HomeMy WebLinkAboutPermit Mechanical 1985-8-21
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Lane County Authorization for:
INSTALL WOODSTOVE INSERT
FOR OFFICE USE ONLY
Application/ ~~~~~~
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~J :,iJside.ntial Dlndustr'ial
l 0 CGlh..'7Iercial D Public.
BLOCK
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2580 Harvest Ln., Springfield
S:::"JC:';'"?.ES C:JR.l:\E~TL,{ O1J PROPERTY
97477
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1-5 to 5th - 5th to Q - Q to Hayden Bridge - Hayden Bridge to Harvest
:<::'sCRIP7:Oil C?' PROPOSW ~ORl< - 3C S?EClrIC
Install woodstove insert in fireplace
DECLARED S VALUE
r 0? $7+ I' OF ;;~~-RI /1-
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Frank & Patricia DiCarlo,
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TELEPHO~E NU:1BER
747 4294
2580 Harvest Ln., Springfield, Or, 97477
C'::.T,,-;C:OR'S ,JANE ';::0 OSR. if
TELEPHQtlE NUi1BER
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?':;:::';.lII ':J .3~ :-l.JULED TO (l.;";.iE i....~D ADDF,zSS)
owner
TELE:PHQNE N"J;>lBER
I HAVE CAREFULLY i:/{AMINED THE C0l1PLETED APPLIC1\TION VOR PERHIT, <I./,j do l1crcbv '~..c~;f~' th..lt ~ll ~JlionnatiOll hereon is true and correct, and that I!
~ave the fol10....ing legal interest in the property: [i]cwner of record; OCvtlcrd';~ pllcchast<c;O;authorized agent with evidC!nC'c of authority attached. i
I f:.rther certify thdt. any and all work p~rf:)rmed shall be dOne in .;<';l.:U~J..l:1<;" Id t!l tb~ (j::dlllilnce~ of Lane County and the Laws of the State of Oregon !
rcrt,:nning to the ....ork described herein, and that NO OCCUPANCY will be ;:lado of '1r.,' st,rllctUJ:e without the pCl7.'.ission of the Building ~ivision. I fur- ;
thee certify that registrat.ion with the Builder's Board is in full for-ell ;m..\ effect <15 re'iuired by OKS 701.055, that if exempt the basis for exemption!
~:~~:~Lia;::~Y'" who 7l~~~~~Wi~h O~L~:;;:;d on thi, proj,ct. I :~~ :::D I
, :;'',.''I.E (please print) SIGlli\7URE or,roE i
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RSr\D TiUS SECTION CAREFULLY. YOUR AUTHORIZATION ~iAS BEEN BASED ON THE FOLLmnNG CONDITIONS:
o PL.;:,NI;~G/ZO:HNG:
Zone
parti tion
Parcel #
Parcel Size
l'lininu.'n Setb<1cks:
C
L, front
CL, side
intericlr
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No special planning required.
Date:
8-20-85
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Installation
Re.cord IssuC!d? 0 Yes 0 No
!1aximum Depth
0: Trenches
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Inst.allat.ion
S;:cci f ica.tions:
Gallon
Tan_Ie
Li :'l<':<..ll !-".~c t
..: !'!."Iir:ti,_ld
CO:.~.lE!:TS :
~L.;"S EXAJ-:r"~TION, 1'/po -
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LANE COUNTY DEPARTMENT OF PUBLIC WORKS LAND MANAGEMENT DIVISION. 667-4061.
.5 EAST 6TH AVENUE. EUGENE. OREGO.401
SEE REVERSE FOR "INSPECTION INFORMATION
C 14-25
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ACTIVITY INFORMATION SHEET
klne counry
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COMPLETE THIS SECTION. INCOMPLETE FORMS WILL BE REJECTED!
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- 1PERSDN MAKI~G REQUEST
(I'l~)
~S!k.> 4A/l..YE56 LANe
MAILING ADDRESS
.#..e.-~fl~/G> to.e. 9 7~ 77
rITY STATE ZIP CODE
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HOME TELEPHONE #
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PROPERTY OWNER
5)J 4? C
MAILING ADDRESS
CITY
STATE
ZIP CODE
BUSINESS TELEPHONE #
BUSINESS TELEPHONE #
HOME TELEPHONE #
2 PROPERTY ADDRESS
(IF DIFFERENT FROM MAILING ADDRESS)
3 MAP & PARCEL NUMBER (from tax maps in Department of Assessment and Taxation
(REQUIRED INFORMATION) or from tax statement)
_ /7 _ 0 ~ 23"tj,'-j. t/oo.
TOWNSHIP RANGE SECTION TAX LOT(S) OR PARCEL # ZONING
TOWNSHIP RANGE SECTION
TAX LOT(S) UK PARCEL # ZONING
TOWNSHIP RANGE SECTION
TAX LOT(S) OR PARCEL # ZONING
ACRES
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP:
4 SUBDIVISION (if applicable)
5 REQUEST (state exactly what you plan to do) ,I~~~A~
LOT BLOCK
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6 DIRECTIONS TO SITE:..z::s ~~_~-.u.~ t9 - a ~ -,0q1/JE..4) 1J,e//J.~ r,
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** FOR STAFF USE ONLY **
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NUMBER
DATE
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ZONE/LAND USE:
BY: DATE:
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TIME IN:
OUT:
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LAND MANAGEMENT DIVISION / 125 E. 8th ^VE., EUGENE, OR 97401 / 687-4061
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LANE COUNTY DEPT ENV MGT RECEIPT 0 ?'~'7'lR~ Rf"l'F Aa?0RS
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TlO 1703234400400 SUBDIY ,LOT BlK
NEW BLDG TYPE USE R DDRMS 0 UNITS 001 STORIES OBLDGS 001 PHONE 747 4294
. OWNEf( Nt1E DICARLO, f"r~mICI'A (iDDF; 2580 HAj,YEST l.N., SpfnNGFIElD, OF\EGO.
CODE AppL NO ACTION DESCRIPTION SQ FT UNIT COST VALUATION' FEE. DAY~
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4.75
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EST. COMPLETiON DATE
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