HomeMy WebLinkAboutPermit Plumbing 1997-3-29
.
.
,/
(Date recEII~Efd) .
SEWAGE DISPOSAL SYSTEIIIl..:AS BUlL Tn PLMi MAY 2 91997
Pursuant to the requirements within OAR 4504.665. OAR 340-71-170 and OAR 340-71-175, the system installer and/or the pennitl.. must notify the Oepartment of Envlronmental Cu.hty (Ol'
its authorizod Agent) when the COflstNdiotl, alteration or repair of. system for which. permit was issued is completed (except for the backfllling or covering of the installjltio(l)
,l1le .
Department ( or Agent) has IlIven (7) daYlto perform an inspection of the completed constnJctjon after the official notice date, unless the Department (or Agent) elects \6twlrfI &. H
EAi..1 ( .
inspection and euthorizes the IYllern 10 be baCkfll1ed earlier, Receipt and acceptance of this completed form by the Department (or Agent) establish.. the ol'flciel notice dale of your
request to( the pnHXlver inspection. Plllll""" o:lmnllllA An thrM a..oiDn!l of lhll form And rntum In lAnA r.12l.lDb:.,l=nvimnmltnllll ~e811h 125 E 8th Ave EUCltru' Orsnnn Q74n1.
SECTION 1: BASIC INFORMATION
Permit # ~-q7
MapfTaxLot# iR-OZ -Droll. 5- 77@
10 Be Comoleted Bv Installec:
PERMIT ISSUED TO:
Name:..bM:>4 ~aObrfL{Clf-MailingAd&ess: /o7( /..cW~ ?Jv~
Property Address: LA-U~tr?_ A-</(;-l ~Pfl..A)
TOTAL #: Bedrooms_ Living Units _ Basement: Yes_ No _ ~
WATER SUPPLY: Public .i"lndividual 0 Community 0 Other (Name) ~
SECTIO~Materials List (Identify and list all materials used in system):
SEPTIC TANK: ^" concr~~pol 0 Metal
Manufacturerta/h~#,... ~ ~ Total Liquid Capacity /CJ~1J nal.
Distance from Dwelling 5 f(; Effl ent Sewer ASTM # ; Distance from well~ft.
DRAINFIELD: Se./1.lrttf/.<:, l/O . .
Total Linear Feet ..24t? r : Drainfield Pipe (ASTM#) uUlfe-IU.;-Header Pipe (ASTM#)~ll)e ~O
Depth Rock Beneath Drain Line )( in.; Depth Rock Over Drain Line_~..in. pVc!.
Distance of WELL from Closest Portion of DRAINFIEJ,.D n lei'.
Mfg.fType/Size of Rock Filter Material /Y:z/r A"fiT/Ad
PUMP SYSTEM: '-..........
I (installer's name), ~ , certify that a
(Mfg.) Model No:----" Pump and Mercury Float
Switch (Mfg. and No.) ha~nstalled with this sewage installation.
(Complete as Applicable): Working Capacity of Chamber qal. Gallons per Cycle aal.
"Working Capacity" remaining after alarm has activated_ aal.
Signat.ure u;lt.,~
./) / i1t /jj/J.
OTHER: (;;Zerials n~ t . a
~~
Date ~ 7/r T
" ('
**************111
It.**
FOR SANITARIAN'S USE ONLY:
~YGtem Approved 0 System Disapproved. 0 Needs Correction
COMMENTS:
o System Corrected; Date: ;J / . System Capacity Lfq;/ aaVday
Signature ~(d Date (,-1,/9 ")
~,_ ~ t rfl~l -
INSTALLATION RECORD ~FICATE OF SATISFACTORY COMPLETlON. \Nhen signed by the County Sanitarian. this certificate is evidence as per ORS
454.665 of satisfactory completion of a subSurface sewage disposal system at the above location.
(over)
. .~
(\\
\0 \
~/
.
.
Permit #
;;::89 ~ r '7.
.SECTION 3:
.,
AS-BUILT PLAN OF THE CONSTRUCTED SYSTEM. Show the following: North arrow, septic system
referenced to a fixed point, such as, building foundation or property corner, property lines, wells and water lines
within 200 ft., drive or walk-ways, all buildings, property dimensions, streams, ponds, cuts, escarpments (>50%
slopes). include final grade shots of ends of trenches, distribution box, and septic tank outlet elevation.
*.******************************************************...***..**************.*.************....*.****.*********.*.
.-_..........~-...;:..-'....,_'"' '- I,.........v
V-";"'~-... --...-_-.. -...-........~.. ......-..--.r~ '-"F""'...-....-... -_- __~J
J-.r.. "
N
Ji?
"'"- - --,
.--.--....
-
""
-'-ot;;,,-
- ~(J
r---- _.
I
~
t"
- - n____ ------ ---__ _..___.__ __________.... ~_4h
,,,-,,, ..
--- -.-- ------. ----.----.--
1b
\0 ~
I
.-..----- --.-- - .-.
'-co
_u_u~~~~i~- h-----)i~6~'CfKJREC-
:..E,
.,....... --- .
I
-,~--- - '.------ - ----
._ 4______ ._._ _ ____.. _.~
\--- --
,
u_ -- --~--- - U/'f/ ----
--'-'---.. '--'~-~---t1./..--j ,----,
- 'LI/
,- -- ---- --I
1
,............--.- _.~_: ---
----.- -'------
.....
c;)
- -._- -------
-------.-- -------- -
s
/..-tUt)n rl.4'ie
f5vevJua.{fLt
c
. ' .
*********************~**********************
...
-******************************************
VICINITY MAP _
CD
N
I certify the information provided in this notice is
correct, and that the construction of this system was in
accordance with the permit and the rules regulating the
construction of an on-site sewage disposal system. I
have tested the septic tank for water tightness per OAR
340-73-025(3) and found it to comply.
Installer (Please Print)
(Title as shown on DEQ license)
Telephone
License No.
Bonding Company
Signature
II' ...,
"'.'~ : :,
,,,.., ,..-
, ".t.\;;.~~.~, . .
~f;.~\~,;.:\ "
~:i.i\;+:I~"':';'
t';'\~~~:::,' .
, ~.drl<;'l.:~.,.
/ ...:.~I^~~"~'i'" .
~I-".'~" .
'~~)'i'!' :.:',
11.36". e
.. ,',.;..
2,'1:,:":
t4'B~:;.i ".:.
t~;{/< .
f' .
.' "
I L<~:'
~ '.'
,~. .
~,
-::,'1,<;.':
;'; ~.~.: ..
"",."
';'. .
, ~<-:'1
:":;"~:.
..,...
j,",:'
. .,..
rt~., .
If
.,../ "
!:,: :.
w'
-
-
N'
"~~
.~~
C"( _
~~,
z
:;,',
". }.:"',
. ~;".~.
'..:.. ..
. ~,
I
~
, I
'"7 ~6,;'1J I '
4 o3S'~111 ' _
. " ~lJ.J~
'."'~\
..,~. . . ..~
~'
.
.. ..
,Q.
Q
z
r
50, clO
p",rcel ); :;>
J/O
--I.
I~I
I
34J
'I ---
I
:..!_'-' _ .t!2 ____ ~
. 1/, J
~CQ. Ie J .::" 2.~
i.
I,
I
-. .
~:": !--- ---
',.'~:" .......... --- .
. . . " , ---- ~ .'
.--
, .......
,.',- .
"l
I~
,
\
'I
I
I
.i. . jrl's";~,, L
..1 TAll" 1- ( , ,,'
,I ,. ,
~.:, ,0 ~' -1': 11>.:~I'f'.'
- - - '-\l~"...~
Y"..<; I
CU: . <)'
",,;, . I..
-.:....- '" 1- I'
-
, ,- - 1-- , I '
~ . --... --...
---.
. -
J
'-
S5.aS' ,
,> ,
',.' .
.ti;J=ORi;.:;"
.,. . ~
eer
'N BeJoU'20u ' ..
, '263.SS" UJ
..
'. ",
'..
S)B" 1.1~,
,ut .
. 'Ie -f '
. ~..11' ~J8'
, . ....- .., - '
. . '---......,.. 411"\ ,,_
\
.' . ..
...............
. ... .'
.' i.\ .
. .PA~CEL .3
13,43cZ).5 e~. .ft.
.
.
.
Rt~\u~",e.J-
A,OtA. No"-
l?e1.t;rt9.-~e
.1 otl.", ""//3/'17 9' I
.> _ Co.1. /){'-:I'"r..~-f','"
(i) ,.,>,,,,/;, ";J" .lrJ
~ ~~ :s~.p.'.. ~,-,,-,L.~(/.: i
~ ...; .-k;. s '(~
- .
-
.,
~
I.:'
- ..
-.-
.......
l~ 45.0eJ~
-
;n'
..:~:.
...... ...
,',
&~ ~ #vtAdt6,
~~-~?7Z-r~PL~77-'L4Lr .
> Jbu ~~ b~ ~~f
b luthJ-<.--aL-Zm~L4V ./0;7/ dAt..;L / L).'i~, . \ ' :ti
~1UbUI.tltJ~-.;~p;'t2v',~7yt~f' .,'
. i?ttA~:'l (f~~', ~fJ~~~.
''-/20.-' /?~ ~ PO? rtb', a4/ A-eui1...Ib..L tJJ~. .
,', .,.., .... , ., I
?A~(l~~l ~u:ILo/ ~m~/ ,;: :
.,f!d:th~aJLA)U:~ ~-tWtU~b,' 1:1
, ~. ' ~ c,o~ 'u.k-ihp'Z/ a.jab/ ,:~,
f1U~<-;P0-U:cf tPf ~'~,'~,... .r I
.~~ ' '. ,A/if_ . ' ",Pd,~..~,
'. . ,',' ../ .''-''/A,,'~d~ '
~~ ~ ,.' '
~, ,~,.~_'~~/JUr~~' .
~'~~~<I~d' .
. , . '-"\
~o!-.'
, ' '4!f'i q~ :5/,/Vu;h'iCLP ' ,
ev[jU0W~a:> . '
, ,
~
"
;~j
.,
, i.
I.
I
Ii
.,
I
J
, \ ' .
.(
, ,:
. j'
"
'~ J~
~;~
I.
", .~
,~
:{;
~
.,!
.
I.'. .
'.
}
~ {
.. ,
J
" t
. ~
' ' ,
'. . . .!
,., '.'.'-0"'
I ~,~1;~~j~t.~(>,..:,. '
I ." '
. '
"\.:"11
;.-'
.
REQUEST
FOR:
INSTALL SEPTIC. SYSTEM
< WM<;HP ur' 0'2""" 0 (:'."1":' 3 ""LOT ill o";'~Il"""""
LCG'T1"'7Ro' 7 ~ LAUREL ~'., SPRINGFIELD,
STRUCT\JRES NOW ON PROPERTY
NO EXISTING STRUCTURES
PAOf"OSCDUSE SEPTICNSTAllE) WAl'EANSTALLS>
RESIDENTIAL USE WELL
0ESCHI7f0lQ'1'ft'.:I'l;I;CDwtA(
INSTALL SEPTIC SYSTEM
LO'TIPAROEL Ill.OO(
A
*
OREGON
NO OFSTORES
NO OF EMPlOYEES
CONSl'RUCTICN CQSTIYAUJE
NO"'''''''''''''
DIRECTIONS TO 6ITE fflC>>,l NEAREST IUJN NTERSEC11CJIl
NONE GIVEN
.-.pPUCANT~Ii' ADlH'IES8
WILLI FROEHLICH,
OWNERS NAME' ADDRESS
TIM MITCHUM, 92671 N. COBURG RD., EUGENE, OREGON
CONTRACTORIINSTALLEWSUILDEA NAME calf
WILLI FROEHLICH
" MAIL PERMIT TO:
WILLI FROEHLICH, 3014 W. 15TH AVE., EUGENE, OREGON
PHONE
344-0560
,"ON<
747-0Bll
PHONE
97402
I - STREET OTV 1S'
,<
'. t;}J1jia'af;~m,O~H~Sldes 01 this apPII~ ~~Y" Inlor~a:I~~"I~~~~~ct
CAREFULL VI Vour Authorization Is Based On The Following Conditions
FEES DUE: $
APPROVED BY:
DATE
~
.,
(CALL FOR INSPECTIONS (SEE BACK OF FORM FOR
SEPTIC permUs sre good for one yesr, ALL other permUs expire
LMD 040 Rov. 6/92
INSTRUCTIONS) 687-4065
sfter 180 dsys unless Inspections sre current.
,
r U".' -.r,....-r.....-....."-......" "';_.,~.....":......,,\.;(',I~I".l.........;;..;'-.-.-'~~}....-.IA-~~'(;,,...;.I.':~K/-"'~~,Z.a.~.':!-"L..6>>l~'~,'~C',~-I" 1o'7~~. "';..r.~'-'
';: "-~o;.'....-;."-.T,,.<--.~......' ~ 0/...' r'
... .,~
':..1\
...\' I
.,
\,.=
\..i\ _.
~\'
, (-,'
...:3:,....)(;,-:.
.
.. II
r
'., . ~ ...
~,
-,. . \'.f. , r:
VIOLA nONS
SBTBACKS AND OTHBR CONDmONS OP APPROV ALMOST BD S11UC'It. Y OBSBRVFD. VIOLATION CAN RBSULTD\l RBVOCATION OPnDS PBRMIT.
"' \ CITATIONS MAY BB ISSUED UNDBR nIB PROVISIONS OP LANE COUNTY'S lNPRACl10N ORDINANCE AND/OR 011IBR. RBMBDIBS AlLOWBD BY LAW.
;: )~ ..,y-\'....
A MINIMUM OF AT LEAST 24 HOURS AnV ANCE NOTICE MUST BE GIVEN FOR INSPECTION REQUESTS
"'
Have the following information ready when you call: 687-4065
Permit nwnber - Job address - Type of inspection required - _ y.'hen it will be ready
Your name and phone number - Any special directio,~ to,llJe site ., '"
PUBLIC omClAL RIGlIT TO TRESPASS ON PRIVATE PROPERTY ORS ns.olD
POWER TO BN7BR UPON LAND. nIB COMMISSION, AND ANY OP ITS MEMBERS, OFfICERS AND BMPLOYBS, IN nlBPBRPORMANCB OP nmIR FUNcnoNS. MAY
ENTER UPON ANY LAND AND MAKE ~AnoNS AND S11RVBVS AND PLACl AND MAINTAIN nIB NBCBSSARY MONUMENTS AND MARKERS lHBRs()N.
REQUIRED INSPECfIONS
FOUNDATION INSPECfION: To be made after excavations for footings are complete and any required reinforcing steel is in place.
UNDERGROUND PIPING INSPECfION: To be made after all underground piping has been installed, prior to any backfill.
CONCRETE SLAB OR UNDER-FLOOR INSPECfION: To be made after all in-slab or under,floor building service equipmen~ condui~ piping
accessories and other ancillary equipment items are in place but before any concrete is placed or floor sheathing installed, including the subfloor.
ROUGH MECHANICAL INSPECfION: To be made after all ducting and gas piping has been installed and prior to being covered.
ROUGH PLUMBING INSPECfION: To be made after all plumbing rough-in is in place, prior to being covered. '
FRAMING lNSPECfION: To be made after the all framing, frre blocking, bracing and roof are in place and all pipes, chimneys and vents are complete
and the rough electrical, plwnbing, and mechanical inspections have been made and' approved.
INSULATION INSPECfION: To be made after all insulation and vaperbam"", are in place, prior to covering.
LATH AND/OR GYPSUM BOARD INSPECfION: To be made after alllathing and gypsum board, interior and exterior, is in place but before any
plastering is applied or before gypsum board joints and fasten"", are taped and fInished.
ADDITIONAL INSPECTIONS MAY BE REQUIRED, such as but not limited to; '.
BLOCK WALL: To be made afterreinforcing is in place, but before any grout is poured. The inspection is required for each bond beam pour. There
will be no approval until the plumbing and electrical inspections have been made and approved. .
FINAL MECHANICAL INSPECfION: To be rirade just prior to the structure or remodeled area being occupied and prior to operating';'y equiPment
FINAL PLUMBING INSPECfION: To be mad~ just prior to the building, structure or remodeled area being occupied.
FINAL BUILDING INSPECfION: To be made after fInish grading and the building, structure or remodeled area is completed and ready for occupancy.
MOBILE/MANUFACfURED HOMES: An inspection is required after the mobile home is connected to an approved sewer or septic
system, prior to covering sewer or water lines, for setback requirements, blocking, tiedowns and plumbing connections.
Footings and piers to comply with State foundation requirements for mobile homes or as recommended by the manufacturer,
Minimum fmished floor elevation shall be certified when required by Floodplain Management
Tiedowns, if required, shall be installed and ready for inspection within 30 days after occupancy. Tiedowns shall be installed per enclosure.
" ' . .," '... ,:.,.,,',j '.."." '- 0~\ ", ~,~ "'-,.....:. ,', "l_ <::.'>..- .~:~ "'--J
,. , ' ,.. . APPROVAL REQUIRED
No work shall'be &;rie on 'any.p~ of the building or structure beyond the point indicated in each successive inspection without first obtaining the
approval of the building official. Such approval shall be given only after an. inspection shall have been made of each successive step in the construction
as indicated by each of the inspections required. ..... /
. ., -: ' ~.. ,. :::. APPROVED pwJS'MUS;'B'i'\>N TIlE JOii-~JE AT ~8'!~ES DURING WORKING HOURS.
TIllS PERMIT WIU EXPIRE IF WORK DOES NOT BEGIN WITllIN 180 DAYS, OR IF WORK IS STOPPED OR ABANDONED FOR MORE TIlAN .180 DAYS.
SUSPENSION OR REVOCATION MAY OCCUR IF TIllS PERMIT W AS ISSUED ON Tim'BAS1S OF INCOMPI,E'\'E OR'ERRONEOUS INFORMATION.
\ . . . - ... \ -. "
ANYONE PROCEEDING PAST THE POINT OF REQUIRED INSPECTIONS WILL DO'SO AT THEIR OWN. RISK.
, , . - ~ ...- 1.' . ~ ., '..... I J' " \ ~. : .\ . " , \''- , .,; \ ....:
\ . '- ""',' . ..
Your signahire on tI1e front of this form verifIes the following: '!,HA YE CAREFULLY EXAMINED THIS COMPLETED APPLICATION, and do
hereby certify tha.t all information hereon is true and correct. and that I have a legal interest in the property as owner of record or authorized agent. I
further certify that any and all work performed shall be done in accordance with the Ordinances of Lane County and the laws of the State of Oregon per-
taining to the work described herein. I further certify that if I am not the owner of the I'_Wl'-..~' my registration with the Builders Board is in full force
and effect as required by ORS 701.055, and that if exempt the basis for the exemption is noted hereon, and that only subcontractors and employees who
are in compliance with ORS 701.005 will be used on the job.
SUBSURFACE & ALTERNATIVE SEW AGE DISPOSAL SYSTEMS:
When subsurface construction is complete. the permit holder shall notify the County Land Management Division by submitting the installation record
form. An inspection will be made by a qualified sanitarian. If construction complies with all rules a certificate of completion will be issued to the permit
holder, If construction does not comply with rules. the permit holder will be notified. and all corrections shall be made before a certificate of completion
will be issued. Failure to meet satisfactory completion within the allotted time constitutes a violation of ORS 454.605 to 454.745 and this rule.
SUBSURFACE SEW AGE DISPOSAL SETBACKS SEPTIC TANK
From: Interior """_,,, lines 10'
Edge ofroad right-of-way 10'
Building foundation 5'
Wells or other water sources 50'
DRAlNFIELD
10'
10'
10'
100'
-
.
.
.
N
.~
-~:-..
"
. ,
..
,
.,
I
,-
I
+-
- ...-:
-r_n_M..-.._....M......
~~\<lt:ll r
..:....j
,
<67. 70
B? L/3(p- r(.
SEW AGE DISPOSAL
PLOT PLAN APPROVED
. A permit Is required
prior to lIerting construction,;
DATE ..2 - 134'
BY c.~.;.::Is.
ENVIRONMENTAL HKAL.TH 8KAYlcae
liD EAST 8TH AVENUE
lUGEN&:. OREGON D7.o1
-
-M~
-..--......
I
I
1
<.J>
-f
/
/
(PI
s;l :
- -.,.
.s.~ h I~
~Pfl.~t L,~. ~'"6.
,-~-~.
I
I
I
G7. ~
~ flu ~E.(..
- '- -
~
I
i
1--
Drl ve..
2
(
~
-.
'I
. "'>
.1:)
?:to
--...
......
')..'1
.-,
\
\
\ \'
"
e
Q...
!
<:
"
-I-
~
df
,~
<..
~
.Q
"
s...J F,I/.~
~(>fJ~tP."',.~-(
l." "f /
;:v _ _ _/
,
I
l.b
-1
13-bJ.- o~,13 II-. /OJ-DO
I II /
Sc<7/e /.:= /0
..i;
. Sfn,,~1);(~ (). ~
REQUEST FOR ASSISTANCE
~ane
~ ~ou~ty
-
land Management Div. '25 E. 8th AVe. Eugene,' on 97401
~'>.< ~::'-..
......."'.... '.
:"<:.', :' ~ ~
tANn .......NA.GlMI.NI DIVISION
,
Please complete all lines inside white boxes, if possible.
W;"'LA./ ~P{)E/-/,{/~r/
'fu"J1( N"''''t:
~/Aj W--eJ. /~.h
TUUH Il.OOltt:SS
ElNJ.t::5r) ~
CITV
. 7IJn //J/ -r eJU! /}?
OWNER OF PROPERTY (If nol Mme .. .bon)
OWNt?~?I... ~ .. .f.?hd-c; E:i.
{~.. J.~J -=
,-'/-d~ 7'0
(Un;
3/.c'l-aJ6()
, t'nVNC
9:7c;1c:72
lIP .
.~fZ-d//
ZOP
~c~....... s,;Jo;
L1CenH.
,
MAP, PARCEL NUMBER ..
(Found on tn map. In the ..........m.nt II T.utlon Oept.)
,oL~p ~!!:on lI(lcuon J~::;:.O
hwnship ~ Section 'fI" &lction r.. lot
lownshlp ~ ~CH:Uon t/4 ~cl6on
I..l.ot
,
';"-.. . ......................-.........-.........-...
,
SITE ADDRESS
1111111
~~....I Oile,
Sy> tieL
,
,
MAIL PERMIT TO:
l.{)J'-L/~/' HZt'J,c4L>~//
,,:;~p/ //), /5Jt~h
.uuH<h/~?~.
cJl7L/cJZ
;':Ilf
,
ZIP
~
'. "::""..::;}.',:.:.:;-,:'. '.'.;',":,.,:.
'. STAFFS EzV{i~U.At/q/ii
'. Ini6rnia:tici:~ :I~.e:~u'c's'f(~H!'Y:;:
'. .............:.....................;.'. ;.................,...',..........,..:........~.....',.....,.'..,..'....'.;;.... g~~J~~....T....._".,.....S.U........,....p.I,.......< iI,it...,...,.....,.
....\\!/l:gartition/ S!-,bdiyisl.ol1,
:' "~.>.<:::'"
...,....
TRS Verifirid".c=JYe.'.;!'!oc=J
Allowed Usc.....\i::::JYcs "\!,!o=
.;" :.: '..'~
,':'./.
,
~ ."" .'
Land Management Div. staff can
not be held raspons:iblc for
ovaluatlons or recommendations
based on falso, Inaccurato or
Incomplelo Information
':,
. .
7j1'/7A) ~
-S"TA# 4/~os<'"('..,...
. ;
Exlsllng Buildings or
Improvements on
Property
I=:J Houso
CI Barn
~ Garage
~ Mlbilo. Homo
~ Shed
SEPTIC INSTALLED
~
l w.!;;:'</ -S>O
,
( , DIrections to sile
from Courthouse
-I
I
.; .'.~._,...,-. .;.-....... ...... ,. ~
,
.....,."..,,,...,,._,>'
-I
1
I
I
1
lOP
,
For Mobile Home
Placement Only
Brand
Year
Size
No. of Tip.outs
No. of Bedrmc:-
Liconso #
I
,,'
,
.~,.~""-: ..-.;,...
. . Lof-& Block,.:.'
U~I.
;:'1.11'",1./0
,
I,.. .
.' ,
.
.
II )1 ~ r
.
.
.
.
r:m
I .
.
)
.
I-
-
.
, .'
.
.
.
.'
.~I)
,. ' </,
.11
~I
.~
.
. ,
.
"',I
, "\ ~
.
.
.
.
,
SWR:
-
1
I
COUNTY DEPT ENV MGT RECEIPT. ~ 43696 DATE 0202. I
ADDR 3'014 W. 15TH AVE., EUGENE iJ~'
LOT [ILK . ~
~BLDGS 001 PHONE 344 056.
COBURG Rti., EUGENE .
COST VALUATION FEE D~"I
.
.A
.~
~~
. ,j'l
.9
~
.1
.
.1
442.00 CI( 9J
:1
, ,
UNITS 001 STORIES
ADDR.92671 N.
SQ FT UNIT
. W: 3 LANE
, ',' APPLICANT FROEHLICH. WILLI
";,""jTL'il< 1802061310200 SUBDIV
_ NEW BLDG' TYPE USE R BDRMS 0
OWNER NME MI~CHUM. TIM
CODE. APPL NO ACTION DESCRIPTION.
. BF' .
BP
BP
_ BF'
BP
. PL
"\I:,MECH
'.""'SUR
. PCK ,
SDS
SDEQ
. ADM
TECH
'il<FIX/BATH:
FT. WTR :"
MECHANICAL FEE
STATE SURCHARGE
PLAN CHECK FEE
FT.
RAIN:
FT
5%
2~)/.
. CATG:.
SEQU:
TAKEN
.
LC 4,3696 SDSS
FEE. SDSS
FEE
FEE
. PLN F(A SDS ELE PCK ISS /
1 2
BY MLC EST. .COMPLETION DATE
350.00
30.00
57.00
5.00
SI
OTR
DEPOSIT ""*
,.",'
J1ti11
I-
. . - ~
..la-ne.
County
s
I
-
5t5fJ.71 C IM/7/ /1'
=-
'llVV. IAJ/?L mK/6
".~~ IAi;:b TV
t('5,. .~~..
o/0~
LANE COUNTY OREGON
EUGENE,OREGON
Date d./~9,b
Received from X ,:l1oe J, 1/e.iL.
l:;
. ''''
. .v,
, !,'
00 ..
Dollars $ #2...- :.
For L.. C. Jf3b - 9.b ~,p..I-tt:=_ ~~
. sPpd..-/ tJ68 ~
, ~~
DEPARTMENT ~ ~ I-
By ~
.eAIIl BY.
CASH /',I'
CHECK y.s- ij-/~T
OTHER
N~ 210299
I.
J. ......
). .
" t'.,.
. .'.,