HomeMy WebLinkAboutPermit Building 1974-3-4
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PROPERTY OWNER
LANE COUNT.UI~DING" PER~li O~ MOBILE HO.USE PERMIT
BUILDING ~ MH [] PERMIT NO,
MAILING ADDRESS
PHONE.
CONTRACTOR
MAILING ADDRESS
PHONE
PROPERTY LOCATION - INCLUDE POST OFFICE
PROPERTY LEGAL DESCRIPTION - METES, BOUNDS
Twe
RANGE
SECTION
,4,2.-
TAX LOT NO CODE
~ :1F170()
CENSUS TRACT
APPl.
NAME
EXISTING STRUCTURES ON PROPERTY
&
LEGAL ACCESS TO PROPERTY
. ~(pl/ 0
, hOPE'TY SIZE - FT,
MAIliNG
ADDRESS
FOR MOBILE HOME PERMITS ONLY
No. of Bedrooms
STRlIc1f'uRES TO BE BUILT THIS PERMIT
WIDTH
DEPTH
AREA
Connect to Existing Sewase System LJ New System [l
TVPE CONSTRUCTION 66. FT :: BDRMS VALUATION
SEWAGE DISPOSAL
PUBLIC n
BUILDING
WASTE DISPOSAL
PLUMBING
PLAN REVIEW
PARK. TRAILER
.
FEES
PLUMBING INSTAllED BY
OWNER n OTHER: NAME
WATER SV~PlY
SEPTIC TANK 0
OTHERD
PUBLIC 0
[] OTHE'
MIN. SEPTIC TANK CAPACITY
WITH OISl. BOX: GAl.
s--'-'------
COUNTY BUILDING & SANITATION SPECIFICATIONS
DRAIN FIELD REQUIRED
TOTAL
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 with uniform building code and county regulations
covering plumbing ond sewage disposal. All buildings require Q 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 = CSS-ll
BUILDING SITE EVALUATION
.,
... "j,::';:/(,.I-I.
App I i cat ion No.2'5'6 - 7 Y
~ Buildjng Permit
() S he I nspect ion
() Pre-Permit Investigation
T-.1%:..R Z s. h TAX LOT 3t r,lo .,.
C~~TR T . ~
.:5. - ,?tt'~,;.,. ~ /"3,8,3
APPL NT: /1'(/ r7
Ni\ME / II
AODRESS
PHONE
DATE
:< -.;In-71/
.~
DiHE
lI\NE COUNTY PLANNING DEPARTMENT NOT NO YES
app I i cab I e
I. Zon i ng Ordinance Compl iance ( ) ( ) ( 1
(Zone ~A- )
2. Subdivision Ordinance Compl iance ( ) ( ) (
-, Required Access ( ) ( ) (
~ .
4. Bui Iding Site (Area, Width, ( ) ( ) (
Frontage, Setback) ((i
5. Ot her (see comments) ( ) ( )
COMMENTS:
NN1E
~
l..--z,~
,
=
BU I LD ING INSPECTION SECTION NOT NO YES NAME DATE
~pp I icab Ie W1
6. Plans Subm i tted ( ) ( )
7. Soil Stability (foot i ngs) rf) ( ) ( )
8. Flood Plain ~ ( ) ( )
9. Other (see Comments) i1 ( ) ( ) (j71~ 3"/-71/
COMMENTS: p"-
SANITATION SECTION NOT NO YES NN1E DATE
app I icab I e
10. Sewage Disposal ( ) ( ) ~
II. Usable Area ( ) ( ) <A ~~A ~p
12. Water Supply ( ) ( ) tit
13. o the r (see Comments) ( ) ( ) ( )
COMMENTS:
TO APPL I CANT:
Building Permit / Site Inspection:
Can be approved.
Cannot be approved at this time as indicated on item NO. above.
Quest ions and further informat ion on items I through 5 contact the Lane-
COUNTY PLANNING DEPARTMENT. Quest ions and further informat ion on items 6
through 13 contact the Lane Counlv Buildinq ""d Sanitation Division.
Will be held in this officc until you can re,;olve the problems indicat'cd.
Is being returned.
Your buildinCJ permit appl icat ion fee is being returned under separatc C,der.
3-t( if ~r
( )
( )
( )
Li\N1' COIlN'I Y "I.IINN I NG DEI'IIRTMENT
I :I." ~ i)< Iii A,ellue E~s t. Eugelle, Or~9lln 9740 I
"llllNt:: HZ--I:lll EXI. BI
LANE COUNTY BUILDING & SANITATION DIVISION
135' Sixth I'lv~mue EdSt, E"'jell", O'c,!nn 97401
J>lKllH, : 342-1311 [XT. 411
M55-28
" \
..
.
Date
Permit No.
CURB CUT
PERMIT
IN THE BOARD OF COUNTY COMMISSIONERS OF LANE COUNTY
WHEREAS, the attached application has been fully considered by the Board of County Com,
missioners 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
for placing, building
or constructing the following facility:
upon the right.of,way of County Road No. , Mile Post
in strict conformity to the exhibits attached hereto, and subject to all terms, conditions, agreements,
stipulations and provisions contained in the application and permit, the Rules and Regulations Gov'
erning Facilities to be Permitted upon County Road Rights,of,Way, as set forth by the lane Man,
ual 50.190(2) any amendments thereto, and an yother opplicable regulations, law or ordinance.
Specia I Provisions:
I, Driveway will be constructed in accordance with the attoched driveway approach specifica.
tions (Drawing M98,50).
2. Permittee will be responsible for the immediate removal of all mud, dirt and debris from the
roadway and right of way caused by his operation, leaving the roadway and area in a neat,
acceptable condition.
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 void unless the work herein contemplated shall have been completed be,
fore
_,19__
Expires
, 19
Inspected and Approved
Approved by Board of County Commissioners
By
Date
By
Director of Public Works
WHITE - OFFICE fILE
GREEN - RESIDENT ENGINEER
PINK - PERMITTEE
BLUE - ROAD SUPERVISOR
ORANGE - BUILDING & SANITATION DEPT
YELLOW - REAL ESTATE
C98-79
,r"-
..
.
Building Permit #
Date
APPLICATION FOR FACILITY PERMIT
I,
(Applicant's Name)
hereby make application under Rules and Regulations Gaverning Facilities to be Permitted Upon
County Rights,of,Way, to construct the following facility,
Upon the right.af.way of County Road No,
, at mile post
on the
No, So. E. W. side of the road, or
(mark wi\h X)
as shown on the exhibits which are attached hereto, in strict conformity to the statements of the
exact nature and amount of work to be done, and to the description of the facilities contained
in said exhibits. The applicant will be the principle owner of the facility as canstructed, or other,
wise primarily liable and responsible to members af the public for its proper maintenance, repair,
operatian and use. The applicant accepts all terms, conditions, agreements, stipulations and pro,
visions, in Rules and Regulations Governing Facilities to be Permitted Upon County Raad Rights,
of,Way, as set forth by the lane Manual 50.190(2), any amendments thereto, and any other ap'
plicable regulation, law or ordinance.
To
Permits Processing
Noted
Date
Noted
Director
Principal Engineer
Subdivision Engineer
Signature
Permit Engineer
Address
Weighmaster
Zone No.
WHITE
GREEN
PINK
- OffiCE FILE
- RESIDENT ENGINEER
- PERMITTEE
BLUE - ROAD SUPV.
ORANGE - BLDG. & SANIT.
YelLOW - REAL EST ATE
Phone No.
C98-78
LANE COUNTY&ILDING
BUILDING rl
PERMIT OR MOBILE
HoAsE PERMIT
PERMIT NO,
OWNER
MH 0
MAILING AobRESS
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
LEGAL ACCESS TO PROPERTY
&
MAILING
ADDRESS
FOR MOBILE HOME PERMITS ONLY
No. of Bedrooms
b'r~UCTURES TO BE BUILT THIS PERMIT
PROPERTY SIZE - FT.
WIDTH
DEPTH
AREA
Connect to Existing Sewage System r 1 New System n
TYPE CONSTRUCTIOl-.l sa FT :: A'tf~'Ms VALU"{~lbN
SEWAGE DISPOSAL
PUBLIC n
BUILDING
WASTE DISPOSAL
PLUMBING
PLAN REVIEW
PARK TRAILER
PLUMBING INST AllEO BY
SEPTIC TANK n
OTI'ERn
.
FEES
emi\'JPLY OTHER, NAME
PUBLIC 0
o OTHER
TOTAL
MIN. SEPTIC TANK CAPACITY
WITH 0151. BOX: GAl.
S-~bLNTY BU/IP\NO & SANITATION SPECIFICATIONS
DRAIN F U~ REQUIRED
lIN. FT
TRENCH WIDTH FT.
OR SQ. FT.
TYPE OF STRUCTURE
OCCUPANCY
ZONE
PU8l1C 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 cerfificate
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"'" = C5s-n
.
SLAB FLOOR
PLUMBING GROUNDWORK
ApPROVEO ;---y D,SAPPROVEO ~ DATE
REMARKS
GAS PIPING GROUNDWORK
ApPROVED / / DISAPPROVED ~ DATE
REMARKS
ROUGH PLUMBING
.
INSPECTOR
INSPECTOR
ApPROVED ~ DISAPPROVED ~
REMARKS
DAT"-:{::./_ J"l.- INSPECTe'
I
ROUGH GAS PIPING
ApPROVED ~ DISAPPROVED ~ DATE
REMARKS
INSPECTOR
.
-~
V
ApPROVED t;2:l 01 SAPPROVED ~
REMARKS
'",5- 'I - ft'I ,"",,,"..4,/'/
FINAL PLUMBING
FINAL GAS PIPING
ApPROVED ~ DISAPPROVED ~ DATE
REMARKS
CERTIFICATE OF OCCUPANCY
REAOY TO ISSUE ;---y NOT REAOY TO ISSUE ;---y DATE
ReMARKS
INSPECTOR
INSPECTOR
-
LANE COUN~.UILDING
BUILDING MH .,
MAILING ADDRESS
. '.
PERMIT OR MOBILE
HO.USE PERMIT
PERMIT NO.
PROPERTY OWNER
PHONE
CONTRACTOR
MAILING ADDRESS
PHONE
PROPERTY lOCATION - INCLUDE POST OFFICE
PROPERTY LEGAL DESCRIPTION - METES, BOUNDS
w,
RANGE
SECTION
TAX LOT NO
CODE
CENSUS TRACT
APPl.
EXISTING STRUCTURES ON PROPERTY
NAME
LEGAL ACCESS TO PROPERTY
&
MAIliNG
ADDRESS
FOR MOBILE HOME PERMITS ONLY
No. of Bedrooms
STRUCTURES- TO BE BUILT THIS PERMIT
PROPERTY SIZE - FT.
WIDTH
DEPTH
AREA
Connect to Existing Sewofle System New System r]
T....PE CONSTRUCTION a~ FT - BDRMS VALUATION
SEWAGE DISPOSAL
PUBliC rl
BUILDING
WASTE DISPOSAL
PLUMBING
PLAN REVIEW
PARK TRAILER
PLUMBING INSTALLED BY
SEPTIC T ANI< 1
OTHERf""l
<
fEES
OWNER ~ OTHER: NAME
WATER SUPPLY
PUBLIC r]
[1 OTHER
TOTAL
<
MIN. SEPTIC TANK CAPACITY
WITH 0151 BOX: GAL
COUNTY BUILDING & 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
BlOG PERMIT - WHITE
OFfICE COPY - WHITE
COUNTY TAX - PINK
PLUMBING - CANARY
BUILDING - GREEN
SANITATION - GOLDENROD
Construction to comply with uniform building code and county regulalions
covering plumbing and sewage disposal. All buildings require 0 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
...IIIIl
.
.
. ,.
..
SITE INSPECTION
APPROVED.Cl OISAPPROVED.Cl DATE
INSPECTOR
REMARKS
FOUNDATION INSPECTION
ApPROVED r"i7"f 01 SAPPROVED / / DATE ''3-'.2.1- INSPECTOR (fJt
REMARKS h-4?!ML- ~ 3J J~'?I/ &.
II
I
FRAMING INSPECTION 11~
ApPROVED pDISAPP~OVED 17 DATE /Itl- 11-7.qNSPECTORLZ
REMARK~ .;;.,rr ~ qvj y 711( ,
,
LATH OR S~E;~CK INSPECTION
ApPROVED DISAPPROVED /
INSPECTOR
rU--
I DATEi{-/'j.'1tJ
REMARKS
'~,. -1t, III
/ '. ,~
FINAL INSPECTION .- 0
APPROVED -~ISAPPROVED L:J--?~1 LI'---
{
'i-J. i. - 'Ii/
INSPECTOR~
REMARK 5
CERTIFICATE OF ~
READY TO ISSUE or READY TO ISSUE L:::7 DATE
INSPECTOR
REMARK 5
,
L~!d~
;(38'-7L( Jt i& 3~ rO IJ~
~~1ffr~
....
_JI,
e;
(fJ --" J_
e..J
e!
9t~1
($11
SEWAGEj)~SPOSAL SYSTEM R~ ~
to signature and submit t~ copies with application. "f'
PERMIT NO. Jl38- 77
PROPERTY ADDRESS '
INSTALLER:
.POSED
Complete top part~ form
INSTALLER'S NAME
~j/rQ1f1/\ 6f2EW
No. Living Units Bedrooms
t .3
Septic Tank:
Ft. from well
Steel
Inside
Len!.tth
OWNER
NAME
Baths
I
- ':51" 1D
Basement
Yes No
l\S(~
Water Supply
)'... Publ icY Other-List
D
Concrete ~ No. Compartments
I~
Gal. Capacity
Tile Disposal Field:
Distribution Box: Yes ~ No
Other Distribution-Type
~,t:)$ ~
MAILING
ADDRESS ~
L<;mlth of Lines-FI. J ,frenCh I Total Sq.
'~~7lD3. 4. 5. 6. AWidth~ Ft. _~()()
'lot Plan (see instructions):
Feet from
WEll Foundation I~
Lot Li ne
Front _ Side In Rear 16
I 'to Between IFiller. IFilfer Depth IFille}' Below
Lines In Tvoe I,r Above Ti Ie 2Jn.ITi )e~ in.
j
(0'
I
--r:
10\
S i 9~aturtJd.: . 1-1 16"-"_
CERTIFICATE OF SATISFA RY COMPt!'i-10N . - -
For Sanitarian Use Only:
In accordance with 1973 Oregon Laws Chapter 835. Section 214 this certificate
as evidence of satisfactory completion of a subsurface sewage disposal system
location.
~ Approved: System Installation conforms to current standards
~ Disapproved: Does not conform to current standards
Remarks:
101-
J:01
1
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I
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1-[0'-1
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Date .'i -f_ - " I./.
C55-11
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("'I ~ ~_11 "1.
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MAY u 6 1914
~S-I
t.;.
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J ~'t\H .t
-
s-t>'
-,-
I . I
--10-
~at7:o/;'f17~
IS ISS6e~ /
at the above
~.IA-.m~
~~rtarian's Signature
~NE COUNTY
STATE OF OREGON DEPARTMENT OF ENVIRONMENTAL QUALITY
'/'1:
LANE COUNT&9-DING PERMIT OR MOBILE HOM JSE, APPLICATION
PERMIT TYPE - BUILDING r;( MOBILE HOME DOSC REG, # 'f'i\ PERMIT:#: ;<'.50- 7'(
PRr.;rll~NERRo(,~ /lJ M;r9;DDRE~ Ce00~AJAJ(~/ sr>p)f) r;';2-9'o/~
CONTRACT~ MAILING ADDRESS --,- PHO-NE
~M-<'
PROPERTY l~C(TJON - I.NCLUDE POST OFFICE ." A /J
;S b 7,D n" lie ~ /_ :;;. .Pe-I..;) < Petty
PROPERTY LEG~l DESCR~PII0-;:; fYl- - () /I J C' 'l- s~Jt. J 7
,lOT"?' BlOCK.3- SUBDIV, P AJ/m..1. lo(>~e A) C$ ((rr',o~ IkM( J.-r:rT 0,)
TWP RANGE SEC. TAX lOT # CODE
N :2.. L.. J b J./O
Qr,{.,ef?7" /J/ 1/
/"
APPLICANT
Mc...s
NAME
AND
MAILING
ADDReSS
FOR MOBILE HOME PERMIT ONLY
Number of Bedrooms
STRUCTURES TO BE BUILT THIS PERMIT
~Ff)
~ IV\. -e
~/o<..K ~
METES & BOUNDS 0 YES
ATTACHED ~NO
CENSUS TRACT
::1,;'- I f:J.. 17
DESCRIBE EXISTING StRUCTURES ON PROPERTY IF ANY
fJ)(),J}t:.
LEGAL ACCESS TO PROPERTY - ROAD NAME OR #
{)tt.ke. S,.
PRdPERTY SIZE-WIDTH DEPTH
7DI'
AREA
/-<.. / /
Connect to Existing
TYPE CONSTRUCTION
V
GCI! elL~ C ' L< ., ~ _e.,l.e j)
SEWAGE DISPOSAL
PUBLIC 0
SEPTIC TANK IB""
,<:"'6-
:30
;;Z<g
OTHER 0
WATER SUPPLY
PUBLIC cg./' OTHER
Pl~rNG FEES @.S ;' -< y
_ FIXTURES
BLDG.
WASTE DIS.
PLUMBING
PLAN REVIEW
PARK TRlR.
<
FEES
CASH 0 JEWER
CHECK ~CONNECTION FEE
PUBLIC WATER
CONNECTION FEE
-::1,00
TOTAL
of' tJ '1-
~ 00
Sewage System 0 ar New System Req. 0
SQ. FT. ;S # BEDROOMS VALUATION
/035 @ 1'7.....(3) I::(lf:<o
-,
"I6?.. (!J
.3
I ( 3"6b
I.SlfDt,
PLUMBING INSTALLED BY
OWNER 0 OTHER ~AME ./tLlJ_k J()",kc./bA>
PLANS fURNISHED FACILITY PERMIT
YES V NO 0 YES ~ NO 0
~~GNATUR~~ '1Pl~T J I..
W /'/~) ~ cNjL ~-.:<.O
(FEE -RECEI ED BY" DATE
.../-3
PERMIT #
'J.-3~-?"I
DATE
;;J..-;z,o
/
COUNTY BUILDING & SANITATION SPECIFICATIONS
DRAIN FIELD REQUIRED
?OO UN, FT,/!>-o TRENCH WIDTH FT, 2-
ReJCJf d'rat)7S -0 .s-&~l .
MIN. SEPTIC TANK CAPACITY
WITH 0151. BOX: GAl.
TYPE OF STRUCTURE
OCCUPANCY
/C//(/
OF ROAD RIGHT OF WAY
6'11
BLDG. SETBACKS - FT. fROM eJR.
<.f S- SIDE INT.
s- S18[ "VT
~
REAR
Dale BLDG. INSP.
7--'"2.-I-,<{..
Of=' 37''1 -l<-
~cea..
Directions to Find Property:
COPY 1 - OFFICE
COPY 2 - JOURNAL
COPY 3 - AUDIT
Form # CSS-1Z
,:500
OR SQUARE FEET
l F
1/
HI
if
ZONE
REAR YARD
PUBLIC UTlL. EASEMENT
R^.--.
f ' f't)~
JJ c..i:', ,./ /}f''::) Dot.
f.I.~ ~t%i. 7-1-71/
Y', r) I I
.j(J,spe~ ev
USE CLASSIFICATION