HomeMy WebLinkAboutPermit Building 1974-1-10
I
LANE COUNTY B.ING PERMIT OR MOBILE HOME. APPLICATION t I
PERMIT TYPE - BUILDING'rst MOBILE HOME OOSC REG, # PERMIT:#: ~ <6 -7 ,
PROPERTY OWNER ph II \ .I 6AILlNG ADDRESS W" P~E
CO~~~~~VI) i --LF -M~eN~ADDR'S~~ th~h ISr ~d., , 7.Ho~-t270
II 1/
PRj.h y:;;~N - t;UDE/(J OFFlC~ f
PROPERTY LEGAL DESCRIPTION
LOT - BLOCK - SUBDIV.
TWP RANGE
II .--:<,
Oebr~
On've- .
In.
&pr1~'e/~ES & BOUNDS 0 YES
ATTACHED 0 NO
SE'7 /
Q.. (Q . I,
TAX LOl #
lOb
CODE
t)1 q-on
DE RIBE EXISTING STRUCTURES ON PROPERTY IF ANY
CENSUS TRACT
APPLICANT
NAME
AND Co.. YV\-e..-
MAILING
ADDRESS
FOR MOBILE HOME PERMIT ONLY
Number of Bedrooms
ST~CTURES\ TO BEt BJlILT TH1S/PERMITO I (,
I+[] H C u 'Ii! rt.I rl"l Y - i-rlnn €-
Connect to Existing
TYPE CONSTRUCTION
~
ae-
LiGALFklv;;;~ERTYtrD. ,~OR ~O iY 66)
PROPERTY sln??< 27 5 At/ Olle.-
I
Sewage
System 0
SQ, FT,
/~o
or New System Req. 0
# BEDROOMS VALUATION
/0.-
BLDG.
WASTE OIS.
PLUMBING
PLAN REVIEW
PARK lRLR.
.
SEPTIC TANK 0
10.-
FEES
OTHER 0
WATER SUPPLY
PLUMBING INSTALLED BY
OWNER 0 OTHER 0 NAME
PLANS FURNISHED
FACILITY PERMIT
SEWAGE DISPOSAL
PUBLIC 0
TOTAL
10.--
CASH 0 pER
CHECK t?'CONNECTlON FEE
PUBLIC WATER
CONNECTION FEE
YES 0 NO 0 YES 0
SIGNATURE OF APPllCANt~
~;n<;::(.
~RECrfbw&L
PERMIT #,
r#-5?-7~
COUNTY BUILDING & SANITATION SPECIFICAt~ONS /'
DRAIN FiElD REQUIRED \ /
lIN. FT. TRENCH WIDTH FT, OR SQU~E FEET
~ 1:7"", mr..s-J Ov-{?Y' SJ::JS?: /
/
_ FIXTURES
DATE
1-IO-7~
DATE
1-10-7'+
PUBLIC 0
PLUMBING FEES
OTHER
NO 0
."
~
MIN. SEPTIC TANK CAPACITY
WITH DIST. BOX: GAl.
PIA + nO J00fl.-J
I
oP
TYPE OF STRUCTURE
SN
\'~EAR YARD
PUBLIC UTll. EASEMENT
OCCU~Y
~
BLDG. SETBACKS - FT. FROM CTR. OF ROAD RIGHT OF WAY
FRONT Y S- SIDE INT. ~ SIDE EXT. Y c
Jwn::o. ;-fL/-7Lt,e P~
Directions to Find Property:
ZONE
Date
~ CLA~IC~ A /J.
REAR S- J /'~ I./~I
BLDG'lPNSP. ~f I'/#' 1_ /
, 'lL/-/6 -1J-.
/; I -
Date
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COPY 1 - OFFICE
COPY 2 - JOURNAL
COpy 3 - AUDIT
Farm # C55-IZ