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HomeMy WebLinkAboutPermit Plumbing 1976-8-31 o OIlNER '../ 'Whme f'7l CONTRACTOR (f/-e tll/JOl/la. /.....* Name O.S. REG. 0 ~ l'wp. 17 Range () ~ ~~N f\ NOTE: NO PERMI&aE ISSUED UNTIL THIS APPLI.&S . / APPLICATION FOR: CONSTRUCTION ~ MOBILE HOME 0 PLAN REVIEW 0 CHANGE OF OCCUPANCY L=:J Citrrlt 6Jnnellv '678 ildI(J~118t.J(J, S.Pt/mh-R/J. 7.2~-7/S"'<) -J . Address" City ~ I Zip Phone Red:> Co 2 S Ocd~~.eUI /lldll ~/a. 57V1J/ j>VJ;. Y rY7 ./ Address V City 1 Zip ~ . \~ PERMIT /;d \S d ~~1 BEEN APPROVED Phone Section 2. S 'Lf.l( Tax Lot 2.. 000 Code t\ \ c...-Q--\ Censua Tract Subdivisi~.. .... ~.. Lot Block ACCESS TO PROPERTY (Road Name)_N(l.9t!~tT {3rlgt ~ ( Existing Structures on Property: ~ /~ c e...-. - hCUJ -e / Property Location - Address/Directiona: I tJ 7 fI' N-zr'f )~14 ~k,I2J.. ,I I ~1 tlrJ ('j IV 0 di Ll 0 , J E (1-r.,1-e-..5. I" Lol ~ 8/t;.r;,k .,7 I Below for Office Use OnlvXXXXXXXXXXXXX:XXXXXXXXXXXXXXXxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxyVVVVYxxxxxxxxxxxxxxxx \ Sq. Ft. / flBedrooms I tl ~ Aa~~a tion ~ Q)' ~_~~,"T:r'" ,~.. .;:)p,X ~\ ~'P~\Cl.i")\~.- \..-tl-\l,.,\",- ~.pA.~ ME'\;)~c,~ & ~"-'\.,.'" j I ~':-J"f 'E'){'S.-\'y,.G~" ',\~."",.. I SEWAGE DISPOSAL: \r'-,. ('0, -....) ~ I Site Inspection fI , ," Existing Sewage Disposal System c=J , Pub lie C:::1J Community eLl I ~.~~~~:~ by Owner c.=Jl Other c.=J Name ~UMBING FEES: ~~U of FixtjU es Sewage I Connection /' I dzf CASH\~ c.=J mECK I Property Acreage Width______Depth or New System Required c.=J WATER SI1(R-Y~ Well ~~~pring Other Name of Community or Public System FEES: Bldg. Plumbing 3% Surcharge' ~';>.~ Q. ",0 \. E\3 Water Connection Waste Disp. Plan Review TOTAL ~n -.:J. 53 PLANS ~ED FACILITY PERM:T~ MYES c=J NO c=J YES 9(;NO Signature of APPr;:t: ""'tiu 1i"1/;J.j:J~1Q!j (; Fee Received By: Y"'V'"'v.,- _ \ Date: ~Z.f' 7' Mobile Home Min. Septic Tank Capacity Draibfield( Required - Lineal Feet Maximum Depth -.oc d^,7~J.- _at./fY'J~ .d.;~r~r"Z .,In-'';..I..<~..O!'''- f4~ 'i?-'...'.d;; J/j ~ 4/J"...AJ ~1 /vJ;-=.~' \ / Type of Construction ~~ Group :I Fire Zone :::r ....., Use ClasSification~. BIdg Setbacks - from Center of Road Right of Way: Front Side Int. Side Exterior Rear Zone C55-12 SANITAJr~:d 1YJ ctG, AAI_ ~ J LANE COUNTY DE"~1MENT OF , PlANNING: DATE: g'2 7..~!: r:.#ABUI'!ZY~J ENVIRONMEN~ MANAGEMENT . DATE: 5f7~//> ~