HomeMy WebLinkAboutPermit Plumbing 1973-2-26
LANE COUNTY BUILDING PERMIT OR MOBILE HOME USE APPLICATION
PERMIT TYPE - BUILDI.O MOBILE HOME oosc REG, # . PERMIT #
PROPERTY OWNER MAILING ADDRESS
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CONTRACT6.tt - MAiLiNG ADDRESS ~ 0'
.:1-9 J-73
PROPERTY loeA TlON - INCLUDE POST OFFICE
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~I ,-I?~ ~A'1AA-
/ O~ C7
PHONE
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PHONE '
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METES & 8Q'~NDS -S. YES
ATTACHED D NO
PROPERTY LEGAL DESCRIPTION
LOT - BLOCK - SUBDIV.
TWP RANGE
/1 3
SEC.
2-7, /
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"It.<./ ~.L d-
TAX lOT #
V6da
CODE
CENSUS TRACT
52.- </00
APPLICANT
NAME
AND
!1-(l&
DESCRIBE EXISTING STRUCTURES ON PROPERTY IF ANY
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lEGAL ACCESS TO PROPERTtL ROAD NAME OR # /
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PROPERTY SI~IDTH DEPTH .J _ AREA
.ZL /"5 2... X C-G,.';) (
MAILING
ADDRESS 4t~ /.;.R..fJ ~.
FOR MOBllEjtfO~~NL Y 0
Number of Bedro~s
STRUCTURES TO BE BUILT THIS PERMIT
.'r;:,fl/l/ '#: S. IlS
Connect to Existing Sewoge System 0
TYPE CONSTRUCTION SQ. FT.
/ IZ (I?/Y7 A-,'" /'r\/ ,r.P7H c- /:" / LPridJ
or New System Req. 0
# BEDROOMS VALUATION
'-
SEWAGE DISPOSAL
PUBLIC 0
PLUMBING INSTALLED BY
SEPTIC TANK t81'
BLDG.
WASTE DIS.
PLUMBING
PLAN REVIEW
PARK TRLR.
,
FEES
OTHER D
WATER SUPPLY
PUBLIC 0
PLUMBING FEES
OTHER 'ZV~
OWNER D OTHER D NAME
PLANS FURNISHED /'
YES D NO r.l'
SIGNATURE OF APPLICANT
.:J,,'/U;fL_
~
TOTAL
~1J1
_ FIXTURES
CASH D ~wER
CHECK If.A:ONNECTION FEE
PUBLIC WATER
CONNECTION FEE
DATE
z. -;;.t;-73
COUNTY BUILDING & SANITATION
SPECIFICi\l'1'ONS
DRAIN FIELD REQUIRED L
UN. FT. /] r> TRENCH WIDTH FT. fl
~
MIN. SEPTIC TANK CAPACITY
WITH DIST. BOX, GAL .R;.(,..:x;t;;;)
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~1J). ~ .lap ~~T'~
TYrrt. STRUCTe./ ~1P__-:p..J?~ OCCUPANCY V ZONE
5'// ,~
OR SQUARE FEET ;2 t, 0
dutt ) ~~fi Au AJ:"
~ .f?A.--LAP_ ..,../-/fi1, h/.J/,I2&~
REAR YARD
PUBLIC UTIL. EASEMENT
BLDG. SETBACKS - FT. FROM CTR. OF ROAD RIGHT OF WAY
USE CLASSIFICATION
FRONT SIDE INT.
SANITARIAN Date
4J/J,dA_, 3, /-7..?
Directions : F~ Property:
SIDE EXT.
PLANNING
REAR
Date B'fI3. INSP.:../
~..I .x...L--'
C-/
Date
3A-/7~
, ;
Ch1.
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COPY 1 - OFFICE
COPY 2 - JOURNAL
COPY 3 - AUDIT
Form # C55-IZ