HomeMy WebLinkAboutPermit Building 1977-1-24
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PERMIT #
LANE COUNTY PERMIT
.
SUbdivision~~ (..i~
Lot.5 Block.:L .
Acreage or Lot Si7~
Contractor's O,S. #
Partitioning # ) Completed
APPLICANT'S NAME AND ADDRES<:
OWNER'S NAME AND ADDRES<:
CONTRACTOR'S NAME AND ADDRESf:
Mail permit to ( ) Applicant ( ) Owner
) Contractor. ( ) Prefer to pick up. Call
Phon~
Phon~
Phone_
(owner, etc,) when ready.
STRUCTURES NOW ON THE PROPERTY
.THIS PERMIT IS FOR
WATER SUPPLY
~ BEDROOMS_~ PLUMBING CONNECTIONS-
SEWAGE DISPOSAl
S,I. #
THIS PROPERTY ISWITHIN ONE MILE 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 the owner I I am authorized to act for the owner of
record, and that said owner is aware and approves of this action. I hereby agree to comply with all applicable Codes relating to this permit.
Fee Paid $ Signature
) NEW ADDRESS ( ) FACILITY PERMIT TO TRANSPORTATION DEPT.
Dat~
) SPECIAL PMT, AREA. MIN, ELEVATION:
SANITATION
. Comments:
Minimum Septic Tank Capacity (Gallons)
Drainfield Required. Lineal Feet
Maximum Depth
BUILDING
Type of Construction _
Ilse Classification
Group
Fire Zone
Comments:
By: Date:
PLANNING REQUIREMENTS SATISFIED. By:
ZONE: SETBACKS: FRONT
By: Date:
Date: Date Issued:
SIDE FACING STREET (FROM C/L) INT. SIDE YARD REAR
(FROM P/L)
LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST BTH AVE., EUGENE, OREGON 97401
POST THIS PERMIT ON MAIN BUILDING AT SITE
PHONE: 687-4394
C55.'3
BLDG. PERMIT - WHITE: BUILDING -GREEN; PLUMBING - CANARY; SANITATION - GOLDENROD: OFFICE COpy WHITE
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Job Location lot.! 5
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INFORMATION SHEET
) Site Feasibility Study for Septic Tank.
( ) Would like to meet on site. Call
Acreage or Lot Sizp Test holes will be ready u_
Partitioning # ( ) Completed Subdivision A.L.~_..p /L.-~
( ) Pending /) J} - . /)
APPLICANT'S NAME AND ADDRESS -V~ C ~ /t'/tI F d/-<<., -"---" ~
OWNER'S NAME AND ADDRESS, if different from applicant's~;
CONTRACTOR'S NAME AND ADDRES~
Mail permit or results of site feasibility study to ()() Applicant ( ) Owner ( ) Contractor.
e( ) Prefer to pick up. Call (owner, etc.) when ready.
~
( 'f) Building Permit
Number of sites
(owner, etc.)
Lot S
Bloc~ 2.
~~....,
,r
o-~ Phone-Z..'I 7 -} r 72...
Phone
Phone
STRUCTURES NOW ON THE PROPERTY
PROPOSED USE (this permit)
~~
~,_d.-.~
WATER SUPPLY
jJ a-I--L:-
(existing or proposed well, etc. If public, name of system)
SEWAGE DISPOSAl ~
/
~./;:;. ~A
(existing or proposed septic tank, etc.) S.1. #
PLUMBING BY
(y) PROPERTY ISWITHIN ONE MILE OF CITY ( ~~
. / .
Address
Z:-~
******************************************* OFFICE USE ONLY BELOW THIS LINE *******************************************
( ) New Address Necessary
eZONF
) Facility Permit NeCessary
SETBACKS: Front Side Facing Street
(FROM CENTERLINE OF ROAD)
) Specia I Perm it Area,
Minimum Elevation:
I nterior Side Yard. . Rear
(FROM PROPERTY LINES)
To: Planning/Building Inspector/Sanitarian/Surveyor.
This applicant appears to have a problem with
Your assistance will be appreciated.
By
Permit Processing Section
Responsp'
C55.' 2
By
DEPARTMENT OF ENVIRONMENTAL.MANAGEMENT
Permit Processing Section
125 East 8th Avenue
687-4394
lIivision
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JOB LOCATION
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PERMIT # It/I-II
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LANE COUNTY PERMIT
) Completed Subdivision ~Lfm'J J aA-e.-cz.--./
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Contractor's 0.5. # Lot - Block r-...'
APPLICANT'S NAME AND ADDRF<:<:JJrJ1I.11J j7 r ,::1".;, ,d', /d1Js I k1)./~h t:.?'.<:rJ:. ,-:]cl-R Phonp/cj7--317~
OWNER'S NAME AND ADDRES<: -' f- ..' , {./ Phonp'
CONTRACTOR'S NAME AND ADDR<=<:<: Phonp
Mail permit to ( ) Applicant ( ) Owner ( ) Contractor. ( ) Prefer to pick up. Call (owner, etc.) when ready.
STRUCTURES NOW ON THE PROPERTyJ,?-l/.<"1...2. ~
. .THISPERMITISFOR -.aI1A!.I~/ tZaA_~/
WATER SUPPLY ,Aft> ./ '
Acreage or Lot Size
Partitioning #
,~
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THIS PROP'~RT":' IS WITHIN ONE MI LE OF THE CITY OF
# BEDROOMS_# PLUMBING CONNECTION5--
SEWAGE DISPOSAL. ,-_Uc-'/_~-F 5.1. #
/
., 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 the owner) I am authorized to act for the owner of
record, and t.hat said owner is aware and approves of this action. I hereby agree to comply with all applicable Codes relating to this permit. I
~) .-, / . ~ ' 7
Fee Paid $4--}, d / . - Signature jy~-4' ,r ,.4.;~,..... Datp /- ;; ~ -7
( ) NEW ADDRESS ( ) FACILITY PERMIT TO TRANSPORTATION DEPT. ( ) SPECIAL PMT, AREA, MIN, ELEVATION:
SANITATION
...
,
Minimum Septic Tank Capacity (Gallons)
Drainfield Required. Lineal Feet
Maximum Depth
BUILDING
_ .erA/. Type of Construction J Group
. A>;'-<"..,-!",~llse Classification
/r I I
Comments:
~ Fire Zone
.Comments:
By: vi ~,J/' Jr.~ ~"Date: /- :2-~-71
'--r-r-:l/h.A.::r- (/ Date: j-cY4- Y/l Date Issued: 1-,;)'-1- 77
(/ SIDE FACING STREET (FROM C/L) INT. SlDE YARD REAR (FROM P/L)
,-..,
By: Date:
PLANNING REQUIREMENTS SATISFIED. By:
ZONE: A/A SETBACKS: FRONT
LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE., EUGENE, OREGON 97401
POST THIS PERMIT ON MAIN BUILDING AT SITE
PHONE: 687.4394
G55.' 3
BLDG. PERMIT - WHITE; BUILDING - GREEN; PLUMBING - CANARY; SANITATION - GOLDENROD; OFFICE COPY -WHITE
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SITE INSPECTION
ApPROVED Cl DISAPPROVED Cl DATE
REMARKS
FOUNDATION INSPECTION
ApPROVED ~ DISAPPROVED ~ DATE
REMARKS. & 0
FRAMING INSPECTIDN
ApPROVED / V'/ DIS~PPRDVED Cl DATE 1-1--1- 17
REMARKS
LATH OR SHEETROCK INSPECTION
ApPROVED t.-I OISAPPROVED L-I DATE
REMARKS
14 /f'Id---
FINAL INSPECTION
ApPROVED ~DISAPPROVED
.
INSPECTOR
INSPECTOR
INSPECTOR ~~
.f
I
! 1 NSPECTOR
Cl
DATE!-7-7.7? INSPECTOR ~
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REMARK 5
CERTIFICATE OF OCCUPANCY
READY TO ISSUE L:::7 NOT READY TO ISSUE L:::7 DATE
REMARKS
INSPECTOR