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HomeMy WebLinkAboutPermit Building 1973-7-17 fi ,~. \'~--- .~. f .~ oJ ,'... ..:~-: - '\ ~-,. ~j.-"t ; >1 r:~-'...: :AA:' - J, '" -~.---...........",.~- -~ _'i: ,'. ..:. :; -. .' LANE COUNTAILDING' PE;MIT OR MOBILE BUilDING ;[]l MH 0 MAILING ADDRESS 1370 \1EST CEt~TEmJl AL , 5PR I tJar I no, O~ECOrJ MAILING ADDRESS HOaSE PERMIT PERMIT NO, , " . ,'/.!ibt:' -"13 1,00- 7:] PHONE 746-9916 PHONE PROPERTY owt\t"R 1-11 LL, f'lOO&RT CONTRACTOR PROPERTY LOCATION - INClUDe POST OFFICE 1165 DOrJDEA PROPERTY LEGAL DESCRIPTION - METES, BOUNDS 1ST ADDITIDN TP ~&ADOW GREEN ESTATES BLOCK 2 LOT 12 TWP RANGE SECTION 06, /,3 TAX LOT NO, CODE CENSUS TRACT 18 02 .Jt 1/,">0-0 EXISTING STRUCTURES ON '.\'5-1'52 AI PROPERTY APPL. NAME & MAILING ADDRESS 5rR I NOrt ELD, OREGOrJ FOR MOBilE HOME PERMITS ONLY No. of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT RODERT N. HILL NOtJE LEGAL ACCESS TO PROPERTY DOtlOEA PROPERTY SIZE - FT. 879 ~E~T CENTENNIAL WIDTH DEPTH AREA Connect to Existing Sewage System 0 TYPE CONSTRUCTION SQ. FT. # BDRMS New System 0 VALUATION D;;ELL WG F~AME 11070 12 1::\, 284 505 C 3 1, '518 lL1,(;O~ GARACE-ATTACHED AND UMCEILED ltJSTALLEI;lS.D.S. SEWAGE DISPOSAL PUBLIC D BUILDING WASTE DISPOSAL PLUMBING PLAN REVIEW PARK TRAilER SEPTIC TANK rn OTHERD . ",eLm :;IU){) ~~,",n FEES PLUMBING INSTAllED BY OWNER D OTHER, NAME WATER SUPPLY PUBLIC D'll, D OTHER MIN, SEPTIC TANK CAPACITY WITH DIST. BOX: GAl. 1000 . II? <;n COUNTY BUILDING & SANITATION SPECIFICATIONS DRAIN FIELD REQUIRED TOTAL L1N. FT 200 TRENCH WIDTH FT. 2 OR SQ. FT. hon DIVERT Roo;:, DRAINS TO STAEE:T. riLL SWALI:: A(:lEA TO TH'" LF'V~l o~ THr '"1flnTIr':,I(\ ()~"nH"_ SOAV 10 FT. ~ROM THE HOUS[ AND PROPERTY LIN~ WITH All PAAT~ n~ T~~ nQ^I~'~lrl M_ ~nl n TnrMrllrn TO A 24 ItJCH MAXI~UM OEPTH. TYPE OF STRUCTURE OCCUPANCY ZONE PUBLIC UTll. EASEMENT " rJ BLDG. SETBACKS.. FT. FRONT 11'1 I "11.1,,.. FROM CTR. OF ROAD RIGHT OF WAY QA, USE CLASSIFICATION SlOE INT, 7 Sl SIDE EXT, r:; AUTHORIZED SIGNATURE - DATE /S/ J.E. 009S BY CHARLES HAnBAUOH REAR 7 DATE ~_w_ ~RAV. ~A~ITAnl^N 7117 h~ ~~ BLDG. PERMIT - WH ITE 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 0" FORM == C55- \3 " , u 1).c.?,3 , e:.", /' .... ... //.- " /) .~- ,,-,,' DATE 0 . J -~7'" /i/-7-, ~' BILLED/-i(-"73No. ["~- ,. ".,... .'.- " fHA FORM NO'v-'Ji.J_loj{j/73 No,u,loEPART{.ENT OF HOUSING AND URBAN DE'Y{LOPMENT ,..,. ,', .. "'F~'m App'ov.' Ro.... lona ., , FEDERAL HOUSING ADMINISTRATION Budget Bureau No. 63-R0296 HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPL Y AND SEWAGE DISPOSAL SYSTEM PART I -TO BE COMPLET.ED-8Y-fHA-_,' -,,, '. "-,"';:C",,;; _".. Ilnsurlng QHlce ~-: l'I'PHA Coae Nn. Federal Housinq Administration ,,"0' ----4Jl-'l:21695 203 Mortgsgee _ Nome, Addres. ond ZIp Code ~ Mortltagor or Sponsor: I - ,,\\"\0 ~\\.. ..', ,.,' ....'" ',',"', I ~\\ \:!-- .. \\ '. - .. - ~. Portland Federal Savings <Z \, ~.' / \, ,1lnl-,prt N. ..111 1.1 " P. O. Box 1066 vc, ~\\ \~. .....'\ Property Addre..: Eugene, Oregon 97.,4Q1, \\: , ,\C)!' 1165 Dondea, Springfield, Oregon 97477 \ \ , ' . '\ ~~ . ..' 0:'1 / ,",' \ ,~~~"., . .. su~~,,:",,5'ion: , I ' .,\ , . , .. ....Jy',. First Addition' to Meadow: :Green'"'"""" 12 .,:"" ", ",','", ';""'..0I/f,2, n N '"I' t "I'I"'t' . ~;. .... -' Can-1\tttC"'"Orother^Ten be-mtrde 'lillo-additional -= _L..j{X",ew ns a a Ion bedrooms? (II YOS. how many?) G.xNo-- .~ :;<!:n;, "'1- :ilter ~,l\enli o~' {~ill.vp.';; ~ No :n.:..-:; ..:1:, Lot No. L 1 "'OTAL NUMt:J,Ii'Q ~ OM" IleAIF" BASEl,iEN',." -..1-'- \v.\" O"Yes \'lATER SUPPL Y BY, ~ Public System SEWAGE DISPOSAL BY, o Public System SYSTEM DESIGNED FOR D Community System >:-::;, De~ndi~~j.J~lcn,:It'r:J;:~_'. ~r I _ I;)isoosal o Community System " """0 i~d';~id~~T I"":' '1 ""'l Ll ,es [xl No. PART II. - TO 8E COMPLETE[),8,Y.:IH:AL TH DEPARTMENT ~- I ,t 1-- I 1------ ~---- , , , , .- - - -- BLDG. PERMIT 1300-7~ -~ I , I' , , L'_'~~'='=\::j::\-L~~I= =,=1=~~::~::,=: -- -1-lu = U - - := ~ - -t~~ ~==~ =:1~J,~ :=~~ ~~~=~ ~ ~~~: ~:~~ ~~~=: ::=~~: - u :: t - , - n = = n "'.: - - - - - - - - - - - - -I - - - _ _ ~ ~: - _ll>'_~'~: ~ = ~ ~ ~ J ~~ ~ ~ I::: = = =;. - -~k ----~ ~~+I' r""F '.' ";:;: ~~"~" -.,~= ;1""0- . II ---- ---~=:-----~l~=='-=_.._--- I -:-:'L., HEAl, TH DE PARTMENT INS PECTOR'S SKETCH ~'-'-'- I- '-t':: '=':'='_' _' _' _' _~ 1_' _'.' , -- 1-- I I , ' I---U ~- 1-- r - - - :: : -II ,-tl 1- -I - --- - - -. - - - - - ,- - - - - _. - 1====--- uuU '1' r--un"C:u~_:,~,::::u- , ',' , _ ++ + n -= = ~ _ : : : , " - '=uu_ 1- - -- - . '--===t===::j~"", ., ------------- ~---- __r,:,"- , , , IU- 1-- i::;: -: i:,' ,,'=.L F = : = = = , ' .1 '1 f-' 11~~ '(~=~::I It is the opinion of the 0 State 0 County Loca~ Depar~,~itt of-He~lth that thls"individual water-supply system o is 0 is not satisfactory as a domestic water supp!y for t~e..S;l!l?jes:t P!ppe~~~..:.H" --I I --I I I ,- ,- , 1---- It is the opinion of the with proper maintenance: IZilI Can be expected to functio~ satisfactorily. and is not likeiy to create_an insanitary condition DATE SIG~~~ O. I(t~ ~ 9-4-73 ~~CHARD A. KiRBY, R,S:--- () o State ~ County o Local Department of Health that this individual sewage-disposal system --"+:: :C. _ld.f:annot.be_expected to function satisfactorily TITLE SUOERVIS1NG SANITARIAN NOTE: The health authority should complete the appropriate opnion statement above and affix dote, signature and title In tho spaces provided. Use of the above grid for Health"Department Inspector's sketch as well as use of the bock of this for~ is at the opinion of tho hoo Ith authority. PART III. -FOR USE OF FHA OFFICE TO THE CHIEF UNDERWRITER: I have reviewed the foregoing and the pertinent FHA Compliance Inspection Report, and recommend that the _ Individual water-supply system be considered 0 Acceptable 0 Not Acceptable Sewage disposal be considered 0 Acceptable 0 Not Acceptable. DATE SIGNATURE o C/IIEF ARC/IITECT o DEPUTY FOR CHIEFARC/IITECT I ~c.~~>,' "Il!',"=~,,,,",1't.::!Y'~lVro:~-+ ,''''''''''''~ HEAL TH AUTHORITY AP PROV AL FHA FORM NO, 2S73 ,>"'-- _ INDIVIDUAL)'fA Hi< SUP!,L)' AND .SEW~GE ,DI~P"OSA,L. ~~.~~~.~,~\,~~,:,:-:.~:v_~~O/'Z~,:. '""~:,.",, .. i "",. " REPORT OF IN4ti:Ci'lON-INj)iVIj)iJA!.'S~W AGE-lp05AL . -.c..' " SYSTEM PRIMARY TREATMENT l'OnSiSlS (If [j'. Septic tank. 0 Cesspool. Sop.k Tank: '," Distance (rom' wdl, Total liquid (apacil)'. Inside length C.upool: Disuncc from: Well. feet. Material 1000 CONCRETE Number of compartments (teL Inside width, "alluns. C..patity inlet compartment feet. Liqui~ depth I?allons. fect. feel; found.Hino, _feet; nearest lot feel. Liquid' capacity. o Seepa,.::c pirs. Other line at 0 (rom, 0 side, 0 rear, i:allons. lininR m,ucrial f<<t, Inside diameter, (('('t. Depth $ICONDA.AY TRIAYMiNT cunsisls of XJ Tile disposal ridd. TUe'Olllpollalll.ld: Di!lranc( (rom: \'('dl Total len,lo{th of rile lines._~7 Trench width, ?4 LcnKlh of.each I;ne, 100-Q') Type of nher material: 00 Gra~el. Depth of filter matcrial beneath til" feC"'t; foumLHion. 10 fC'Ct; nt.'arcs[ lot line at 0 (rom. rn sidC"'. ~ rear.--10 feeL Number o( lines, ? Distance betwC"'en linC"'s, 10 _inches. Tot.al effe(tive absorption arca in bollom of uenches, 400 feeL Depth, (Op (!( tile (0 finish grad" o Broken srone. Oth.., r:. (<<t. f<<t. square fen. inches. inches. Depth of f1her material over tJle._? inches. Mepage Plta: Numher of pits__. Dist.1nce from: Well, . OutsidC"' diameter feer. (eet; building (oundation, Deplh, Inspection made by: 0 State. f!J County. 0 Local Heahh feet. lining material feet; nearest lot line at 0 front, 0 side, 0 rear, Authority. Inspected b) f<<t, /s/ G.W. GRAY SANITARIAN Date of inspenillll AUGLJ<;T ":l1 19-13 (TITlE) REPORT OF INSPECTION-INDIVIDUAL WATER-SUPPLY SYSTEM Distan(e to nearest puhlic water main, feet. Size of main inchr-s. Indivi,lual wdls 0 art. 0 are not (ustmnary in neighh9rhood. Give most re(t~nr rt.'(o'rd of failure of wells in immediate vicinity to furnish adequate supply of water Properties in neiJothhorhood 0 are 0 are nor being developed with both individual water-supply and sewa;:e-disposal. sys~ms. lot siu: feet wide._ (eet deep. DwellinR set' back from front property lin" feet. Individual W;Her supply from: 0 Drilled well. 0 Driven well. 0 DUf:: well. 0 Bored well. Dlstonce of wen 'rom: Ruildin;: foundation, (aSI iron st'wer, (eet; tile sewer, feet; cesspool, (eet; nearest lot line at 0 front. 0 side, 0 reil" feet; septic tanl- feet; disposal feet; other sources 0; possible pollution, field, (<<t. f<<t: f<<t; seepage pit, wen construction: Diameter. inches. Total depth Approximate depth [0 pumping level of water in well, Sealed watertight co t.lepth of (eel. F.xterio; spa(e around casing sealed with: 0 Cement grout. 0 Puddled clay. 0 Ordinary backfill. Well cover: 0 Con((~e. '0 Wood. 0 Metal. Openings in well cover warertiXhr: 0 Yes. 0 No. Pvmp: 0 Shallow well. 0 Deep well. Length of drop pipe, feet. Pump capacity, Located in: 0 B.uement. 0 Pumproom off basement. 0 Pumphouse ahovC"' ground. 0 Pump pit. Pumproom properly drained: 0 Yes. 0 No. Pump mounting watertight: 0 Yes. 0 No. Type of storage: D-PressurC'. 0 Gravity. Capacity, gallons. Has oocterioloRical examination of water been made? 0 Yes. 0 No. If answer 'js "yes," give dat,. Quality of water 0 is q is not satisfactory for human consumption. Installation 0 does 0 does not comply with approved exhibits, if any. Inspection made by: 0 St.:uC'. 0 County. 0 local Health Authority. Inspected by feet. Type of casing, feet. Approximate yield, . Depth of casing, ~allons per minute. (<<t. .~allons per minute. 19_ ;, ". Date of inspection , 19_ (TITLE) GP 0 900.6112 :l./. ~."';,,,_:.-,_ ....J..___~~..'O;<~. ...~i;?;\1h.~~t;~4~ /- , i ) . ... -. ..'~.: . -. -r.;_-. _ .,; "t~:.\'...Jo ,~~:;., ,A..- ~1L>.i';:;::'~~ lJi~>.~:9J.<<dj ."l};.".!!~,)o,*,j~1/'.;.~t.o"""l~u~~,~,~;,-. :.l-.""::;"'; I...,~~~.$:"'~~~4.i:;.'1.''e-?"~~~'~~~;,~~rJ.:;f-:N",i~~~''''''::''rl7::~',~,;,~?).l;".,,,'l~::~~~~'aV:'I~',.'f!'S"3!t]~_. ( ~~djng Permit ~~~~' "i h - "" -- . , ,. '. . EV~LU~ T lori '<\~. '~~~'="~trtlR~R~;S ~ o. ~ ~~ APPLICANT: ~ " App I i cat ion No. / lit) D ~ ?..J N/\ME J-I :t.-I ADDRESS ' ".",;;;' ;"{. , ~..,..:....~~ .;-.: . ~ :., . .. . ~U!LD IliG SITE TAX un ( ) ( ) Site Inspection Pre-Permit Investigation PHONE DATE 7-1"-. " LANE COUNTY PLANNING DEPARTMENT J. Zoning Ordinance Compl iance (Zone~4- ) Subdivision Ordinance Compl ianc~ NOT app 1 icab) e () () ( ) ( ) J ) ( ) NO YES NAME DATE 3. 4. Required Access ( , ( ) ( ) ( ) (+- (r (.J- (r ( ) Lk/- ~i 7.~ 2. Building Site (Area, Width, Front~ge. Setback)' Other (see comments) 5. ~ ~ z; "'..~ COMMENTS :' - - BUilDING INSPECTION SECT ION NOT NO YES NAME DATE appl icable riJ 6. Plans Submitted ( ) ( ) 7. Soil Stabil ity (foot i ngs) 0/) ( ) ( ) 8. Flood Plain tX), ( ) ( ), ~ _. A 9. Other (see Comments) ('i> ( ) ( ) C~.'II~ 1'~/~~ '7); ~ , COMMENTS: SAN ITAT I ON SECTION NOT NO, YES NAME DATE app! i cab I.e rP) 10. Sewage Disposal ( ) ( ) / 11. Usable Area ( ) ( ) ( ) A1 ( ) ( ) ( ) . .AA-.l,0, 12. Water Supp I y /]~ (see Comments) ( ) ( ) ( ) ~ 1-'\ \~ 13. Other COMMENTS: TO APPlI CANT: Your Building Permit / Site Ins~~tion: t4 Ca~ be approved. K ~ "I If". () Cannot be approved at this time as indicated on item HO, ~bove. Questions and further information on items I through 5 contact the Lane- COUrny PlANN ING DEPARTMENT. Quest ions and. further informat ion on j tems 6 through 13 contact the Lane County Buildinq and Sanitation Division. () Wi) I 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 cu"cr, Ii\W: COUNTY PU\lH: lUG llEPi\RTMENT I'~(l Sixth J\\t:nlh~ rit<;t," Euqenf", 01""<]0n ')74UI LANE COUNTY BUILDING I; SAtJITI\TION DIVISIOIl 135 Sixth .\venue East. Eugene. 0l"C9.on 974 l'IiON!:: 31/2-1311 EXl".411 l'IIl'lll: \1, ~'"" I \ II I \ 1. 7'; 1 , ~ I' ~, LANE COUNTY 4tILDING' PE~MIT OR MOBILE BUILDING :rn MH 0 MAlllNG ADDRESS " \,,0 ,::,,01 Ca~mW;lIAL . ~DillC.C7ICLOj G:U;CU:l MAILING ADDRESS HO~SE PERMIT PERMIT NO. ( ~ J '-.... ~ \1"'tc("\ ;, , . :_~..J.1 " PROPERTY OWNER ;1 ILL. ~J,,~Q'i' CONTRACTOR PHONE .7"f' ~':)('(. I' .,P . ~" PHONE PROPERTY LOCATION - INCLUDE POST OFFICE 116'5 t1:l::D:lA PROPERTY LEGAL DESCRIPTION - METES, BOUNDS 101 ADDIYlCfl VD t:-::A~:J ~:::;c::: E07A1CO D.e::n 2 Loy m TWP RANGE SECTION TAX LOT NO. CODE CENSUS TRACT 11) C2 cIS 'qqu 1 ~i~ (l' EXISTING STRUCTURES ON PROPERTY r:O;:1I -LEGAL ACCESS TO PROPERTY Oc;n::A PROPERTY SIZE - FT. APPl. NAME & MAILING ADDRESS !]l-':1 ICDl CI.D, C:1!lOc:J FOR MOBILE HOME PERMITS ONLY ~O::J:;nT N. tll!.!. G79 \JeOT CEN1EtlClIAL WIDTH DEPTH AREA No. of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT fr.;e!.L tc:O Connect to Existing Sewage System 0 TYPE CONSTRUCTION SQ. FT. # BDRMS vnl:.~! 1107 C 12 ~?, New System 0 VALUATION ,.-"J. Co... "'-~ 0A~AC3~ATTAC~ZD A~~ U~CEIL~O ;jQtio3 I, 'jj(i UlJ,( .tL~ o tJo'M~il.crc3. \!:I.S. SEWAGE DISPOSAL , OTHERD C;"0.M j:o.mJ ,:!'L"D FEES PLUMBING INSTALLED BY OWNER 0 OTHER: NAME WATER SUPPLY PUBLIC 0 BUILDING WASTE DISPOSAL PLUMBING PLAN REVIEW PARK TRAILER SEPTIC TANK []l PUBLIC om o OTHER MIN. SEPTIC TANK CAPACITY WITH DIST. BOX, GAL. lDro , Ill) _"fl COUNTY BUILDING & SANITATION SPECIFICATIONS DRAIN FielD REQUIRED TOTAL UN. FT 2{ll) TRENCH WIDTH FT. 2 OR SQ. FT. !;:~ DIViWV ~'~'I" D::lAIt:O YD OY~IIll:7. VH..1. l:i~1ALII ME:A YO YUll: L~VC!. Cl' vm: (:111011(:(1 a:'c..-c:I'\. ~at..v 10 ~v. v'~~C;,~ Y'ie t~~UDa f:lt::o ()~opeovv L H!Z tHYH ALL "~r2?1J ov Yt2R D~Cl It.:F t rrLO. t:~1.0 \;.-~~:~~(:l:r:r: VO A 24 It:Cli ~rHc.:::~l n:1PVtt. TYPE OF STRUCTURE eH'l I At!;) J BLDG. SETBACKS _ FT. FROM CTR. OF ROAD RIGHT OF WAY FRONT I)') ", OCCUPANCY ZONE r:A USE CLASSIFICATION PUBLIC UTlL. EASEMENT SIDE INT. 7 11 SIDE EXT. AUTHORIZED SIGNATURE - DATE /0/ J.E. lJooo OV CUAtlLll:O HA~lQAUC:ll 'j REAR 7 DATE G.~. CnAV. SA~11^~IAU 7/17h~ co 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. DIY., COURT HOUSE, EUGENE, OREGON 97401 FORM:=r~~_q . " SLAB FLOOR PLUMBING GROUNDWORK ApPROVED ;---y DISAPPROVED ~ DATE REMARKS GAS PIPING GROUNDWORK ApPROVED ~ DISAPPROVED ~ DATE REMARKS ROUGH PLUMBING ApPROVED l5i;J DISAPPROVED C1 DATE 9- ')-/:1 REMARKS ROUGH GAS PIPING ApPROVED C1 01 SAPPROVEO C1 DATE REMARKS !.; FINAL PLUMBING ApPROVED C1 DISAPPROVED C1 DATE fI~.~.. ~ O~CttI'J'II'[J kA " ~ REMARKS --.LJLD \ RLJIH. e c.Y// /1/0 (/H~ FINAL GAS PIPING ApPROVED C1 DISAPPROVED ;---y DATE REMARKS CERTIFICATE OF OCCUPANCY READY TO ISSUE / / NOT READY TO ISSUE ;---y DATE REMARKS . v '. INSPECTOR INSPECTOR INSPECTOR~/./ INSPECTOR INSPECTOR ")4., II NAA. ~ /0 ./.JJ ~~ v._ , //- ~-77 -<7'tf7'11 (/ - INSPECTOR INSPECTOR InstJller.s Name A I Property Address ^ (Jy!'\(\ lttr.:> E:t::.7J 116'1 DONDEA ' No.Livingunits IBedroomslBaths I Basement I Water S~p~ly I -3 I Yes 0 No X Public ROther-List Sept1c TanK: Ft. from well - SteelLJ InS1de Dl.IllenS1ons: .'t. Length Width Applicant Name ,. ROBERT HILL . INDIVIDUAL" SEWA~E D~SPOSAL S~ RECORD Installer: Complete top'par~ form to signature and return both copies to Lane County Building Sanitation Department. . . Pj:"~MIT Nn_ 1 'WO- 7. GRAY Concrete ~ Gal. Capacity. I 0 Cl C> Tile Disposal Field: Distribution Box: Yes Jl!l No 0 Other Distribut1on- Type NO. Compartments Diameter Depth M '1' Feet from al. l.ng ~ \.Ic-<:T r,:"hl"'';~'~'' \' Well - Foundation J 0 Address Lot Line ~~o I hlf"t" I t"'-."" f'\Ot""'''M Front - Side! 0 Rear I () Length of Lines - Ft. ] Trench ITotal SqjFt.betweenlFiller /, IF~ller deothlFiller depth" l.l0C\2.CJ::D. 4. 5. 6. Width 2-- ft. 400llines In Type / /12.l~i~:e :2- in_ ~N~w G,. in. Sketch (See instructions): ". \ ~l f?/ _10'_1 \ ,'0 ' r \-1~-' -IO~ \ ..... \ - r-I <'i ~I I \ I \ J \ ~o r I ~-~~ 4.:?' -- ~ \ ~IOI- IS' \ - ss' --~ -- ./ ni I~ ~ ~ n WI ~ T L AU G 30 1973 ' / I 101 I lANE COUfm HEALTH UNIT Date ~ -2 S - CJ .Q. Si<:nat:iure ::::.. _ For Sanitarian Use Only: ~pproved: System Installation Conforms to Current S andards o Disapproved: Does Not Conform to Current Standards Remarks: .})-t / -'-C' Date: 8"-31.7..] Lane County Building & Sanitation Dept. ~IL) ~ /. ~_l\-13 ,~. f' anitarian's ~~ture . ~ OWNER LANE COUNTY 4tLDING PERMIT OR MOBILE 8UILDING MH MAILING ADDRESS HOM.SE PERMIT PERMIT NO. . PHONE CONTRACTOR MAILING ADDRESS PHONE PROPERTY LOCATION - INCLUDE POST OFFICE PROPERTY LEGAL DESCRIPTION - METES, BOUNDS TIN AN. ;, " NO o :f N~ 15 ^' APPl. NAME & EXISTING STRUCTURES ON PROPERTY LEGAL ACCESS TO PROPERTY MAIliNG ADDRESS PROPERTY SIZE - FT. WIDTH DEPTH AREA FOR MOBILE HOME PERMITS ONLY No. of Bedrooms TRill: URlc; TO l: E E IL ~lS F :RMI Connect to Existing Sewa~e System New System r l TV lNST TIO'" ~a F ftbA"Ms 'vA,LuA'IlJ~ SEWAGE DISPOSAL PUBLIC BUilDING WASTE DISPOSAL PlUMBING PLAN REVIEW PARK TRAilER ! FEES PLUMBING INSTAllED BY OWNER 1 OTHER: NAME WATER SU~PLY SEPTIC TANK OTHER! PUBLIC OTHER TOTAL s MIN SEPTIC TANK CAPACITY WITH 0151 BOX: GAl. COUNTY hUILDING & SANITATION SPECIFICATIONS DRAIN FIELD REQUIRED UN. 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 wi,h uniform building code and county regulations covering plumbing and sewage disposal All buildings require a certificate of occupancy before being occupied (See State men' on Reverse Side) (POST THIS PERMIT ON MAIN BLDG. AT SITE) lANE COUNTY, BLDG. &. SAN. DIY COURT HOUSE EUGENE OREGON 97401 )R'-' C ~~ 13 r ,~ . . . SITE INSPECTION ApPROVED Cl DISAPPROVED Cl DATE . INSPECTOR REMARKS FOUNDATION INSPECTION /' r....jL;z .7J INSPECTOR'. ft ApPROVEO / ~ / D'SAPPROVEO~! DATE REMARKS " FRAMING INSPECTION ApPROVEO ! I/! DISAPPROVEO! ! DAT~ fl')2' 73 INSPECTOR Ii- REMARKS LATH OR SHEETROCK INSPECTION ApPROVEO 1---/ DISAPPROVEO 1---/ DATE INSPECTOR REMARKS FINAL INSPECTION , /J / ~ ApPROVEO ~/ DISAPPROVED ~ DATE /7- F -71 INSPECTOR REMARKS~ A'f~q~ 1.j~--"~ ~..u..f--1t.D bOU.k~ J/J -IIJ-?JtI ..N\A) /YtA /~' H ~ '13 CERTIFICATE OF OCCUPANCY READY TO ISSUE ~ NOT READY TO ISSUE ;---y DATE INSPECTOR REMARKS C~^,;i 13Pt;. 1'3. 'PJ~7tdP ~/~O O~A 3.r-;'S';i -4 LANE COUNTY BaNG PERMIT OR MOBILE HOME I APPLICATION PERMIT 'TYPE - BUILDING M MOBilE HOME Dose REG, # PERMIT # /3/JrJ. - "J.3 TY pWNE~ /J I _ L- MAILING ADDRE~. J, . 4., ~~. 9": , .', /I. 41- _ J!. PHONE )L- J ,I(' ~~ 7), ~7' 0 W / -d7 CIU1 LlMA/lL/.b.f// a' ONTRACTOR I MAILING ADDRESS .' PHONE 7~" - 99J6 Jf--z J::/,z ?"hi ~ . J PI 4' -J- /METES & BOUNDS 0 YES //UA4Af....f~) ~/"M -' /4.-L--- \ ATTACHED 0 NO TAX LOT # CODE CENSU$ TRACT 3S-tC;24 DESCRIBE EXISTING STRUCTURES ON PROPERTY IFf ANY <--n A.ar/~ LEGA'"h.~~~D NAME OR # PROPERTY SIZE-WIDTH DEPTH PROPERTY lOCATION - INCLUDE POST OFFice /LB'5" .J)ht d./ a ..J PROPERTY LEGAL DESCRIPTION / _ ~_ , J J LOT - BLOCK - SUBDIV. / .LJ-r" ;:; ~A . 7.1 ~E Zc. APPLICANT NAME r? ~~~ AND MAILING ADDRESS FOR MOBILE HOME PERMIT ONLY Number of Bedrooms STR'!,S,URES TO BE BUllI. THIS PERMIT -Phl/~/~J ~'l-~ (2.2-,V"'2~ _) , ~h L.J .,#/..V. - SEWAGE DISPOSAL AREA Connect to Existing Sewage TYPE CONSTRUCTION ~ ~h d./??'f1 t&;:{-7~ System 0 or New System Req. 0 SQ. FT. )i, BEDROOMS VALUATIO~ ~/ / / IJ'/ re PL_ ./..~2rf9- fi{-.. t9 .3 OWNER 0 OTHER 0 NAME PLANS FURNISHED FACILITY PERMIT ~ YES 0 N~ YES 0 NOD / .SI~NATURE OF '~L~ANT J A IJ DATE <- y~ jJ-'"'- ~.j Jj, /./tV /Z b7'll ARECEIVEO llY h DATE (za.4 '#-~- 'A3 '-"eRMIT # / /.3M-~ COUNTY BUilDING & SANITATION SPECIFICATIONS / MIN. SEPTIC TANK CAPACITY DRAIN FIELD REQUIRED / WITH DIST, OOX, GAL jd}O 0 L1N, FT..J. 00 TRENCH WIDTH FT. l OR SQUARE/E'ET '-/00 fi)~ ~ ~;c: /Jf/JtJOt., LiLf x'h~~~.J z: ,;tk ~ hd;J . - , U ~ -1-~ j~~, r~' ~-' /~ f- L,~ rkLf I~Jdtp .J~ {!!<1tu cJi. ~..{ -!tv 4M1LA~ ~~~*/L;)ql/~, -TVPE OF STRUCTURE '&;./ u OC'CUPAJ~::(' v -e:t:..E TvREARYARD PUBLIC UTlL EASEMENT BLDG. SETBACKS - FT. FROM CTR. OF ROAD RIGHT OF ::H.AY USE CLASSIFICATION 4 -I ~T, ~EfT I I FRONT ':;> SIDE-':- '7 SIDE-alr.- z:; REAR 7 !L ~TARIAN Dot. PL1NNI~G ~,/,,:o/: BLDG, I~S . _ I ~~~_ / J , JJJ~ '7-16-)"I.kAIA<;,ir-. '",,-'-" ~ r.-J. U ' . ( - Directions to Find Property: PUBLIC 0 SEPTIC TANK bl $_ .~: AlA) .~'jIb FEES OTHER 0 WATER SUPPLY PUBLIC 'bl OTHER PLUMBING FEE~ J v,I-AJ ~ FIXTURES ~ l' IJ _ &-<J BLDG. WASTE D15. PLUMBING PLAN REVIEW PARK TRlR. CASH ,0 ~ CHECK Q"'"CONNECTION FEE PUBLIC WATER CONNECTION FEE ~G:o I.,sJ TOTAL // ..2,0-0 COPY 1 - OFFICE COPY 2 - JOURNAL COPY 3 - AUDIT Form # C55-IZ " 5/;? /4j5'e.::z .... PLUMBING INSTALLED BY Doto '/:::/ ,,- 11