HomeMy WebLinkAboutBuilding Miscellaneous 1967-3-14 PROPOSED MONTCLAIR ' 'DITION
RECE I PT- .NO. 9n475 • • • TWP. 17 RANGE 03 SE0._3!L
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TAX LOT NO. CODE_
SERIAL NO.
REQUEST FOR SITE INSPECTION DATE 1, , ,
BY BRITfON, Jones MAILING ADDRESS 751 West 12th TEL . No. -7840
Eugene, Oregon
and Sink
OWNER OF PROPERTY Rassmussen SIZE OF PROP. • .6 acre LEGAL ACCESS? Garden Way
CONSENT OF OWNER? Yes
EXISTING STRUCTURES ON PROPERTY I dwelling
SOURCE OF WATER SUPPLY: PUBLIC XX SPRING WELL : DRILLED DRIVEN DUG
DESCRIPTION OF SITE (DIRECTIONS, LANDMARKS, HOUSE OR BOX NO., IF ANY) :
Garden Way south of Centennial .
PROPOSED USE OF SITE (E.G., NUMBER OF DWELLINGS, COMMERCIAL OR INDUSTRIAL USE, SUBDIVISION) :
Subdivision
L7 URBANIZING AREA. FEE:
No. OF SITES 1 $ 5.00
SPECIAL PERMIT AREA. NO. OF ACRES 1 7.00
BB:sk TOTAL $ 7.00
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RESULTS OF INVESTIGATION: / / / (// ��� �//�,
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BEFORE CO UCTION IS ST RTBRING THIS FORM TO THE BUILDING AND SANITATION DIVISION AND
MAKE APPLICATION FOR A BUILDING PERMIT. IF THE PROPERTY IS A PORTION ONLY Or A TAX LOT, A
METES AND BOUNDS DESCRIPTION OF THE PARCEL MUST BE FURNISHED. EXACT SPECIFICATIONS FOR THE
SEWAGE DISPOSAL. SYSTEM WILL APPEAR ON THE BUILDING PERMIT. TWO SETS OF THE BUILDING PLANS
AND PLOT PLAN WILL BE REQUIRED.
LANE COUNTY BUILDING AND SANITATION DIVISION:
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&BUILDING INSPECTOR SANITARIAN! DATE
THIS REPORT IS NOT COMPLETE WITHOUT THE SIGNATURES OF THE BUILDING INSPECTOR AND SANITARIAN.
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