HomeMy WebLinkAboutPermit Building 1976-4-27
r
.~,
'-'.", 1"" ..;
d ~ ;...~ ,.
~ ~ \.,;
'~"{~ '. -
\ ;
PERMIT NO
LANE COUNTY PERMIT FOR'
6(,t>;'~
CONSTRUCTION [X] MOBILE HOME ['-] PLAN REVIEW [] CHANGE OF OCCUPANCY [ ]
DOwner Robert rJ Hf1 1 BuildelY' 870 If!;}s t Celrl'i:ei111 i a 1 G hf(~
, NAME ADDRESS CITY ZIP CODE 0
o Contractor ~l\me
NAME ADDRESS CITY ZIP CODE
OS Reg, # '*
Twr 1 A Range 2 Section
2~~ Add to NBadow Green
SubdiVISion Lot
F./.$ax Lot Q?07 Codp Census Tract
~9 ?
B locI< - Acreage Width
L tll.J1 IT'G ti Street Depth
Nome
1072 laurel Stl~~t
Spr1~Qfielcl Ore~on 0'1/)77
Access to Property (Road Name)
EXisting Structures on Property
Directions to Property - Address
STRUCTURE (# BEDROOMS)
iJ~IA\1-l? vnrt' k'l",lIe",
D.".\'I'I'1'1;1- ~nl1" C.::l".~n~
--~--~-
SO FT
~]59 @ ~L80
413 @ 5.30
VALUATION
3 Bad: $25.266.~O
, _ '>11; il,'t
I.IN FT MAX TRENCH DEPTH ~(;II
71:; 1 <<::;:)"..r'\1 RI':lc:!l:lltl'\lCl::1l .c",~'i",,,,,..,t;'!"""'''' ~'''''''' .-;:"''''
-~-~ -- ~ -';"~r"---~.~""""
Y"'<<>{"!'I11 "',.........'''rH''',.,. <;)on 1M'\U~ "",."r! ...1........ ",1 "....
- ----..~ ----.,-.......;r .-".._~.... ~--.--STAy..ioo'FROMALLWELLS
11'11,.1 FIRE ZONF USE CLASSIF
SEWAGE DISPOSAL
PUBLIC [] SEPTIC TANK [] OTHER [] Prim"
BUILDING 1?1.00
PLUMBING ?tt (I;':
3% SURCHARGF Ij, 1i.7
MOBILE HOMF
WASTE 0 ISPOSA I 1:::n nn
PLAN REVIEW
PLUMBING INSTALLED BY
OWNER [] OTHER [] NAMF
WATER SUPPLY PROPOSED [ ]
EXISTING []
[ ] PUBLIC
[ ] COMMUNITY - NAME
[ ] PR IVATE WELL
[ ] OTHER - SPECIFY
TOTAL
CONSTRUCTION PERMITS & INSPECTIONS AND WATER POLLUTION CONTROL SPECIFICATIONS
MIN SEPTIC TANK CAPACITY
GALS qnnoMIN DRAINFIELD 1r.;n
r:';;:'~['jt,",'dVi i'2nllt'll lcmcn'\'>k Hnr.:>!i: ,n?,
~~'1;;:;~ ni C:~M::l)l "V~Y~m DCi
------
INCHES
TYPE OF CONSTRUCTION !iN
GROUP
SETBACKS - FT FROM CTR OF r/W
FRONT 35 SIDE EXT
FT FROM PROP LINE
SIDE INT ;: REAR
7~ Pi I!:' ZONF
AUTHOR IZED SIGNATURES
/s/ J. Eo BOss bv Haroauah
(;1f'<'I\l1 4:::;:'tlwil t l'i v-i;an
ISSUANCE DATE
ll/?7 IfIA
-f' , -
)l1I"~ ,1f1.
PHONE
PHONE
17 ..125
(\?7 ll.P.l hO
ril'l
..11.--
IMPORTANT
Call 687-4065 to schedule all required construction Inspections Call 687-4061 to schedule all required
septic system InspectIOns All construction shall comply With the State BUldllng Code, D E Q standards
for subsurface sewage disposal and the State Plumbing Code All bUildings require a certificate of
occupancy before bel ng occupied
BLDG PERMIT - WHITE
OFFICE COPY - WHITE
COUNTY TAX - PINK
PLUMBING - CANARY
BUILDING - GREEN
SANITATION - GOLDENROD
(See Details on Reverse Side)
(POST THIS PERMIT ON MAIN BLDG. AT SITE)
o
LANE COUNTY, DEPT OF ENVIRONMENTAL MANAGEMENT
COURTHOUSE ANNEX. 135 EAST 6th, EUGENE, OREGON 97401
C55 13
,.
&& 'lGf~ !~ # 0 '2-;
({ SUBDIV~~:
PERMIT APPLICATION NO. ~c/J-~7b ' LOT:
- .
~-
BU.L~I~G~5ITE EVALUATION
-'
~~
BUILDING
() SITE INSPECTION
PLANNING DIVISION Not
-#-p 1 icable
1. Zoning Ordinance Compliance: Zone ( )
2. Subdivision Ordinance Compliance ( )
3. Requ i red Access ( )
4. Building Site (Area, Width, Frontage) ()
5. Other (see comments) ( )
COMMENTS:
(j ~ TAX LOT 92-0 7
BLOCK :'
APPL I CANT
DATE
No Y~s
() ( )
( ) ( )
( ) <I)
( ) ( )
( ) ( )
CKID BY: ~ ~ t&;. 7fo
Setbacks from ell of I~ad:
Front ~ ,36
Si~ior
Setbacks from interior lines:
Side ~
Rear
6.
7 ;0#6
PLANN I NG D I V I S 10N..ACTlON PEND IHG: YES t ) NO ( ) APPL I CAT iON#
BUtLDING INSPECTION DIVISION
Not
App 1 icab 1 e
( )
r)
( )
)
7. Plans Submitted
8. Soil Stability (footings)
9. Flood Plain
10. Other (see comments)
COMMENTS:
, WATER POLUTION CONTROL
Not
App 1 icab 1 e
( )
( )
11. Meets Department of Environmental
Quality Standards.
12. Other (see comments)
COMMENTS:
No ~1J
() )f1!
( ) ( )
( ) ( )
( ) ( )
CKID
BY~I./ - 1-;.. ./1~
DATE
No Yes
()~
( ) ( )
CKID B~J..~ cf...J1-.71L
/ - DATE
TO APPLICANT:
Your Building I Site Inspection:
~'~Can be approved.
_>o( ) Cannot be approved at this time as indicated on item NO. above.
I \ ~7) I Questions and further information on items 1 through 6 contact the LANE-
'1~LJ @; COUNTY PLANNING DIVISION. Questions and further information on items 7
through 12 contact the LANE COUNTY BUILDING AND SANITATION DIVISION.
\ ) Will be held in this office until you can resolve the problems indicated.
( ) Is being returned.
( ) Your building permit appli~2!.i9.':l_w~~.~j_~~in9...!:eturned ulJ~separl'lte cover.
DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
135 Sixth Avenue East Eugene Oregon 97401
PHONE: 687-4065
LANE COUNTY PLANNING DIVISION PHONE: 687-4186
C55-28
r "
,;I/> '\ ~ ..". .,..
.
, ',.' Date
APRIL 22. 1976
Perm it 1'40.
642 -76
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
Robert N HTll
870 West Centennial Blvd
or constructing the following facility:
Sorinafield Oreaon 97477 for placing, building
2nd ADD: Meadow Green Lot 19 Block 2
1072 Laurel SPY'ingfiplrl nY'Pgon
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 any other applicable regulations, law or ordinance.
Special Provisions:
1. Driveway will be constructed in accordance with the attached 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.
3. Sidewalks will be constructed in accordance with the attached sidewalk
specifications and drawing M98-49. The Standard Curb Type shall be
constructed unless otherwise specified.
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-
Apri 1 22
Expires , 19
:~o~ of Coun~ cznors
B~ ~ ~ Director of Public Works
PINK - PERMITTEE ~
ORANGE-BUILDING & SANITATION DEPT. C74-129
, 19 77
fore
Inspected and Approved
Date
By
WHITE - OFFICE FILE
YELLOW - REAL ESTATE
V, .r, '.,'-'
r. ':' ,LJ
, ,4
. fl' i;}''''. ... 'cSp.'_
...-,',,. ~"' I." ,r
)y -r" ~.# ~.\'
'."" ,/" ",
" ;'. · ;~"';'ga-te"
I'
~ ...r.,e,..-;;-....'.',-.~ ......;. "_~..;..-__..;.--....
."< I'
,,-.....
/
AP~Il 22. 1 976. "~"'
i
,
Permit 'N6.
642~7€
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 t/~~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 .
Robert ;J Hnl
870 ~~st Centennial nlvd.
or, constructing the following facility:
2nd ADO: f~ado.J Green Lot 19 31ocf:{ 2
Sf}r1n~tlllfiel d (h\'H~Cln r.;,)1417 for placing, building
1072 lauml SPth~\(:r'itHl ~ Ol"qaon
- ,.;
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 any other applicable regulations, law or ordinance.
Special Provisions:
1. Driveway will be constructed in accordance with the attached 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.
3. Sidewalks will be constructed in accordance with the attached sidewalk
specifications and drawing M98-49. The Standard Curb Type shall be
constructed unless otherwise specified.
,.
,i"o,1b
G/P
This permit s revocable at any time, and will be strictly adhered to and no work other than
(" -that specifically mentioned above is hereby autho~ized.
This permit shall be void unless the work herein contemplated shall have been completed be-
Af>r1 1 22 77
, 19 Expires , 19
fore
Inspected and Approved
Approved by Board of County C<3m'missioners./
By' .
.A'~ . ,/"",::;r
.'.. "t' ." ~,..... } J'.; ,",(;J: ..J
,l"/-':{ ;t."; f i ..... ._. .'~ ~",.~.
Date
WHITE - OFFICE FILE
YELLOW - REAL ESTATE
PINK - PERMITTEE
ORANGE - BUILDING & SANITATION DEPT.
1 ""'.,''': '
.r' ~
If q~ i' f
,
.!
Director of Public Works
By
C74-129
. ~ "
,:.." ;,.... . __ ,;~:', ." 0..'.,... :. ;., " .. l . ,i ~"'_' , .
. L.. .
.:.:.::-
'4
~
POSED SEWAGE DISPOSAL SYSTEM REf ~ .
IN~TALlER: Complete top ~ft '- form to signature and submit bo.. copies with applisat.io/l~ '~:';~
/ J...... PERMIT NO. (~~ ~-- /~
'7L~R:S NA?>>J;:; 1"7~R~Jf/hfl~' i;f .- ,'"
No. L ~ Un its '" \B~~pms Ba~hs / Basement I\r. . Water {s''l.J P.HP;Jf
I ~(/ / Yes No", Public 'IOther-List
Sept i clank: V . )
Ft. from we 11 Stee I 0 Concrete rl1.. No. compartments! Gal. Capaci ty /,tJ 0 CP
InsideJ)mSJ=l'5-ions: ft__ ./ kfle Disposal Field: ~
Len9.thhJ Width~/J1lDiameter"-- DePttviS' Distribution Box: Yes No
OWNER I j(j II vr; J I ~ ~ /J I Other Di str ibut i on-Type
NAME . r ~ ,C N-(~I"
MA I LING J: 1IJ ~ i~J1i ;U4ilP 1JfI~
AODRES~. 1\ ;t~
'/~7>?'
- , '
L<<19~f~ ~L i nt/sf Ft. Trench L Tota.~ Sqb
IhJ 2~ 3. 4. 5. 6. WidthV'f Ft.~O,e
Plot Pian (see instructions):
~
t/(- ~
Feet from
WEll
Lot Li ne
Front
1Ft. Between
Lines 10
Foundation
/0
Side It(.) Rear / CJ
F~ ri'l ler Depth Fi Iler Below
Tvpe Above Ti 1 e 1/1 n _.Ti 1 e /... in.
,,'
RECEIVED
. '
~~
,-
JUN 1 r) 1976
J
(
f
I
I
bf.tt~~ COUNTY
~NV!R@NIYIg,N;-AL MGMT.
. J _
.nfr/' ·
l.j H~ ~B~'
QV
8J- I
~.s- i
--,
C55 -11
A~.__
San i tar i an f 5 S i grri"tu're
LANE COUNTY V
STATE OF OREGON DEPARTMENT OF ENVIRONMENTAL QUALITY
I
(
I ." ,C'~I 0 O~/,~: ~
Date /0 r /rj '7 /)c Siqnature I~ - / 'j-->'v>''''- - /J
. '( CERTIFICATE OF SATISFACTORY pCOMPLETIO!IJ / fL / ~ 7/
For Sanitarian Use Only: V D te b-/J- .(0
In accordance with 1973 Oregon Laws Chapter 835, Section 214 this certificate is 'ssued
as evidence of satisfactory completion of a subsurface sewage disposal system at the above
1 oca t i on. '
~ Approved: System Installation conforms to current standards
I (Disapproved: Does not conform to current standards
Remarks:
(., ";
.:-.
-, (~~" -.'
:..,.. : ~. : ' \- - - ~'-."', ~~: ,--
~rj/: ~ '-~',J
PERMIT NO, 642.,16'
. .
i.
1'(-"
'. ~.
. ,
,
i
, )
...,....-.....
...--..,
LANE COUNTY PERMIT FOR:( >-
~
, ,
.~~:4 Ji .
.. .
,t'!_
l:' '
. ./
CONSTRUCTION'[l(] MOBILE HOME [....1
.0 Owner ' '\ ~b~~ N H~l1 BMHderr
Ii ,NAME ADDRESS
PLAN REVIEW [ ]. CHANGE OF OCCUPANCY
).
670 West Ce~te~ni~l alv~
CITY ZIP CODE
Sr)V'~i1Q.
PHONE' ,
~, .
1 4'-
;0 ContraCtor' .
.'Samit'l
NAME
ADDR,ESS
CITY
ZIP CODE
PHONE
O.S. Reg, #
,Tlllip 18' . Rangp .2 Section
2nd A~cl ~o ~adow G~~en
(Subdivision Lot
, ~,
;i n I '
L .'Adcessto Property (Road Name):
6 Tax Lot
Hi 'BlocI<2
loursl Str'iSl~t
92tl7 '
. Codp
Census Tract '
l7...1~
I'
L .'
Acreage
Width
'J
j'
, ,
I.:
Depth
J'
,. l' ,'. ....1
'Ex,isting Structures.on Property:
,Directions to Propert'y -Address:
t~O:1lG
1072 LQIJlr@l Stl"€iet
~pr~n9f1~ld O~e~on
.1;
""10.11
,.to>.
. "';""""-
,- . .'
,,' S1.8:UCTURE(# BEDROOMS) .
, , ~orml'i ~ ~1!lJW' Hau~l!Il
.Prem~t V@1Jt. &El~t1m
~
,SQ. FT.
'H59@ 2L8,O
4~a @ 5~30
VALUATION
, 3 30th . $2$;2G)6. 20. .
2~2~5"tU}
$21,,<%Bl'~ {f,(}
, .,
'.
BUILDING"
PLUMB ING
3%ISURCHARGE\
MOBILE HOME
YV.A:~:(E D ISrOSA L ',1 COn 00
.' .,P,l~~~5~~yt!:~"'~;:~":~';'1.-,c;:i~~;':~;_ '. .:'_'_':' ,
. ", '
TOTAL "'"
SEWAGE qISPOSAL:
PUBLIC ( i. ,SEPTIC TANK [ ]
I ,
121.00
2.8Q 00
1.'L~1
,OTHER (
~ior
PLUMBING 'INSTALLED BY:
. .
OWNER (] OTHER [] NAMF
WATER SUPPLY: PROPOSED ( ]
,EXISTING (]
( ] PUBLIC "
( ] COMMUNITY. NAME:
[ ]" PR IVATEWELL
( ] OTHER - SPECIFY: ,
!J'
\.
''\,
CON~TRUCTION PERMITS & INSPECTIONS A'~D WATER POLLUTION CONTROL SPECIFICATIONS
-~~
"'~'" '''-.)
L1N, FT. MAX. 'fRENCH DEPTH :gG~ INCHES
:?€i f EB4:t'i RQM~~Ya &\ oon 1 ~h'6o~ftt El1Ff!B flll'!f
~nS\t{!jn ateOO1l"'cliniti 1t6 pt,}~I.g'!1:~d ri'Ufi~nhl1l
, StAY 100' FROM ALL WELLS
. X&J FIRE ZONF USE CLASSIF,
MIN. SEPTIC TANK CAPACITY: ,
GALS ilOO" MIN, DRAINFIELD ~50
M~1n~ain ~4it!u'~efJl~%!liHnQg Q~
SetfJiM1S DigOO$lii~ $VSu:-m ~~
". .'fYPE OF CONSTRUCTIONlS~r
GROUP
, ,
SETBACKS -FTff'FROM CTR. OF r/W: .
;' FRONT.' 3(5, SIDE EXT, .
FT'-FROM PROP. L'iNE: '
SIDE INT, 5, REAR
1Q~EzONE 'IRA
'.
: (-;
AUTHORIZED SIGNATURES: "
, ';5/ ,. J. E. ~lOss~y MtlV'b~ugh' 'l
G'fa'VJs&n1tG?ia~
ISSUANCE DATE:
lJ/2"fJ7(; dlm
BLDG, PERMIT - WHITE
. OFFICE COpy - WHITE
COUNTY TAX - PINK
PLUMBING'- CANARY
, BUILDING - GREEN
. SANITATION - GOLDENROD
. .j-';' ,
""'" ,"
> '
. ; . ~ - - . ,~. " - .
, Cail.687'4065 to. schedule all-required canstructian inspections:- Call 687-4061 to. 'schedule' all required
septic system inspectians, Ali construction shall camply with the State Buidling Cade, D,E,Q, standards
far'subsurface sewage,dispasal and',lheState Plumbing' Cade, 'AII buildings require a certificate af: .
. occupancy before being accupied, '
IMPORTANT:
(See Details an ~everse Side)
~'
C.55.1,~ .
,. o'::t-
.. J '" ~,. ;'.". . '
. , - I
(POST THIS PERMIT ON MAIN, BLDG. AT SITE)
LANE CblJNT'i. DEPT, OF ENVIRONMENTAL MANAGEMENT
COURT;HOLJSE ANNEX, 135 EAST,6th,EUGENE, OREGON'97401
:i ;:.; :.~_. ~,'. ::\~._t'~'.-'~, ~,~..-, ::_:. .t.!;.," !;:"~::. . '_:...:~~-:~.'. '." ;
. ~, '- '- -
SLAB FLOOR
PLUMBING GROUNDWORK
ApPROVED /
/ DISAPPROVED /
REMARKS
GAS PIPING GROUNDWORK
ApPROVED /
/ DISAPPROVED /
REMARKS
ROUGH PLUMBING
ApPROVED /
/ DISAPPROVED /
REMARKS
ROUGH GAS PIPING
ApPROVED /
/ DISAPPROVED /
REMARKS
FINAL PLUMBING
,;'"
ApPROVED / ~ DISAPPROVED /
REMARKS
FINAL GAS PIPING
ApPROVED /
/ DISAPPROVED /
REMARKS
CERTIFICATE OF OCCUPANCY
\
~ .
/ DATE
INSPECTOR
/ DATE
INSPECTOR
/ DATE
INSPECTOR
/ DATE
INSPECTOR
/ DATE!' -dlr? ~?(. I NSPECTOR ~ ~ )
..: ~;-' ( --
/ DATE
INSPECTOR
READY TO ISSUE /
/ NOT READY TO ISSUE /
INSPECTOR
REMARKS
/ DA TE
~
.~
. -..'
~.
/-"
,~~
..... ~- .
/" ....
LANE COUNTY PERMIT FOR:'0
PERMIT NO. C:'-4~~-'fG
CONSTRUCTION [K J
:0 Owner
" ~:1.?h~rrt
MOB I LE HOME ["J
H Hill 4ul1der
ADDRESS
PLAN REVIEW [J CHANGE OF OCCUPANCY [ J
:Tl0 Ht;s't Centnnnial f~lvd :if}r~nc.
CITY ZIP CODE PHONE
'0 Contractor
NAME
. $a~~?B
.NAME
, .
*
ADDRESS
CITY
ZIP CODE
PHONE
9.S, Reg. #
Jwr H! Range ?
2n~ Ac~~~ '~t,jl f:~~1!em16
Subdivision
Section
!}~~
Lot
6
Tax Lot
B locI< 2
ta~~t"tll S'h,~~t
)?~1
Codp
Census Tra,ct
,
1"J.<.'l0G
. Il~ I{'"","'~
19
Acreage
Width
.Access to Property (Road Name):
Depth
Existing Structures on Property:
none. '.'
\ \~
.,Directions to Property - Address:
1 0:t2 l~.:jtfll $tftlD/:;'.,
::;pf'\ni:new \J}rC~nH
,
,
;)1471
'STRUCTURE (# BEDROOMS)
r"?r''!1t fOflt~xt;~
~'Ii.~Jli t f~H"!' ;r"~;':('\
SQ. FT.
H:59 C
, . ~~.,,'~ tJ _,J,1:
2~ . t"
~.. i:,~)
VA\"'l)%-T,t9,~ ,",
:3 ~d,. ;",~,1; ::.~ut....ac;
2 b:'21 ~'q '1 ~.
'..' : '., ,
J........
, )
, " \
,
,
~ . " ."i. ~ ~.. \.,
c'"'...., :~t '.1 r:,I~,
I ~ '" ,:~ '.... ,.' ,~
.-~." ..:' ", ".
SEWAGE DISPOSAL:
PUBLIC [] SEP.TIC TANK [
OTHER [
Prior
PLUMBING. INSTALLED B~: "'.
.'. ':OWN"ER',[:) - OtHE'R [']"NAMF \'
WATER SUPPLY: PROPOSED [ ]
EXISTING []
BUILD ING
PLUMBIN<?
3%SURCHARGI=
MOBILE HOME'
WASTE DISPOSAL
PLAN REVIEW" '-:-"' J'
1'" '....,
. ...; ,: .." . ;~
...... " ~-, ' ~ ",'1
'J J
,'~< ~?
~.;, J\
~-,
1 G!tt)'!}J
i., ,:.'...,"
... ,
[ ] PUBLIC
[ ] COMMUNITY, NAME:
[ ] PR IVATE WELL
[ L\m~HER, \S0ECIFY:, ,.
"
~~~~~~
~
~"~
..' .\
1._ I \ ,,~~
TOTAL
CONSTRUCTION PERMITS & INSPECTIONS AND WATER POLLUTION CONTROL SPECIFICATIONS
MIN. SEPTIC TA~.:~.fAPACITY: 1'''"0
GALS . ""MIN. DRAINFJELD:).-; L1N. FT. MAX. TRENCH DEPTH :Uy' INCHES
:",""..1'''. 'f..:!:\'in AII!'i'~131 ~ ,b.,,(., '\':Cl 1,41""",lP' 17,-:; "'~ '[.Il>""~', \tlAt"~_#~ '" ';;;"'i'l ''''''It,-'!'''''''+ "'''''..,.~~ 1""'"
~~ ~~ ow,,", ru~t,3It,"} _ ij'gf~ ~....- ._.~\.~,,~ '>.f fiI ~... ..."...l;f.>>r";""<l-<t1 ..",Q'<..o:.~tI ~~ ,-~J ~/:~- >i - \~'\roV",:".~"~ 5:1 ~\S q.li;ri :~ iJ'
5j;i:}it!lt{lt; ;jlSi:)on~'1 5'{-"$(}:tr!'i W~ I\l't~:~H,.>. ~~cm~~ji;"l~) ~ rev,h~{} ol~t. nlAj";
-..J'-.j ~ \ -....... C J. -\' ~, ,~~" -'S~A~,100'FROMALLWELLS'
il;lJ FIRE ZONF 'USE CLASSIF.
t..l.\
TYPE OF CONSTRUCTION" '
GROUP
SETBACKS ''3."1:,. FROM CTR. OF r/W:
FRONT ~ SIDE EXT.
FT. FROM PROP, LINE:
SIDE INT. 5 REAR
7& PH: ZONF
F\~
AUTHORIZED SIGNATURES:
/s/ J. 11::0 8ft~s by naroaugl1
Qra1lsooito.~foo
ISSUANCE DATE:
o!/""'/'lI~
q (,/ (11";
dlr;,(
'.
\ ' :'
(POST THIS PERMIT ON MAiN BLDG. AT SITE)
Call 687,4065 to schedule all required construction inspections. Call 687-4061 to schedule all required
septic system inspections. All construction shall comply with the State Buidling Code, D.E.O. standards
for, subsurface sewage disposal and the State Plumbing Code. All buildings require a certificate of.
occupancy before being occupied. \
'. (See Details on Reverse Side!
:':-' 'J
BLDG. PERMIT - WHITE
OFFICE COPY - WHITE
. COUNTY TAX - PINK
PLUMBING - CANARY
BUILDING - GREEN
SANITATION - GOLDENROD
IMPORTANT:
C55.13
LANE COUNTY, DEPT. OF ENVIRONMENTAL MANAGEMENT
COURTHOUSE ANNEX, 135 EAST 6th, EUGENE, OREGON 97401
,'_ r~v;. '<C/,
v
SITE INSPECTION
ApPROVED / I DISAPPROVED / I DATE
INSPECTOR
REMARKS
FOUNDATION INSPECTION
ApPROVED / I DISAPPROVED I I ,DATE ".,. ~ INSPECTOR
REMARKS /J /y'l$ Jtt&/ ~~.k 1J--:-Aj,.7/'f(}6Z/
/ /
, /
(0-/',
"
FRAMING INSPECTION /' ~/
ApPROVED / I 01 SAPPROVED / ~ATE .j: 2 ~J "l? I NSPEC""R~
REMARKS dt4-ti~tf}~~~~ ~~
..,J{J-/7~t,/ ~Z;;;~t
LATH OR SHEETROCK INSPECTION ~~
ApPROVED L..1L./ D~SAPPRDVE~D / I DATE~ ~ 3 ;J~ 7. PECTO'~. A
REM"K' t;k~ ~ ~~-IlP/
,
FINAL INSPECTION
ApPROVED ~";;;JISAPPR VED / I DATE r;;:/$~INSPECTOR
REMARKS ~ 'ttI 'J~ ~ ~ ~ r" ~ ---
- ('
~~
CERTIFICATE OF OCCUPANCY
READY TO ISSUE I / NOT READY TO ISSUE I I DATE
INS,?ECTOR
REMARKS
/i ./
./"1) / / / /-
'f/ J ". '- f) 1/ I,/; ~, ~
V~"-U
&1(1-7(P lOdP /Q<<"~
....
~
.) (
'.
\~
."
~ L(~ 7/
PERMIT IF .rt?
HAS BEEN APPROVED
NOTE:
NO PERMIT WI
BE ISSUED UNTIL THIS APPLICATI~
APPLICATION FOR:
" -
CONSTRUCTION lA ~ MOBILE HOME I I PLAN REVIEW I I CHANGE OF OCCUPANCY I I
-/ - ~.. ~
,~ OWNER ~dD r~\"' t\) . \-\~ \\ ) ~wl<\~ ~-<. ~ ~/CU~. e~,UhJ._ ~~~c..J(r)~ql~11~/'~ Oj~l '
Name AddP'ess Cl.ty _ ZiJp ~ J Phone
I I CONTRACTO~\)~<'\ ~. \\.~\\ ~ J..c~1 ~iu... . - ~7 D- \~) . ~g'i'\tQI\'\;j ~~hJ, ~ k. ,Olf. crl\jj -, ~ '1\1 \,~~ l \0
Name '" ~~dress City r , \ Ji1P' Phone
ax Lot q 1,AJ1 J Code
t ---....... fCI Block ?-4-- Property Acreage
'A'AJ.:A'5~
' \
~~
\ / II _
\/07:i ~
\ . / ~. )-
~elo for Office Use ~ly~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
__. . -'1 7 ~.- -sq:- F.1-, rc, (edrOOms ,Valuation
- ;;f ~ ,~.,~~ ///~ L ~ ) dJS:;;2&~.;;:LO
, CJLUI/~ /Zt7 '-"2/-:<.j1 t 0_/ ,.:)t r:?/, <). qV
U- 0 ., I /)'7'j-~P/.t;,.O
/ ~ - . ~ -
PLANS FURNISHED FACILITY PERMIT
~ I INO I I
'"gnaC"'" of A~~
~ Fee Rece1ved B . ~ Date:
Min. ~pt:4: Tank ca~acity q..f2I). Dra1nf LeI Requued - Lmeal Feet j r6 Maximum Depth~ n /J
?J1~ - 4.~)-- of ~)( ~ ~~ a_~
tV-tp.~ _ fA. - 11),C. J~ (',i c. ~~ lJL,dL~--," -
- D - - (7 1/- r~
O.S. RE.fD
TwP.--1-/J Ran e
SUbd1ViS10r!J
ACCESS TO PROPERTY
Exist1ng Structures on Property:
Property Locat1on - Address/D1rect1ons:
SEWAGE DISPOSAL: \
Site Inspection #~
WATER SUPPLY:
Well
EX1sting Sewage D1SpO
Other
Spr1ng
FEES:
PLUMBING:
;d /y f:!P\ Installe~er
~/{~ ~~'""o(@
Bldg.
Plumbing
3 % Surcharge
Waste D1SP,
Plan Review
Mobile Home
TOTAL
CJS-j.1J-
Census Tract ,tl,- l&"
i
W1dth
Depth
I System I I
~--
,
./
or New System Requued 1'-
----
Name of Commun1ty or Pub11c System
Other I I Name
Sewage
Connection ~
Water
Connect1on
:<
Type of Construct1on
,I' A/
" ) Group
J~~ Fire Zone
Use Class1f1cat1on
Rea:]' (J {( ~e
Bldg Setbacks - from Center of Road Right of Way:
Front 35" S1de Int. j-- ~'~-_
fi ' fl-' .
to {Lv 7b
~
DATE: ~'IJING,: /~, /.? DATE:
,!/k2~~ 4-,Q*% ~(t(d ~Q~fb..t~
COUNTY ';PARTME;T 6 ENVI~ONMENTAL MA AGEMENT I - - - I -
PlANNING:
01\5 '
DATE:
SANITATION:
C 55 - 12
LANE