HomeMy WebLinkAboutPermit Building 1976-12-7
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JOB LOCATION
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LANE COUNTY PERMIT
Acreage or Lot Si7<> I/~.J C(.<:A',(~.~
Contractor's O.S. #
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APPLICANT'S NAME AND ADDRESS 7J..Z<v.:J e: jlalA,'.tL.". ;tlt'lS-:
OWNER'S NAME AND ADDRESS_S"{;t;."n.(j~f!".,.r.'
CONTRACTOR'S NAME AND ADDRESS
Mail permit to C>)'tApplicant ( ) Owner
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Subdivision ...j""J-ijf.M'..,r.,A- /r.",/';;'~..".1":f>~ -ttL-
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Phone 7'l7"'" 319,::;L
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'TRUCTURJS NOW ON THE PROPERTY
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(owner, etc.) when ready.
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THIS PERMIT IS FOR.I'J!<~t;c::...~~..
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,t.~.tf;'4;'iw# Nl; /""",t,,,.'fAl'S # BEDROOMS .,~ # PLUMBING CONNECTIONS
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SEWAGE DISPOSAl "_/..-.:,Li!'....~~.'/:,i'""'" .:~,*" ~-' _ S.1. #
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THIS PROPERTY IS WITHIN ONE MI LE OF THE CITY OF"
PLUMBING BY
:i I hereby certify that the above statements are true and accurate, and that I have the following legal interest in the property: X owner of record; .
contract purchaser; potential buyer; realtor or agent. I further certify that (if not th,€! 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 comP1Y with allapplica~.le,",<1?des relating to this permit.
Fee Paid $ '~J:":::J '7 , Signature f/ t'</--", .- . ~"I..i:..i;t.,. Date 1;;J..~. .;J~..<7t5...
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) NEW ADDRESS
SANITATION
) FACILITY PERMIT TO TRANSPORTATION DEPT.
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) SPECIAL PMT. AREA. MIN. ELEVATION:
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Minimum Septic Tank Capacity (Gallons)
Drainfield Required. Lineal Feet
Maximum Depth
BUILDING
Type of Construction Group
Use Classification -
Fire Zone
Comments:
Comments:
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. B'I;:~.:;~.'''' , f" ~. Date:,' .." By: . -at /:. ./ ~..",u."...:~~",,1,1 L6!.J" '\';'/Ji}1.f.. Date:,.f"":.'." ..~ 1"" ""-"""'1"$:.....
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P'liXNNINGREQUIREMENTSSATISFIED. By:, Date:. f' / Date Issued: /-;),-7-71_
ZONE: />1- .Ii} il SETBACKS: FRONT tJ.::..{- SIDE FACING STREET -- (FROM CIL) INT. SIDE YARD 5" REAR .5' (FROM P/U
LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE., EUGENE, OREGON 97401 PHONE: 687-4394
POST THIS PERMIT ON MAIN BUILDING AT SITE
C55.13
. BLDG. PERMIT - WHITE; BUILDING - GREEN; PLUMBING - CANARY; SANITATION - GOLDENROD; OFFICE COpy ~ WHITE
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