The URL can be used to link to this page

Home My WebLink AboutPermit Building 1973-2-19 r (, i) " to",.. 'f;". , " I~<t~~~.(: " .;..:: ?~ ;..,... j~.~~J .~'.", f:. .. ~- .". .>:-:-s./ ,~..; :"., i \ , . LANE COUNTY ~..J'1,; - -, BUILDING OJ, PROPE~JY OW~ERCC'! T:71.;cr IOtJ ,'.' "3 T' II E I~ ~;a:~,<;.:(UtiU(d~1 CO~1 ILDING PERMIT OR MOBILE HON MH 0 MAILING ADDRESS '1SE PER'MIT PERMIT NO. . t)j.9--7-3 .... ,. .~~ .~. t ;? i ..~~:".. f.; 'PHONE CONTRACTOR l'-'~;J'':'' I~I '.'h'." ,), .....1 M' -J. ') } ,.-. ~ I!-.. ... .: MAILING ADDRESS, SPr-"L L'. PHONE :< f4t,;~:: 7!17o'qc7'j PROPERTY LOCATION - INCLUDE POST OFFICE 27idj CAlHr:R81;RV 1 ST. i\DO PROPERTY LEGAL DESCRIPTION - METES, BOUNDS C~NTERaURY VILLAGE B-2 L - 12 TWP RANGE SECTION C~-( 0.3 2~~;.{,{ TAX LOT NO, '1f- J ()cJ I CODE CENSUS TRACT APPL. NAME & MAILING ADDRESS SPRINGFIELD, OREGON FOR MOBILE HOME PERMITS ONLY No. of Bedrooms h'ESTOVE'; CONSTFWCT IO~J Co. 20 EXISTING STRUCTURES ON PROPERTY .. r~ONE LEGAL ACCESS TO PROPERTY - EO [( f)C 2589 N. 35TH PL. Ct\f~TEi~BU::lY ST. PROPERTY SIZE - FT, WIDTH DEPTH AREA STRUCTURES TO BE BUILT THIS PERMIT i).'iELLCNG Connect to Existing Sewage System 0' TYPE CONSTRUCTION SQ, FT, # BDRMS n60 \.: : 2 ( ~ New System D 'VALUATION ~()" .'j;~O GARAGt. - ATT - UNCEILED 40,1. f' (.;At \: , i.~O .. 6:~1.'. ~..,., " i G, >,11 ",', I ;,~ 7 f~LL SDS SEWAGE DISPOSAL $" " OTHERO 71.00 FEES 20.00 ii.;;O PLUMBING INSTALLED BY OWNER 0 OTHER: NAME WATER SUPPLY ~! AI. I. \'!" PUBLIC 0' BUILDING WASTE DISPOSAL PLUMBING PLAN REVIEW PARK TRAltER SEPTIC TANK 0' PUBLIC 1Kl~ o OTHER TOTAL t 124.~o COUNTY BUILDING & PLUMI3If~G FEES 3.00 [J.'CH; , SEWER CONNECTION F~E 2.00 ~/ATE~ COmJECTIOrTiEE t ,50 SANITATION SPECIFICATIONS WITH DIST. BOX: GAL. 900 DRAIN FiElD REQUIRED L1N. FT 150 TRENCH WIDTH FT. .3 OR SQ, FT, lfC)O MIN, SEPTIC TANK CAPACITY HOOF DRAINS TO STR~[;T. TYPE OF STRUCTURE 5~~ BLDG, SETBACKS __ FT, FROM CTR, OF ROAD RIGHT OF WAY FRONT 45 SIDE INT,' 5 SIDE EXT. AUTHORIZED SIGNATURE - DATE /sl \, 30SD BY C~J\RL IE HARISlAUGH OCCUPANCY t1, J ZONE PUBLIC UTIL. EASEMENT USE CLASSIFICATION REAR 7 DATE JOMN COUIC~SHANK R.S. 2/1 ::; /'/~ 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 # C55-13 " 4 , (!~~~ B-~ ff ~' T / 7 ~ ~?i ~ S _ ;2 /, T/\X LnT_~-/_~_ S CEN~ TRACT c:2 0 -;-. "E..-P/5t:? ' . . ~ to. . , ' APPllCA T' ~ " No.02/~-'7 'NJ\ME~:/~~~~j ADDRESS o BUJLDIN~ SiTE EVALUATION - r Building Permit Appl ication () Site Inspection () Pre-Permit Investigation PHONE DATE .J ~/3 -73 LANE COUNTY PLANNING DEPARTMENT 3. 4. Required Access NOT app I icab I e () () ( ) ( ) ( ) ( ) NO YES NAME (~ ,~fl:? -~' " (~ ' ' (~ ()~ - ( ) DATE I. 2--/3-7~ Zoning Ordinance Compl iance (Zone12-J ) 2. Subd i vis i onO rd i nance Camp I 'i ance Building Site (Area, Width, Frontage, Setbackj Other (see comments) ( ) ( ) ( ) ( ) 5. COMM ENTS : BUilDING INSPECTION SECTION NOT NO YES, NAME ,DATE app I i cab I e 6. Plans Submitted ( ) ( ) (y) 7. SoilStabil ity (foot ings) 0 ( ) ( ) 8. ,Flood Plain ? ( ) ( ) (~lJ~1 \ \ 2 - 1.. I c,)~ '\ 9. o the r (see Comments) ( ) ( ) - , COMM ENTS : I SANITATION SECT! ON NOT NO YES,' 'NAME DATE app I icab I e 10. Sewage Disposal' ( ) ( ) <)( II. Usable Area, ( ) ( ) u #~ 12. Water Supply ( ) ( ) 24\ 13. o t he r (see Comments) ( , ( ) ( ) COMMENTS: '.. TO APPLICANT: ( ) ( ) - ( J Youryilding Permit /Si..:e '~sp-ect~ (~ Can be approved. 2- Ll 1 ~~, () Cannot be approved at this time as ind'icated on item NO. above. Quest ions and further informat ion on items I through 5 contact the lane- COUNTY PLANNING DEPARTMENL Questions and further information on items 6 through 13 contact the Lan~ Couhty Buildinq and Sanitation Division. Wil I be held in this office until you can resolve the problems indi~ated. Is being returned. Your building permit appl ication fee is being returned under separate cover. , LANE COUNTY PLANN I NG DEPARTMENT 135 Sixth Avenue East, Eugene, Oregon 97401 PHONE: 342-1311 ' EXT. 231 LANE COUNTY BUILDING & SANITATION DIVISION 135 Sixth Avenue East, Eugene, Oregon 97401 PHONE: 342~1311 EXT. 411 M55-28 ',", ~.~~~ .., f':. ~ Date .. '.:..' ~:'"t ~'-. J '. i '; No. PERMIT IN THE BOARD OF COUNTY COMMISSIONERS OF LANE COUNTY WHEREAS, the attached application has been fully considered by the' Board of County Commissioners 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 iss ued, now, therefore, it is hereby ORDERED, that a permit be and is hereby issued to ~, ~LJ .f~\J'::~~: ::-;n:;~~:;.f ',' .,:r:\.. tl for the placing, building and constructing of the following facility: v; :\.~:I t<.!: : P7t': , . Q'(~' ' {'.'1'.:'-1?~:!~,'t'.::;".~,..'~l : ~J~<'-r~::.~: ':\~t'tJ j.:~~t,.fr;:~l'}t.~;!.'? \t~:.;J,{~~!.:~"-.! .f.) ~ ~f rei . r.t~~ ~, 'f ,.; l' '. ~,f',"" t;" ': upon the right-of-way of County Road No.':)"Jt,~~;t1:':;j1 in strict conformity to the exhibits attached thereto, and subject to all terms, conditions, agreements, stipulations and pro- visions contained in the application and permit, the Rules and Regulations Governing Facilities to be Permitted upon County Road Rights-of-Way, dated March 31, 1960 and any amendments thereto, and any other applicable regulation, law or ordinance. Special provisions: ~:,)'~ f' \} :;; ',:~H :.'~ C01"hjt'r.'"if.t<?;!1~ ~,~J ", ;'.. '\ f{) ?~,.,~, H'~~;t:}~6.1;~t :1:r: ," ,Jt,1,."t '.;.i i fc"L':'IV::! ,;1' ,{ 'F:,;\,<',:J::C' ," '~ " ,,:_. l,":' "'r. ~.~:hli:~ ;:'f~.~ t,:"-:'-~'~ ":'.~_~..: f''''', > ~ . "';-"\ ; ~~~ -i',! ;~'~::~-,H 0' ~y~ '!: t' _f;; ~:\~\tt. t;,.--l..~,' r~ It~!~.t r.f:~~ f\ !.\ 1111' {:l. 7,' .'~ :'5," ..' .I: I" ;-f ;~. ''"' :'\ ~ '. ' -- J .;' ! ~'(:;\) t;.r~':~-,;~ ;)",::t ,~:~:~'t,,~ ~tt':l.~:;fihi~.!i{-Jle ~~~~~d:'tt..."'.), 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 ~<;'ti,.::' II Ji" J~'1, completed before ,19 '. Expires , 19 Inspected and Approved Approved by Board of Commissioners By Date By Director of Public Works WHITE. OFFICE FILE PINK. PERMITTEE ORANGE. BUILDING & SANITATION DEPT, GREEN. RESIDENT ENGINEER BLUE. ROAD SUPERVISOR YELLOw. SURVEYOR 08- 52 . " ;~, '.. . . D,ate . ~ .f.:"" " 't'. ~ . , "l....~... "... APPLICATIDN FDR FACILITY PERMIT IN THE BOA~t;);;OF COUNTY COMMISSIONERS OF LANE COUNTY . , Your applIcant, I hereby makes application under Rules and Regulations Governing Facilities to be Per- mitted Upon County Road Rights-Of~Way, to construct the following facility: " .' ~. Upon the right~of-way of County Road No. f:' ,,;:.,'.', ,::, at the following lo~ii~~n~ .0,,' ", , ~ ..., ,~.,'. as shown on the exhibits which are attached hereto, in strict conformity to the state- ments of the exact nature and amount of work to be done, and to the description of the facilities contained in said exhibits. Your applicant will be the beneficial owner of the facility as constructed, or otherwise primari Iy I iable and responsible to members of the' public for its proper maintenance, repair, operation and use. 'Your applicant accepts all , , terms, conditions, agreements, stipulations and provisions, in Rules and Regulations Gov.erning Faci lities to be Permitted Upon County Road Rights-of-Way, dated March 31, 1960, and any amendments thereto, and any other applicable regulation, law or ordinance. ..; ~:l__ . ;..s-~. "', ~ j r ., !.f .' ~' r ~ 1 i . t ...~. t '-, ,. (j , . .' .. ~ , ;._ l ~~ ;.~; Signature Address . f WHITE.OFFICE,FI.LE GREEN. RESIDENT ENGINEER PINK. PERMITTEE , BLUE. ROAD SUPERVISOR ORANGE. BUILDING AND SANITATION DEPT. YELLOW. SURVEYOR Phone No. ' ~ 4, .. ;;. 17-.7 J LANE COUNT' BUILDING 0 JILDING PERMIT OR MOBILE HOi MH 0 MAILING ADDRESS 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 & 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 0 TYPE CONSTRUCTION SQ, FT, # BDRMS New System 0 VALUATION t fEES PLUMBING INSTALLED BY OWNER D OTHER: NAME WATER SUPPLY SEWAGE DISPOSAL PUBLIC D BUILDING WASTE DISPOSAL PLUMBING PLAN REVIEW PARK TRAILER SEPTIC TANK D OTHERD PUBLIC D D OTHER TOTAL t MIN. SEPTIC TANK CAPACITY WITH DlsT. 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 - 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 :it C55-13 ~\ t.. '. SLAB FLOOR PLUMBING GROUNdwORK ApPROVED / / DISAPPROVED / REMARKS GAS PIPING GROUNDWORK ApPROVED / / DISAPPROVED / REMARKS ROUGH-PLUMBING ApPROVED / /(i DISAPPROVED / REMARKS ROUGH GAS PIPING, ApPROVED / / _ 01 SAPPROVED 1 REMARKS FINAL PLUMBING ApPROVED If'tI" 1 DISAPPROVED 1 ; , REMARKS' FINAL GAS PIPING ApPROVED 1 .I 0 I SAPPROVED 1 REMARKS CERTIFICATE OF OCCUPANCY / DATE / DATE / DATEq - t/ - /J / DATE / DATE5-,j/._~.J / DATE READY TO ISSUE ,I I NOT READY TO ISSUE I REMARKS / DA TE '. .,):".1-1 INSPECTOR INSPECTOR " , INSPECTO~~ {/ : INSPECTOR I",,"T~ INSPECTOR INSPECTOR . .. LANE COUNn -j BUILDING 0 JILDING PERMIT COR MOBILE HOI-. MH 0 MAILING ADDRESS JSE PERMIT PERMIT NO. PROPERTY OWNER CONTRACTOR to , MAILING ADDRESS PROPERTY LOCATION - INCLUDE POST OFFICE ,.. ~,:.. ~ ~, .' PROPERTY LEGAL DESCRIPTION - METES, BOUNDS I 'j -r APe? TWP RANGE SECTION TAX LOT NO, APPL. NAME & MAILING ADDRESS FOR MOBILE HOME PERMITS ONLY No. of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT , \ \' .>..... - ~~' r\ SEWAGE DISPOSAL PUBLIC D BUILDING WASTE DISPOSAL PLUMBING PLAN REVIEW PARK TRAILER OTHERD SEPTIC TANK D $ FEES TOT A~ $, .., CODE CENSUS TRACT EXISTING STRUCTURES ON PROPERTY LEGAL ACCESS TO PROPERTY PROPERTY SIZE - FT. WIDTH DEPTH AREA Connect to Existing Sewage System 0 TYPE CONSTRUCTION SQ, FT, # BDRMS PLUMBING INSTALLED BY OWNER D OTHER: NAME WATER SUPPLY PUBLIC D D OTHER MIN, SEPTIC TANK CAPACITY WITH DIST, BOX: GAL. ~ COUNTY BUILDING & SANITATION SPECIFICATIONS DRAIN FiElD REQUIRED L1N. FT TRENCH WIDTH FT. , ~ l\' ~ \ ~ " '~ \-. \.' '- \ " \ ~~ '<',~';'b , ~,tJ ~~ ,:~ ~t \\ ")..\ \;" ~\. ~ _ -, ". ...''l:- - ...... \ . TYPE OF STRUCTURE OCCUPANCY ',", BLDG, SETBACKS u FT, FROM CTR, OF ROAD RIGHT OF WAY FRONT SIDE INT, SIDE EXT, AUTHORIZED SIGNATURE - DATE REAR OR SQ, FT. ~ ":"\ i .~\~. ':'\~ ~~~~/ " I' ",,'\, '... -\ , ~ ~)'Y~'~~~~\,~":"~> "" J V\ l\ ....1.l >~d' "-,,:. .'. \-,_,,,"'" l, \ ,'. \~ '.', \~ .' 'I PUBLIC UTIL. EASEMENT ,.< ZONE USE CLASSIFICATION '~/, PHONE PHONE New System 0 VALUATION 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) FORM :It C55-13 LANE COUNTY, BLDG, & SAN, DIV" COURT HOUSE, EUGENE, OREGON 97401 ~ ..... , -\ '. SITE INSPECTION ApPROVED / / DISAPPROVED / / DATE INSPECTOR (~/L/~dJ ,:;,--2]~~ I REMARKS FOUNDATION INSPECTION /1 ---i '/ 11-7. 12 DA TE ,.j.-."..... t)- I ~7 INS PE C TOR C.;::z-- ./ ApPROVED / 1/// DISAPPROVED / / REMARKS FRAMING INSPECTION ../' ApPROVED / J/'/ DISAPPROVED / 'N,,,no' R- \':" "i J.~ I DATE ,) -~.J" 73 REMARKS LATH OR SHEETROCK INSPECTION ApPROVED / / DISAPPROVED / / DATE INSPECTOR REMARKS j : or FINAL INSPECTION ~ A','o"o /;1 0''''''0''0 / / On, ,.1(;/( - '7.1'N",no, ~ REMARKS~ ~~jltJ-/~""1j~' ~<J-~8"-73(f il f - -. CERTIFICATE OF OCCUPANCY READY TO ISSUE / / NOT READY TO ISSUE / / DATE INSPECTOR REMARKS C~ ;2'/?..'l~ #~.2?28 ;( 0 -a () t;) '- r. Z,AAkA It:.Jkailer I !i Nlllne (J No.LivingUnits Bedrooms Baths , / 'Septic TanJt: Ft. from well Steel 0 Ins~Qe D~ens~ons: Ft. Length lJ- WidthLj,J- Applicant, Name Westover Const. Il"'\ -4 . . .. . ," . INDIVIDUAL SEWAGE DISPOSAL SY ~M RECORD Installer: Complete top parL ~ form to signature and return both copies to Lane County Building Sanitation Department. 219-73 PFRMIT No. , ~ "'\, ,3 I property Address 2728 Canterbury St. Basement Water Supply Yes 0 No 'W Public ,~ Other-List Concrete lti I Gal. Capacity, I tflCJ () Tile Disposal Field='- Distribution BOX:YeS~ No 0 Other Distribut~on- Type to Feet lfijrom . J! ) welll/(J u>>.fl'Foundation I ~ Lot 'Line dront Side /0 Rear /() Fill r.# V Filler depth Fl.ller deptfi I above below / Typ. l1U4t-d...,tile ,2-., in..tile ", iQ... No. Compartments Diameter Depth ~ .J- Mailing 2589 N. 35th Pl. Address Springfield, Or. Length of Lines - Ft. Trench Tot~7 sq. Ft.between l.Z(2lf3. 4. 5. 6. Width dft .-7'...) lJ lines.lf J Ske~ (See instructions):, j J IV ,r rLf!.' ~._, (Y") t:;::;:;-- ' r'- c::- en c=:: 0 [Ln.' ~ a::: @ 0_ 0:.:-..( illlJ , r.-v- la~ 1 1 ~ "'" 5- x:l i- ;:il '..J.J :x:: >- I- ~.::..- :5 ';::l '~ , u.J ~ 1- , < }, /\. v{'f/ l:S'i~ t~ Y Jy, ~ "". 1~6J.l)b _ I , r '; l c b I to -? (f 1j , T I ~ Date i-I./ j '7; --I q '11, " , , 1 For San~tar~an Use On y: , ,t{'APproved: System Installation iJ!Disapproved: Does Not Conform Remarks: Lane County Building ~- ) f~ - / ~''WJ)/J / - - , ' s~nitarianls & San' ation Dept. 111 siJ'pure C55-11 LANE COUNTY BUILDING PERMIT OR MOBILE HOME USE APPLICATION PERMIT l'YJ1'E - BUILDING bi MOBILE HOME Dose REG. # PERMIT' #27 9- 73, P~~PERTY OWNER ,/" / lv\"ILlNG ADDRE~ ' t:tL A. PHONE ll//AhY?/--C/2/ Lt1-7l-~ .c!o dS-yf:j '71.35 f?P. ',_ 1/1# (ONTRACTO~, ' MAILING ADDRESS . . I "/ ~ , PHONE, ~~ ' /~, 747-997/ PROPERTY LOCAgON - JJ'C;~~~. -:/....,g.. J ~ (j-LV"V\--;" "-V--f /( ....~-1 '1..~-'l--" d? d- VU;/;7-;~{.fj~~ /" PROPERTy'LEGAL DESCRIPTION' /r~ .: J-,.., /'IA / J 'AI / Ii/> /1/ . -<<"_ 'J /, _', / { '7, ' V LOT - BLOCK - SUBDIV. (~M/UY2A/1A/Vl01 1~(t4..YK/ jU- (;;>( ~ Ip(,; TWP RANGE ' SE.C. j Ii TAX LgllT# 17 ~ "0..3 ;;2 +- II APPLICANT ~, I' NAME I , METES & 'BOUNDS 0 YES ATTACHED 0 NO AND MAILING ADDRESS FOR MOBILE HOME PERMIT ONLY Number of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT ,dAArl~~~i -~L- (ad-~ f' ;I -~ . CENSUS TRACT ,-2 t; -.,t5lJ /s 0 DESCRIBE EXISTING STRUCTURES ON PROPERTY IF ANY ~~. LEGALACCESS T9 PR~PErY - ROAD NAME OR # , ~H.uuA' ft. PROPERTY SIZE-WIDTH ~TH AREA CODE \ . Connect to Existing TYPE CONSTRUCTION Sewage System 0 or New System Req. 0 SQ, FT,. # &EDROOMS VALo/'}ON ' /36 () IZJ IoU (d) /~Jf;? l) /(4-~-j;6~ 1~9;;L~ I - 1-- /?fJ;' 4 , / ~/f ~LdL 'sEWAGE DISPOSAL' PUBLIC 0 SEPTIC ~ANK t BLDG. $ '7/, () . ' , 2-0', {) 0 S3~ -5i> TOTAL . /.:<4.5 ~ OTHER 0 FEES WATER SUPPLY PUBLIC ~ OTHER PLUMBIl,(G)EES 3' ~ / I':) FIXTUR~ . -1 {). #-0 ,CASH 0 'SE~ '1 CHECK~NNECTION FEE eX ; '~'" PUBLIC WATER J CONNECTION FEE /J. t> , PLUMBING INSTALLED, BY / OWNER 0 OTHER 0 NAME .%/~ PLANS FURNISHED ' FACILITY PERM.!9' YES ~ NO '0 YES)6 NO 0 S~~ OF.;?, L1C~~' ~' _ DATE 'X~.~~-11'-73 , l ~~CEIVED BY DATE (44/ 02-/3-73 PERMIT # WASTE DIS., PLUMBING PLAN REVIEW PARK TRLR. -73 C9UN~Y BUILDINGSAt-l1J A,. TION SPECIFICA nONS - ~~..' "~ '.} ,DRAIN ""fIELD EQUIRED.... qcro , L1,N. FT. .~' -'.' T~ENCH WIDTH FT', S. OR SQUARE FEET J?~f ~c. <~.i;-f:rr.~-, -,I T'" OFSTRUCTURE SA! 14~~ BLDG. SETBACKS - FT, FROM CTR, OF ROAD RIGHT OF'WAY \. FRONT _ <f-~' _SIDE.INT.,,6 SIDE~,_ _ REAR :l-..' ~~ 4J''Ji)d/7D;te PL~, Z.-l~t:7~G, INSP. , ~,,, ~ . _ Directions to Find Property: ' MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GAL </t::0 ZONE REAR YARD . PUBLIC UTIL EASEMENT USE CLASSIFICATION #~tJ!2~J9''JJ Date COPY 1 - OFFICE " COpy 2 - JOURNAL, COpy 3 - AUDIT Form # C55-1Z --- ~ ,~ ('" rV - , /' I \ I n .e::. '~. ..... ~ \ L .~ -, ;..~- 't I . , i / ~ Lt \ '),f l~/? , If,--7~ '. 'z2fi \ ' ' ~>; .1'Jt{{.c ~~Vl-tefb~VY 51 :" ~-" _L / ~( ).- i...1 b -7'- I .' 5, J- OJ -~ \ . . ' 1. \ \ "'\ \ - ~ . ~~ t I.J.... , 1-:-- \ ~ .. -, ... ~t 7l/ -; . ' . ~..: .. \ <f' .. . - . ,'.\,..0., \ _ .' ') " --