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JOB LOCATION
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Acreage or Lot Si7P Partitioning #
Contractor's O,S, # ' ~ '1_ ') J e::; . l
APPtIC~NT'S N~ME AND A~DRESS cN-ClPI f)/JA~ LJ ,~
OWNER'S NAME AND ADDRESS 717-Y1; A J""': ~ ./-IdA /')-11.1 A1h-A._
. CONTRACTOB'S NAME AND ADDRES~ . -,.. --- ;r-,.
Mail permit (0 ( ) Applicant ( ) Own~i ( ) Contractor, ( l.,).P-refer to pick up.
. .TRUCTURES NOW ON THE PROPERl't !h) !/,h":"il-,
THIS PERMIT IS FOR. t2.d.....,f~ "i",f ~)#./h/J'Aj2
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WATER SUPPLY !/j,lJJl! SEWAGE DISPOSAl J?..//~ S.1. #
THIS PROPERTY I: ~ITHIN ONE MILEtF THE CITY OF PLUM~NG 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~b)uyer; , realtor or agent. I further certify that (if r.lOt tA0,owner) I am authorized to act for the owner of
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record, and that said owner is aware and ap'proves of this action, I hereby agree to comply wi~h aWap')'licaele Codes,relating to this permit.
Fee Paid $ $:'1 s 9 1> Signature ItJ IW~"~ , Date -;;. -'"2.<i{ -77
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( ) NEW ADDRESS ( ) FACILITY PERMIT TO TRANSPORTATION DEPT. ( ) SPECIAL PMT. AREA. MIN. ELEVATION: '
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SANITATIO~ (" BUILDING /', )~
* f7-1~'fIA,:!J Minimum Septic Tank Capacity (Gallons) _<A..I T'y~e of Cpnstruction T'? Group ~-5 Fire ~~~e1v
.' Drainfield Required - Lin'eal Feet' ~ -/ A -r::- Use Classification J
Maxi mum Depth I C~~~~ - ~~ - :
Comments: ~ ~ C ',c_ ';f , -%' '~
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LANE eOUNTY PERMIT /J
( ) Completed Subdivision ~/L-c..') /;/1 /,,~;
! Lot 4 Block I ' .,~
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By: ~(~".,.-- Date: _~~;), '" '71/ By: UJ/:),..;,~.4 ~ (4trt~Date: ,3 ~ 1.. - //
PLANNING REQUIREMENTS SATISFIED, By: Vh)/'J1f7:::: t/ Da'te: c;?-;J.I-7/!/ Date Issued:
lONs.: ~rrt~1'J At: f'$ETBACKS: FRONT <;f5 / SIDE FACING STREET (FROM CIL) 'INT. SIDE YARD S'REAR ~ <?(FROM P/U'
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LANE COUNTY DEPARTI,/rENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE., EUGENE, OREGON 97401
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PHONE: 687-4394
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C55-13
POST THIS PERMIT ON MAIN BUILDING AT SITE
BLDG. PE.RMIT - WHITE; BUILDING - GREEN; PLUMBING - CANARY; SANITATION - GOLDENROD; OFFICE COpy - WHITE
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PERMIT #
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LANE COUNTY PERMIT
Acreage or Lot Sizp
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APPLICANT'S NAME AND ADDRESS 4l:ll(
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OWNER'S NAME AND ADDRESSJ/,E ,I,'"
CONTRACTOR'S NAME AND ADDRESS
Mail permit to ( ) Applicant ( ) Owner (
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_STRUCTURES NOW ON THE PRO:,ERTY .J! ,/,. .:; ;'::.,;- ('} 'i
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THIS PERMIT IS FOR .;,1. /!' /( ,/ r,' ,,/;.{' f4/f'F .r';'<'
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# BEDROOMS _./# PLUMBING CONNECTIONS
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SEWAGE DISPOSA'
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TH IS PROPERTY IS WITH I NONE MILE OF THE CITY OF
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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 .Inot 1helowner) I am authorized to actfor the owner of
record, and th~t ,~id owner is aware and approves of this action. I hereby agree to comply '7~th an ap.~lic~~le Code( relating to this permit.
Fee Paid $ ,;; '~/....: ! ~9tC J Signature ri(4.A /'I....J~ Date -2. r "/. ' '7?
,( ) NEW ADDRESS ( ) FACILITY PERMIT TO TRANSPORTATION DEPT. () SPECIAL PMT. AREA. MIN. ELEVATION:
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Minimum Septic Tank Capacity (Gallons)
Drainfield Required" Lineal Feet
Maximum Depth
BUILDING
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-';' J. ,.4,' -;r; I )se Classification
Group
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Fire Zone
SANITATIObt-
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Comments:
Comments:
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By: ....~. . ..,,~-::.. ..-:-" _. ;'~~ Date:..Ji - ,.., -- ~~ ~""-;' By: ',. .'#_ ~ ...... .', . /._....~] t~ _ ..~!~' ;.' Date: ...- ;: .~ -1'1 ~
~PLANNING REQUIREMENTS SATISFIED. By: ~..>t':) I ',:I. Date: t";"~:;J" 7-.'7 Date Issued: :f::-(./- 7 '/
ZONE: ~~' ,,,~/.::. {''SETBACKS: FRONT .'7...F1/ SIDE FACING STREET (FROM CIL) .INT. SIDE YARD.5-; REAR ~ ;(FROM Pill'
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LANE COONTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE,:.;El:JGENE, OREGON 97401 " PHONE: 687-4394
POST THIS PERMIT ON MAIN BUILDING AT SITE
C55-13
BLDG, PERMIT - WHITE; BUILDING - GREEN; PLUMBING - CANARY; SANITATION - GOLDENROD; OFFICE COPY - WHITE
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Job Location
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3;;3-77
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INFORMATION SHEET
~Uilding Permit
~L l L"3
90 ~''iOO
( ) Compll;lted
( ) Pending
APPLICANT'S NAME AND ADDRESS ~ Dh..I~c
OWNER'S NAME AND ADDRESS, if different from applicant's
CONTRACTOR'S NAME AND ADDRESS S~, tJ~
_Mail permit or results of site feasibility study to )><t.Applicant ( ) Owner (
(><LPreferto pick up, Call ,"5i-'"l..~4c::.:'?" ,(owner,etc.) when ready,
Acreage or Lot Si7<>
Partitioning #
) Site Feasibility Study for Septic Tank.
) Would like to meet on site, Call
Test holes will be ready
Subdivision R..~ ~~
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Number of sites
(owner, etc,)
TL S 3GC
3 Block 3
Lot
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U JJ I.. UG)0:::. L fr.;
SrPhonp '31-2... "'3f~ 3
Phonp '"72-4> a--=-.W
Phonp
) Contractor.
STRUCTURES NOW ON THE PROPERTY
PROPOSED USE (this permit) "5 F- R..
WATER SUPPLY <.=:: ~Lc;'"'ho.fl..
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(existing or proposed well, etc, If public, name of system)
SEWAGE DISPOSA' ~u-;;:'h~ 4~'-<.... ~ t\I\'-
PLUMBING BY M-es '?LUI-<6~
( ) PROPERTY IS WITHIN ONE MILE OF CITY (
(existing or proposed septic tank, etc,) S.I.:It
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Address. 8f':;"
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******* ** ** ***************** ** ************* 0 FF ICE USE ON L Y BE LOW TH IS LI N E ***** ** ****** ** * *** ** ** ** ** **** **** ** ** ****
tic I NJddCeressary ( ) Facility Permit Ne\:essary
ONE (} 17 SETBACKS: Front . Side Facing Street
UtL1€. / _/l,..&7.fJ::t h-a (lRA'>..J (FROM CENTERLINE OF ROAD)
To: Planning/Building Inspector/Sanitarian/Surveyor.
This applicant appears to have a problem with
Your assistance will be appreciated.
(
) Special Permit Area.
Minimum Elevation:
Interior Side Yard Rear
(FROM PROPERTY LINES)
By
Permit Processing Section
Response:
C55-12
By
DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
Permit Processing Section
125 East 8th Avenue
687-4394
l1ivision
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Subdivision 1C-~ H.k:- T
Lot ..3
Block L.
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Vicinity Map
C74-150
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Job Location (Address) 24~ S 'COXZ-~~
Permit ,,;;;:f' ;S--i'l For /.i' ~/ ~5 f1:.f) p'ermi,t II
Permit II . For" ,..- ,pertn:1t II
Permi t II For' Permit II
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SITE INSPECTION
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ApPROVED /X/ DISAPPROVED.j
REMARKS
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FOUNDATION INSPECTION
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ApPROVED / f/ / DISAPPROVED / /
REMARKS /)~ -k LJ_12..t -'
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DATE _1=-/4 -71 INSPECTOR ~~
"'?-//J --7"? 9t~J__
FRAMING INSPECTION
Ap",o"o /./( 0'5'"",0"0 I I D"E S /0 -77 'NSPECTO' ~L
REMARKS
LATH OR SHEETROCK INSPECTION
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ApPROVED / ~/ DISAPPROVED /
/ DATE ~;-- / ?.., "7 'J
REMARKS
FINAL INSPECTION
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ApPROVED, / /;A DISAPPROVED /
REMARK S
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DATE t, - /s-?? INSPECTOR
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CERTIFICATE OF OCCUPANCY
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READY TO ISSUE /
/ NOT READY TO ISSUE /
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DATE
INSPECTOR
REMARKS
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JOB LOCATION
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LANE COUNTY PERMIT
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Acreage or Lot Si7'" Partitioning # ( ) Completed Subdivision IC -f."V... _,1_ ' '-;' \ I '
Contractor's O.S, # 5.5 J ~, '~ ,r- . 4' , ; /~. Lot c!}' , Block I _~' " ..
-.. I /J II) , ~J,. 30 ?()' 'L_ ". A ,., Gt~l:?
APPLICANT'S NAME AND ADDRESS . ~ {., f/}fiA-l ~, , PtA:'u. - (),., (t...-uJ-..I!A..4-(. Cl: PhoneJ 0- .dY-.0~
OWNER'S NAME AND ADDRESS ~pj~#":'-'/Y#A_,''11r ,.trJ"-.&t _ I Phone/d00 ~.rj
CONTRACTOR'S NAME AND ADDRESS J ,t7,.:;; -! _ I. ,Phone
Mail permit to ( ) Applicant ( ) Owner ( ) Contractor. (L.).Prefer to pick up.' Call ~.:l-3ljt,..::[ (owner, etc.) when ready.
.RUCTU RES NOW ON THE PROPERTY. !h ) P'./ h:' !j-. . .
THIS PERMIT IS FOR tAL.--,.:f!.~ ~, d~()~ Z2. 3 # BEDROOMS .3# PLUMBING CONNECTIONS
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\tV AT E R SUPP L Y. / / )/LL.{l
SEWAGE DISPOSAl -P~C
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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 ttfulowner) I am authorized to actfor the owner of
record, and thatLidowner i,S aware and approves of t~is action. I herebY. agree to .~omPIY Jlh_'}p7apP.1icao!e Code~ rela~ing to this perJ1lit; '" _ . '
Fee Paid $ 5 1 ,$ 1 . Slgnatl,Jre ~~ ~f.- Datp ~-:- -Z Ss 77
( ) NEW ADDRESS ( ) FACILITY PERMIT TO TRANSPORTATION DEPT. ) SPECIAL PMT. AREA. MIN, ELEVATION:-
5.1. #
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_ ' .L~{..4/ Minimum Septic Tank Capacity (Gallons)
_ Drainfield Required - Lineal Feet
~" ' Maximum Depth
Comments: ~ '7.UMJ ...J..Ha:v -.J.-: f~--,
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BUI LDING
, <; III Type of Construction :z..-
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;or ..4 ...J_ T:;;"', Use Classification
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Group
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By: ~. ' ,'-.r- Date:, _~.~ -77 q By:'~ /.:..>'cr-:t-4 /~ \.L~~rPate: 3 -- 2. -7/
PLANNING REQUIREMENTS SATISFIED, By: Lrj2...:}'U L' .. v.' "Date: c:2-;)3-77 v Date Issued:
ZON!=,: ~~w3 Ab /SETBACKS: FRONT .<;t) / SIDE FACING STREET (FROM CIL) INT, SIDE YARD~ ' REAR (,..,09(FROM P/L)~
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LANE COUNTY DEPARTMENT OF ENVIRONM~NTAL MANAGEMENT, 125 EAST 8TH AVE., EUGENE, OREGON 97401 PHONE: 687-4394
POST THIS PERMIT ON MAIN BUILDING AT SITE
C55.13
BLDG, PERMIT - WHITE; BUILDING - GREEN; PLUMBING - CANARY; SANITATION - GOLDENROD; OFFICE COPY - WHITE
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SLAB FLOOR
PLUMBING GROUNDWORK
ApPROVED / / DISAPPROVED /
REMARKS
GAS PIPING GROUNDWORK
ApPROVED / / DISAPPROVED /
REMARKS
ROUGH PLUMBING
ApPROVED ~DISAPPROVED /
REMARKS
ROUGH GAS PIPING
ApPROVED .I
/ DISAPPROVED /
REMARKS
FINAL PLUMBING
ApPROVED / ~ DISAPPROVED /
REMARKS
FINAL GAS PIPING
ApPROVED /
/ DISAPPROVED /
REMARKS
CERTIFICATE OF OCCUPANCY
/ DATE
/ DATE
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INSPECTOR
'I NSPECTOR
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/
DATE S -//-) > I NSPECTOR /"'7~
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/ DATE
INSPECTOR
/ DATE / tJ-cio ~t7NSPECTOR
/ DATE
READY TO ISSUE /
/ NOT READY TO ISSUE /
/ DATE
REMARKS
INSPECTOR
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INSPECTOR