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HomeMy WebLinkAboutPermit Building 1975-10-6 ~~.:~%~';~:~~r::~f1~~;~:::::;}E~ 'MOBILE, n_J ~, \.... 'BUILDINGi1b'.ii 'c ,c-:'M.'H ,0 PROPERTY OWNER..,. MAILING ;ADDR~SS . "'c2G!fd;"'"7 Y' HOM.... USE PERMIT PERMIT NO. ,"1" 2656-75 PHONE -.l .T.!hhi>-rt- N ~ Hill' CONTRACTOR ' .' :R10 .T.Jt=\~i G;.f.>nt"Anrd:<11 : ~ . ~!lrinef,iAld!! fir~O'nn 'MA,ILlNG ADDRESS 74h_qqHi PHONE . . '-.~'::r .}l' : ._.:.,:;..) :;~ ;'; -: .....'RAh",l'-r- .N..Hil 1 'RldlClA-i- :T"r;{, ". 'PROP'ERTY LOCATION''':''' .It;fCLl!.DE POST OFFICE 'R>>ln&>' 0_ !'i_R':'o.:.. if: A 1'/>" ',"':"': " ....; ., - r _, ',: '. -':" :,t"(j?4;L~Hlr.t:!1 St:'rAAt ~nrinp.f:iAld.:Or~p.on, ":~R9P~RTY LEGAL, DESCRIPTION - METE;;, BOU,ISlDS: .. .' .' '?ridAddi~ion .to MAf.ldm4'~l-A~iI'.RR,r~fli!~ .,TWP.. . RANGE '::SESTlqN "1A- . . AP"PL. ..NAME &. . .- ",":'AILlNG . O? ~. .' ..06 I I. 3 Lot:. 15 . ~Block :? TAX LOT NO.. CODE CENSUS TRAC.T ~ 9 ZO ~-s .,: EXISTING 'STR'UCTURES ON PROPERTY . . .'~:' . RobArt Nft Hil-t None" . LEGAL ACCESS".W',PROPERTY ~ " -.j" 'LaH~Al StrAA~ PRO!"ERTy SIZE.'c:FJ. ' WIDTH tlj'ft 7.S' PEPTH 1{)O..89 AREA S70 lik~t.. Ce.~.r-enniia]'; t ~ _ ,<. ',' AD~RESS Sorin~HArd''-.''D'-iAi?(jn. 97477 ,,:F0R.,M0!3ILE HOME PERMITS ONLY~ "'. No. of Bedrooms . . .. '<..J.. o. New. Sy~tem [j, VALUATION STRUCTURES-TO BE B.UILT 'THIS PERMIT .Connect to. Existing. Sewage System 0 TYf'E CONSJRUCTI6N:'.. ,SQ. FT." #,BDRMS- . . ~il1'.'ll/;\' family dWf>.Uin<it. ll' " " .,:, ... 1056 @) 71.80 n.o'70' . ,'f'" 528. @' 5~.30 . ' } .:.~.~. 'i' ( ~::() ':L. 798 --" .. --,,- $25;818, .' Aon:rovp-d sit:p- insoAct:ion 9'/3/74 bv John Shook . . / New.in.stal~~t~on ~ . : OTHERO"- ~, it'i~OO ,/ 100'.:00 .,n_oo' . PLUMBING I1'lSTALLED BY' ",' ,: SEWAGE DISPOSAL. :. PUBLIC. 0 SEPTIC TANK \B(!llDIl>lG '. 'IWASi:E' DISP.OSAL. -'~PLUMBlt:olG ' .p,L~N REVI~W PARK TRAILER, 'su;:charge , 'TOTAL . FEES, OWNER'"0 'OTHER: NAME WATERSUf'PL~, PUBLIC D ]H~. OTHER. Citv v1ater .' ,':,,,. Plumbina' . . .' ~, . $2.00 .;. Water: :Connectt9it: :Ii 2.00, - ~e}Ve r Conn~~ i;.1on '7 ft'l1" ?44^'11' COUNTY BUILDING & SANITATION SPECIFICATIONS' , . ,:',-:)JiN!:"sEPffc'1Ai:::fK"CAP A"c[ty-""""~'"'!""~"'~:-",,",,;':; "., bRA INFTElf)"'RIQUfRED':'""":, tUaxlmUm"':"dep'th . j. t ee"f"----"'~........._~"-~..,,>-'::.:'":':",' ... ':": :'- ' ~'. "'WITH"DIST. BOX: GAL.'90.0" ., UN: FT . ,,1:50 TRENCH WIQ,THFT. . . 'OR SQ. FT, 300' .~ ",', ,"~':" .".:, :'1"'WfPEiOFSTRUCTURE . ".':"~\''''.. oCCGUPrAoN. UCYp 10. 0;, ~:::' '5N . J . BLD.G. ,SETBACKS:, FT. :FROM CTR. OF ROAD RIGHT OFvi'A~.. . .,','" ~ ZONE . PUBLIC UTIL. EASEMENT ..' J '. " .FR~ONT' 4.5' . SIDE INT. 5,' SIDE.,EX;]', . AUTHORIZED SIGNATURE -'- DATE REAR 5' USE CLASSIFICATION Zone RA DATE. . - .is/.John E. Boss bv Charles' Harbaugh, John Ii.;' Shook,. R.Solgf/ Octo 6, 1975~' . '.... ": ~'~'?",~~WV~",,r.'W<:f~""':~'~'''''J:'!-('''~';''''''''W''''io'[~''''''''f'''''':t~~~~'q''~~O;'~~'I;';;.'!rI;.._~''l'!!''''''.lI~Tl~'''~~'''C''=.~-';M';:''~~''o~''-~''''~~''t>';''""~,.'"l\ ~t~.e.a''Ii~''''<J''"'~~~''~'''''''''l\.~....\,,!'"~~;;t:,,~. g;:~.<1'~':'.1""""'~'ol;n'-~" ., l:"'><f..lf:-f1';~"'~""f't..>e._::-,;,~,.","'J,"~~"""~"~' i~.~l~~Y:"'1'<.l'p:,r"Q' .; BLDG. PERMIT -WHITE Call 687-4065 to schedule all required inspeCtions. All consfruc-, OFFICE COPY......, WHITE 'h II I "h' U 'f B .Id' C d DE Q' t d d COUNTY TAX -.PINK ... tlon sa, comp y Wit nl orm UI mg 0 e,. . ,. san ar. s. PLUMBING -,CANARY , IMPORTANT: for subsurface sewage disposal and county regulations covering' "BUILDING - ~REEN " . . plumbing. AII.buildings require a. certificate of occupancy before. :.. SANIJATION - GOLDENROD bei!"g o,ccupied, ' . . .' , (See Details on Reverse Side) ',' . '~""'. (~OSl THIS PERMIT ON MAIN 'BLD(;..ATSI'TE) . '.. .' " '. ., . ":' ..' d., ,"~.': .. ' LAI'l~ COUNTY(DEPT. OF, .ENVIRONMENTAL-MANAGEMENT :~:":oi:',.~~C~5':'1;~;;;" ,. :;,;;;,~ .i: .,;:~;:i ;~;~;,:;:,~;;:;;,:;:;~,.~;;~:;~~'~}~Yc~1..~?;~.~t,~~N:~p~;~ ?~' EA~L6~~~ . E~~~~E-::i;~~'~;~.?'~: ~~ 401;. .', :., " .~. '.- ..,'~ ..,; .'."' , ~". ~' 4_ C) .~ .'::~~" :..."\ :: ~,~-i;" .... "#c l .. .~,~ .":i.\ I ~~ ,~ .' '{~,.M . ~( \' '".', "d \ 1" ~..-t~~ ~ ~ i PROPERTY OWNER \, \ LANE COUNn. BUILDINq;;.EJ JILDING PERMIT OR MO'BILE MH 0 MAILING ADD~ESS HOMt USE PERMIT PERMIT NO, 2~Ji}"J:;to~1 PHONE , .':o./:~!-'.r?:.-_ L:t. }.T' ~ ::iii i( CdNTRACTOR ; ::;'1~ ,.Jt?gjt~In.~:H~li,;:Lal ~ MAILING ADDRESS f~ii.t~~ i~ll:::'L~:f ~i.i~ lv;.:~! ~ Ut'C~_~'un. .--..... ~ 'J ?\o(.~i~;' ~ PHONE l? ;'::.. ~l'U,l ':J~d,j.oi.H~ }i1"M::',L PROPERTY LOCATION - INCLUDE POST OFFICE ~5,j.j.'-,rct1!, ~~..i~. ;,~i~~f:l. ~. .!~1 1.",u.~~1 ;ilt1:"_~j.t ~~l~:i:it..:"t:i*rl,~L. !lJt't,t.wn PROPERTY LEGAL DESCRIPTION - METES, BOUNDS TWP ..,;ii;~Ht:i\)~.. t/l) 1"~L~o;.r ~'l~~ t.fAi:l'ki:1i:fj~~~ RANGE SECTION I :3 I ' . J ~_ ~ (,):t~ Let l~ ....~ A d~~\.,,- ~t:, TAX 40'T'NO~7 ? (,.,co.g.E CENSUS TRACT ~"t.; APPl. NAME EXISTING STRUCTURES ON PROPERTY il.fJb':.t:e Nclo ,W1L ::i;'O;:A;'i-~ FOR MOBILE HOME PERMITS ONLY No. of Bed'Zoq'rr.l~s ~, VI.~,. \, ,,_..... S;fRl!JC.~URE5~6 BE Ei\!F1~T'TH.lSlPERMI:'r-"~'" , . , - ' ~ . .,.., !" ". "" a ?~. .;t_::"M" ,.~ .~ 'I.~'.4J,.4.,:.; -,(".~ .t>o".:,_>--!U~~~ .......;.J::d]..tl-J..l~~ " , - '.\ '-,~,)-', lV LEGAL ACCESS TO PROPERTY '\.. ~ J.';J~\.t,!..,~.H..':;~_rt. ~- ~~\~PR~PEJ';);~I~..tY.J*'.. :\.J.)..' , ' WIDTH ,. ',"', DEPTH ~Y' ;:" AREA r JI ~ ~./t;\..... ..v e' , '\ ,v, ';_Q,qn_n,~~ttF_ ~xistln~g}~e.wag~ ,~yst~.f\1 0 'l)-' .:rjYP;E.'G-6f~(ST--l't~<::TiI0N'j~~~~sSil~ Ft\ \,'#, BDRMS .. .. ,'\ . \ " . 1--;t1v~, \_~ ,;. ,,~ ~1;jIJ New System 0 VALUATION & MAILING ADDRESS \..st;J if:lcst ~~{~:~riitl:i , . \ ": " ';\' '\ \ ~-...' .f '", j ""v 11':}rit,,{jfiU21~J* ':-_.{\;~;::~~H1 \ '. "\\ ~~ \. ~"4fl-,';"; .- ..'f- " ;::'1f\.y3 ~. lJi "j' "- .., "-, \. .,....~ "\,\ .~ \_~ .~ " ...: "\:~'.I ,;~) ";-s~~\-:t1Y (~.(i ~l:t t(.t L~~:.J-(~ t:t':lrt\ . -.t ,P -i~ i~'Lr~.' r!~..:;.':'! ..,., ,'" . ~.. '..... ~''\.if...-'..._ '1':. t' ~ ~ ... .J -.. :,ji~~~, ' ,". '\ ,.::".,. ...~ \1 SEWAGE DISPOS.A:L .PUBlIC 0 BUILDING WASTE DISPOSAL PLUMBING PLAN REVIEW PARK TRAILER l\"~' ~ 4~i':1,y?;o_..'~ \t..\'~1<:'L"~-! '\F\-\,'.; .>14~,;" ".,..I"v "":' '''''''-'!- ,,-'I.. "o\, ~'\.. "X" \ 't I ~:.:.,... '".",' _ \, SEPTIC TANK {~ '. .". OTHERO'- ''t, '.... , ". .. )., '\ , . \ "~__~\3>E~YMBING\i~Sl'~llED'ilY" - . ~ OWNER '0 Ol'I;lER: NAME WATER SUPPLY \' ''-. "":.~ t ~,~ 1:, ~S' * a~J FEES t:' ~:~ ,~,t)J .., i-' "'.11. i!1.,.,'i',..; "~.' , ~~;;;~:,.... PUBLIC 0 ;~[J OTHER. ,~J,t,Y' W....t;.iU. J ~:{40J j ,v .~4X}".... (..;;;:;~"'W;" f~~1f,1iif~t1t4~., . I;. ' "'~ , ~~""'\'_ 1/.~,.,j . t. ~...'\ ~:,-.;.j,:~l~~',' ~:~ ~""",,_i'x...t...;~~~~~;{'.~' ~ .";.. ,~..' '.A,~,;;;:' ~....U.,.--::-" -~. ., '~'~'Il,,'L!~' ~.r.:l:ff.;.. ~'Io'..j;-."*....~,,,,,,;irl,, ''l<\\) '-\ ," r-" \ \~~} .~~'::t;.. \...7 j,t. \\ :~y:;J\... :.~ ~>, .: _ ~. ~ j It'1t \".'., _' '. \. .... ,),..~ \. .r,~\-v~-rl--*'t4JL \. . '1:.~ \ ~.. $ .~';4.]: :;:.t~i'~X~;.,.~.t TOTAL COUNTY BUILDING & SANITATION SPECIF.ICATlONS MIN, SEPTIC TANK CAPACITY".. " DRAIN FiElD REQUIRED ;,:~:c!~-~tt,;U;~it ~~"O P '~~.t , t~t WITH DIST. BOX: GAl.:",. ,\'2J , "- -', lIN, FT ,t~l{;~ TRENCH WIDTH FT, OR SQ. FT, J()O ",'~,) \ J\.._ '~( \ . ~ \ . ~ \ ..,"'\,. '... '" ~ .~ ,';-. .. "'. -; ',\ , ' I '. , ,. .n -, :- TYPE OF STRUCTURE J'~i OCCUPANCY ~i;j;..;rui 1,;) J. .ZONE PUBLIC UTll. EASEMENT BLDG. SETBACKS n FT. FROM CTR. OF ROAD RIGHT OF WAY FRONT .!~:.f SIDE INT, ;';$ 'SIDE"EXT. AUTHORIZED SIGNATURE - DATE l J,/ .!'i:;.l.;{l l:.. i~1;i~1fi, .b) :J11dj,; i;,,;.J:,b'iP.J6~~ REAR USE ClASSIFICATION ..~~f t' $._~~PS:I. ..~ 1- Jot,M iI. ,,~ii'.}.;., '';'Y'.;.!) ~:j.1 DATE ~.lwClf ,.,).. ::'~"~' BLDG. PERMIT - WHITE 'OFFICE COpy - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENROD IMPORTANT: Call 687-4065 to"-s<;hedule all' required inspections. All construc- tion shall comply ~ith Uniform Building Code, D.E,Q, standards for subsurfac~ sewage disposal and county regulations covering. plumbing. ,'All buildings require a certificate of occupancy beJore being occupied. ", ' \ ' . ". '\. , (See Details on Reverse Side) ',' " ,\' :\.- l "\ (POST THIS PERMIT ON MAIN BLDG. AT SITE) LANE. COUNTY, DEPT. OF ENVIRONMENTAL MANAGEMENT COURTHOUSE ANNEX, 135 EAST 6th, EUGENE, OREGON 97401 "i':. \ ~ -, JIll . FORM == cr;tj '": 11 S I.TE .1 NSPECT ION \~ - "'\~ ApPROVE'D..1 . 1 01 SAPPROVED 1 1 DATE INSPECTOR , ", REMARKS FOUNDATION INSPECTION :::::::'D(jJ( ~~D~A .,. / I /':J. ~',. ~~ /I . . '/1. //j ..' .4 . . ~At c'. oJ )<: If (1, ,../.f$..flj! .4LA'Jjt[~.vil(, (if/' t'f/.'1-i~~U/rtp;, U -r.-~' Frl; ,~ N ~ ~l I' -, f ' ..,:c;." Ii FRAMING INSPECTION . ~?J/1 ApPRO"O /y('O',^PPRO"O / I o'Hkl(}-;!.:z.'7""'P'''OR~ (f3/~, I NSP_E~ IO-~ -'?5~ ~, REMARKS, LATH, ORSH/.EE:~/.5K INSPECTION 1 1 '/./'._/_ _JY~-'... . l!)/' /;) 1 ApPROVED, . y .'J DISAPP<ROVED . DATE.. (.Y I~ INSPECTOR",.~~..... to; I REMA~K S .A.:;:.C'ft:"/ltJ:t:: z;; ~~;/;. t<4:/...e. -it'~-c,~ .', i~</?:'t#--R j /-{,.f./[- YtJ.~O.j./ '" f/II II '-'" ;~I .' /' / . . . ~)j/I FINA~"..I~SPECTION ./c .' . .' . ,V /"'1 ' ;';'..-.c '. '/, J ~ .;j"1~ r. (.',.A/" . () / APP.ROVED I M DISAPPROVED 1 I DATE r ::-/,"'..- 16 I NSPECTOR,-f't, G.;., R~ARK~&k4 ~j~) 4/7PA:~~ ~-~/ e;!~..t/~< , (t'A~l,q.~q-&#! l.i)4;l;~, ~~(-~";"l&r~- (/1-'6'~'74't{/ " - V - , "' CERTIFICATE OF dCCUPANCY READY TO I~SUE . 1 1 NOT READY TO ISSUE 1 1 DATE INSPECTOR REMARKS, /J /1l #// ~/ / "",\"p P'. '~........ , tV' /VV~V'./f.O'/ /I /I . ".....~,.4rl-(p56-7J/ 76;11' 10':21 ~ ~" ".. , " <: /j_~, 1 ~. . ... , " " ". ~P~.1 ~&:,MGS'~?E;;~::~~r';O~" '- '.' >c,: )~~'t~;, ;~~~/~,W'O '" ;AX' ~Q::" . ". . '.. ......~... .", ." ~ . . SUBDIVIS'r'aN. " ..': ~~,~V'LD.~;~Goc,':~7~~,'J::~.~rp<~,~.i~zct,~~.";~P~ '. z~~8D7.~. .' .... .,-, i::\;<" ~'~~~:,:,~~~.-'>~~"" ;:.,BLOCKY . .. ....,;~MN ~ ::E,D:~~ri;:~}J~i'::.': ,,"-!, -," ,,' ,'., ..!!,-J61H~ib :-~:-'No:~...:~:?;;rc~;:;';y~~,.',q' ~~~-7'S .~':- ' . " .,'.F.' Zoni ng:.0:raJn~n,c.e;:,Compliance):;Z6.n'e~A '. 1< F' 'r},~:?"r6\'::':,~etbacks~:f:r0irF:;~lt:of rQad: . ..".- ,'". - :.~ . -, . ~ , I, ': .:.. .:. ~~. t'~~:';''' .' . .~.; ..". . ~-~ .. , . '" '. .. .... . ... ...... :':'fp'L~N~ IN'G 'D,ly::t~lO~~~A~~~LO~' ,eE~p fNG;~~~V,~s, (i ),',NO:'(-'.")"'~~';'LJ:9~T:.I'P'~'#.' ",.''';. ~. .~. . .'~'''' . ..._, " ~:_<<,~:-::~",:'-;.:~_y:: )~..;:-~ ~-.;.; .- " ...._..... \~" . .'.... _ . _:''1. ., ~_ '.BuJLD I NG: ;;INSPECTlON~'-D'IYI SlOW;, , :.' , . "'.,' '" "':\./:: . Nq't .'. '.:'. " '. . " ' . ","". ,':;',. '.:' ... ''--.' ".. '. '.:. .c', -0'.' '.-. -:,;:, x,f..:'. -;"'. '. ';-~,,:; .' . :AppH cab 1 e<: 'No: '.Ylts"" " . , . :-. '. ",' ..'>, ': > -- .. ':.. -- .....i~':\~il~.n~.'s:~.~iy~'te~{::E::~,:~;',/.."..:~~~~;::,,;, ...:., . --::L)::"',:'-:C> ';~)'/~_:'.,,:: '..,:/'.-..'." ",,-:,',,:,,~,~::,..',{:.." . , ';" ,{,8;~,.. __. ~.Q.I I S t~~ ~'l :!;~X-if;lf~ot 1 rig,s }"<~"::~;':;!' ;. _.;:"". ((' \)} : .<" ,((".>) ,(,:~:>,"': ,:.:' ~:-'-', ':'.. -.-: . ;:.:.: . _ :" ,""-.. '.: ~:"'- .: '. ;' . ',9 .'F,lood Plain.'.' ,.p'::.y.---.' ..:",.'..~'~"" ',"'."":' ._,}.:,.....;. ';':'/i)"2>,'A/.::', '. ' ':'.fO~'.~c;'.:ci'th'~.I:"' (~,~,~:~~~'c;>~~;'t,~'>>~~:,- ,~~'.:' '. .-:~" .;::~: :,(I)~"::'::. l,:),.".,(r:.;.tf; :,.~K,~ ~':BY:,V;,()~~ ~ 9~.J (; ,.IfJ': ., '. , ' ",. ,.' ." " r, ',... ,. ,,,.... '. '.'/7 DATE ' , ':Ca~~'E~T;::: ' . '~" 'j' , .'. ~ ".: '.,., , ,,:: ")\:'..:, " . .:.'>> ,.c,' "., '" ,: :'>' ::il({": '< .::', ','. ~.' .' .1 .' - . '". ~... -. . .'~ . .... .~. ...... - ,,;. .' , . ., , .., ~ -,' . . . - . .. '~",.:~.".......'.:'.. " ",' -~>"'." . - .- ;c".: ~: <.' .. . ' :- .( ~ .- 4'.: ' . .~ .'~ . -,.... . ~-. .'\." :. - ~ . , - . _. . '-.<.~.,: .:,~,..""-:~;f~>.'~'. .~-. . _ .-f:::ri:~,."... ~'~~."'~"" "......"'-',,,,.,," ." . 'WATER POLUT ION:'Cl)NtROli,: .; :" :. " ->~f{.:;;:< Not, , ., .' ':,..,' ,,;"':;,;"-:':,0 '11' :~~:}fte~~i:~~:~il~c:,t~Vi'~:f~b;t~~l> ..APPI ~r~l ?~;t.r/. .;,~'\:~i~rl;.': ,E5j-~i; .' ..... ,'.' 12"-(ltn~'r (s~~' cdinme~t-~). ,,;.<. > -', '.,,' , .. . (v- ( ') 'f)L CK" b~-flY:' \ It ~ S1,,~. 2- '7"''' 1 rr: . . ,. . C:~~EN~~:;;; ..... ,; ':.:F;f~:1(:"'{,fj:;: . .,' -;:.".!' ,.'.,,:-...(,;.':"~:.'.'~,;..',,;;.,".';(:J'V.,','. ... ' - "0- '-~:~~qf\tE. . ',:--', - :'-. . . .."'':0'''' ' ,- .. /' ,.,:; ',' '.' . ,: .". . . '.~, \ ::.t:"',:,: ,:'::,}J,;~'"c,' . _'. ~~ .:\. :', ,,:, ~ '. . _',' .- :. ,~- .f" :-. . ../J .... .'.. '" .-. ~:i.:"..'" ;.- ':. .< ".:. '-~,~....~ . . :: ~_. ~ - t :.: .. ~ " - ,-' '.~ ~. .~,~" ,': ."., ';- ~~_'~':' ~'i-. . . . ~. .\~~ -':..~-""_::.>~: '.~-' '.~J;:."'o.~'''- .~. . t .~. '" . ,. - . ," p~ ," _ -. - f-.' .:~ -.... . . . , ~: '" " ":" ~. w _ '". : - . ", j ~ . ~. ~ ,'". ~ -: .. ~ " .-. ., .'-. , ~'. - ~ :,,~.' . ~ T" ,,;"'. ..", .. '. . ,". _. i:' -1~ ";. '. . ~ ~ :';" .~ ~ "..!:-..,:". '''.. ;".' ..... ~". . ~ ." . '=-~,:r__. '. .. . + o~ .. 0 ~~_:' ~ .~~'+ ."':, 0;. ~.. . + ~.;.... .~ .'. --::. !!. -:'. . '. 7..~r:+~- .-:'" < i-. ". ~.-:, . n". ., ,., . ''''. .. ,n, ,. . ~"~:-:. :':;-_', ~. -. ~.:..;.o;<~. .: TO 'APrjt_J.C~NT:':~':: ," >, ~'"./"< ,-: "-.. _,: , __'. ..: . --' .. .-'-'t;~~~'. ,.,:;',;'~ '{::~/~~~'~;:':~",:.:?::.~:~~\:>:~:~' '," .. ", ',' . ".y.our Buddl,ng,I,Slte, Il1spectl:on: ....::.~,'.->".,':f;..- :,>,,;--;:: '::','; .' . '. . . :', ", . 'C' 'Ii'f C~'r(\~e' approyed.<' ." :-;': '., '", :~:,;,>;,::-'-:::,\<'-:'::~l.~,:c.:~: '. :-.' -- >,"~:-- ", - ..\ ., "'- ':., ': .', .".(\~. {j~;ta~~'o't"b~~'ap~r.oV'ed".a{..this ti~e as',.:"i.ni:j-'fcai~d..~'n~:'i~t.~;n-c~;Nb,~',:~.. "<:,:'..above.'-:" '. '._ ',', ":/ Y< '-,':::,~::' Q~~s.t i.?~s'" aQdJ::~~try~r.T~:f:of.m~t i o~, :q!i::';.i.tems: :j.,: ~h'~~~'gli 6 .cC?~~act ..-.t,~~" L~NE~ :" ' , " ' . ':"'\~' ';'" '__~..:f,:C~UN!~. PLANNING ~~,IVISI,O~:o' Quest'o'~lJ.;,a~d:"f;u~t~e:r.;-:"nfor!1lat'lon O,!:' ,,':te,msJ' '.:: :.:.: .-,":": :,\":;;::',t,nrQug~'J2')~ont<i'~t.,,~~~,'tANE COUNTY' BUJtDING:AND"SANITATlON DIVJ-S-I.ON.,-,::;', ;:' . . >,:," :(:.) WiJ r ,b~h~) d .ir.i' :th-i.'-~' .Q(f ice until'.yC:iLi: ~~.rkr.e~~rl ~e~ .th.e .prQ~'I'ems. :,~f:!~ica:~'ed. ' . (:}. I.~ ,:be i ,ri'g -- refurned,~" '-;,' ,'".' :,,: :' .~ ... ,> ,'.:.::':, _' ;'. ....... . . ..' <;'.: . . ,," :,.',;"..:,:' > h)~" YOl!r1>~'u.i}C1ing,~'perm i t",B[ipt i c~.!L2!!::J!?~'~ds\Hein~'~~l~i\fin'~d "uri'ders~o'a'l"ate- ~over"~<', :', : ':. "i,'Y',: -",...,DEPARTMENT-'..'OF,ENVIRONMENTAL:MANAGEMEN'" ..' "'. ,,:.,.' '. .'".' .,',' CSS-28 ... .., ...:.:., . ; '. .,;:.. ..;r~M~d~~~j~~~~N~::t~,~;;y::'::~~~~~~~P~:~1,~~:E>'y,-.,.. ... . ... ".-'l'<... " +" ~;..' '~'~?~~~:~';2!j'~}'~:' '~:"7' :: .J' ". ~ ''';.,,' LANE B LHL DIN G.l{rLJ .. JILDING :MH D MAILING ADDRESS 1'\ . PERMIT OR' MOBILE, HO~._ USE PERMIT PERMIT NO. j,lC4:i:':~._'t>i~M.. HUJ\ ,CONTRACTOR , i.j', '1~ 119 . 'iit~r.\f::e,.~~t~1!j;fitml 'Mt>.ILlNG ADDRESS ~ ~~~!~~U~~~~~.O~~~~~' ,2~SVa'" 15 PHONE 1{~fi",!,;r':;J'1,~ , PHONE.. .' PROPERTY OWNER ~' .: lIl""':."'A1!'k ~1." m'll ~lt!l',4'.lnt!' ~.~n,,' "PROPERTY LOCATION - INClUDE POST OFFICE .; 'tt1Hllrt. L/"\'U~~i.SCJi'jt.!f:!n:.$\nf.r~:i:traly~l~... ~rJ~ , PROPERTY LEGAL DESCRIPTION c-METES, BOUNDS', ,.~,,1 ,f!.r\1~!ll!t.'l'l.OJti\ ~a r,~..d.mlt ~?t:~1'n' P..b-;-hn:tt~g 'TWP RANGE SECTION ~ "'j;,.,J;i,,, p';~r;!:;': ,#,!;g 1 ~ " ..> . ~ " L~jt~ TAX LOT NO., !ll:!OJ~ '.;! CODE .CE.NSUS TRACT Hj A.PPL. NAME & " MAILING ADDRESS ;~'1'ti~f1Jl:~~QliL, ei.i~!3ri., 911:l.1"i. 'FOR MOBILE HOME PERMITS'ONLY ,'No. of Bedrooms 0:;1: ""~' \ll!;l r(GiH~~ 1~... mu EXISTING STRUCTURES ON PROPERTY' ~ll~ LEGAL ACCESS'TO PROPERTY LCliI.t:l1J~r, $ti:~!a!~ PROPERTY SIZE ~ fl. , WIDTHjfl,il;S, DEPTHSUltl,d,39 AREA '" r~1fJ ~'lf,Hlilt~l~~~tiWi!ta1.' : 'STRUCTURES TO.BE BUILT THIS PERMIT r~~:~ " .: - ;" -. ,S,in~i~ f~tat:)l~, ~;~m'1.:1l:fU~l" . ~ Connect to Existing Sewage System D ,TYPE CONSTRUCTION SQ, FT, # BDRMS New System 0' VALUATION ' . ,. jlCHiltl@l 21 ,.~t~ ~~3 ..Cl~f}' ..; ~ " L!:.J!)ri~~.tr.lltli b'lU..m;{f,llllllrllllt:t'1UtS-:-n, r:;l:?JJ11.~ b'iV Jtl!l~l ~@~~ (..,~') .;~.k,1t;;{~~I' ~$~If;gn:fr"' ,S>Jm i.l1 $olO', .'f. ',':": SEWAGE,DISpOSAL PUBlic 0 " .>BUILDING ':WASTE DISPOSAL ; ~; p'lUMB'ING ,AAN> REVIEW 'P,ARK TRAILER . ;:'}!ti~~1;u;;I1fae TOTAL' ~~, ~~~1AAtt~ '~ OTHERD' 1l:R!:t,~{j:l) '"'00..00 ;;'!-;It,,,f:l6:' ,FEES PLUMBING 'INSTALLED BY' OWNER D' ,00:HER: NAME WATER SUPPLY' SEPTIC TANK ~r PUBLIC 0 lll!!l OTHER ~~W \1(AC;{yr, ""1 'Il , .... 'ia<^fi: ntrfii"......,;i~~y t 1.:'A;q' , 2{'~A" :tli, . COUNTY BUILDING & SANITATION SPECIFICATIONS DRAIN FIELD ,REQUIRED !;Th'i~~1W$tf ~1:,le>'~)3 , ".', ",. :v " .1IN~ FT -. '''. $till' :s~' ,.\1:> W'~t~.t"~ot1~ $2",00 9~{~~~ ~~~~~!~' Mil,,!; SEPTIC TANKCAP~GITY .. :. , . ''''y~''': '. ~...., '~" , 'WITH DIST:BOX: GAL ' '900 TRENCH WIDTH FT, i~~t" . 'J1 OR SQ. fT.:', .,; ...~-;jl.. '", ~' ~~\) ..: . ". . > ~ ... . , , . ,"" " TYPE OF STRUCTURE OCCUPANCY ZONE . PUBUC UTIL EASEMENT' l\.: " ~)) 1 Glt>1P.$1~ .aU J ',BLDG, SETBA<;:KS __ FT, FROM CTR,OF ROAD R!GHT OF WAY ".,~ hONT 45' SIDE INT, $t 'sfD~"EXT.', AUTHORIZED SIGNATURE - DATE. REAR $" USE CLASSIFICATION ',~t\ 2~ " :"',, . t~IJol~ .i?,f}~.o.S~ bJi' ci~ttalo' f~'l1p~~ J{l1~ ~'. $~1tifj R$b;e;lt;ri!.f DATE " 'U$t;.., ttti 1..~!~ " ,";' ~ '. -'. , B~DG, pERMIT - WHITE' ,OFFICE COPY- WHITE COUNTY TAX'-p(NK PLUMBING -'- CANARY 'BUILDING -GREEN' SANITATION - GOLDENROD IMPORTANT: , '. -' ~ Call 687-4065 to schedule all. required inspections.' All 'con'sf'r.uc~ tion s/1all comply with Uniform Building Code, D.E,Q,standarc;k' '-' for 'sl!bsurface. sewcigedisposal and county regulations cpveririg ,''': plumbing. All buildil1gs requir'~ a certificate 'of occupancy' before. ';: being occupied, . \ .' (See 'Det9i1s on Rever~e Side) , . ',; . :\ ' ;.'., . . ,'J , ' '(POST .THIS PERMIT ON, MAIN BLD~.,ATSITE), , ' ,. ' , .LA!"l,E COUNTY,' DEPT, OFENVIRONMENTALMA~AGEMENT., " . "~f,o ~~,# :C'5 5.'..1:L.,.2;,,,,:,ii;~"1J:,,r.:'L,~;~,;i,,i,;,',,;:l~,\L~~i.,]~~;~}~~:~;tt~~~~;J~~~;~~~~,: ~:',~i;,~,~~,~.~t.~,~~~~~;i;~~1?;\ ;;""~,;;c~,f,J;.,;;~;;;~:;,;",;;.. :;;,~:: ":"';;'" L';O~"~~'; :: ~~, SLAB FLOOR' , PLUMB ING' 'CROUNOOOR.K ApPROVED I I DISAPPROVED I REMARKS GAS PI pI NG.GROUNDNORK -.. . ApPROVEP I l ' 01 S APPROVED ' I REMARKS . ROUGH PLUMB I NG' 'ApPROVED VO/ ,DISAPPROVED I / . . REMARKS' ROUGH GAS PIP I NG: - .' I DATE I DATE ',' ." ~ '1' .. , ' ,I NSPECTOR ." I N'SPECTOR ... ',;:' '~', I. DAH/t?-/.,.:-;) r INS~E':~t'~~ , "t/": ~ ~ REMARKS I Oi SAPPROVED. ./, I DATE ApPROVED I FiNAL PLUMBING ApPROVED IX/ 01 SAPPROVED I REMARKS F:I NAL GAS pIPING 'ApPROVED I., I DISAf?PROVED I REMARKS :,' CERnFlc~'rE OF. OCCYPANCY . - .J " :i.- .. . INSPECTOR ;'!>f, I D~;~"j' -:td-?c,' 'I ~SPEC'TOR:-~" . ". . {/: I . DATE- REApy' TO. ISSUE I..' I NOT . R.~ ADY TO' :\SSUE Rq.1ARKS. ! . I .. (-- DA'TE I NS,PE C TOR, .... ; .' ~ ii, INSPECTOR r,'. .. ...... . .;::u'.PRe'EO s~AGL;SPOS~LS:STE~.~:C"& :'. \:. ',;. ,.;A ,. '1.N:STA(LEI\:>~.'fg1fife top:' p!2rt '~~rm 'tc(,~~rgnatli're' and s~binJ f: bo~p i e'~ 'w'(~I:l. "ap-p 1 {'caHan. .'; ~:/';":'" .. . ' , ., .. , ~ if> . "::~;"~,:." . ";' C PERMftNO:,/ .~?6,'i,iJ:'~7,).' 1 NSTALL-ER/ S NAME. '. .'. '. J~RO~;R:rY.ADOR~SS' , .,'. '-" 4?hn::.~t::~~ook" '" '. ~~:f'; '.~ .': p'e"tr..co....'.: ',;~ .~. ..<....;:.:.,.1.~\iF~1<st~:~t""'::...::.10'24:: ",::'.. ;:". .. , No~ '.li'vi ng ',Uni ts'..~.: B.edrooms::. . Batl:fs. '. '" Baseme.n:t.-'. "'Wat~joSupply"" . " =o~l.: " '.,,,~ ......1 ' . ,2::< '-'vis,' '.' No'X ':Pub)}c' X Other--t..ist", .. .... ~;~1.~~~;:~jlr'.... '0~S~~~(;d..'; ;e,~.hfJ;,[Jr~?: c<>np.~\m.~t,s .l.....~~p;c.~.ci ty .1000 . Ins td.cf'Di.n:iens'io!ls:::.\f~~..:' .;.. ":" ;" ' 7:.' 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F i l.~,e~-i': IF-" i 11 er: ~ep~h ::.' ~: f ~ 1..1 ~r B<<;.low .1?' 2~ .l..504,,":5.':,'6,,:,.;Wldth.2. ..Ft.,> 39.0.; Lines .1.0.', Tvpe l'2R Abo\le.T.-1.e2."ln..Tl1e..6 In. .)lot;i.Rlaii.'(see..iris:trllct'i,ons.):..,... .. ..... :','. ., ';". '.: ", . ..' , :l .o. -. ;.' .. ~.~. :' .... ."; ,... ". :: '.'" ".:- .^ .J" .-' .. '.-:- -.;- . ,^ .' . r: . " \. . . _. .." ~. - ~ . _-.. . t. ~ '_~' ,_ ~". . -, - - : .. '.-' . . . .' -. ~ .$'.:'- "-t:. ...... .~ r', r'."'.'. ._ ',' . ,.',;, . .'.. ,...', . . ... .~- ?" :i~ '_. :'.'. "\"f .:'" . '. ,"- ,'-. . .' . .' . . "' _...:.- . :.:: -. -'~ - "0'-' , . .-+0 ,..;.;' ". ....'.:~}.. :/:" ,-. """:--0.' :: .... '.?(" " ," ~- -", <... ,c,' '.' ~,:.~ ."~" . ::...-- . - ,. ':,,:, "- ~ '~ . ~: .Oafe': :d:O_20'::75 . .:' . , '.':' .....S iqnaturfV/f::tlnyrj '.s.T~"':Pt:>rr6"t:t: . . ..,' ,'.' 5'- . CERTIFICATE.OF.:SATTSFACTORY:COMPLETION..-'::," .. l :' " /,;__~ ,;,~ ~a~:~~~.:~'1:~~~'~h' ~~.~.~}~:;e~.o~'..'l~~~~:':2K~Pt ~r:. '8~5iJ'S:~'dl;;~:~;il'4" thi's 'c:';'t~'i;;.ca'te "~:: f~~~~qi~~~.7SfG:'. . ..a'~~~vJ~erl~e:'of':::satJ sf ~.c:t6ry, ':c~p,let'i~on :,?f:atsu.b.~.~rfac~" "s~wage;d, i sp()s~al ,~ystei;".. at::~fb.~ibrov~.:~:,. -, "locat:iciri;. ....,:.::-::',.:....;,;...>,{..., ....~':. :.:,>.);~~..':'~:>:..,.L.;..: .'>.c' :. .:>. ." ':. ,'.. , , .... .~~Appr.o\i~5f:':.sy;s:t':e!n:J'nstalla.~tbnco.nf(i~ms:.,tA.~~ufreni'shlfl~"ard$"',: ~. $,:':, -. :'.b" '~:Oisapproved.:<D6es.not c'diiform~to.cur:r~~t.ist..a'n~ar~ds:'.:'~ ',.' .. . Remarks /t'". ~ :::-'.:t '< '/ "". '. ' : _ .': '~~. -:.'. ':. " ....'- -;o..... ,', . ,..- . . .:;fh~:':..f~i~/~I\~. fp. ':k' 'I/;/~;PA~" "~'.'~r .,~ ,.,.., . .' 'o." c55-a' '. '.' . ...... .. e,. '. .. ';~::~::{1~r: : ','," :": . :.:".'~::., c. ... 'c :;.:-, c.' :.:.'.' " :..:;LANE' "COU~TY'.'" '.J" .STATE".OF~:.OREGON..'DEPARTM'ENT OF- .ENVtliRON..' "',~, QUAt"TV"J;~";~:: ~_~_~;~..:- .', ,-~-<.' ;_~~."';~' n ',- ~_:L.~~~t f.,.:t.~;~:~A~~.~;~~_ ~.' ~ <?" ~~;; ,il~~:.i(~fy~!:{:7. ':~~,.~, ..;,.... - ~- "'- ~~~:t~ :~~ ~ ,. >,' .", -.,-..': ; ., .....-. . .. , ,'" ';Nb:~:~:Nd"~E~IT ;1~:;~~ ~SSrjp~~~~N::S.AP~~TcA~tji..~,H~~N."A~k~~~~ '. ~lc.CO,~~TR~~~'I~~.'),-,:\~,:,: tlOBI1E)i~~~. '1, I.,> ~~AN~~~~~EW I. 'L~:>:.Ct~~~i)~,~~.oc~Up~jC~.;'I_.":: " ( ': _ "._' '.. ~'l' ",ow~~~tl;1t, Jl-' W[@\~~.:-'::.'~: "%?lJ>lLJ. t~~:.-~'.:; ~:;:.:;";-::~/J:<?i?J?, -,~ ..:ZSlj.~9/' ".;:.' :;'...'.~.:..~:..:.\f'.{t..::.:;7:..,:. ".-I.NttJe./j\':i.;:: };'..:"j:/))~,'An.r...es.s_..;t~.;::i,.;;',., Ci~;;r:.l_,~;:...:;:.tli'.Z;iilP.. " '-::.::~hon~ .', .' :1,' :1':cON:rJU\cTo~~~2:- 7J.... #:1ff.~.edb';r'~('j'.: :, .:~.~~. .,., .' .'," . '. -:' '... ,c.' .Jirame' . ,'. . ,.: ',:': Adar'ess.,.. , . " Cit:;r :..',.,.;' "Zip. '. '. ',;Phone' .f : " ',~ '-s' "R~d' fi..2J '. ->. ", .-' ':;, ". ' .. ..... '--;,: .,' '" , ....,..,. .... /J~:;e}J~~"~;):f;j.~;;~;,J.e .... ;a,~o;' '; .... CQi'" ,'.C=,u, .Tnc, '. ~tu~.~YiSiOI)I/t~~,//~;'::~!~~'~ot' . l~' B~~~k:. '.:1 ~ , .;~,~~~;ty;:Acr~~k.e.>- , ,wi~6f,;l44r-{lliiJ.i-tJ ., ACCESS T? ~~RO;~R~;)~~~4 :N~m~;~', . ~~!', . ..4 Jt1;4;.," , ,:. '~'..-., '.- .', . :'.~.. ....: '~'.:.,. .:t:~~:,~::l~~~:::;f:r~f:;::;::)~i~f,7;rl~y/ ';~;; ;#\:..'~:~/~/. ~..,.,',~ ." ....~~~;ufi1;~~~~li~~~~. .~..<...~ " ~,' .....r'-, ':...; .... '.;;:~". ....~ '.~:,.:,'-.:.:.S9" .. ";li(:f.:?2,)fI,Bf}.~room,s, ~l'8'O ,.va~~...~.;,:..~,~:., .,... ~~".0'~'~ ,,;:'~',~'.";.~.'-.~~ . ~r:~.~~J~~"~~"-\':\~<.'\~~F.1o ~~:5'~~" . ..~,~~~dq";O. . . . . , . ~ ' ..'. . .. .;-', . .;~. !:'\...;..) ~ p,. ..n.... ~"l .'..:0.:.......,....; '~C: "'~-:". ..~:.~.-..:..:..,.~/.,.,.,<..:;...,~~.;:.~~.,~: :,~~cs.:....'._. .Su\:" ~,(.., ~ ~.. / ,;.r ,. '. "~_" "'/. ';...: .. . '4/-. SEWAGE DISPOSAL: . l. ( . , .'.' .. ' . .' .-/. p. . .' " .. . .lJL7' :,...Site_~nspection fi~,\'::<..\~~,;: .-E~~~,~ing,.S~~a~e D.~~~;.~~'~~st.~! ..,.:.. ?<Nf~.};ys'~em R'eq'uir',~Cl;' 1vt...1'/j;}" WATER SUPPLY: ',,' ':.:, " , "'.' ,'. PUb1ii/..I....;,,'1: ",' d, ..' _'~.q 'Well .' "Siring -:.-, Other. ":'.2;.COIllIl1.~}y":1;' ,I .. Nam'e of.Commuri\ty.6r PuliHc '~ystem' r\~~",-::'.,\: :<~~:,~~'/,~/: ..:....., ~i'Db; ,..;~~~~t,,,y~' . "Q"orl ,IN'", ; Blag. . \. ~ .' ..,:X '/ ' ::::;;:::'. . ~~:::::~~~", '. ~{:i:;:t~)~d~'1~;~:~'~~~ .> '~ ''', .. . .:, '. "" PrlN~ : FlJRNI . . D, . ' ': .~ '. .:: :::' <:FA(h.'t~TY'~IT " /".. ,,\-\,,\\ '. :_~? :<':,' ",., ",:"..' d......' :,L.:\;~:".::/""!/' .'.,:: ,,::- . I.:...,,~:, . .' , ': . . YES r .': i-::NO'-'" ~:";.' r 1 YES L I '1 N.o~:: J ~Ltd:~~~9~:$\\'A~' "" ,'_'s~.g;~':ur~_ of ~P~~~'~~~~4fJl:J;IJ;~ l/.i1/;V}~~i~/'~ . :'.:"_' . ..'. "'," . ';'," F:,e;.~~~;.ived_ ~Y:~'~:V~~;;'.~.~!:~:~,\r?\~ ,. 3''. =.. . FEES: . .- Mobile Home ,"1% ,surcharg~ . -.r . . TOTAL ;;.:)~~:. \\ . .-" "-:oJ' ,~~. . . :'Min. " Sepd.~ Ta,~k' capa~:~y '.,,{flYO. . .'... 'Drainf~e1d iRequfred' ~: L~neal 'Feet. .:: ~ ,~' ...:,.' '''., "J .- ......1, . . .~ - '. ~ .".. .. . ..-' - . - . ~.:'l)Tpe .Of.COIlsti-u~tion" .1 .:,'~. I)::~':c" " ,-.~/ .~ 11/..<.: G~~~uP~~/GKJ' 'Ffre'~~ne," . , .... ,.; Use :CHiss~f.iqit.ioii: ' -.~'''':'I- .~ ~.., . . .....j.:; " BldgSetbacks -':f:rcim c'eIlt~r' :b(R6.a.-d~~~l,ght:'o'f .W.~'f: .'. . . Frpnt A.p,...' ::'Std~~. In~:.('5':"':'.. ~:; ~~..f'~o: i;-.~~;~_. 'o. .. :: . . . ~ . -. . ':.. . , - ~ :;;';./ . ... .Jl" ."" '. :<"~:'~.~~;Rei~:::S r :l .. ":'iti?t'€' -:t<A. , . '. ".p IA.. ~ING: :~'.J.A *- ~('-'''''''A./\" . . '. ,."-;. 'DA~~:~~~. . . . ":'~' S~'ATiON':-?1' "_ ': DATE;'I:'" .', . Bu,~i.DIiG': :Rt..- 'fl' . DATE.:.- /;I'r-:' O,....,,..,...-Je... ".., '.. ,." ". . " . ~O-'1~', "r:...:-:~I/J.hl "" ~"'8A Ifl) -, .:'-w-./~ w -' .'or ,,~, . - -d, .,,~. "". ,~~~ r.:.j"V"_ ;7V . :' ~NE':.douW;~Y':D\' RTMEN~'OF,Emi~~O~~~" ~'JANA2EMENI{' '. .'> " .: . . . . =- '. .. , ~" - ".". "(55.12