HomeMy WebLinkAboutPermit Plumbing 1971-9-27
~ _ ,Recor? )f Individual Sewage~isposal system/-,.-....
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TO BE COMPLETED BY INSTAllER- I ~ /J ..-../1/
PERMIT ISSUED TO- Installer's name t ~~r. J'l/C....ctA
KENNETH MEY ERS
Basement: Yes D No D
Community system
~~o of compartments
ft Inside width
ft
Other
ft
ft
ft
ft
ft
Other
Nam,.
MOIling addrpcc 261:)0 NORTH il ST.. SPR I NGFIEtO
Total number lIVIng unlts~ Bed~c Baths
Water supply by Public system V. IndIVIdual system
Septic tank Distance from well Feet Material
Total liquid capacity q(J/1 gal Inside length
Diameter ft liquid depth ~
Tile disposal field DistributIOn box:-'.ties ~No D
length each IlneL~O ...;,;uL
Total length 1m
Width of trench t~
Total square footage ~ 3't1 t)
Distance between lines l' 0
Type of filter material- Gravel I t ~th.vw...A!
Depth of filter material over tile '2- Inches
SKETCH (See instructions)
BUilding permit number S I-S
Property address 52No. STREET, SPR tNGF&:ELO
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ft
Distance from
Well
Nearest
lot line Front D Side DRear D
Foundation feet
Depth of filter material beneath tile ?
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feet
Inches
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BE SURE TO INDICATE NORTHERLY DIRECTION
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Signature
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FOR USE OF SANITARIAN O~Y
System apparently Will ~I not D
Remarks
function satisfactorily, and IS therefore approved for occupancy ~roved D
bate 9 ~ 7- 7 - 7 /
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LANE ]Ur~t H:!D:~T
V '- ~ SANITARIAN
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l'N( COUNTY HEALTH OEPARTUENT
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RECEIPT No. 79745
REQUEST FOR SITE INSPECTION
TWP. 17 RANGE 02 SEC. 28
TAX LOT NO. 700 CODE
DATE ~-ll-71
BY
MEYERS. KENNETH
MAILING ADDRESS
2650 N. 31st TEL. No. 747-3572
Springfield. Oreg~n 97477 ~
SIZE OF PROP. .46 LEGAL ACCESS? High Banks Road
Is PROPERTY CONTIGUOUS TO ANY CITY LIMIT? Inside Springfield
House to be torn down
OWNER OF PROPERTY ?
CONSENT OF OWNER?
EXISTING STRUCTURES ON PROPERTY
SOURCE OF WATER SUPPLY: PUBLIC
SPRING
WELL: DRILLED
DRIVEN
DUG
DESCRIPTION OF SITE (DIRECTIONS, LANDMARKS, HOUSE OR BOX NO., IF ANY):
Out 1-5 to 52nd street. Left on 52nd. First house on High Banks Road.
PROPOSED USE OF SITE (E.G., NUMBER OF DWELLINGS, COMMERCIAL OR INDUSTRIAL USE, SUBDIVISIDN):
Future warehouse, house to be torn down.
Ix I URBANIZING AREA.
~I SPECIAL PERMIT AREA.
JW : j w
FEE:
No. OF SITES
No. OF ACRES
TOTAL
$
$
5.00
5.00
RESULTS OF INVESTIGATION:
SITE INSPECTION FEE REFUNDED -
, ~~ 4-13-71
BECAUSE IT~~E'CITY LINITS OF SPRINGFIELO.
THIS IS A PRELIMINARY REPORT WHICH DOES NOT INSURE THE ISSUANCE OF A FUTURE BUILDING
PERMIT. ANY PLANS OR EXPENDITURES MADE IN RELIANCE UPON THIS REPORT ARE AT YOUR OWN RISK:
BEFORE CONSTRUCTION IS STARTED BRING THIS FORM TO THE BUILDING AND SANITATION DIVISION AND
MAKE APPLICATION FOR A BUILDING PERMIT. IF THE PRDPERTY IS A PORTION ONLY OF A TAX LOT, A
METES AND BOUNDS DESCRIPTION OF THE PARCEL MUST BE FURNISHED. EXACT SPECIFICATIONS FOR THE
SEWAGE DISPOSAL SYSTEM WILL APPEAR ON THE BUILDING PERMIT. Two SFTS OF THE BUILDING PLANS
AND PLOT PLAN WILL BE REQUIRED.
LANE COUNTY BUILDING AND SANITATION DIVISION:
BUILDING INSPECTOR
SANITARIAN
DATE
THIS REPORT IS NOT COMPLETE WITHOUT THE SIGNATURES OF THE BUILDING INSPECTOR AND SANITARIAN.
e",-097-07
3;)-'11
..
R E rUN D 0 r
FEE
THE LANE COUNTY DEPARTMENT Of HEALTH AND SANITATION HAVING REQUESTED REfUND
OF FEE TO:-
Kenneth Meyers
Of
2650 N. 31st Springfield, Oregon
NAME
ADDRESS
ApPLICATION FOR BUILDING PERMIT DENIED, AND NO APPEAL OF SUCH DENIAL
HAVING BEEN MADE.
ApPLICATION fOR BUILDING PERMIT CANCELED.
APPLICATION fOR BUILDING PERMIT, OVERPAYMENT.
ZON ING PET IT ION.
APPLICATION FOR RESTAURANT LICENSE.
ApPLICATION"fOR CERTifiCATE nf SANITATION.
X APPLICATION fOR PRELIMINARY SITE INS~ECTION.
FOR THE fOLLOWING REASON:
We are refunding site Inspection fee of $5.00 because It Is Inside the City limits
of Springfield.
AND THE APPLICANT DESIRING THAT THE fEE BE REfUNDEe, T~E08IRt~T~R ~f FINANCE
AND AUDITING IS REQUESTED TO REfUND THE AMOUNT er $ · , UNDER APPLICATION
NUMBER 79745 IN THE CASE Of APPLICATION FOR BUILDING PERMfT., WHICH IS THE
FEE CHARGED.
DATE 4-13...71
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55-029-12