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Home My WebLink AboutPermit Building 1973-1-22 ., . ":j i';', '{ ;.; \'...,~:, " ,.~( PROPERTY '0 NER _ ... H Ill, Robert .i/,"c'/; /\ LANE CO~NT~ILDING PERMIT OR MOBILE BUILDING [! .. MH D MAILING ADDRESS . 2324 Darnoch, Spfd. MAILING ADDRESS HoAusE PERMIT ..- PERMIT NO. (\~p.~/" "".,\..:. ~ 59-;'3 \) PHONE 746-9916 PHONE CONTRACTOR PROPERTY lOCATION - INCLUOE POST OFFICE 1160 Dondee St. TWP 18 RANGE 2 SECTION 6d,3 'a;/~ Ie. _ TAX'LOT NO. CODE //,;l.J~ CENSUS TRACT 3S-IS2A .PROPERTY LEGAL DESCRIPTION - METES. BOUNDS Meadow Green Estates, Lot 18, Blk. 1 2324 Dornoch EXISTING' STRUCTURES ON PROPERTY None LEGAL ACCESS TO PROPERTY Dandea St. PROPERTY SIZE - FT. APPL. NAME & MAILING ADDRESS Springfield, Or. FOR MOBilE HOME PERMITS ONLY No. of Bedrooms Robert Hili WIDTH DEPTH AREA STRUCTURES TO BE BUILT THIS PERMIT Connect to Existing Sewage System D TYPE CONSTRUCTION SQ. FT. # BDRMS Wood 1094 Gl 12 3 483<P3 New System D VALUATION 13,128 1.449 I~,)II Dwelling Garcge - att. - unc. ~~w~r oonnec~lon - &.uu Install se~ogc disposal system; 6 plumbing fixtures ~ 3.00; ~ater connection - 1.50 SEWAGE DISPOSAL PUBLIC 0 SEPTIC TANK :0 BUILDING It WASTE DISPOSAL PLUMBING PLAN REVIEW PARK TRAILER PLUMBING INSTALLED BY OTHE'D ,:l.uu :lU.UU " .5U FEES ,OWNER 0 OTHER, NAME WATER SUPPLY PUBLIC )b 0 OTHER Jock Jackson TOTAL <---roo. 50 COUNTY BUILDING & SANITATION SPECIFICATIONS MIN. SEPTIC TANK CAPACITY WITH 0151. BOX: GAL. 1000 DRAIN FIELD REQUIRED lIN. FT ISO TRENCH WIOTH FT. 3 OR SQ. FT. 4so Maintain ten feet from the propeety line and house with all parts of the dralnfleld. Divert roof drains to Qhe street. TYPE OF STRUCTURE StJ OCCUPANCY & J ZONE PUBLIC UTIL. EASEMENT BLDG. SETBACKS".... FT.IFRQM CiTRo OF ROAD RIGHT Of WAY I\~ pt:. P O\; P <in FRONT SIDE INT. SIDE EXT. AUTHORIZED SIGNATURE - DATE Isl Boss by Harb~uQh USE CLASSIFICATION REAR G.~. Gray, R.S.T. DATE 1-22-73 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 97.401 FORM::: C55-13 )4 N .c..K.. C '(1 Building Permit Application No. 59-1a I I SUILD'IIlIG ~ITE EVALUATION , Site Inspection ( ) Investigation " Pre-Perm i t LANE COUNTY PLANNING DEPARTMENT NOT NO aDD I icab Ie I. Zon i ng Ordinance Compl iance ( ) ( ) (Zone R h- ) 2. Subdivision Ordinance' Compl iance ( ) ( ) 3. Required Access ( ) ( ) 4. Building Site (Area, Width, ( ) ( ) Frontage, Setback) 5. Other (see comments) ( ) ( ) l~i~If'M~}j()O~6~~,. Bc:.L l~ T 1t1.R6Zs O~ Ti\-X,Lor,', ' C~TRACT 5~-\52--A APPLI CAJil: _ NAME~"I ADDRESS \-I:ILL PHONE DATE I-I t;r I:> - YES NAME DATE ( ..r--' ?/k'.L/ /~/~-}..3 ( ..r--- I (~ (~ ( ) COMMENTS: BUILDING INSPECTION SECTION NOT NO YES NAME DATE aDDl icable ~ 6. Plans Subm i tted ( ) ( ) 7. Soi I Stabil ity (foot i ngs) (!/) ( ) ( ) 8. Flood Plain (j) ( ) ( ) . 9. Other (see Comments) (~) ( ) ( ) {tj~~ /...;.j,....?, . "" COMMENTS: , \.. SANITATION SECTION NOT NO YES NAMli DATE aDDl icable 10. Sewage Disposal ( ) ( ) ~) II. Usable Area ( ) ( ) ( ) I'1_J. ~~ 12. Water Supply ( ) ( ) ( ) 13. Other (see Comments) ( , ( ) ( ) p COMMENTS: ~ , TO APPLICANT: Your Building Permit / Site In~ection: (/ Can be app roved. 1- ~ 713 f' () Cannot be app roved at ~ ~ ~ s t im~ as i nd i cated on i tern NO. above. Questions and further information on items I through 5 contact the Lane- COUNTY PLANNING DEPARTMENT. Questi.ons and further information on items 6 through 13 contact the Lane Countv BuildinQ and Sanitation Division. () Will be held in this.office until you can resolve the problems indicated. () Is being returned. . \ () Your building permit appl ication fee is being returned under separate cover. _ - __-,~ _Or ~._.~- '.. LANE COUNTY PLANNING DEPARTMENT ~ 135 Sixth Avenue East, Eugene, Oregon 9740~ . PHONE: 342-1311 EXT. 231 LANE COUNTY BUILDING & SANITATION DIVISION 135 Sixth Avenue East. Eugene, Oregon 97401 PHONE: 342- , 311 EXT. 411 M55- 28 ". ,,~. 01(,) ro~ie CE~-73 ("0' t.;'"";';- . .. Date -Ynnunv'lI ?lL lll71 . 11 , , 1011'1 7 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 issued, now, therefore, it is hereby ORDERED, that a permit be and is hereby issued to Robavt Htll for the placing, building and constructing of the following facility: D1'tVOi::av opproCleh tI1~tl curb cut-COado" Green Estates-Lot HI aleck 1 1I1)~' UGllael.l ;)\;NOl: upon the right-of-way of County Road No. 1016 , 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: nr1!Jm1QY tltll be constructed tn accordance \:11th .the! nttllchod dvtvGtfDY opproadl apactfteottons (D~utng ~m8-50). Porotttee ttfll bo I"Qsponstble ~ol" the t~dtate r'eD01I111 of 011 n:ud. dtrt and debris frc::1 tho roa~'1!IY and right of l:Iay caUlled by hill operatton. 100lltng tile rco~ay and arao tn Q neat. acceptable condttton. 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 Jonu&!'Y 24 completed beforf' void unless the work herein contemplated shall have been 74 ,19_, Expiref' . 19 Inspected and Approved DatI" , , Approved by Board of Commissioners By . '. --- .' /" .~..... - .. By :/ . LDirector of Public Works WHlTE . OFFICE FILE PINK. PERMITTEE ORANGE. BUILDING & SANITATION DEPT. GREEN. RESIDENT ENGINEER BLUE. ROAD SUPERVISOR YELLOW _ SURVEYOR Cg,I-S2 . 1 ... " DalP . . APPLICATION FOR FACILITY PERMIT IN THE BOARD OF COUNTY COMMISSIONERS OF LANE COUNTY Your applicant. hereby makes application under Rules and Regulations Governing Facilities to be Per- mitted Upon County Road Rights-of-Way, to construct the following faci lity: Upon the right-of-way of County Road No, , at the following location: 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 primarily liable 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 Governing 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. Signature Address WHITE. OFFICE FilE GREEN - RESIDENT ENGINEER PINK. PERMITTEE BLUE. ROAD SUPERVISOR ORANGE. BUilDING AND SANITATION DEPT. YellOW. SURVEYOR Phone No, ~ ~ ~~I . 5J-~ hfJ V H'ERBST~Marge jafnl'- -~ ... IN~ ~ rc:;'~.=:'NO'~' :I '~llo/7:>~_r'- q~,}-y ~ VETERANS ADMINISTRATION 11\\ ~ - u [j ~ 1/1/ - ~~\ 'J?f; ~.- '')1 REP,ORLOf INSPECTION, INDIVIDUAL WATER SUPPLY AND SEWAGE.DIS.~O$Al. SYStJM oP ifIIi!!!/J..-'!- (TOP SECTIOM TO BE FILLED 1M BY VA,) . - ~ v /.;){;) - \'~ Veterans Administration /"O'''1YAOO'''5 15UIOIVI510NNAMf1st Add tl ''', 11160 Dondea Street lAM. roU Meadow Green Estates ,426 S,~', Stark Street Springfield, Oregon 97477 N:V HE.\,llloc,,!>oPT 110. NO, ,,~ort1and. oregon 97404 , i' 18 NAME Of BUILDER NAME Of LENDER CA$f NO. First Nstiona1 Bank of Oregon 64468 Real Estate Loan Division ~1Y"OFINS''''LATlON P,O, Box 1786, Eugene, Oregon 974 ih 1VI CJ N'W ~ ."STlNG If YES, HOW I WATER SUPPLY AND SEWAGE DISPOSAL (Check) ....NY? I I PUBLIC COMMUNITY INDIVIDUA.l WA.TER SUPPlY IY I X , l SEWAGE DISPOSAL IV X (Fill in be/ow information applicable to subject installation) INSTRUCTIONS: If new inslal/otion, inspect for 'compliance with approved uhibib and record any ob..,."eod information nol shown on, Of which vori.. from, ,h. oppro't'ed exhibih. If existing instollotion, 'furnish os much of the informatiOn al may be a't'Qiloble. Al applicable Ule inlpedor'. .~etch on rever.e. Robert N. Hill TOTAL NUMBER I 8ASEMENT . CAN Amc OR OTHER AREA BE MADE INTO ADDITIONAl BEDROOMS? Om LIVING UNITS BEDROOMS BATHS 1 3 1 DNo Om DNo 'ART I-FOR USE OF INSPECTING OFFICIAL INDIVIDUAL WATER SUPPLY SYSTEM Distance to neare.t public water main, ,"to Size of main, inche.. Individual wells 0 ore 0 ore not customary in neighborhood. Gi't'e most recent record of failure of wells in immediate 't'icinity to furnish adequate supply of water PropertiM in neighborhood 0 ore 0 are not being de't'eloped with bath individual wateNupply and M1wage-disposol systems. lot size: f..t wide, feet deep. Dwelling set bock from front property line, feel. Indi't'idlHll water IUpply from: 0 Drilled well. 0 Driven well. 0 Dug well, 0 Bored well. Distonce of well from: Building foundation cost iron sewer feet; tile sewer feet; ceupool, I"",et; nearest lot line at 0 front, 0 .ide, 0 rear feet; septic tonk feet; other lOurces of possible pollution, feel; disposol field, feet. "et; "et; ..epage pit Well construction: Diameter, inche.. Total depth, feet. Type of co.ing, feet. Approximate yield, Depth of ca.ing, feet. Approximate depth of pumping le't'el of water in well, gallons per minute. Sealed watertight to depth of feet. Exterior space around casing sealed with: 0 Cement grout. 0 Puddled cloy. 0 Ordinary bockfill. Well cover: 0 Concrete. 0 Wood. 0 Metal. Opening~ in well cover watertight: 0 Ves. 0 No. Pump: 0 Shallow well. 0 Deep well. length of drap pipe, f..t. Pump capacity, gallons per minute. located in: 0 Basement. 0 Pump room oH basement. 0 Pump hou.. above grnund. 0 Pump pit. Pump room properly drained: 0 Ves. 0 No. Pump mounting watertight: 0 Ves. 0 No. Type of storage: 0 PreslUre. 0 Gravity. Copocity, gallons. Has bocNrialogical elamination of water been made? 0 Ves. 0 No. If answer is "ye.;' give date Quality of water 0 is 0 is not satisfactory for human consumplion. Instal lotion 0 doe. 0 does not comply with approved exhibits, if any. 19_. INDIVIDUAL SEWAGE,DISPOSAl SYSTEM PRIMARV TREATMENT consi.ts of ~ Septic lank. Septic tank: Di.tance from well, Total liquid capocity, o Cenpool. feet. ,.al, CONCRITE Number of comportmenh '1allons. 1 Inside length Cesspool: Distance from: f..t. Inside width gallons. Capacity inlet comportment f..t. liquid depth feet. Well feet; foundation feet. Depft. feet; n~re.t lot line at 0 front, 0 side, 0 rear feel, Inside diameter f_t. liquid capacity, gallon.. lining material_ SECONDARY TREATMENT consists of ~'Di.tribulian box and efTiledisposol field. 0 S_page pits. Other Tile disposal field: Distance from: Well leet; foundation, 20 feet. neorelllot line at 0 front, 0 side, ~ rear, Totollength af tile lines, 150 feet. Number of I~e. 2 Distonce between lines, 10 f..l. Total eHactin ablO"tiO:reo in bottom of trenches,. Ii). \quare feet. Tren~h width, ~6 inches. length of each IiM, 70 f_t. Depth, top af.hle.ta fiOlsh grade, IOche.. Type of filter material: I!J Grovel. 0 Braken stone. 0 Cinders. Ofh-o" Depth of filter mo,.rial beneath tile, 6 inche.. Depth of fil"r material o't'er lile,_':I Seepage pits: Number of pits, Di.tance from: Well, ''l,..l, inche.. Outside diameter, feet; foundatia", feet. Depth, feet. lining material feet; neare.1 lot line at 0 front, 0 side, 0 rear feel, If e.i.ting in.tallation, gi't'e 011 the following additional information a't'ailable: Di.tance to nearest: Public sewer feet. Community system, feel. Appralimate direction of IUrface drainage of 10' . Appralimate slope "et per 1 00 feet. Soil i.: 0 loom. 0 Sandy loam. 0 Clay. 0 Sandy cloy. 0 Coar.. IOnd or grovel. 0 Hardpan. 0 Roc.... Other Number of bathroom., . Is there a baMlmenl? 0 Ve.. 0 No. Bosement drain. ,... fixture. in ba..ment: 0 laundry tray. 0 Toilet. 0 Bathtub. 0 Shower. 0 None. 0 floor drain. 0 Sump pump. laundry waste dispOlOl1 Direct to 0 Seepage pit. Other Thraugtl sump pit to: 0 Septic tonk. 0 Seepage pih. II footing droin provided? 0 Ve.. 0 No. Drain. tal 0 Surface. 0 Dry ,*,,11. 0 Sump in basement. Other DownipOUts or oreaway drain to: 0 Surface discharge. 0 Dry well. Other Depth of house lOWer below flnim grade at foundation feet. PART' (Continued on 1everse) V' FOAM 26-6395 JAN 10.. EXISTING STOCKS OF VA POAM 2e_II'1 MAR. 1010; WILL lSE. USED " , , (OU:) o;SI-tl1t - 0 ust : 3;)LofdO DNl.LI>ill:ld .LN:a:WN1f3:AO!> 's "R<v>. '. " :1 NOUJiS ".."-. c""-"_ ~'\V.uv""'1lo ., DOg9~O %0 JDBS IBnOltB~ 3B~iq '1131.0 M:r'lI?l.J:.J,S. G noo~ _ ~~ oi a3 1 )1;0 '?'u....,... l'VaU",V ,CIIU~Cuw. ,VU\.L AUU .v.. c-... IlllI'<W" 8IqoJdo:))o ,ON 0 8IQDlda:J)V 0 p8J8PISUO) oq w8.1ds IDlods!P"800MOS IOnp!A!pU! 8Iqoldo))o ,ON 0 olqDldD))V 0 pOJOP!IUC>> oq w~ds ..(Iddns J~DM lonp!A!pu! eli' IDYl PU8WWO)8J pUD fJodOH UO!f)8dSUI 8)UO!ldwo) y ^ IUOU!,Jed 8lfl pUD 6u!o88JOj 8~ PO"'8!"8J 8A0"4 I " NYIYYLINYS ~N191AY3dns JlljjO YA jO un IOj-1II1IYd I T~ tA~HI)l~OVCO~HJIH hyfV')/ "'0 ON'''''' V""" v' '- . 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'0lfI 1IO!lIfdo 110 WI "nlal Ao"lp!lfM p4lnoJ ..10 _'''PlIO) n 'lIO!fI)IIUOIU! ,IMU!...-d IOflMw.,ddn. "UD "lON' SlNJWWOJ _1_ LI - - - -I-~ ~'- - +::::I=':':'::j:::::=1=':+I==:=I=::::I::: ::::::: ::=:: - :::::::@-:::: - - - -~ - - - - - -1- -" - * - "" -1- - - -1- - - - - - - - - - - - - - - - - - - - - - - - I- - - - - - - - ,- -'-, "" -.-,- "" - -.- - - -r- - - - - - "" - - - - - - - "" - - - "" - - - - - -- u__, 1-1+ ! I _-1-__u_n h___h,h_____ t,=t= ' ::::: u -I IT - Tt' -j: ::1::1:: : : : : ::: :: :::::: ::: : : : ::fl: : : :: ::::::: r :::,~,~,~,~ ~I; - = ~ ~ ~J::':::'il= = = ~;;;; ~ ~ ~.~ ~ ~ ;; ;.~ ~ ~ ~: ~ ~ =~: ~ ~ :-,;.~ ~ ~ - - - - - =::::: ::::::: : II::::: $:::-:::::::::::: :=::: : : ::::: :: :::: ::::: : ::: : : : :::::::::: --'~~- --:l~l ::H~: ~~ ~ ~ E' -H:~:~: -: _:::: ~:~: ~ ~n! n-! -~: ~) ~ t_ ~! ~ ~ ~ ~)) ~) ~E ~)! ~----------------------------------------""----- ------- ::: +- - -,-,-,-,- -'-!- -,- I: _u_ :$:::: h_ - #==~- ~=t,*; =; ;'- ::i_::_ -* ~ ~'~ u :E = -I-: :::::::::'3: -----1---------- - - - - -I- - - - - - - -- :+::t:::: u- : :::f'::: :': ::: :::'- _+___uu ---------------- ---------------- ---------------- ---------------- - - - - - -,- - -,- -,- - - - - -.....-..-..-- 1----------- ~ - - - -,- - - - - - --------------------------------------- ('''P'' ~o uo pMfJnf8p "II~ IOU r&JpcI(I 1'*'!'JOd .cUD .....OIMJ ~~lp .cq NIO~sl H:)1.i)lS S,VOO*,SN1 (pOll"!IUO)) 111Yd PROPERTY OWNER LANE COUN.UILDING PERMIT OR MOBILE H<e USE PERMIT BUILDING 0 MH 0 PERMIT NO, MAILING ADDRESS '. . 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 & EXISTING STRUCTURES ON PROPERTY LEGAL ACCESS TO PROPERTY MAILING PROPERTY SIZE - FT. ADDRESS FOR MOBILE HOME PERMITS ONLY No. of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT WIDTH DEPTH AREA Connect to Existing Sewaae. System TYPE CONSTRUCTION s~ FT :: BDRMS New System 0 V....LUATION SEWAGE DISPOSAL PUBLIC n BUILDING WASTE DISPOSAL PLUMBING PLAN REVIEW PARK TRAILER PLUMBING INSTALLED BY SEPTIC TANK n ! OTHERO FEES ~ni\QpLY OTHER, NAME PUBLIC 0 o OTHER MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GAl. $_ COUNty AUILDING & SANITATION SPECIFICATIONS DRAIN FIELD REQUIRED TOTAL lIN. FT TRENCH WIDTH FT. OR SQ. FT. TYPE OF STRUCTURE OCCUPANCY ZONE PUBLIC UTll. EASEMENT BLDG. SETBACKS FT. FROM CTR. OF ROAD RIGHT OF WAY USE CLASSIFICATION FRONT SIDE INT. SIDE EXT. AUTHORIZED SIGNATURE - DATE REAR DATE BLDG. PERMIT - WHITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENROD Construction to comply with uniform building code and county regulations covering plumbing and sewage disposal. All buildings require a certificate of occupancy before being occupied. (See Statement on Reverse Side) (POST THIS PERMIT ON MAIN BLDG, AT SITE) LANE COUNTY, BLDG. & SAN. DIV., COURT HOUSE, EUGENE, OREGON 9UOl FORM::: C55- J) '"~ io . . . ..". .~, S LAB FLOOR PLUMBING GROUNDWORK ApPROVED ~ DISAPPROVED ~ DATE INSPECTOR REMARK S GAS PIPING GROUNDWORK ApPROVED / / DISAPPROVED I:::J DATE INSPECTOR REMARKS ROUGH PLUMB I NG REMARKS . I:::J t/.P. DISAPPROVED I:::J DATE? ~ f'} -? 3 I NSPECTOR .Al'1../ (;I' h" t::!AI/ .p",,,. . ApPROVED /?/c '5'), ....-I ',,. ",c.jt:' "" J;1 ~ " ~.. c .,.., "'14 ~- 'J- '7 _ r)"J. --<7 i.../ ROUGH GAS PI PI NG , - f.j';$ I INSPE~TOR'-~# ~ ApPROVED I:::J DISAPPROVED I:::J ~- D~r" <- '''I ?'1i REMARKS ~ _~b r,.,. ~/ FINAL PLUMBING ApPROVEO I:::J DISAPPROVED I:::J OATE~-I:"_/1. INSPECTO~~ REMARKS N?\ /" fd// -0", '-' ~jJA ~~ :h~ ~ fr&.' ........ ./ t1 ' CO-'p/T'" " ~ i OL.j{' I!!A.( FINAL GAS PIPING ApPROVED I:::J DISAPPROVED I:::J DATE INSPECTOR REMARKS . CERTIFICATE OF OCCUPANCY READY TO ISSUE L:::7 NOT READY TO ISSUE L:::7 DATE INSPECTOR REMARKS PROPERTY OWNER LANE COUN.UILDING PERMIT OR MOBILE H. BUILDING ; MH D MAILING ADDRESS USE PERMIT PERMIT NO, j 'r' PHof.JL CONTRACTOR MAILING ADDRESS PHONE PROPERTY LOCATION -INCLUDE POST OFFICE TWF RANGE SECTION f I f ~~1:/{ct{{. (Ct'U ) CEN"... ....~T PROPERTY LEGAL DESCRIPTION - METES, BOUNDS APPl. NAME EXISTING STRUCTURES ON PROPERTY LEGAL ACCESS TO PROPERTY & MAILING PROPERTY SIZE - FT. .' DEPTH AREA ADDRESS FOR MOBILE HOME PERMITS ONLY No. of Bedrooms :;TRUCTURES TO BE BUILT THIS PERMIT WIDTH Connect to Existing Sewaqe System TYPE CONSTRUCTION !\~ FT ~ ~'t1~'Ms New System [] VALUATION FEES PLUMBING INSTALLED BY OWNER n OTHER: NAME WATER SU'~LY SEWAGE DISPOSAL PUBLIC rl !WIlDING WASTE DISPOSAL PLUMBING PLAN REVIEW PARK. TRAilER SEPTIC TANK fl $ IlIHI'R" PUBLIC n n OTHER TOTAi. $ MIN. SEPTIC TANK CAPACITY WITH DIST BOX: GAl. COUNTY ~UILDING & SANITATION SPECIFICATIONS DRAIN FIELD REQUIRED lIN. FT TPENCH WIDTH FT, OR SQ. FT TYPE OF STRUCTURE OCCUPANCY ZONE PUBLIC UTIl EASEMENT BLDG. SETBACKS FT FROM CTR, OF ROAD RIGHT OF WAY USE CLASSIF ICA TlON 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 c ~' ~rt" . SITE INSPECTION ApPROVED L::::7 DISAPPROVED L::::7 DATE REMARKS FOUNDATION INSPECTION ApPROVED ~ DISAPPROVED ~ DATE ,2~/;] -7J REMARKS FRAMING INSPECTION ApPROVED d DISAPPROVED L::::7 DATE;2-/3 - '}7 REMARKS LATH OR SHEETROCK INSPECTION ApPROVED / / DISAPPROVED L----/ DATE REMARKS . .' '.' INSPECTOR INSPECTOR ~ INSPECTOR Y INSPECTOR FINAL INSPECTION ~ ApPROVEO LlZf' DISA,PPROVED Cl DATE.}}' /./7 ~ ,.~ I NSPECTOR('!;:fI. REMARKS ~ #A~ ~ J-)f?:- 'lJ R- Al?ltL. J ,-J ~-'7j f! -dD-?JY #-;;L,IJ :;,7;7 -~ . CERTIFICATE OF OCCUPANCY READY TO ISSUE / / NOT READY TO ISSUE ;---y DATE REMARKS /,/} /; ./J It.... ~ -f("'C-~~-!r/ 0'7-7') 1'6.Jg / /(,{) lJ~ INSPECTOR 3.j-:"/.j"). 4 ") ""' ,.NDIVIDUAL SEWAGE DISPOSAL SYSIRECORD nstaller: Complete top part orm to signature and return both copie to Lane County Building Sanitation Department. , . t- .... . '. " ~ .,. ". ..,- ... , . 0..;.... P'RMIT Nn, 59-73 GG I Property Aaaress IJJiO Oord~'l St. I Basement Water Supply Yes 0 No jZI Publi~ tia' Other-List Feet from I Well Foundation 2. 0 Lot Line ( Front - Side - Rear 10 ITotal SqjFt.betweenlFiller I IF~ller dePthlF~ller aeptn II ' /.' II. above below / ft. ..,50 l~nes '" Type Z- ton" 2... in Hlp f.-, in (-----"- I \ \ 'VI l\)l I \ I \ \ I~ I \10 +_1 10' Signature ~_ -71.....P ,,~ Conforms to Current St~ndards Date: "'3 -:21_ 73 qIJ, to Current Standards .I} LftJ. ~ ~ Sanitarian's Sig~re Inst,ller's Name t IjX !V>_ /,"1 (? Ee-IV No.L~v~ngUn~ts IJe~roomslBatns / .:s / sept~c Tanx: Ft. from well _ Steel 0 l.ns~ae uunenS1.0ns: ,t"l:... Length Width Applicant Name Robert Hill Concrete li1! No. Compartments Diameter Depth Mailing 2324 Dornoch Address Springfield, Or. 97477 Length of Lines - Ft. I Trench 1.802.703. 4. 5. 6. Width oS Sketch (See instructions): t111~" kl WIO') j~\'(I lI~\O " ~ -,'I ,'I'rI\\\ , " ~~ ~.:;:'-', ~ _ -"- , ' 'Io~. . \ ::I 0 '2.1 [j~ \I 21 e::J ~. \ l o r\ovS( Date -< -/7 - 73 FO~ ~itarian Use Only: !B' Approved: System Instaflation o Disapproved: Does Not Conform Remarks: i Gal. Capacity. JfI() () Tile Disposal Field,- Distribution Bo,,:Yes f"f No 0 Other Distribut~on- Type I 30 I 2B' - -- ~"""I 1,0' f I t "2.0' - -I -~l -, \ I - ,. 10_ ~~ . Lane County Building & Sanitation Dept. C55-11 , ~ LANE COUNTY e>ING PERMIT OR MOBILE HOME. APPLICATION PERMIT TYPE - BUilDING 'tr MOBilE HOME 0 -:::II=- 5? I PERMIT:# s7'-7...-f ~~NE P /_ L - MAILING ADDRESS /7 _ _ _ ./ "./,' PHONE _ ~ .;::J6;)r./'Jf/~ 7r6-::-77~ CO : ACT~ ' P'~-,,~,p MAILING ADDRES$ , / PHONE "PiltJ.ERTYLo- 1~1-;i:!-POSr"021FI-E - / 16 d --1/- / ~I,c,Lr.:V(1 ~/ $ ~- { 4fltt;-- PROPERTY LEGAL E5CRIPTlON',/'Y7' / d #! , : / /7 ~ET;S-" BOUNDS 0 YES LOT - BLOCK - iY, /" /"e.' A" ~ ,.....~-x..--...~ /" d ATTACHED 0 NO TWP/, 1/ RANGE~. ~. TAX L<)T # CODe CENSUS TRACT 3 -- c..<=' 3 b'--":. J~'-'~ 4 DESCRIBE EXISTING STRUCTURES ON PROPERTY iF ANY . t7~ APPllCANT NAME ~~ LEGA~~_:,ROA~;;;;~R # PR6~ERTY SIZE-WIDTH DEPTH AREA AND MAILING ADDRESS FOR MOBILE HOME PERMIT ONLY Number of Bedrooms STRUCTU~" BE BUILT ~H.!7'~RMIT ~1///,g---:, ~Lw/.::l/-/~o ./ Connect to Existing TYPE CONSTRUCTION t. ~ tf-~ ;' -- //A'-4.4P--,L~ Sewage System 0 ar New System Req. 0 SQ. FT. 6'--1 B~O'1S VALUATION /Of?Y' ~(~J /=?; /~R' ft3 ~ J> /. #'47 ~ /~. S77 J s~/ /~/ PUBLIC 0 SEPTIC TANK MOTHER 0 BLOG. $ ~9,,') d' FEES WATER SUPPLY WASTE DIS, ;;,~ ./}, r.JtJ PUBLIC 'isV PLUMBING -@. / ,,<::;V PL'6'NCf ~EES PLAN REVIEW _ E,lXTURES PARK TRLR. CASH 0 ~ CHECK pt'"CON-N-eCTION FEE PLUMBING INSTAllED BY OWNER 0 OTHER 'IZ1' NAME PLANS FURNISHED ~ YIS V NO 0 O '>( SI6~TURE OF APPLICANT /R: t? I FEE R:P;;CEIVED ~,?Jr1 ' A-W/--," ./ PERMI #' ~ ./ PUBLIC WATER ~ ~ CONNECTION FEE /,.s (J ...-' _ '7 COUNTY BUILDING & SANITATION SPECIFICATIONS / DRAIN FIELD REQUIRED / /lIl'Jn lIN. FT. / S'(,) TRENCH WIDTH FT. 3 OI'$QUARE FEET sir-a 7Il....~) -;1~ fr I-" ,(4,,~. .IM.<'( h/J L~_ ",iN, aU>- ~~..:fi) 'i ;dn JMf~' D~ ~ dltA'~ ~~ OTHER ~~ /" FACILITY i'tRMIT YES f>(' NO 0 DATE /-/5"'-7.3 DATE / -/J-: 7...3 TOTAL /C) cJ ,,,sCJ MIN. SEPTIC TANK CAPACITY WITH OISl. BOX: GAl. TYPE OF STRUCTURE J JI OCCUPAN/~..f BLDG. SETBACKS - FT. F~~... 9R. ?F "O~D~ R,IGHT 9F WAY fRONT ~~I~IDE EXT. REAR ,;jJt~. I _/8~O;3 PLANNING '/ /_/&, -7 ~ole :LDG. INSP, 1/ tJ ~RL I" J1,. -I) 1 Direction~to ad Property' #'J:J ~-=3"7 ZX ~'~,/~~__ ~ ~ /-/ ~ ZONE REAR Y ARC PUBLIC UTll. EASEMENT USE CLASSIFICATION Dote COpy 1 - OFFICE COpy 2 - JOURNAL COpy 3 - AUDIT ~' Form # C55-12