR MOBilE HOME PERMIT ONLY Number of Bedrooms STRUC RES TO BE BU~V THIS PERMIT .. A e ~ g7 ,- )J~~-~. -r~ ~ ".. AREA ,Connect to Existing T~6NSTRUCTlON 0--4~- ~- Sewage System D or New System Req, D SQ, FT. .J;) # BED~O~ VALUATION '/U~cY/;- Cd') "Vfi;.G.j , " @~ .- / ,) 9dlr ;.5lJ6 I ,_/? 1/..... '0 '- 1/2 '/I/J/ I 1./ 't}~ ...... / SEWAGE DISPOSAL PUBLIC 0 .TOTAL :/2 \7. ~ ~ PUBLIC WATER , CONNECTION FEE .3 d"'dt? .;< ~ .cJ 0 /~,-S~, PLUMBING INSTALLED BY A ~ -'./7 ~ OW~ER d" OTHER~AME tJ/~PG",_~ ~ANS URN ISH ED l- , FACILrPER,<!;IT 7 YE /I NO 0 YES V NO 0 SI AT~F APPLICANT.. ~ '\ DATE .7Ld.".A~~ ,,-P'...../';:>-73 I FEE RECEI~.EDEY - DATE , , A4q/' J 9-/';>-2.5 PERMIT 1/: . / ~ - /~ ,r')/1 -' ::<:< 6 SPECIFICATIONS SEPTIC T~}lK f;f; . ~"'t " 7"r~d'O ~cJ,.od 73 r ('\71 " ,OTHER 0 FEES WATER SUPPLY PUBLIC 1(' PLUMBIr(!G FEES ../ 0 y.tXTURES CASH 0 S~ CHECK...6A"ONN'ECTION FEE OTHER BLDG. WASTE DIS, PLUMBING PLAN REVIEW PARK TRLR, COUNTY BUILDING & SANITATION MIN" SEPTIC TANK CAPACITY WITH DIST, BOX: GAL. Cjoo K6'of .draihG t6 ~et'~ '+;'eI7 {f( ',hI IiI ch'h4 . ~ '" (/ DRAIN FiElD REQUIRED lIN. FT, 2-],6- TRENCH WlbT'HF]. 2-. ,OR SQUARE FEET ,~I'/JW WftA/~ '. LAC) ic-J? 'J7jhr-h1c, / / /, /' TYPE OF STRUCTURE If"tI OCCU/~4 e~1 REAR YARD PUBLIC UTll.jEMENT BLDG, SETBACKS - FT, FROM CTR, OF ROAD RIGHT OF WAY, 'I, USE CLASSIFICATION / FRONT "~SIDE INT, ~ SIDE EXT, ---- REAR '7 fI'(J'r:r... \ ; ~~Jd;; r~/MMA f'~;~:nLDG IN5P~ ~.o~ V/ t. _;; r - (' I' p- cr VY;;I ~ c;;e>[- Directions to Find Property: COpy 1 - OFFICE COPY 2 - JOURNAL COpy 3 - AUDIT Form # C55,12 ( ~.-----" ../ //- /- ..~I " '. ,- ,'-:, '" '. '~<, '..','. ',/~':" ".'''': . ....- ~ .- .:-.."... 7/- .' i L -.---'--. --" ------ I;, '.. .:. "'4 . __- -, ,- --I .....___' =-- . .~ "Y7'f}. ~ 7J__/ ~ .... ..--. - .1 /'.-...-. .. '-'t \ ~ - .. '; - "y1I~ ~ kLc.ti --,"--- . .