HomeMy WebLinkAboutPermit Septic Tank 1969-4-29
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RECEIPT No. 51482
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27 & TAX LOT NO.-17.03" CODE
REQUEST FOR SITE I NSPECT I ON DA TE 4- 24-6q
BY
EWING. Michael
MAILING ADDRESS 857 Willow Ave.
TEL. No.
688-0847 /
/
Euaene. Oroaon
OWNER Of PROPERTY Richard Fambers SIZE Of PROP.
CONSENT Of OWNER? VeS Is PROPERTY CONTIGUOUS
Ex I ST I NG STRUCTURES ON PROPERTY None ',---
Oabay
SOURCE OF WATER SUPPLY: PUBLIC xx SPRING
LEGAL ACCESS?
TO ANY CITY LIMIT?
WELL:
DRILLED
DRIVEN
Ves
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DESCRIPTION OF SITE (DIRECTIONS, LANDMARKS, HOUSE OR BOX NO., If ANY):
State Fann end Gmne Farm - Intersection South West Corner.
PROPOSED USE OF SITE (E.G., NUMBER Of DWELLINGS, COMMERCIAL OR INDUSTRIAL USE, SUBDIVISION):
Four pl~ site
Ll[7 URBANIZING AREA.
~ SPECIAL PERMIT AREA.
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FEE:
No. Of SITES 1 $ 5.00
No. Of ACRES-
TOTAL- $ 5.00
RESULTS OF INVESTIGATION:
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THIS IS A PRELIMINARY REPORT WHICH DOES NOT INSURE THE ISSUANCE Of A fUTURE BUILDING
PERMIT. ANY PLANS OR EXPENDITURES MADE IN RELIANCE UPON THIS REPORT ARE AT YOUR OWN RISK:
BEFORE CONSTRUCTION IS STARTED BRING THIS fORM TO THE BUILDING AND SANITATION DIVISION AND
MAKE APPLICATION fOR A BUILDING PERMIT. If THE PROPERTY is A PORTION ONLY Of 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 srTS Of THE BUILDING PLANS
AND PLOT PLAN WILL BE REQUIRED.
"LANE C,WNTY BU I LDI NG AND SAN ITAT ION DI~Lj19/? ~ /1J (). /)
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U BUILDING INSPECTOR I . - ~ SANITARIAN
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THIS REPORT IS NOT COMPLETE WITHOUT THE SIGNATURES OF THE BUILDING INSPECTOR AND SANITARIAN.
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