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Home My WebLink AboutPermit Building 1975-1-14 ".~' < ", ,'. ~' ~r.......~~"'--"~ '~''"''' ~ .. ~.(... "" " ,~",'. ~ -...~~,'. " '. :'OC' . 1. '; . ;.-, ~.. '7.'"'" ,< " .' ,I. ,p. ._. .' LANE COUNTY BUilDING 0 XX . ' BUILDING PERMIT OR MOBILE HOME MH [j MAILING ADDRESS 870 WE~T CENTENNIAL MAILING ADDRESS USE PERMIT PERMIT NO< :; ;2 ., 7 r 22-75 PROPERTY OWNER rlOC:ERT NHILL SPRINGFIELD PHONE OREGON 74C.<')C)H, PHONE CONTRACTOR SAME PROPERTY LOCATION - INCLUDE POST OFFICE orr 37TH+- JASPER ROAO 1180 DONDEA PRO~GRTY LEGAL DESCRIPTION - METES, BOUNDS jRD ADDITION MEADOW GREEN ESTATES lOT 20 BLOCtI TWP 18 APPl. NAME & MAILING RANGE SECTION TAX LOT NO. CODE CENSUS TRACT 02 06./,.3 .p:. q 2--/ ~ 3'>.-J"i2A EXISTING STRUCTURES ON PROPERTY ROSERT N.' HILL NONE 870 WEST 'CENTENNIAL LEGAL ACCESS TO PROPERTY DONDtA 'STREET, PROPERTY SIZE - FT. ADDRESS SPR I NGF IELD OREGON FOR MOBilE HOME PERMITS ONLY No. of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT WIDTH DEPTH AREA r Connect to Existing TYPE CONSTRUCTION 1098 @21.8o 484 e 5.30, Sewage System 0 SQ. FT. ;: BDRMS - !>..:!:.~: ~=: 3 New System 0, VALUATION 23, 936.l10 2,565"fQ 26, '501. 6c GARAGE SEWAGE DISPOSAL PUBLIC P[j' OR SEPTIC TANK 0 OTHERO BUILDING . 110.00 WASTE DISPOSAL ')(l.00 PLUMBING 2').00 PLAN REVIEW ) PARK TRAILER 1.4':1 1j3SURCHARGE TOTAL . 1Q4.4~ COUNTY MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GAl. 900 FEES PLUMBING INSTALLED BY OWNER 0 OTHER: NAME WATER SUPPLY PUBLIC 0 o OTHER " BUilDING & SANITATION SPECIFICATIONS DRAIN FIelD REQUIRED DEPTH lIN, FT 150 TRENCH WIDTH FT, 'I' OR SQ, FT, "1 TYPE OF STRUCTURE OCCUPANCY ZONE PUBLIC UTll. EASEMENT BLDG. SETBACKS__ FRONT 45' /5/ J. Eo FT: FROM CTR. OF ROAD RIGHT OF WAY SIDE INT. l' SIDE EXT. AUTHORIZED SIGNATURE - DATE Boss BY C. HARBAUGH USE CLASSIFICATION REAR 'i' JOHN SHOOK/SANITARIAN DATE 1/14/7') DLI1 BLDG. PERMIT - WH ITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENROD Call 6B7.4065 to schedule all required inspectiDns. All construe. tion shall comply with Uniform Building Code, D,E,Q, standards IMPORTANT: for subsurface sewage disposal and county regulations covering plumbing, All buildings require a certificate of occupancy before . being occupied. (See Details an Reverse Side) FORM::: CSS-13 (POST THIS PERMIT ON MAIN BLDG. AT SITE) LANE COUNTY, DEPT. OF ENVIRONMENTAL MANAGEMENT COURTHOUSE ANNEX, 135 EAST 6th, EUGENE, OREGON 97401 l!J'. ;~.~_~"""n.,....~---,- --- -')--~--""'~-~'-~--''-'''-.- .-."",__~..'";,--J _"_J.<~____"""'-__"""""~'._.~"~-______"_ ---- , .'. , , ~ . __, ',. ~..1 . . V..' i _.f '-, . .. .<. ., ,,'It LANE COUNTY BUILDING 0 JUt BUILDING PERMIT OR MOBILE HOME USE PERMIT MH D PERMIT NO, MAILING ADDRESS 870 tJlt'~l' Ce tJV II ~~tJl /ll., ~ .. )J 22~75 PROPERTY OWNER r.O~IWT ri HILI. [lP:llC::lF I IlL 0 PHONE O:lCCC,lll;~:;:;I(' PHONE CONTRACTOR SA~~ MAILING ADDRESS PROPERTY LOCATION - INCLUDE POST OffICE O~? 31TH & JAODlln RJAD 1 '80 DONDltA .... PROPERTY LEGAL DESCRIPTION - METES, BOUNDS j(lD ADDITION ~AOG~ G~lt'll~ [OTATEO I.OT 20 6l. atn 1 18 RANGE SECTION TAX LOT NO. CODE CENSUS TRACT 02 06. I, 3 -If. q 2/ ~ ':\:;"'"I2A EXISTING STRUCTURES ON PROPERTY ROGEtlT N. NILL l'b:JE TWP APPL. NAME & MAILING 810 HerDT CENTll~NI~L LEGAL ACCESS TO PROPERTY DoNDitA Sma:I!:T PROPERTY SIZE - fT. ADDRESS SP>JH~flllLD, O:ltIOCr4 FOR MOBILE HOME PERMITS ONLY No. of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT WIDTH DEPTH AREA ~"'.I.""'" Connect to Existing TYPE CONSTRUCTION lW.,8 0 21.80 IJ84 0 5.30 Sewage System D SQ. FT. # BDRMS 3 New System D VALUATION 23. 936.to GAllAOQ" OJ (~~ c--., "11 ...U).L.(, ----.--.-"'" c:~. ~D' .cj SEWAGE DISPOSAL F PUBLIC d O(l SEPTIC TANK 0 BUILDING It WASTE DISPOSAL PLUMBING PLAN REVIEW PARK TRAILER l~UilCllAllG[ TOTAL PLUMBING INSTALLED BY OTHERO Ilt'.CO 50.00 E5.00 FEES OWNER 0 OTHER, NAME WATER SUPPLY PUBLIC 0 o OTHER . 1.4, 19~.1J':\ COUNTY BUILDING & SANITATION SPECIFICATIONS MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GAt. sao DRAIN FIELD REQUIRED lIN, FT 150 Dl!PT~1 TRENCH WIDTH FT. 3' OR SQ. FT. " TYPE OF STRUCTURE OCCUPANCY lONE PUBLIC UTIt. EASEMENT BLDG. SETBACKS.. FT. FROM CTR. OF ROAD RIGHT OF WAY FRONT t].5' SIDE INT. 51 SIDE EXT. AUTHORIZED SIGNATURE - DATE /0/ J. E. BO~3 DV C. HAROA~QM USE CLASSIFICATION REAR 5' JOl;;J SI10c''t/:lIlNITAIlIA'J DATE 1/11)/75 cu. BLDG. PERMIT - WHITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENROD Call 6B7.4065 to schedule all required inspedions, All construe. tion shall comply with Uniform Building Code. D.E,Q, standards IMPORTANT: for subsurface sewage disposal and county regulations covering plumbing. All buildings require a certificate of occupancy before being occupied. (See Details on Reverse Side) rORM ::: CSS-13 (POST THIS PERMIT ON MAIN BLDG. AT SITE) LANE COUNTY, DEPT. OF ENVIRONMENTAL MANAGEMENT COURTHOUSE ANNEX. 135 EAST 6th. EUGENE. OREGON 97401 . . . ~ SLAB FLOOR PLUMBING GROUNDWORK I !i '.." , " ApPROVED / I / DISAPPROVEO ~ DATE INSPECTOR REMARKS GAS PIPING GROUNDWORK ApPROVED / / DISAPPROVED ~ DATE INSPECTOR REMARKS ROUGH PLUMB I NG DATE,J-/Z-/J INSPEC~# t/ ApPROVED ~ DISAPPROVED C1 REMARKS ROUGH GAS PIPING ApPROVED ~ DISAPPROVED ~ DATE INS~ECTOR REMARKS FINAL PLUMBING DATE~- ~ -;?r INSPEC?", r~ ApPROVED ifX!J DISAPPROVED ~ REMARKS FINAL GAS PIPING ApPROVED C1 DISAPPROVED / / DATE INSPECTOR REMARKS CERTIFICATE OF OCCUPANCY READY TO ISSUE C1 NOT READY TO ISSUE C1 DATE INSPECTOR REMARK S ~ . l-ouJev_' --' .C;'v' IiUILI~ING SITE EVALUATION' \ '')7' \1 . ... . . (~UILDING PERMIT APPLICATION NO. 2-z..:-75 ~'\~(t) () SITE' I NSPECTJ ON PLANNING DIVISION' Not AIlPllcable Kff l) ( ) ( ) ( ) ( ) 1. 2. 3. 4. . 5. Zoning Ordinance Compliance: Zone Subdivision Ordinance Compliance Requ i red Access . . Building Site (Area, Width, Frontage) Other (see comments) COMMENTS: .' T--'.f; R OZ S 0,," TAX LOT <?ZI'b SUBDIVISION: LOT: U11l BLOCK: APPLI CANT DATE No Yes T)rn ( ) ( ( ) ( ) ( ) q) ( ) ( ) '1-"1:>" t.. j CK'~I/e~ 6. ,Setbacks "from c11-'of road: Front <?.s-t ...... . .)...'t. ,-^"C::IIUr Setbacks from Side Rear Interior lInes: -f5,1 ~ PLANNING DIVISION ACTION PENDING: YESl,} NOl } APPLICATIONH BUILDING INSPECTION DIVISION Not _ APDllcable l ) ( ) ( ) ( ) 7. Plans Submitted 8. Soil Stability (footings) ,9. Flood Plain 10. Other (see comments) COMMENTS: '- WATER POLUTION CONTRO~ Not I ADDl icable l ) ( ) , 11. Meets Department of Environmental Quality Standards. 12. Other (see comments) COMMENTS: No Yes r)W ( ) 1 ) ( ) ( ) () ( ) CK',D By:t?~~/;-/Oi:.. . IJATE No Yrs r) TT ( ) (,) CK'D BY: ~~ //o/hK "y . DATE TO APPL~ANT: ' ~ Your Building / Site Inspection: \[J' .f<r Can be approved. \/ '/.f!} () Cannot be approved at this time as Indicated on item NO. above. .~ Questions and further information on items 1 through 6 contact the LANE- COUNTY'PLANNING DIVISION. Questions and ,further Information on Items 7 through 12 contact the LANE COUNTY BUILDING AND SANITATION DIVISION. ( ) Will be he I'd in th i s off I ce unt II you can resolve the prob I ems i nd I cated. ( ) 'Is being returned. ( ) Your building permlt,aEplication fee Is belng,x~tur:!:l.'ld-!!nder seoarate cover. DEPARTMENT OF ENVIRONMENTAL MANAuEM~NI 135 Sixth Avenue East Eugene Oregon 97401 PHONE: 687-4065 LANE COUNTY PLANNING DIVISION PHONE: 687-4186 C55-2B ~,. ,. -.- c.,,~,^,-: ~, -.........=---.-,;;-.f~~--;~~~'('..- ..,.....,--; .,......:, /,.r LANE COUNTY BUilDING 0 lm BUILDING PERMIT OR MOBILE HOME MH 0 MAILING ADDRESS C70 tfC:DV CCtm:flfJlt.1. MAILING Al?DRESS USE PERMIT PERMIT NO, ,-' .--~~7~ ;:.t.'{5 PROPERTY OWNER ~~OJ~nV CJ n~L'" CONTRACTOR ~,!'.:~S PROPERTY LOCATION - INCLUDE POST OFFICE or. 37.n ~ JA07Cr.'(.j~o flf':lIC=:;v I GLD PHONE " .', ~.... ,,' \,;.J~CCt. (" ....~I,)lf PHONE 11lJo DcIlD;:A ,I " I PROPERTY LEGAL DESCRIPTION - METES, BOUNDS J"J IlD!iI Tlot: r';:;i\C::; t:::llEU COrAVIIO loy ZO D.OC/l I TWP ltl RANGE SECTION TAX LOT NO. CODE CENSUS TRACT <rl 06 ?i-o 1 121\ EXISTING STRUCTURES ON PROPERTY i'~O~iE APPL. (~:J3ll:CY n. tllLL " ' ,.:;.' & \ G7~,11ItO'f Cct--vumlSf..l,. MAILING '-J '\ "- ADDRESS ,\\ gGt~3VI(jI.o'~,"r.O:l FOR MOBilE HOME 'PERMITS ONLY No, of Bedrooms ~('" ST,RUCTURES'T08~ BUILT THI~ PERMIT '1,'- ..J "''" ~ '" .. ..,J \ - ~ ".--.." ,,...t. NAME LEGAL ACCESS TO PROPERTY Oar;D~A SV;;CtIV " " . PROPERTY SIZE - FT. , ' , . WIDTH. .'"- DEP.TH AREA {;'~~~~"~'''~'':\. ~~,,.. ""'\&\ ,., CQnnect to Ex.i.sting Sewage'System 0 ~~_~YPE CONST'Wf,J"io\:, " SQ~"FT.;~ BDRMS ~~~ ~~t.~{1'Y" ~~ ~\;, '\ 'I' ... ...."..... '~ .... . ....." \ "", . ',' ,~iJttJ () 5.30 \ " ~~-'" '" " ~. v" I New ,System 0, VALUATION :;--' f'" --' ...\... 12.'\,:n,., \ . l:',: '" [ ) (,t~J" --,,", ,.....' ;:.; t: iI ., ,"I , ~ SEWAGE DISPOSAL ,'H\,;l PUBLIC 0 BUILDING WASTE DISPOSAL PLUMBING SEPTIC TANK" 0 ~. OTHERO Y Iv.YU FEES );J.~ ,~ l',;).{,~C\ . ~ ~ ~ C --~~.~\..\. ~\;---~~!:"\ PLUMBING INSTALLED BY \ : '\ OWNER 0 OTHER: NAME WATER SUPPLY PUBLIC 0 o OTHER ",\ PLAN REVIEW 1'~ \ PARK TRAILER , t~<~~~C~1t.~;Or. \ " TOTAL q'.. ..... \ MIN. SEPTIC TANK CAPACITY WITH 0151. BOX: GAL ,1." J ':'...1) .. . ~ \.... \ ." . . Y0.4L COUNTY BUilDING & SANITATION SPECIFICATIONS DRAIN FielD REQUIRED C "PYI1 Sr'im UN, FT I~ TRENCH W;OTH FT, 3' OR SQ. FT. TYPE OF STRUCTURE . "\ .. \,'" ) ,\~ . . ...... ... ~ .~" ,', ~ ~~~"J'~J~~'-b,~*\~~~~ ", ~ . OCCUPANCY Z~E " PUBLIC UTlL. EASEMENT ::>~ .,~ c ~. ~ .........:........~. ",. '--...... ", 't~~ \""\.~'7" ,~.. ,..." BLDG. SETBACKS.. FT. FROM CTR. OF ROAD RIGHT OF WAY USE CLASSIFICATION r---:- t (~I yJ SIDE INT. .1 SIDE EXT. I AUTHORIZED SIGNATURE - DATE h J. 1::. l..:'JU C'I ,'. I'N;,-,r.;t~'1 \'",. '~l,~' ~~.. FRONT REAR :;' JCK~ GHo~/Dt~''fAnOn~ DATE 1 /1 ~:/I'J , l;~ ~ . BLDG. PERMIT - WHITE OffICE COPY - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENROD Call 687,4065 to schedule all required inspections, All construe. tion shall comply with Uniform Building Code, D.E.Q. stondards IMPORTANT: for subsurface sewage disposal and county regulations covering plumbing. All buildings require a certificate of occupancy before being occupied. . (See Details on Reverse' Side) FORM:: C55-1) (POST THIS PERMIT ON MAIN BLDG. AT SITE) LANE COUNTY. DEPT, OF ENVIRONMENTAL MANAGEMENT COURTHOUSE ANNEX. 135 EAST 6th, EUGENE, OREGON 97401 ~ ~...;-.. . .' . SITE INSPECTION >~PPROVEO ~ DISA,::ROVEO Cl DA~~ ' REMARI<S ~.,f!1.. _7r'~6~ INSPECTOR FOUNDATION I NSPECJ,ION (j ,/ ,., J' ~' ApPROVED L!::...,/ DI SAPPROVED 1---/ DATE j-/.7' 7 INSPECTOR C RE,""",$J}.!f'~/ ~ .~ 2, -/.i-?f'P,/ "/, "" I~ -.L' ",off'~-j 4JA.;rL-~'2 -:1.7~, ~A , . i;!. .h~"" "3',~~'i"'!,;r-n- j . / _ . ..,/1f -~U~hoff.' ".. ti~,(~ VVf31""'(!:!,c!, F A~~G}f~P7 ~ ~ I, -u 8 ApPROVED DISAPPROVED C1 DATE /1 -/1- ;7() I NSPECTO~ _ -:.f:f.-. (f r/. REMARKSr1f/d,;~ uil1/n-,utlri/lv, ';1.. i :r~7,}'-<! /k4I!Ld2L1f~./~''f- 1(/- 7F (D,J : ~" /') "rn " ';';?:"'''''''" ,0 J/ APPROVEO' D'SAPPROVED c::J DATE rb'-l q- 7'5'::.SPECTOIX- REMARKS t)r('~i:.dL 4..t-,~A~~1~,/!?Ju;P4~; . ~ . fHf..ifl - ~-<i12'7'4-1<. ~ ..&;z.,~: ...4~./-- ~-U, n'J 1 <,u''''r' ,/-JI//I''1'';5 / / qt FINAL INSPECTION ApPROVED r.- CERTIFICATE OF OCCUPANCY READY TO ISSUE Cl NOT REAOY TO ISSUE Cl DATE INSPECTOR REMARK 5 A AI / / // i/ / ~., A V //A :. ~ "'-' '~\~""P/ ;;';<-76" 11~ f/ // 3'0 (J.V~_ " . '. '. . . PROPOS EO SEWAGE DISPOSAL SYSTEM RECORD INSTAL'lER:'Complete top part of form to signature and submit both . . . copies with appl icat'ion. ' 10', PERM IT NO. 22-7')' JS \ I INSTALLER'S NAME ~, PROPERTY ADDRESS f)Re6IJAI d2t~ dG" ~DONDEA STREET No. Living Units Bedrooms Baths Basement Water Supply Yes No Pub Ii c ')1 Other-Li st Septic Tank: Ft. from well ;VO ttlf;i( Inside Dimensions: Lenqth Width OWNER NAME Steel D Concrete rl h~h4('<lJ Ft. Diameter No. Compartments ::l-. Tile Disposal Field: Distribution Box: Yes Y Other Distribution-Type Gal. Capacity /~O Depth No RnR~~T N 1-41 t I HAILING 870 WEST CENTENNIAL ADDRESS Feet from ,,// , WE 11 A/[jt(J~l.-- Foundat i on I () Lot Li ne _ I _ I ~, Front .4:'1 Side ('1 Rear 0 1Ft. Between IFill1)j IFiller Depth IFIller Below Li nes I () I Tvpe/r?lfL Above T i Ie (" In Jr 11 e c.. in. SPRINGfiELD OREGON Length of Lines-Ft. lTrench'l Total Sq. -f) l21 3. 4. 5. 6. Width:> Ft. 7?oO {'lot Plan (see instructions): C' (..nV S'v S 7e4~ 3J-- .I!>-;z..A- ofo.-- - \' - " I "I -.-GJ 1/00 i\ I -tv ., I ~O ~!E(cE~V~D . L~l ~- &J- p- f30~ ( M/.\R ~ 41975 1~~ IO~ I - ( ( jtJ "> ~~, COUNTY Yr ~VliW~M~TAL MGMT. I ( II d I \ -- ( -, Date }1 fO D()nJ ()cft .g~ a UJ/?//~-/ S i qnature ' ~ CERTIFICATE OF SATISFACTORY COMPLETION --..' . For Sanitarian Use Only: Date:,3-2'i?-75 In accordance with 1973 Oregon Laws Chapter 835. Section 214 this certificate is issued as evidence of satisfactory completion of a subsurface sewage disposal system at the above I ocat ion. ~ Approved: System Installation conforms to current standards c::J Disapproved: Does not conform to current standards Remarks: C55-11 \~~ S~~~rfan's Signature LA~COUNTY STATE OF OREGON DEPARTMENT OF ENVIRONMENTAL QUALITY NOTE: PERMIT IF~.) - /\- NO PERMIT WILL BE ISSUED UNTIL THIS APPLICATION HAS BEEN APPROVED . ~ ., . APPLICATION FOR: CONSTRUCTION ~ MOBILE HOME CJ J"7o 'h) PLAN REVIEW CJ U-~.L City CHANGE OF OCCUPANCY c::=J t.lZi 1lWNER ,tfn [JGR.r /II J//LL Name CJ CONTRACTOR-4/>......'} Name Address .Jp>'~,/,II- 7C/t~9f/(' I 7ifiP Phone Address City Zip Phone O,S. REG, /I Twp. I Y Range ().). Section () c" S~&'iM{{o~'.I"'d ~ &!-.J;;;, Lot ACCESS TO PROPERTY (Road Name) JJ()-t1 ,t ..J Existing Structures on Property: ~A4>'J'__ Property Location - AddreSS/Direct~ons:fl# 2r;?f, J.. ~.J P.......I... >1"/ Tax Lot Code Census Tract.3S--/.j-.::! It Width.r"~th.Li.J..?J ,:}j7 J-t, .-;-:t:-.- Block I Property Acreage - //RV A~."" Below for Office Use OnlyXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX \ Sq, Fe. ~r:J/. g-O (IBedrooms Valuation /u9/P, ,. C:3 ) :3 -=? en,;.. vb 1J~'IIBo':>'<JV ~ .~.......... >r ~ !'l ~~... _0 _C) ~ ~ / /' "!. _ !l.-~....... J::. ~~",1 . d~ o.l/ . c7 SEWAGE DISPOSAL: .n _ ,~ Site Inspection # ~ WATER SUPPLY: Well Spring _ Existing Sewage Disposal System Public CJ Community~ CJ or New System Required CJ Min. Septic Tank Capacity Cf()f-... nrainteld Require , / i I I / I / Fire Zone I / I / ~d, Right Of:1t.~'____~h / " Name of Community or PU?,SYBtem AJ~ Other r="1 Name bj4- - LA..--..J ~ Il //~., Sewage (/ /' Water connect~~ Connection ;J. PLANS FURN)7' FACILITY PERMIT !S2r t.s/ c=J NO f) )71 YES P NO Si ~,(:. of APPlicant:~ ~. !ld4~1l~ 7Received BYJs'~ Date:~/5(/7.j- - Lineal Feet ,) ~ Maximum Depth ~ ./ , Other FEES: Bldg, Waste Dlsp. Plumbing Plan Review Mobile Home 1% Surcharge 1/?tJtJ ,>0.00 ::2.5": 0 0 PLUMBING: Installed by Owner CJ PLUMBING FEES: j7 U of Fixtures ~ \ /,1/3 . o CASH TOTAL /9#. V3 ~ CHECK Type of Construction Group Use Classification BIdg Setbacks - from Center of Front~' Side Int,. Rear F:.' Zone R.b.. ~/1hS C5S-12 DATE: \\r~ON: ;ft/7J DEP~TMENT OF ENVIRONMENTAL Pd'::J~ff7:"I'p-}t{ JAG~ENT / LANE COUNTY ... Lane . County Authorization SEPTIC INSPECTION FOR LOAN REVIEW '.. for: FOR OFFICE USE ONLY . Application; /L./ A //_ (J? Perm.lt t / 7V rOo If - . . roW;;SHIP 18 I RANGE 02 S~BDIVISION/PARTITION {if applicable) SECTION ) T9IC2' lw6T 06.1. 3 I LOT/PARCE!. I DOUT OF PROpoSED USE OF PROPERTY ~ Residential 0 Industr ia1 D Commercial D Public, BLOCK LOCATION ADDRESS STREET 1180 DONDEA ST.. SPRINGFIELD. OREGON CITY ZIP STRUCTURES CURRENTLY ON PROPERTY EXISTING SINGLE FAMILY DWELLING DIRLCTION~ TO ~lTE 42ND ST. TO MA I N ST., RIGHT ON JASPER ROAD, LEFT ON DONDEA ST., ACROSS FROM SCHOOL ~~SCRIPTION OF PROPOSED WORK - BE SPECIFIC DECLARED S VALUE SEPTIC .. OF BEDROOMS l # OF STORIES NA NA O;~"NER' S NAME AND ADDRESS INSPECTION FOR LOAN REVIEW IIf OF EI-1P:;EI:S I WATER SUPPLY PUBLIC D_proposed AExisting TELEPHONE NUMBER 741-0291 MIKE CORGAIN, SAME AS THE JOB ADDRESS ABOVE C0NTRACTOR'S NAME AND OSR #I SAME AS THE ABOVE TELEPHONE NUMBER SAME P:::;RNIT TO BE MAILED TO lNAME AND ADDRESS) SHERRY \'100DS, 1142 WILLAGILLESPIE, EUGENE, ORE. 97401-2142 TELEPHONE NUMBER 484-9815 I HAVE CAREFULLY EXAMINED THE C<>>!PLETED APPLICATION FOR PERMIT, and tlo hereby certify that all infortDlStioJl hereon is true and correct, and that I have the following legal interest in the property; Downer of record; 0 contrclct purchaser;fiauthorized agent. I f:;rther certify that any and all work performed shall be done in accordance with the Ordinances of Lane County and the Laws of tho Stato of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without the permission of the Building Division. I fur- ther certify that registration with the Builder's Board is in full force and effect as Iequirod by ORS 701.055, that if 'exempt the basis for exemption is noted hereon, And that only subcontractors And employees who are in compliance with ORS 701.055 will be used on this project. I HAVE READ AND CHECKED THIS APPLICATION THOROUGHLY. NAME (p~ease print) ~k^/ /A )~~.:LaJ DATE SHERRY WOODS READ THIS SECTION CAREFULLY. YOUR AUTHORIZATION ~AS BEEN BASED ON THE FOLLOWING CONDITIONS~ [] PLANNING/ZONING, Zone Parti tiol} # CL. side Parcel fI Parcel Size Minimum Setbacks: C L, front interior rear COl't'lENTS : NO SPECIAL PLANNING ACTION REQUIRED. Date : n Installation Record Issued? 0 Yes 0 No Maximum Depth _;::::i~. ~t ;;~~SU.<) . O~t:;;; $ 4L L2;;::" o:r ~~9;7..q./. ((i#-e~".o~<=If n; M f1J~~I!.iW.1J 6-r-i({I [] PLANS EXAMINATION, Type [] SANITATION, S. 1. fI B. P. it Installation Gallon Lineal Feet ~- Grouo Use COMHEN'TS : Dale: n PE~I~~f:d~~;;;8c~~6.B05(l)) ~ ~~iJ LANE COUNTY DEPARTMENT OF. U IC WORKS LAND MANAGEMENT DIVISION, 687-4061, 125 EAST 8 ENUE, EUGENE, OREGON 97401 SEE REVERSE FOR INSPECTION INFORMATION C 14-25 R84-