Loading...
HomeMy WebLinkAboutPermit Building 1976-5-14 r,) ~ ~ -- ,- ~ '~,",' :. y " ,,:.-;~.~ ,,: ~'...: ", J ~,.,."r,::! ~,~ fl', ~p '~~~;~~"1.~. ':.". ,;- .~~ """ .;; ,e. ~~}J' . . , LANE COUNTY PERMIT FOR: \" .PERMIT No873-76 j" , ~. .. t 6. ~~. CONSTRUCTION [X] MOBILE HOME [ ] Robe...t N. Hi 11 Buil der t, DOwner PLAN REVIEW [] CHANGE OF OCCUPANCY [ ] 870'~Jest Centennial Blvd. Springfield,O!'egon . 0 Contractor NAME Same -'NAME '* '" ;ADDRESS CITY . ZIP CODE. PHONE 746-9916 .,' ",.' ADDRESS CITY' ZIP CODE PHONE, ;',' O.S. Reg, # 18 Twp Range Meadow Gl-een Subdivision Lot 6.1.3 Tax Lot 14 Block Laurel 9 2-{) '2-. Code' :::, . 2 . Ac'reagfi CenslJs Tract '105 2 '~Se~tion Width Access t?J?roperty(~oad Name}: Existing "Structures on Property: . Depth , . . None f., Di~ections to Property - Address: : Jasper Rd to Laurel . - .. -- - . _.. lUll Laurel ~~ree~ Springfield uKegon ~fql! SQ. FT. 1 056@ 21. 80 312 @ 5.30 3 Bed: VALUATION $23.020.80 1..653..60 $24.674.40 STRUCTURE (# BEDROOMS) POIf'I"i'" . -fin!". ffulO1 1 inn . _. - .._. - - - - _.w __. _ _ _. _ y Do".m';'!- oI!<'\11' r.:l".:lIna., .--....- ~_. ......---<lJ- !'~~~,~ -t:~ !!'!~'t::n S~~'!;,~~ !:i~~~0';~~ ~~5't~~ SEWAGE DISPOSAL:' PUBLIC [] SEPTIC TANK [ BUILD ING 11? on PLUMBING ?? nn 3% SURCf:jARGI.= 4 (l? MOB.lLE HOMI.= WASTE DISPOSALlnn nn PLAN REVIEW OTHER [] New TOTAL 238.02 CONSTRUCTION PERMITS.&,INSPECTlONS AND WATER POLLUT.IOI\I;CONTROL SPECIFICATIONS MIN. SEPTIC TANK CAPACITY: ... GALS, 900 MIN.DHAINFIELD 150 UN. FT. MAX. TRENCH.DEPTH 36" INCHES Ins ta 11 Accardi no to' arm roved 01 at 1211 an . TYPE OF CONSTRucnON 5N GROUP I&J FIRE ZONF STAY 100' FROM ALL WELLS USECLASSI F. SETBACKS - FT. FROM CTR. OF r!W: FRONT . 45 . SIDE EXT, FT. FROM PROP. L:INE~';' SIDE INT. 5:. . REAR 71PUE ZONF RA Al)THORIZED SIGNATURES: /s/ .1. F. Rn~c:: IHI H;u"h;\unh , ~r. .':.;:. '11,," '.,'k' < c:: \J .C::"'a,lIc:~ni+:JV'i:lln . --"". - --. - -=-=,- - -.-- ISSUANCE DATE: ../111/7;:" r11m .--;; ':"'.'- r - Of . - BLDG. PERMIT - WHITE OFFICE COPY --.: WHITE COUNTY TAX :...- PINK .PLUMBING - CANARY BUILDING- GREEN SANITATION - GOLDENROD . IMPORTANT: ' , , . Call 687-4065 to schedule all required constrOcti'on inspec'tions. Call 687:4061 to schedule all required septic system inspections, All constru,ction ?hallcomply with the State Buidling Code, .D.E.O, standards for subsurface sewage disposal and the ,State'Plymbing Code. Ali buildings require a certificate 'of occupancy before being occupied, . ,. (See De'tails on. Re'verse Side) , .(POST. THIS PER'MIT ON MAIN SLOG. AT' SITE'). C55~.13 . '. . . LANE COUNTY, DEPT. OF ENVIRONMENTAL MANAGEMENT COURTHOUSE ANNEX,135 EAST 6th, EUGENE, OREGON 97401 ~/D .. . Go/eN 973 -7' ~) BUllDING.,SITE' EVALUATION' , . K--.BUI'LDING PERMIT APPLICAtiON NO., ( ) . ,S IrE I NSi=l,ECTI ON ' PLANNING DIVISION Not 'App 1 i cabl e 1. Zoning Ordinance, Cempl i~nce: Zone., J') ~ (-) 2 ~ 'Subd i vi s i onOrd inance Cc5mp ll~nce'''7T7'' ,() 3. Requi red Access, ." ( ) 4. ' Bui Iding Si te (Area, Width',' Fron~age) () 5. Other (see commel'lts) ( ) COMMENTS: T" Ir ''''f)~sh/J/3 ~AX LOT '7--()~ SUBDIVI),,,,~: ": LOT: BLOCK:! APPLICANT .' DATE', No Yes () ( ) () (.), ( ) (') . ( ) ( ), '( )( ) \ , .CK'D'BY: ' ,ttA . 'I/IZ~7(; 6. Setbacks from cll of road: ., .' ,Front.' tI~ ',' .'Si~r Setbacks from interior Side Rear' 1 i nes : 5'"'.- , 1;:1'" /J. € ",' U-r;;- , . BUtLDI~G INSP~ctION~1~1SI0~ PLANNING DIVISIOtfACT10N'PENDING':,YES( ) NOt l ApPClcAtfON# 7. PI ans Submi tted ''';, 8~. Soil Stability (footing~) 9. Flood Plain 10. Other (see comm~nt~) Not 'App 1 icab 1 e' ( ) (, ) (() : ( ). , COMMENTS: WATER POLUTION CONTROL' Not , App 1 icabl e ( ) () '1' ", 11. Meets Department of Environmental Quality Standards. ' 12. Other (see com!rients) COMMENTS: " No, Y~s T)U') ( ) ( ) ,,( ) (;) ()-. () , C~'DBzg/l 1'. /1- , DATE 7~ No Yes' '"() tc}::' ( :> () ,CK'I'O '~~:~A~~. ' -=- -,/ :~(#'7L DATE TO APPL ICANT.::' .'. .' . > ." , '/I~. ' ~ C:~i ~~i~~p~o~~~;~ .'1 n,sp~c't i'on : --L' . ( "r Cannot' be, approved: at th fs time as i nd i cated On item NO. above. ..r)I1;" Ques. t ions. arid furthe.ri.nfonnat i on on" items 1 through. 6 . contact the LANE- ? " COUNTY, PLANNING DIVISION. Questions and further information on items, 7, through 12 contact the.,LANE COUNTY BUILDING AND SANITATldN DIVISION. , . ( r Wi)llJeheld in this office until' you can resolve the problems indicated. ( ) Is being return~d. , . " .' ..: ,,' , ,. , ( ) Your buildi:ng pe.rmit aepl i~~!}>g!:!.:~f~.~,.l~.I?ein!Li.~turne'd .uIJger.:seoMilte cover.: DEPARTMENT OF ENV I RONMENTAL MANA.GEMENT " ., " , 135 Sixth Avenue East' Eugene Oregon 974;01,' . PHONE: .687-4065 . ' . LANE COUNTVPLANNING DIVISION PHONE: '687-4186;" C55-28 r;.", '. , e.": .J ".. ~ . ';' .,>J. . i' , pate' May 14 ~ i 976 ' , P. N' '...' :':. ;"873-76;' .ermit ..0:" . . .CURB C,U1 f'-" ';;' " .....~..,' .' . < ..P"ER MI'T .... ..:', iJ~t:, , IN THE BOAR'D OF COUNTY, COMMISSIONERS O~..t.A~rE' COUNTY'I,:;ix(,;,:' .. , ,... . , ',,' . ,,",' '. . :". " .' .. ': "'" :: "':;">>'i>,',' "<7f~}f:: "...WHEREAS, 'the atta~h~d 'a PfJ I ication has been fully co~sidefed~b'Y the:Board:of~:Counly.':Com~P":~;t~;)" missiO'ners Qt.Lane Co,unty'~and,it'is'the opinion a nd'judgmen'tof the Board.that .thei'said applicbtion' '::~:~:'~ should be gra,hted, and that a perm it, sholJld be issued,.n9\f.{, therefore, it is. hereby ~~. " ''':':;;iBi-' , f ",', '~ ~. '" ' '; , ;~ " . : "1 -:< ::;i{~:f~: . ORDERErr'that;a'perrhit be and is hereby issued ,t?, . :Robe.rt N H'illBund~r ',' '. ~ .,~, .870,West Centenn:i a 1 Blvd~ , or constructing the foll~wing ..faciHty: . . . '$pri ngfi e 1 d Oregon 97477 .~ . ': .for plgdng,building:"': .'j' ~ ' .'-0. " _' 'Meadow Green Lot 14 .' aLock2 , ,1 ., ~ r012 Laure l':street ". Sprinqfi e 1 d 'Ore " ':.' upon theright-oi-waY:orCqunty'R~ad'N6'., . .,. . , Mile ,Po~t. . ; . in strict confor'iii ity to. the. exh ibits' attached. he'rete,and s~biect,to a 1,1 terms, cond itiohs,agreements,' .., "',stipulati9ns,'~.nd provisions cOl)taired' in the applicd.tion gnd perm.it~the Rules (;md Reg~la.tions Gov.. . erning FaciliHe's to qePermit,ted upon."County Ro..ad. ~ights-Of-Way, as ~et .forth by the lane Man- . ual 50.1.90(2)ony amendments thereto, and any other'applicable. ~egulations, law,.or ordina,rice~; . Special Provision?:, " :".:,;:" , , . ,. .' '" ., -, ... 1. Driveway 0i'il be constru'ctEid in accordance yvith the ,attached driveway approach specifica-. .' tions (Drawing M98~5q): . '. ' '," .' ", .-. ,,'.. . . _ .'. " I - i , . .' ~, .' ., ;, . ..... . " ,~ '.2., , Permittee ,<<ill, be responsible for: the immediate Te~oval, of all. mud, dirt 't;lnd debris. from the. roadway al")d' right of" way .caused by his operatiqr"leciving"the roadway and area in a neat, '(' acceptable conditior;':,'."':"; . ", '. ';, J- / . '.' . ':' .:,. .' ,."',' . 3: Sidewalks will be tohs:tructed in' accorqa'ncewith the'attach~d sidewaik' specifications and drawjng 'M98-.49~'" The Standard Curb "Type, shall be ' constructed unless:o~.~er e.specified.. .". .... " ,'.:::0." .. . ..':: tJy .1.<j~~~'(; . "'" ,~ (() , -:-- . " d.., ; :.~~ " ': ~\. .,' ';'. . ,.;:, ,-,~ ; : ,~ . , 'r.- ""~', , " ,":"j'" . . ~ . "~' _' .. ". . :. .... I' . " ..' This permit is re~ocable at any tirri'e,..and will.be,sfr'i_ctly .9dhered t.oa~d no work ether than , that 'specifically mentjoned,above IS her~by. aUf.,horiz'ed.".., . . .' '. . " . ' ,.' ,. ,,-. ,Thisperl"l1i! shaH.. be void YT;le~s the" wci~k,her,~in coryternplated. :~ailhave be~;n-completed .be- <.:' dbre' May 14 /19..].7 . >,;," Expires, , , , 19 ' , :1 " . i Date J " Ap~'roved'by l30ard efC~unty Commi~sio'ners By:'. . , &. "';""', "..' .' ...'.,.. . d~ "4;2~~~',' . '.' . Dired!,r of 'Public Works ,Inspected and Ap.proved : ....t, ,', . By. WHITE - OFFICE FilE. 'YEllOW ~- REAL ESTATE ~I( "'-PfRMITTEE .. '; . Atley B\HllllNQ& SANITATION LJEPY. . . C74-129 :$ ':. .~':l...""~ ~c:;;..:--.::.--!b..~ c::> ... ,>-.. ---~~.c;=~" _._~~ ~-< . """"'~".~~~~...~ " ~~ ,~~Soo:l ""<:\...~-::a. ~ <::::> " . . . _._._~-_.._._-...;.- C.., : "-',~~ _.. '''.. i,r ~~i~~ .' "';'i{-, .. y'. ~~j ,'. 1L- ,/~, '?J~# S,~ ~;..., .. . .t~,,: 't' ; \\. . ~ '. ' L; .-:.L .-,.;:-;:.,~~~.. '''00 ""-..,: , . ^/' , . ~.~T I : ". 'C.:.>> .. ~_ .~;. ....-:;, . C>~ .! L ! ,,. I' 'r=::::''' '~.;:.. \._'-.....; " ..:, '" .0.0"'7 -c:;.' ~ /~______~~_. ..... _ c......, '," ,:,., "., - - .. . ..':i .' :". ~ 'v:",,"-~.z. . '..... . :_r. ,.... .,... , " o ~q. -,"";;.. -.; Ii 0' j it .-.~ rj. ~ -, . ="~_-~-v: ~""."'=>~ __-....I -.:? """ ' "2...4: .P .,' fi c,." ..... ,"",", '-0:- -z.:'~ .......~ -.- ';-;'_:2...;;~~'..:'_'"'t" " i(i I . ~-~. . , . .Q11 1-------"'- I :Ii I ~, ()'/ ) ;. --~---~~.~...,...--,-~.;:.. . . I : ~ ~'-:--~..-.~';_.~,......~~- ~;' i .. .. I . t' ':[4:' t '. D -""'- /' " to;. (j ,. ...l; ,..J.. '.';;;'~ -, . ,;' ;>\-,' - ~ J" j , -A.'.,:.-~~ "-:;~ -3'.. ,If+-. .~ -.i..~ \ C)~~ "".:> ? "\~.'\""''-'''.;> i,. " t.', ...ts.'...."~..:..;.."vr ~ '1-: ". ,.::;.".,1 :,;~:, -I, . ~. .~ L. I". , -I' i .J ." .~ ., .-'1 ..:/.,;....: I ,r .,i' o a ,'. :~ iJ .t:l ,. .\ 'l- ,..;- ,,-~: .1.::~~::...:.....:.:.:.:.:::.~--- ~'........"'-v , ~:,', I: "-~;: " ':",' , :: ,,'" <, " :''...', . ,~~, < " ., .. .j .' '> 'i :, . " ,:,:'~, ..: ". '. ~'~'"'' I~I;'_~~:-'" r -"', , -, ...' .'/: ""'.;'.,, ,:':,:/:':'::, ""',':,." . ..<>'" PE it ':'M~<'I:\ T ""," ,', .' .....:: IN'~~E' BJA~D"~F:'~~~NTY: COMM;:~IO~ERS ()~~A~~ CdUNTY " ,c,' ;..,. :;.'<:".. ,/',:O:~'::';""';" ....::, .,: ", "":':,:'::':,:,';',' ".","', : ',' ' ""', .'..' . " ": ;e', ,,' ;.' WI"f1:~~~S/the,;qttdched:,ClPp)i~af'ion' ha,s: 'beE:;"n'{qHY: cOi:lsid~r~d '!iy t.he' Boarq of... County"Com~' mis~ioners';;o(~c:I'n'e,qd.u,~trl'Cl!1?)t.;i,s:,~he opir*',1) ~r,di.u~gm:nt.of th,e:'Boar,~ t~.att~:e~ai~applkation' .. should ,bewgnteq, a,nd:that'Cl;p~r;~lt shou.l,db~'.lssu~d, 'now/.ther~.fore, It IS h,e.re~y;;,', ."':.' ,:"..t, ", ,.' .,.' ,~,:". ~:' ,;' :>. '<;,,_.'.'''\ ,,;!J:~1~\'~~,. .>,;. ',,,, .,~. .~ ,,~..-j ( ,':" ,,' .,;~.l~;"'~':'.::""'l':__:""' ....'., ,~ . 'ORDERED~ that'~R~i;riii"'~i~b~q': i~'/ 'hereby j~su~~'to" ,c\ Robe~tN Hi'll:~Byn der' ,<. /, ;-': .' "'-._, ~ . , _" - .,~~, ~:,,' I". 't'_~ .}:, "~~,:,;,_,, ;'..~ ':'1,. . .,~ _ :' ',',:: <,l....., '.""'" '. "',;. '-, .'_ 870 "West. ,Centennia:.i 'Blv.d,.;.~:' "Spririgfiei dOr~'g6n',"97477: ,~-:;.' f6r'p,la~iiiig/~b,uilding', .';'or constr~ctih'g, 'th~.,foll.ow.ii59,fcicIIHy: ..., '... '," "J' ". ~ ' :.', " ~'.' _' ,. 1:"" ':' ,t '''''It.':'~:'''- " ' ,,:'" ~::':}""., ,,:', ',',-t -.j'_., '. :_:. ,"/",,'_: f" _'~'" : ",:' '.';<:::" "".,~:".:,J._"" . Meadow Green .', ~'9t,' 14, BLo.ck 2 'lO'12'L'aure 1 . Street, ;'Sbri nq.fi:el'd~:,6.re.' '97'477 .' .- ~ ' , ~ :,', ~'"" ."" ..' . , "', ~ ,-\,~..: ,f\tJ ':,..., ~ ,_ ','-' \ ,0:,' ~\,[jate"',','." " M:~~ 14" 1976 ~::,,~ ,,:, '<~ .. i' "'T (.'. '..'~ ' ,~/; . . ., . "< ' Perm!f No...' ,'" . 8tJ':'7.6,:.i: . ':.CURB: CUT" .' ',.' ,f:'"' " .',',:' '.' ". .. ". . .'" . l' , . .\~; ':"',"~. J "..',::'1 ""J' I,' i."l,."'~Jfl~>.""'~" .1-~ ~'" .f,., ,.,....:~,~.,.~-;"'l...,, J , ,_', upon. the,. right-of~way of ;County Rdad' NO'. . ~,.. . "'. ... ,Mil~,:P6st' "",":"', '., ...' .' .,' " in . ,strict ..cori'forh1ity. J9. 'the:~x~'lbits'attached, heretol..ari&,su.bjec~ to,~1 r terrT1.s/cortditi.on's/'a'gr~~rn"enlsl ..~.': . stipu lations a'nd ,provisiops,'containeq '.iri' the' ~appl icqti9n .ancl pe'rf!lit~,the Rliles, al1d~R~g~lat!(:>ns G,ov-.' " :,.. . ."'~rning' Faci,litie.;~t():"be', ,Pern,h!e.d;;up.o~ County R?~d~ig,hts:of-WaXI as,~etforf!1'by.J~el(:.me: ,,^ph> " . . .ual '50;~19.0(2)'anY: bmendrp'Emts,."Jhereto/and, .any other~:'applicab'e regiJlqtions/.Jaw9r~.ordii;lanc~; " ,. .,><: ,::" ,/:.':\:: ~:'~' ~."::,"".':',;,(:<,: '. . .:,:~ ';~L-~~;,: .',~'" " : ',:::;;:;,,: :..' ", ".i",:':':<.':,:." . ',,' ,::SpeciaL Pro'iisions::\", ,..' , ." """., .\"; ': "", '"" "~?I ,':',./,:-::,,: :','~ .',:,:.: ':".:":r:', /~":,,,.', .... .'.. :':,:~";:'/;,~ . . ,'.:,:.:...."':,' ,:-;;,"" "':'.', ,:.,.>"'/,.-\'. "';,1'::,':, Qr,iveVtciywillbeco.!1srrtlcJ~dib"a~cordance/wit~, t.heattached drhi~Way:a'ppr9Cl~,h' ..sp~dfica.~ ::.'.; .:' .ti6n,~~(Dra"\dn~: l~9,~.~~O).~,'.,,:,:,' ," ::." d:i : ',;:' .i:"<":,:: ''':'''''' ;:',. ,-, .: ," . .....:.... .',' :' '. :; 2,'- ... p~r~ Ittee': w,!11 he., "resP.ol1~lble. for ..the: i~in.ed'i qte,' re'rj,o'yal'of'ci'I,I:mud~,di~t. Cin.~; a.~b~,s frorrl,the;:.;' ,.' .' .r~adw~y and righ~,;of""YC?y:,~aus.ed ,by his,'operation; ,leaving t~~, r.~adway ari~,pf;~a in a .riea~/<: ' ,.,.a.cceptc:'.~.'e ~~.~d~t!9?,:"t.'.,.,~:.', ',:,"","~:!:':, '.'::':>:".:' ';"::',~.: :..: J.", .'. ""<,,,;:~~ J:.":;" '" "", 3.' .. Sidewaiks."w'illbe',constructed 'hi, accordance,"wfth,the,attached;:s'idewirlk', ", }- , . . ',,' .'-specifi cations 'and~'ara\.Hng.'~:t98-49; "Th~'::$tandatd Cur:p' Typ~::s'ha 11.be:;" .' '; , .corls:tructeq .~nless,.'"o;t.he{'wjs'e:'s:pecif,ied,.,<" "''', '<;, , :';, ,:> :.',,' " ,> ,i,. 'f} i - - "T' it..,' ',,, ~ , .,. " , _ ' . ~ 'I ,-.- :~, :' '.. ". " 1.' ".~' ' J' " ',. " .\' " '. 1 ~. . . , '" , d,' '_ ' '-, . .n';'., .",', t,""!' , \- J_ ,,"".1, .' t . . ~ " J., .~ ... ' . . '. .1'" ,~ ,: . ~ ",' .. ,H ".,:,..~",,~~.:""~d~ 1',:' ,- . " ' \,'" ,:,., .... 1'1' t ,.; . ">' ",'f . ,; ':' .~ " , . " '~I , . '~1 " ..".- ..' , ..,.', ',,< "'t.;' .. . .,j' . ,::"". ;\"', ".. .,. '. ~." "'.,; _:'. . ". '.?\; -' '.' '''',1, '"",' ,"q";" " ,>!-rhis per~it 'isrEw9.cable'::~(,dny time/.~nd'wrll )?~ :s!r'icfl}/adh~j:ed+o,~nd:n9\~~otk':'qtherthan .' , .: th'~f,specifica,"}t mentioned,aooveis, he'reby authori~ed.," >' ',.:,:::., ":"'. ...:',.' . ;,:: ":"",. .: .,:' :,:',.;:,. ,''.,..,\',,::< "":':, ", , : <:"(',,:',:; :',,', :,' ,:~" :.: ". "c'., ::;,,;":" ",,;<,;" ' . " . ." .This perr'Dit~ball'b'e:NOi(rynr~;(~\h'e work' h'ereln 'co~fElmplptea', shbi,' have "be'en"c:oM1'pleted be~ f~i. May14 "F,:: d;,';~:+19n ,~.XPi;e:~:'" ',:' .. .... ,i"':!'9/':';:: . ',ln~p~cted;ra~d:.A;~~r.p~'ec!".~, ,;:JXPproVed:'by',~6drd"of: County Comm,issiq~ets, . ' . , ",' , " " -, _".';1"'" . " B-' ' ....~, _.' ' ., ~,' . ..,' . '~:". X.' ... . '.,,' ." ,.... . . ;',. . . '. ;&" -'.1:,' ,t,' :" ,'A:;". ",/./J ;<~:~" ' :, . ,,'. .,~" V_~J I.,::";. . .;: Date' j'-. ;.By' :..... .,.'h,:',,:'.., 'WHITE - OFFiCi:: FILE;::",': . 'YELLOVV:+REA~.EStAT~ '>>,.;,'. "", , . ;Dir~ctor 'o.f, Pyblic Works, , , . . .' J +'~ . ;t"" . " ',," , '~, i. ~. ' 'PINK -'PERMiTTE'E . "ORANGE-' BUILDING & SANITATION DEPT; . .' ., ' .,;;t . ,"c-., . ".', '. ".1 ') ,~, ,,- ". ,,,' ~ . ;~ ".'J ' C'74-129.''''' ' ' ~ '. t , ~. , ~ ~ " JoC<~, . -*"~ ;;/, ~,_ _' .;~\ 4J , *j . ; ~~) ':,":~ -.< ,~tf .~,~ ',. .- .,<- ,..: ~- -'.,'_ ""':0', . ., .' r-" r' , " 'l; '0 LAN.E COUNTY PERMIT FOR: 0 PERMIT No;;J73...76 , I' ,., -' 'CONSTRUCTION [Xl MOBIL'E HOME [ J . . Robert N Hfl1 Build0r '0 Contractor NAME $(ll!\e PLAN REVIEW [] CHANGE OF OCCUPANCY [ ] 870 West Cem~'fil In wi. Sprinp,rfield e~gOij CITY ZIP CODE PHONE 746-9916 ,0 Owher ADDRESS NAME * ADDRESS CITY ZIP CODE PHONE q..~~Re9' .# " '1 fj , ,Twr'. Range ; c:t;eadow G~('!V1 ;Subdivision 2 Section 6oL3 Tax Lot Codp Census Tract 105 Lot 14 Block lUMrel f~Ov.B~ JGSpe~Rd tola~~l ~~~~ ~ ~ -~ ~ HlId',; L,,(l\t!t}'UD ";:>"'U~\li. ...... .. r.1l "'. """'_ _ ..J,...,nm-IMI Jj\~u.H~'Ulnw"U vR14lyvn Wf'"ill 2 Acreage Width ,Access to Property (Road Name): Depth' , 'Existing Structures on Property: Directions to Property - Address: .:... 'STRUCTURE (#BEDROOMS) ,'. ~~~mH. 901l" ilt1t!ll1ina ~m~t <fall" ~":lll'~r:tiil - ~mi\t ~l"lf, tn!ii't~H SG!'!1116@ m~ml!!i~1S",J.rtliJm ,'srolJ'@ 21.'80' ZJ120.5..3O ,! 3 S0~: VALUATION $23,OfrO..80 1..~53060 $2~ ..ID74~,40 SEWAGE DISPOSAL, PUBLIC [] SEPTIC TANK [ OTHER [ ] "likt\,( PLUMBING INSTALLED BY: , OWNER [] OTHER [] NAMF WATER SUPPLY: PROPOSED [ ] ',:EXISTII\i'G: [ ] [ ] PUBLIC [ ] COMMUNITY - NAME: [ ] PR!VATE WELL ,[ ] OTHER-SPECIF,Y: BUILDING PLUMBING, 3% SURCHARGF MOBILE HOMF WASTE DISPOSAI1M.OO PLAN REVIEW n2..00 2~L 00 4;,'1)2 TOTAL :t::iii!~~" . r . ", .~.", CONSTRUCTION PERMITS&.INSPECTIONS AND WA'T!=R POLLUTION CONTROL SPECIFICATIONS MIN, SEPTICnTANK CAPACITY: " '\ ''''< GALS <JlW MIN DRAINFIELD' 150 UN, FT. MAX. TRENqH DEPTH .36u INCHES ~Ilston &f.:f$@IM.t~~fjf toa~V>ll'<llv~(\J~l\'Jt pl~ -.: TYPE OF CONSTRUCTION tiW GROUP lM FIR(ZONF , STAY'100' FROM ALL WELLS' USE CLASS I F. SET[3ACKS- FT. ~lF.lOM CTR. OF r/W: FRONT :;)., SIDE.EXT,- FT FR<?M P~OP.L,INE:. ' SIDE INT. REAR' 1Q~E' ZONF RA AUTHORIZED SIGNATURES: /s/ J. l. BoS$by HamMt1h r!. W~ ;V'Qvls61n1 tElt'i an ISSUANCE DATE: !5/~4!1G dlm . i ::1~\> ~.'t <~:' ~ ....' . " ~ . ~ ,. ; . ~ . '. BLDG, PERMIT - WHITE OFFICE COpy....:. WHITE COUNTY TAX - PINK PLUMBING - CANARY , ,BUILDING - GREEN . SANITATION - GOLDENROD 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 Buidling Code, D,E.Q, standards for, subsur.face sewage disposal and the State Plumbing Code, All buildings require a: certificate of occupancy before being occupied. ' -- , (See,Details on Reverse:Side) (Post THIS PERMIT ON MAIN BLDG. AT SITE) IC55_13 LANE COUNTY, DEPT. OF ENVIRONMENTAL MANAGEMENT COURTHOUSb'I,NNEX, 135 EAST 6th" EUGENE,ORE~ON, 97401 .ri~'.. ~rj b ~:/ /.~ .I,...., , ",it' I"r~ 1./ <14 , . I . .~~ . . _"t. SLAB' FLOOR PLUMBING GROUNDWORK .i_, " --- .. ~~ ,\/ ~ :.: :'~.- ",..~ '~. ~. "1:., '0. , -.," .~- t ,',,. ,.... " -:Li-" .J (.t..!"' J NSPE,CTOR. ':,,f. -- .:.: ~ / : '.. REMARKS . _:-~ / DisAPPROVED /., /, D~TE " : "-'< /". ' ~ ApPROVEO'/-tA '0 I SAPPROVE'O REMARKS FIN~~;GAS PIPING ApPROVEO. . I 1 D I SAPPR'OV.ED ,Ap,PROVEO' 1 GAS fHp I.NG GROUNOWORK App~9YE~, 1 I. DISAPPRO'y~E'O / REMARK'S ROUGH PLUMBING ,ApPROVED iVrDISAPPROVED . REMARKS . ROUGH GAS P IPi NG ,. . .,. ApPROVED 1 / DISAPPROVED 1 REMARKS ',; "_1 ., FlNA_L,;,P.~U~B lNG, REMAR'KS CERT f F i:CATE OF OCCUPANCY' . t. , ... ". ~. '.' , RE.AOY,',!O 'IssuE, / ~ - 'C", 1 DATE INS~ECTOR " 1,'-" ,:,' ~ ;. " "" '- - .&.,' :/1...;':; _. i: . '-;.' ,[ .oA'\E:~,-~~ "':'74- '~rNSPEC'T~. "";,;;1 t. ; i 'J J: ,;_1: ... ;..- -,." 1 ~ ...J; ,~ -,~ , , ~',; ~ ... i:, : ~,: ." ':! 1 DATE . : ~. ' I INSPECTOR , I " ' . ~ ~ , ~ -.: I .' ,: . ~ 1> ;- ~.. 9: '~_:~ , _!~~4J ' , \. 'l, 1'.~:' ~ . , .,,-'. , 1.... . . ~ f \ i . .' ':.:,- " ~.'" ...r .,1 ~ I . . / . r{A i ~.8..:j:/t/ ~'? ~ ~'I NS:~E'C'T,~'~'~.'jj.i//.~"" . ,..~ ..~" .', '. ~'!""..,." ", t"."_ ,. -, . , -:i,~'; '"1-: r, "'j;.' ,..... ..., 0";'" "I' DA'T'E INSPECTOR " / ~ ' , . ~ '''''''':.'. ,:; _:1 . -/' "I:. INSPECTOR ,," .- ~~- .". .~. ,,0- '/, NOT READV>TO: 'IssUE, DATE '1--:" REMARKS -'I\.,' ci '.., . ., <~l~'''~'' ~/L~ f '.~ ....: :;:-".' . } ,. ,. :.). '. \ ~'t,.' :-', ," " --t " I'::~, ~, ,. '.oj ',,'.. t -; ,~f ~,,-\ - ,., " ~ '. : :.~ ,.~ ~ ..:.-! ;--. 'j, : .,~ 1 '"' , , "~11- t ~ " I; "'~ ~ .. _' 'I . .. ~ , ~-~~- . f .- ,.~ ~ ~ k 1 :;-". .... - ';'.' '/o~f:u~~~ ." 1/'.' .,' '. :,Pf SED'SEWAGE DisPOSAL SVSTEM:REcr ..' '" ',' 'NSTALLER: Comp 1 e,te .top part, ot 'lo.rm t,? si,gnature . and'subm i.t, bot. .;op i.es wi th app Ii cat ;'on'/. ~ . . , ,,'. , PERMiT NO. " 873-76 '~-! .IN~tER'S>~.EV.."'" ..PROP~.::Yp~:D,~R.'.dESSto." Laure.:l S.tree.t. ",.' ;' GG . .LI/Co .~ ~/~ :':. . ...No..Livi~rlg,.iJnits '~e~~.go.m~... B. a}.hs Baseme,n.t '''X.' :'Water SU~lY, . .'" . r fl. "~" ~., .V.es .....NO.. '.......,..Pub'l i,~', '....,?th. e.....r.,.:.Lis."t,. .____.;. ...., . . Sept ie, Tank: ~'.:' , '. . Ft. f rim we 1.1 ,Steeler Cone ret; ~ No. :~0P~r ~",e~~;l. Ge I.. C.;pacl t Y, It? eJ eJ Inside 9JnJ~ions:"./f:'t.".--' ., '."',./...;l;ile. Disposal Field: . . 'X,. . Length /"t Width4rr4" Dia'mete'r ..-r OePth7t~( 'Oistrib~tio~:BO~:' v,es':'}:'NO ,. OWNER','> .' '.. " .t.. ,... ::"'Other.O I stre but lon~Type," . . . . NAME' '. Rbbert.N,Hi.l1, :.;.:....... ." .. " . ' ~. f. ./~ 'MAIL ING .,' ADDRESS '. :'Spri ngf;el d "Otegon 9747l. ',' .~~tt:.i.4~~~~~.~ ',6. . ~i:~~~ ...~~~~1~;e;.. Plot Ptan(see instructions)':. " .~. . . .., (") 'A(7- '.~ , , 8iO'West.Centennfa 1 Blvd:,., '" . Feet . from. ." ~ ~ . ,,-. ., . -."Wn:l' "". . :,LqtVine . ,Fro'ht' Ft~Betw~en, . .L rnes' / ,'0; Foundation' ~~., , ~.' ,.S'id.e.> (d" " 'Rea~ (6 '.: '.- Fj11IJj1").,Fille. r~ept~ .'. . IF! 11 ~f.B7l~' 1~?~'?"( .Above T.ll e .?4 n Jr I 1 eh In.. '. " >",. "; i'" ~"'r ",-. ., ;'" \i. '. ~ :-, ,..\ . :"..,:': ~ ~ . .; - ....,. ~ Ow' '. . " --', .1'........ , -'.,' ,~ ~~"" . ,. ': ' '._ I ~ . ,;~r::~. '~'" .1~.1C... '.:: , ,ilE CE' I 'I'iff f"\) ., . ~\. . l\9 ,- I, . Y -,,~ _:. ~. fL~~! ....~~...: . . . J.Jf\f f r,. 'J(),.".----... . . :" _~..-. :-;..t':;',..A"',\}.'""l\..J /"b', --~. .'~' i' ".J.,., ' . '. ...;' -';'.,' . t,. "'~_' .. .' ...." '-;' "..' , " " .~,~~;:..~,.. ~.';,,:,......:: ~- ,. ~ '~. . '" , . ".' . . . . I ill /f,j' ". , . '. . . bI'{I1W~" '" , ,'.', f/VvmON' COIJNT!' ,,,,' -, Mt~rAL IlJL~MT.'. ;.~ ...' ..,.... " 'I i . f' . '; " o ~ . . ' B 0 ~T.-->) .', -DW; ~li":r.~.. ,..~.~11. ~Uii,r:"" I -,. 7....- ,,'~' . . ""~ '" , '. .. -, ." I':' ",\.'~" 't, '~ ~" , -....., .~ ,. - /., ," . I'r': . . . '.\ :,.(."..J'._ _ r , <T. . ~ . . r"':',.'. J,"',..... 10;. , I I, . ~ . " n. "~:'" ~ .~ "[. .. .': . . /' '4 'i/;<-ti<' '. S....q:n".at....u.' r'.e. /.J\~,' ..../9..n.,. "11~.J~~ .~>.~ . Date' (P."" I rl.7~/.152, ". . 'f.COMPLI \d. fhpc.-,v. ~I , .' .. .',. ..f "_'~ 'CERTlFlCAlE OF.~SAT. I.SF.A~TOR...CO~PL~. .,~.N.;. "". '."' '/0"/ t.e'.... /t... _,,/f'._ 7/ Fo~ $anit~rt~n pse O~ly~ -. .' . . "'"' '. . ,~l. ~. (~ ~. '. I.n accordance 'with. 1973 Oregon'Laws 'Chapter"83~,.~Sectio~ 21.4'thi.s' cer":ti~ic~t'els.is~ued . .' . as evidence ,of sat]sfactory..,comp1etior:r,of a. subsurfa.ce sewage:disposal.system at.th~above ' 'locaHon. ,', '........ ,:'. '.' ..... .'. ,:. ' ,". .,' . '.. - .L&i. App'roved,.:'S'y'stem',ln~tal ~ation cpnforms: ~o;,cu.rrentstandards . ""'.c. '," "'.' L1 Oi.sapprovect: :06es,not ,corif~rm to current st:andClrds: '". ' Rema.r~s : .' . ,.' ,.\' . '" . .,' ., . r < :" ,. ,.1- . , h" '. ..--. ! '.. <,:.'Q ~, ~',S" . ,+' ;- ,I: . . I . .' .:. r , ~ l r: (, ,.. " . ",. ,i'" . ~. :". , C55-11 ,~ . t .. .;p;..'.....,,~.,-."..... '. . . '. ...- . , . ~ . '. -s""anl ta~ ian.J .5... 's'idat'ur~ ' " . LANE COpNTY-' . 1/. .' , ~Nv ~~ONMENTAL. QUALITY - , STATE OF. ,ORE'GONOE~ARTMENT :OF . , . r .... '.. .."""""'".,...,.....,~.~. . '1'.1 .... "1 _~ .ANE COUNTY PERMIT FOR: PERMIT NOrA:' ?( CONSTRUCTION p:] MOBILE"HOME [] PLAN REVIEW [] CHANGE OF OCCUPANCY [ ] ',0 Owner FtJt~~rt; :~ ':HH ;,'l.il~hk7' f,'f'i: :c~~'!i't t,tmtc~nial ;:1\1'6. :}~',~i' ;~:. ;~'-fi ~ -ld ~,r~ ;~);'~,'; o Contractor , NAME r~'!!n;'? . ADDRESS CITY ZIP CODE ,~ . cPi:!9NE f I, ;.~ . 'r '. i I;"; NAME ~.!'I ADDRESS, CITY ZIP CODE PHONE O.S. Reg. # ~;. Twr' Range ~ -;;'rt;: '":.'1 , 'Subdivision'.' . .... ! A ,.,'/ ~. Section (}~ 1 ~ ~ Tax Lot Code Census Tract J Lot ~ I' . ......\fk~-' .....c ~ . . Block Lnl}rt~ 1 ;/ . Acreage Width Access to Property (Road Name)' Depth . , " \.... 1 . ~. Existing Structur(~_on Propert.y: Directions to Property, Address: 'J'. \ ..~t~;~..~, .. J \ '\t.., '! t. j~::'{r Rt~ ti:' ~<~urnl .., . 'fill .!ci .Q _. ~'" ~ ~ f. ~ -to, _. _.. Jf.. . C ~:-f:_. 1..~.H.f-'Wc ":"'~~-V':~.:~.... ."-- , :t _, .~.s ~ '" _;.' t"il ':ll, _. ~ _ G'....""...'I"J'1'1 ~t~('-~ -:l~f I ~-t: I ~-C! .... ;'.:';~{;<~'5 .$':) .--~1 & , , STRUCTURE (# BEDROOMS) P"l'f,:n: t'lft"IHn'i: t: ,(~',;~ 1'. (-.','" r;~n~ ~ ~~: "i.:;o l.c,;"")f:?, f,l' XI' ;!':,~n !i!:vu\'~~ n::.nO$i:1 ~>V~;OO'j: .~t- ~ -.',~, ,_ ,'~.'\~, ~~~~~ ~ ~~ '\....~~l 'J: ,,-~.K~'-'\~-")~ ,;,,'L5lQ..Q;) SEWAGJ= DISPOS'A\~) ~ \ .~0J \_.~ \..~ -.~ \RLUMB!I'~~I'~S~~b.t'&ED~~'\1;~~~~-.$;.. PUBLIC [ ,J ' SEPTIC TANK [ OTHER [] <5~'! OWNER [J OTHER [ N NAMF',\ BUILDING H2.Cn. _ WATER SUPPLY: PROPOSED [ ] p. LUMBING. ,.:?:H)....., EXISTING [] f~ rj'1l'. \. '" o :;~Y~EC~~~~~ 2'~" '~\ ~ \\ -~ \. ~ ~ l ~~~~~NITY' NAME:"q~~ WASTE DISPOSAlJ~J'~.~ '-...J ~~,\ ~ \ " _,_ [Q~PRIVATE WELL \: . PLAN R EVI~";~~~~ '. "'.' . '%'l\ .~ Wl><SlTH ER"'Ii~CI'~'~~\ "'';~'~'' TOTAL ,~,~r~~~~ \ ~,~~ ~\ ~)~ ~~ ' \\ I'- \ " ,,~~\ ,~ \ 'CPN~JRUc~~g,[\I.r~~MliJ~ & hN~p~!;;.Tr~J'iS~.taNP__WAJER PQ~:~'~Y;LON.,GOI}!TRQt--SP:EGfF;rc~tlbN'S MIN, SEPTICr+A~NK CAPAciTY:-->~' -~.., \;~\ ~ \~, ~ ~:'.; ~"1,~::~~"''1>'''t'~ .', GALS, .~.XJ MIN. DRAINFIELD . :;.,-;' . UN\n. ... MAX. TRENCH DEPTH '\, ~m ,II\!CHES ,t:i J; UH ! ,,'n::~;a.rI.H li~~.t~} i1;);lrljV~'.i H'~.t: r ;;~i: " ' \ , SQ"F.7,. 0''1 l'f ,.;..:: '. C. I ~ ,J ~~ ';,yL VALUATION I:', ~j- ::t ~ ~L7 ,'to> ~'.~ i '] v 1 'l,~j:;.l"l(>~ (, ,. , ~ --r--'" /> / .,," t.X f, .1/ ? . . TYPE OF CONSTRUCTION GROUP ;.\.1. FIRE ZONF .\~ \1, ~ .....,_ 'to . ftrrl'~ ~ '-')...},,,, .:"J\'c \".J.ST/;\Y 100' FROM ALL WELLS -.'- . USE CLAssTF..>', :, . SETBACKS - FT. F.ROM CTR, OF r!W: -tl.-) FRONT ,', SIDE EXT. FT. FROM PBOP. LINE: SIDE INT.;J REAR t"':tJ\: . I " "J ZONF t AUTHORIZED SIGNATURES: Is! ,/. L ~:ns~ :' ,l!; :!1.r;'f~' 1':;11 f! !t t;'r"p ;.?,,,,,~,,,,,;l1l".;,...t f..,~~.i . of f, ..t~ t~ ,-.t-.' ~t..:~.;J i ;...t;\!,; ,. 1. t."" '~i ~ ISSUANCE DATE: ;1 '~ ~}.fl j.\lf~;.' ., 1 ~ BLDG, PERMIT - WHITE OFFICE COpy - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENROD IMPORTANT: }f."" ',- , , Call 687,4065 to schedule all required construction inspections, Call 687-4061 to schedule all required septic system inspectio'ns, All construction shall comply with the State Buidling Code, D,E,a, standar.ds for subsurface sewage disposal and the State Plumbing Code, All buildings reguire a certificate.of, occupancy before being occupied. ." ,; (See Detai Is on Reverse Side) . '\: (POST THIS PERMIT ON MAIN BLDG. AT SITE) \ . " C55-13 LANE COUNTY. DEPT OF ENVIRONMENTAL MANAGEMENT COURTHOUSE ANNEX,'135 EAST 6th, EUGENE, OREGON 97491 .~-'>" ~' j .~ - ~" . ~~' -~ ~ ~~ :J'~ ~ ',~ ~ ~ '.. r~ \~ '~-',~ \ .' .' ,0 '''f. .! ''"' ""~~" ~ SITE I NSPECTI ON ApPROVED / / DISAPPROVE,D.I, I DATE INSPECTOR REMARKS FOUNDATION INSPECTION ApPRO,V ED / / REMARKS f)..!..( DISAPPROVED / " ~h .4, Om /1 MA ~/f:I;iti'./ ~~ ;.... .. ~ . ~{,\ I) FRAMING INSPECTION 'ApPROVED ~/}~ DI S::;ROVED / / ~ATE" ' INSPECTOR '. RE""KS~ 44le~ 1i {i~r ~ -#< ~ ~/_ . {.R-~~~ .f:y~~. ,LI:" 9'- ~71;:J .,/ ("'"! 'l Vi) (t-;, i I / LA TH OR SHE~ I NSPECTI ON . - _ . / ); (0 .. A,",OVE D / (0 ","'ROVED / / O'TE f' - /.]-16 ": PE CTV; ,,'---" I REMARKS /Jiftt:.ffi~~ afr. ~ ;Dfl-?/I~~fJI ()~ CJ'(~ ~/rifl~~.n:;~'4)k~Jijt~ (t!. /) ~ ~ 7/ 1/ 01/ . '~, V ..e~ Ji/JI../ //. " /1 tJ , ~~1U</et:~LtfJ(.,_,/,,-j7W DISAPPROVED / / DATE 1r'/,.." 7ft..NSPECTO{~ FINAL ~i r!!~ ApPROVED REMARKS CERTIFICATE OF OCCUPANCY READY TO ISSUE / / NOT READY TO ISSUE / / DATE INSPECTOR ,""\ /} ./J t1 J, //// I /Jh/P V V~ '__ r- -~ " /) <j'lJ..:-7f;'-7f..tLt ItJI2 REMARKS .~' ~~~_~R' ;. , , , ~~~,_.~"....w -,:.' '':'; CO'RRECTION NOTICE LANE COUNTY DEPT. OF ENVIRONMENTAL MANAGEMENT Construction Permits & Inspections Division EUGENE, OREGON This building or structure does not conform to Lane County building regulations, ordinance~ or ~odes /;;;e:tu~~4__fL tfJ ~0 ,ahu ~1L f k , - / ) 1/ il f' I-/' ,... // 1/ .'l, 1/ 1/ ','--' /J ()/ /l)UAAft A/t' &/ (!/J-J'1lf1fi J&~. ,j!?UJ-;:-=t; A fJ, '"'CIJ !l Cui ~.A'r V ~ - .~n, - I ...,.... - /)/ I \. t? ,-...../4 /J /7. /pJ, , 'fAAI', .Y::;, A-U J. ~ (rp, I -f)l.-U, A. ~ra ,~) If ~ /J. r I 1.,'/ /, 6t~~ 4#~ 1/ ./It. ./ f ~ C55 -7.3 RE-INSPECTION REQUIRED FOR APPROVAL .. ,t'",yr "',,,/,/',;"' ,," ",/;/ ,0 I ,,' : ,;' /'. -; />' (/,"j / ,it /' Ii~'. 'i't! " ~~/r,; ,&";1:;' .p!t;/ ,..-;" ,~~~, ~ v v~: '" ,~ ., Ii j, ,10,\ Inspector ,'~ 1'~{iK~,.;t' ~,,1i&~;'/.'lfMlT.""" 'if-. Date::.'if ,};::../ I I ,,,'y , Ii"'" /':7 '1/ tiff ~J ~. \., ( " r Ii. . Building Permit #,-~J 7(1 I:,..". -:.-f:;" , . ~-^l. '~ ,;. . . . '. ~ ~" 21'7 ~ 7 ' - ~ ,.~"PERMIT 4/:3 , 't , NOTE:~' NO' PERMIT WIl E ISSUED UNTIL THI~t APPLICATIOI. _..AS BEEN APPROVED' , \ 1 APPLICATION FOR: ' \ CONSTRbCTIONA" I MOBILE HOME I I PLAN REVIEW' I ,I, CHAN2E'~;'OCCUPANCY " I . . ., ", . . , ~'.'". . . " " ',' ,', , , " ' ,',', ".," , ' . mmER~,,~~~,+ N~~- \\~\\'')\~k,:Y~~I': ,~1r()es~ .'~~t'\rrol'd\ c~1~<\>~f'll~J~f{~9,1"lp~:n~)~ b-9, I~ ~ONTRA~T~\s,~"''' 'N'\\,~\\,',~:;\lQ\' '} i,Jj) lu> ,C, ~Nl'Q.N~I~\ '~,\\), .:1:<;,,9.., ;~< ."rt! 11 ,.~~. ", ,~,", . Name.."," ." Address", " " ' qV: '. "\}" .Zip: " Phone - ," ' , O.S., (REG., 1~' . . TlYP" ,',IX \X l" , , I 1- ~"g,5-s'""on{;;;tJi3tano,J fud, e~,.. ''""'Lf) ~' S~bdiviSiOnIlUl\c:lr.u..' 6....N>'" ., tJ ::.o,t, ,\ AY /J', , _ Bl?Clcj' ~ pro,pe,:ty Acrea'ge Width, Depth. ACCESS TO PROPERTY (Road Name) ~ n y~, _ Existing Structures on Prcipe,rty: '~:--:-./ '- .. /;:)'/1' ,.." ';};.....'i ~ /1 P"p'''y Lo"acino - Md',,"/~i'~";iO~:~fpu_) /fI:'# ..~~~I{ . , ' , .",-'" /'" JO {;2" ~(/uAjJ j/ ...'>/<'{/ A ~~: - " : , r Off ice Use OnlYXXXXXXXXXX:XXXXxxxxxxxxxxxxxxxxxx~~xxxxxxxxnxxxxxxxxxxxxxxxxXXXXXxxxxxxxxxxxxxxxxxxxxxxx Sf1~F,.tn ,." ',' ?edrooms- 'Valuation ' ,',J., H.I/12r;-(Aac:.:2to6 (::R ') d~ OdO'",jr), 1/, l"~'!uy',~~)#I~.'~1,. ;?,IV~"S:3o" ,~. ~~': "/~~~~.~6 , ,t.vL-P" ~- ~~, :"" " I "..' '.", ~t/.b7(j. GO '''',':,.E~;'''O'' sew,g" Dit.O,sal, 1i".;,~m, ',I ,or, New'System'~equired ..~: " .' ',' ," ')~ubl c ',' '." "I Oth~:r ' "'Comm ,nit'y ,I' ,I "Na~e 9fConmiuni ty or, Pu~li'cSYfltem SEWAGE DISPOSAL:' Site Inspection # WATER SUPPLY: W~l1 Spring' FEES: .PLuMBING,::' .,'~ . / I cJ~ t) ~~st~ued b: Owner l , ~t, U 0 PLUMBING~E~. /L ~ ,t.... ((Yof '"T'" '~(-' , ,/ k'1\ " ,.' -UJu. " '\ ' ','Other " Name Bldg, , Pl~bin'g 3%, Surcharge WasteDlsp; ,Plan Review " Mobile Home I Sewage.' Connec't'iorl '~",. ~"M Water Connection. ,~ rUNS, FURNISHED' FACILITY .'PERMIT TOTAL ,!) :=? K. O~, . '. .~, "'~'I I~O~": '''I'INO . 's~g~aM~ of Ar;lJlt.v.f ..,/Jd:# . '-',7/ Fe~, Rece~ved B,: ,_,' ~ ,Date: ,5 ,~3~ ~ ,~ Li~~a~:, 'F1tt ',' f':? r) ',Maj{imum DTpth' :~ ~, ~~J -, ,/ 'i r ' Mi>>_ S~PticT~n, k~ ca",pacity~ .' J~.J, .~, , .~ ~ Type of Construction /:., ~ ~I.~ /11 Gr~~p~:, !~! Fi,re Zone , ,Use Classification" 'I. . .' " ' . , J' . r BldgSetbacks - ,from ,Center of R()ad,Right of Way: ',. ' ',/~ " '~"" Front, ''''1''''' ' ," Side Int., (;;} :" " Sid~ftrrIbt " - . , .,'""'rn, '~, R~ar~-' r UHzo~e' I " , , , , , "R~4 \ ' , PlANNING: lU;e'7.57Jt.d11' DATE: ,.-"b~~',"'i:tr;h" /Jr~~~~J/~7b coirnr: DEPA~TME~ OF' ENVIRO~NTAL ~N~GEMENT /, ~ , C 55 - 12 LANE