HomeMy WebLinkAboutPermit Building 1977-7-20
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LANE COUNTY PERMIT
Acreage or Lot Si7<>
Contractor's O.S. #
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Partition i ng #
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Subdivision
Lot
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APPLICANT'S NAME AND ADDRESS ,~.-!:-e. ,~~., /:' d.,! ~/. tr" ~ (; .~ l'" ,,,,-;, #....,.... 'i -- Phonp'1(j7-L>r;~ /'
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OWNER'S NAME AND ADDRESS Phonf'
CONTRACTOR'S NAME AND ADDRESS, Phonf'
Mail permit to ( ) Applicant ( ) Owner' ( ) Contractor. ( ) Prefer to pick up. Call _ (owner, etc.) when ready.
_STRUCTURES NOW ON THE PROPERTY ......<"'j F {j 'i (:.:; <L L-I'.' <i;> / )
~HIS PERMIT IS FOR () (~1 ~r-' .ft e<..-...i' -:~<Ir..1..F',i ~ S'~ ~-<),c.:~t~"~i~~~~~/ # PLUMBING CONNECTIONS
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WATER SUPPLY IA,,>tJ,;l.i~ SEWAGE DISPOSAl /~i~ltL',,/,;- S
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THIS PROPERTY IS WITHIN ONE MI LE OF THE CITY OF_
PLUMBING BY
I hereby certify tbat the above statements are true and accurate, and that I have the following legal interest in the property: owner of record;
contract purchaser; potential buyer; realtor or agent. I further certify that (if not the owner) I am authorized to act for the owner of
record, and that said owner is aware and approves of this action. I hereby agree to comply with all applicable Codes relating to this permit.
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( ) NEW ADDRESS ( ) FACILITY PERMIT TO TRANSPORTATION DEPT.
Date
) SPECIAL PMT. AREA. MIN, ELEVATION:
SANITATION
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Comments:
Minimum Septic Tank Capacity (Gallons)
Drainfield Required - Lineal Feet
Maximum Depth
BUILDING
Type of Construction
I Jse Classification
Group
Fire Zone
Comments:
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'By: Date: By: Date:
PLANNING,J3EQUIREMENTS SATISFIED. By:, ,,,,' Date:,' " Date Issued';~U.!f h 20--1'1
ZON.E: IY /..i/- SETBACKS: F~9NT ,'.:' / SID,E .F..AS:ING_ST~EET (FROM CIL) INT. SIDE YARD..5 I REAR.-:5':CfJROM P/U'
LANE COUNTY DEPARTMENT OF EN~i1{b1f~[~~~L(~i~~M~'~;:125 EAST 8TH AVE., EUGENE, OREGON 97401 PHONE: 687-4394
C55-13
POST THIS PERMIT ON MAIN BUILDING AT SITE
BLDG. PERMIT - WHITE; BUILDING - GREEN; PLUMB'ING - CANARY; SANITATION - GOLDENROD; OFFICE COPY - WHITE
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INFORMATION SHEET
) Building Permit
) Site Feasibility Study f9r Septic Tank. Number of sites
STRUCTURES NO~ .oN THE P)-9PE~TY
PROPOSED USE (this permit)_C~
WATER SUPPLY 0/#.
SEWAGE DISPOSAl,~dt:.~;]~
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Acreage or Lot Size Test holes will be ready
Partitioning # ( ) Completed Subdivision
( ) Pendin,g ~ , '..L?# 0
APPLlCANT'SNAMEANDADDRESS'~~'~ /?
OWNER'S NAME AND ADDRESS, if ~rent from applicant's ;::> /f / ?~.L.,.
~ONTRACTOR'S NAME AND ADDRESS ' , '
ail permitor results of site fe(jsibility study to ( ).Applicant ( ) Owner, ( ) Contractor.
) Prefer to pick up. Call (owner, etc.) when ready.
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Phonp 7~7-:J8'.2.. 7
Phonp
Phonp
'Contractors O. s. #
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_(existing or proposed well, etc. If public, name of system)
,(existing or proposed septic tank, etc.) S.I.:#
PLUMBING BY
Address
) PROPERTY IS WITHIN ONE MILE OF CITY (
, )
******************************************* OFFICE USE ONLY BELOW THIS LINE ***********":*****************************_**
) Ne~dd~eCeSSary " ' ( ') Facility Permit N~cessar~
LONEr ~ SETBACKS:, Front Side Faclng'Street
(FROM CENTERLINE OF ROAD)
) Special Permit Area,
Minimum Elevation:.
Interior Side Yard Rear
(FROM PROPERTY LINES)
To: Planning/Building Inspector/Sanitarian/Surveyor.
This applicant appears to have a problem with
Your assistance will be appreciated.
B'y
Permit Processing Section
Response:
C55,12
By
DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
Permit Processing Section
12~ East 8th Avenue
687-4394
r)ivision
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IJ PERMIT # c:2007- 77
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LANE COUNTY PERMIT
Acreage or Lot SizE"
Contractor's O.S.#
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( ) Completed Subdivision
, II Lot
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Partition i ng #
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APPLICANT'S NAME AND ADDRESS
OWNER'S NAME AND ADDRESS
CONTRACTOR'S NAME AND ADDRESS
Mail permit to ( ) Applicant ( ) Owner
( ) Contractor. ( ) Prefer to pick up. Call
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Phone 4t./7- df?7 "
Phonp
Phonp
(owner, etc.) when ready.
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J~aA4~ .:f.rl-d.A.CJ.-~ "'~ ~16~# PLUMBING CONNECTIONS
(j~WAGE DISPOSAl hL~I-S
i' S.I. #
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-""-RUCTURES NOW ON THE PROPERTY.
THIS PERMIT IS FOR_ ();::;LY-
WATER SUPPL; 1~(;11J -
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THIS PROPERTY IS WITHIN ONE MI LE OF THE CITY OF
PLUMBING BY
I hereby certify that the above statements are true and accurate,and that I have the'following legal interest in the property: oWl1er"of record;
contract purchaser; , ,potential buyer; , realtor or agent. I further certify that (if not the owner) I am authorized to act for the owner of
record, and that said owner is aware and approves of this action. I hereby agree to comply with all applicable Codes relating to this permit.
Fee Paid $ /V. '(JV' Signature '- DatE"
( ) NEW ADDRESS ( ) FACILITY PERMIT TO TRANSPORTATION DEPT. ) SPECIAL PMT. AREA, MIN. ELEVATION:
SANITATION
Comments:
BUILDING
Minimum Septic Tank Capacity (Gallons)' Type of Construction (:;roup
D rainfield Renuirer!TJ-TJL,ine,::l I ,fee~L' n' ". ro,:,',',: ''','f "' I-:~' T[, C IJ~ c["~i.fffi~1;i.r.\lrtqRAL
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Maximum D~r:uhoDING, ! m,REBY DECLAHE THAT THiS BUMrWmeWis~ BE USED FOR THE:STORAGE .oF
l\c:rnCUL'TUR1\L PRODUCTS HAl SED ON THE PREMISES, FARM MACHINERY, OR THE RAISING,
ZD r',EE DIJj.G, OR FEEDiNG OF PERMITTED FARM ANIMALS, AND FOR NO OTHER PURPOSE.
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/ SIGNATURE~'-" ~ - ".
Fire Zone
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DATE
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(, ) APPLICANT
( ) APPLICANT'S REPRESENTATIVE
By: Date: By: Date:
PLANN ING)~EQUIREMENTS SATISFIED. By: ()/?-?-'..I~:t;"" h:v/L-.,Date: 7-? 0 ~. 77 Date Issueq.r,U.J.A,.)f 20"'-/7
ZONE: Ir'.- 7'1- SETBACKS: FRq,NT (/ / ~SIQ( FA~.ING STEEET (FROM elL) INT. SIDE YARD..5 (RE~,R.4S I' (..E,ROM Pill'
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LANE COUNTY DEPARTMENT OF ENVIRONMENTAL I'tANAGEMENT, 125 EAST 8TH AVE., EUGENE, OREGON 97401 PHONE: 687-4394
POST THIS PERMIT ON MAIN BUILDING AT SITE
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C55-13
BLDG, PERMIT - WHITE; BUILDING - GREEN; PLUMBING - CANARY; 5ANIT~TION - GOLDENROD; OFFICE COPY - WHITE
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SITE: I NS~Ec:r I O/-
ApPR9vED I.'!"I DISAPPROVED
REM,,~KS'
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F:OlJNDATI'ON INSPECTION
ApPROVED I
I DISAPPROVED I
REMA~KS!
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FRAM.lNG INSPECTION,
ApPROVED I : I' 0 I SAPPROVED ' I
REMARKS
LA TH OR' $HEETROCK I NSPECT I ON
ApPRPVED .I
I DISAPPROVED .I
REMARKS
FINAL I NSPE'C:rV ,
APPR'OVED," ~I DISAPPROVED
RE'MA'RK,S
CERTIFicATE,OFOCCUPANCY
READY TO ISSUE, j
/ I DATE/2~1e/-75l- INSPECTO~
/ DATE
INSPECTOR
/ DATE
INSPECTOR
/ DATE
!'NSPECTOR
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Dm/2~!.:I-1-.7<N""TO' ~'
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REMARKS
/ NOT READY TO ISSUE ! ,,/~ DATE
INSPECTOR
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D~, ,~'iption:
BEGINNING at a point on the \'Jest., line of the Jacob Halstead
Doniltion Lund ,Clniin No. <17, ih Township 17 South, Hanqe 3 West
of the l,,'Jillamctte ~1(~ri()ian, 123S.3 I"~i?t Sooth of the v/(>st
'2?O', Nod,h':/0st'GOmer t,l1(~reor'; thence South 'A90 50' r::~:-;t 192.3 feet;
thence Nor.th r'~lrdUel to the West line of ,said ClAim: 189.7 feet;
thence North 890 SO' West, 192.3 feet; thence South 189.7 feet I
,. alonq the West, line of said Claim to the Point of Beginning, in' \
Lane C~nty" Oregon. '
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I, John Laurila, Jr., registered engin'eet, certify that I,
have surveyed and marked the corners of the above described'
property and find said property as shown above with buildings' \1
tbereon, located as shown, ,and I find no 'part of any building
encroq,ched on the adjacent property nor does any pa,rt 'of any
building on theadjacent'propertyencroachoo,the above described,
property 0 · '
First, National Bank of -Oregon; Mortgage,
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Leona A. Clark
2161 Laura Street
Springfie1d,Oregon
July 30, 1970
'V\(ESTERN E, ~GINEERING 'CONSULTANTS
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1445 WILLAMETTE ST./ EUGENE. OREGON 97401/503/342-2141
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