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HomeMy WebLinkAboutPermit Building 1976-7-26 ...~ ' '. I .. . ,f '. ~ --~.., '. ,".-"-" :~ " " ' ." . " . . ~;, -~ '-', f'f1.. . ",.1 ;.:;, ,:' ~\i'i < ~ , ;........ ~ CLANE COUNTY:~ERMIT FOR:" , . . . ,,,r-'\ U PE"RMIT NO, 1830-76 y . ,J,' tCONSTRUCTION [X] MOBILE HOME [] PLAN REVIEW [ ] CHANGE OF OCCUPANCY [ ,] ;0 Owner M'i111am A. ' RB;nvil1p NAME 'he)2 Mannr nY'. ADDRESS SDV'inafipld.OY'.,Q7477 741-11309 CITY' ZIP COpE' PHONE ,'.'0 Contractor NAME ADD R ESS CITY, ZIP CODE ~HONE ."p.S.Reg. # Twp 17' Range n~ Section ?~L::L ~ Tax Lot 1 linn Code: 1 Q.l'l'.l , CenslJs Tract , Subdivision Lot B,Iock , Acr,eagp , Width Access to Property (Road Name):M"'nn~V'nlt'h,p Depth E:xisting Structures on Property" , ' .::':'Ho~use'g_- "'qaraqe :" c. _J'" '-",. , pirecti,ons to Property - Add'ress: 2592 Manor Or. '~ STRU,CTLJRE (# BEDROOMS). SQ, FT. -.'Arlrli+inn 400 @16.10 'Stud.!?, storeroom,stainia.v to upstairs bedroom which ,will be enlaraed. VALUATION 6440. , ...."';':~~ "SEWAGE DISPOSAL: PUBLlC,[] SEPTICTANK [ OTHER [ r PLUMBING I NSIALLEb E3Y: OWNER ,[] OTHER [ ] ,NAMF WATER SUPPLY: PROPOSED ,[ ] , 'E~fSri,NG [] [ ] PUBLIC [ ] COMMUNITY-NAME: [ ] PR,IVATE WELL [] OTHER - SPECIFY:; BUILDING PLUMBING 3% SURCHARGF MOBILE HOME' WASTE DISPOSAl " PLAN REVIEW Lln.on h.on '_~A TOTAL 47_::lR' CONSTRUCTION PERMITS & INSPECTIONS AND WATER POL,LUTlONCONTROL SPECIFICATI:ONS MIN,SEPTIC TANK CAPACITY:, , GALS, MIN, DRAINflELD L1N, FT, , if ...'h~~.;~-f~,~~1 ~~0~~'~ ~!'!C'~.! ~!'!y ,~~~!:'!~ ~f '?~~~~~~ '" n^......'.,......';..~,..._ .e.~L_;... -",," ~_..l ...,..- -..-...-..... ""-ran':a~~drl' . ........'!"........, "'VlI~"'" ~~ ........''''"''1.. ""....'" ~.n... """1"r.o.;,~~J'~"'~UI . -.- - --. --. MAX. TR~NCH:OEPTH INCHES 'TYPE OF CONSTR'UCTlO.N ,i::M GROUp:,T FIRFZONF STAY 100' FROM ALL WELLS USECLASSIF., SETBAcKS. FT. FROMCTR, OF r!W:, FRONT 8.1; SIDE EXT, , -' . ' . , FT. EROMPROP; LINE> 'SIDE INT. h' ".,REA,R fi , '. ZONF RA' , "'. :',/ ci 'AUTHORIZED SIGNATURES: Is/J.E. BOSSq BY. C. ,HARPAUGH J.MCKAY FOR GRAY~Sahitarfan ISSUAN'CE'DATE: 7-26...76' . -ih. ", " SLOG, PERMIT - WHITE OFFICE coPY - WHITE: COUNTY TAX - PINK , PLUMBING - CANARY BUILDING ~ GREEN , SANITATION - GOLDENROD IMPORTANT: Call'687~4065 to sche'dule all re.quired constructjo~ 'inspections, Call 687-4061 to schedule all required ,septic system inspections, All construction shall comply, with the State Buidling'Code, D,E,Q, standards' for sUbsurface sewage disposal and, th'e State Plumbing Code, All buildings require' a certificate of' occupancY,before being occupied,' ' ' C.SS-13 ,(See Details on Reverse Side) '\ (POST"THIS PERMIT ON 'MAIN BLDG"AT SITE) 'LANE COUNTY, DEPLOF ENVIRONMENTAL MANAGEME~H Cb,URTHOUSE ANNEX: 135 EAST 6th, EUGENS, OFlE.GON97401" . .: -.' " . ". . .. > ' . .' '.' -. .. ":~" ;; '. .': " . . L " BuIiDI~ SITE EVALUATlDN'5~ ..... . ){ . BU ILDING PERMIT AP~i.ICATlDNc,ND. '/.I':3D ....7~. () S,lTE INSPECTION" PLANNING OJ-VISION , "Not , . , Applicable 1.' Zoning,.Qrdinance Compliance: 'Zone:' ~ /J ( ) 2. Subd i vis ion 0 rd i nance Comp 1 iance ,/ ./v-,( ) 3~' ,Requi red Acce~s ( ) 4. Building'Site (Area, Widt~,~roni~ge) () 5. Ot~er :(see comments) ( ) COMMENTS,: . PLANNING DIVISIONAC'tfoN::PENOING':"YES(") , NO( , ]' cAppFicA'rloN# ButLDING 'INSPECTION'DIVISION Not' App 1 icab 1 e ( ) , ,(!>', ( ) .' ( ) , 7. Plans Submitted 8. Soil Stability (footings) 9. Flood Plain " 10. Other (see comments). COMMENTS: WATER POLUTION CONTROL, Not App 1 i cab 1'e ( ) ( ) 11. Meets Department of Environmental' Qual ity Stand~rds., 12. Other' (see comments) COMMENTS: No . Yes,' r)'(M. . (-)/{ H ( ), (J" ( ) (J , CK'D eft~'1-1:.-~ -'1 iP )' , DATE r\,~ev' .'( .')( );, . CK'D BY: ~,.,' ~ 1-2-/~lb (j. ,0 DATE' TO APPL I C.ANT : rYi)/'~~C:~i~~i~~P~b~~~'~ Inspection: . '1/ - '()P)' Cannotbeappr,oved at 'this time as indica.tedqnitem NO. above. , :?:>..., '. ,Questions and further information on 'items '1 throu'gh 6 contact the'LANE:.. ~' ,:,' ,COUNTY PLANNINGOIVJSION. Questions and further, informatio,n on items 7 I) ) " ' through 12 contact the LANE COUNTY BUILDING' AND SANITATION DIVISION'.. ( )W.i.'ll.be held, in this office until you:can resolve the problems indicated~ ' '() .'Is being returned. .. ' , ' ,'. " " "'. ( ) Your buiJ d i n9 perm i tC!.E'Pl ic~.!.L2!l_.;~.~..:l~.!?ei nq return~d under _seoarate cover" DEPARTMENT OFENV I RONMENTAl 'MANAGEMENr" " , 135 Sixth Avenue East Eugene' Oregon: 97401 PHONE: 687-4065 ' LA~E COUNTY PLANNING DIVISION PHONE:'687-4186 C55-28 ; ;. ~' . ",;' ,<', .-'. LANE 'COUNTY,ENVlRONMENTA.... .1ANAGEMENT PLOT PLAN ~ame an.d 'Ad~'resk "~~:'OW~er2J/l'-l'~~' A.' R;")J~Julk&:.. ;;2.CyY:2-- )14A.ft~:>1? DJ?/dE" .'" , ~,pteljtIG,FlELt); '. ~~ ' "", ,!,elephone: -74>, 0~5cYjl" The b!Jilding. beihg' ~,bp.structed under, thisp,e~~it,.w:~ll"h~ tisedfor " ' '..". - 'I, ",., ", A:::1.A;7o~J - 701 ' " t::;x rr;"/J<! ~ 110Mb.. 'Date this property, was purchased 'C)Ep'i'lEh-d3t=;rt: ii.,,' /'7>(:' ,~ 0 . _' \ ' . it ~ Do you'now,ordt'a,:youever,own pr'op,eiity,aqjacent ~t9t.his' tax lot?' 'Uso, please list those tax ~lot nuInbers or draw those:.pr'operties'on the'plo~ plan,belot,i. "))0 . , ,;\.,. " , " , - :r.' ' , ., . ,~~r~~~~~1~~~f:~.~~t~::~;~~-~~-~~~.~~~~;iif~r:n;= ~~~.~.~~m~~;~~o~=o;=:~.~., , , \ . . , . . ~~~I~'., :_~~~~~~~~~i(~~ ~~l;~ ~:~.~ }.~ ;~==;~.:::~~;~.:. ~~:. ~ .:::: =~~ ~:. --'F-:::--~- .~ -..,__..__~.._._,u,_,_'~__.__~_~_,_:-~___,~ . ,-' '~ .---/. -~==::: uf.:: = > - c:: '= : ~,::~.~::: ~::;:- :__~,::' . = =: 'H=: - \ r" - -:- - - - ~ -A~ tr ~ llT-:: '" - - - - - - -: - - ~- - - - - - -c: ~ -c: - -:- -:- - -'... · -:- - . ".-- - . , jq - -. - .--- ,.::-: --: -~ ~('.:'-- tv' '/~l " It -'r -- -- .. - '--. - -- "'--, u__ .-,-.,,,- "_'H ',.,.. -. '.. .... 1"-' _,-:I{JS,IZ -,: :, '~~rft- -\\j -. --..~ - .- - -- --. ...-:-- .. - Uj-' , .. : ,=t :" :;' · n,7 i? V 2 Of,,, D -l ill": ;: ::_,:: ::,,". ~' ,". '. ..... . .... '..,.' - ~ 'TW _~~F_i '~~~.'("~'" L't ',,' '" tft,.'t -., .~- - -- ---. :1' - =-1:1. ,/~:'~:: ~=~ ,..~~~-- i:l'~I",' , ," ",! l': ;,-',. L' - ___=- ~ =-_:~. . ~,~' - ~~~~~~~~~~~~ ~- ---==,~==~~ ~.,H~~___. ",+ h.1 . f.?:-;Ji(,', ~ . ,E~..e,<.:...:. ~" CdvL" " ~) :ST ,,_ _ m_ .. __ _. ~ ~' . ~ [(, u:, :~ ,~~ ,;: ~ ~ 1_ ' n. ,:~~~-. ~it~ I~=l_ ... ... ...._~-_:~~';-f~~.~E~~~~~i==::~:~~=~~~ . r~~~i ~i;, 'j-d ','/, ' ,,:,," ,! ',I ,I" ' I(t.. " ,..,'" ~W'-/?"-, ',.. "r(:,,'\(;}.....'!)),b{;..' ,I' , f.'" ::; /0") c= 1...,>>, I ./ n', _ , , " , ' , . C~JcLc,5(;:;, t~;/~17~, c _,;y;.~7(), ' , ,I.-~J~ tl'-'vv'((;r: l:::;'(I.5 r;r'(~ ,'I "," " \1. - r: ' , --I,' --- -,.- -'=- -- -- - '- -: _L ~~(~/1 - Q:!/5f -- ,-r~~~t). ~'--4~-~ Name of Applicant (if" &Uferent from owner):'"5,AJ{(bi Address ' , . Telephone Applicant's lnte'rest:' BuyerD' "..... ,-"" Seller 0' 1\:ge~tU Map Tax :Lot Permit II If? /8"30-7(, C74..;99 " , t, INSTALLER: Complete top part JPOSED SEWAGE ,DIS~OSAL SYSTEM RE D of form to signature and submit both , 'I ' ' " PROPE~TV ADDRESS '", INSTALLER'S NAME , ' , A/a ., k -e! : 'l&.fa cA'" Nq.~Living Units Bedrooms , ,. .' , '. ~op i es wi th app 1 i cat i o,i-.~: :'lv';" PERMIT NO. ~2:3;&JS .~. . I-l""y J:\A Baths' Basement , Water, Supp ly Yes, No 'Public' Other-List , ,I", ;,ConcretelVl No. Compartments , l0- I ' '.,Tile Disposal Field' . 'DePth.4.1~ltDi~tribution Box:~~ ,,' Otlie,r DTstribution~'e r ' , , Feet from wEll 1 , 'j /"7-r Lot Li n'e. . Fr6nt Tota 1 Sq. "I' Ft. IBetween ' Ft. Li nes !:(J , (l~(~/I Sept i c Tank:, Ft. from well Steel 0 I I' , 1, .J~ Ins,i de D imens ions:, FL ' Len~-~t(Width .6-'1 Diameter OWNER ' " , NAME' Russ~ll E: Dav"ie G<:?l. Capacity !&?-P-tf . fJ-01f;/ ' ,j:/ (/ /' . ' , No '~~ r~~ l?e>-/ eL MAILING 474 Brookside . ADDRESS Eugene,' Or.; , 97405 Foundat ion' Length of Lines~t,~f T~ench, 1. 2.. 3. 4. {SJ/6. Width;! Plot Plan (see rnstrucdons) ::., Side Rear ' Filler, ' Fi ller Depth Fi ller Below Tvpe /?;t:J Above Tile~1n, Tile (....in. ., . I. ! . r~ . }1(' I R' EC' f'lVE[)- 'jy ...-.---',... -'''_h'', Cf4' Pt- 7>,/" ,- --- 'j' [J,r;"" , AUG'261976 - '8'~- I .. _, :. 'f' ~..I; .~. - ~:":"--~ LANE COUNTY g~VJ~ONMENTAL M~MT. ' I , 0 /: / ~I _I ~~ ,,:Pe*f: , ...., 1 r.:r 'I ' '," , 'I' 4-1...-' , "pe,. /"', ,.,'-'", I ...' se/r~ 1'.;9, ." r I~t/I< " 'qt.., I pe~p I" /1/ If V/ Y ~--q} , '. 'If. A J . " Siqnature /Xfl~ fi:d'~,nf CERTlF.ICATE OF SATISFACTORY COMPLEilON,~-' '" ,/ " e, '1......r-?/ For Sanitarian Use Only: ' Date: l r-../ ,tdq In accordance w'ith 1973 Oregon Laws Chaptel7 835, Section 214 this certificate is ,issued " as ev~denc~f'sa't'i,sfactory comPlet,ionOf a,su~surf;'H:~ sewage disposal system at t,he above locatl'oy , " ' , ' ',IV l Approved: 'Systein Instailationconforms to 'Current""standards I I Disapproved: Does not conform to currt;'i'lt standard~, " ' Remarks: Date ''(i - '1-. ""-,-7 ~ .... f< ~ 11~'i?\, L ~ /~ ' an f\tJ 'J: / ' ' , 2 to (' ">~r-o"~"'}4~14 ~' . -~\~n's Signature " ' '~E COUNTY STATE: OF OREGON 'DEPARTMENT OF ,ENV I RONMENTAL QUAL'ITY "I ' '," .C55-11 -- ":",. -,'- ......'>< . ..-.'..j-....,-... ....., ....' ~ .......- -...\-.. ~.. ''', .: '- - ('.. '~~C;-/ ANE COUNTY PERMIT FOR: ~~-..: - ".. r-_- '<....,,( r j"~"';'~')':" . I ~ .' ,~' V' i.;(:~ . " '~) -12. '~"i> c.. t Po?YJI'C'dS yJ , CONSTRuQ;;:Ni*1 MOBILEHO~E [ .._~ ~ ...."'" lJ'~~' t;')m~>>fi> ADDRESS l' , /PERMIT NO, la.~O"'li t-i.:J-B PLAN REVIEW CHANGE OF OCCUPANCY [ ] o Owner M~11~~m A~ ~rr~~~~l~~ NAME ~_ _ ~~~immqirol~_ ~_ ~'~17 CITY ZIP CODE 1a.,...a;~nCl , PHONE h Contractor NAME ADDRESS CITY, ZIP CODE PHONE O,S. Reg. # ' 'Jwr 'il1 Range (}~ Section '~:~"9f; Tax Lot ~~M" Codp 'H~""n'la Census Tract Subdivisio.n Lot B locI< Acreage Width " \, Access to Property (Road Name): o.1.lllillli'lli'1fl" flt"1 ~,~ Depth Existing Structures on Property: . House fl' r~lN,M1~ Directions to Property ~ Address: ,259f ~oor [W' ~ STR'UCTURE (# BEDROOMS), SQ, FT. ", fAAd1.HR~fIIlln 4100 @~Se 10 Stm31I?$ SWl"Crellfilil ~ia~~ ~@P:St.tJiV"~ bod~1iJ t'8IMo~ wnl OOGf1~nl?Q~.. VALUATION ~~O. SEWAGE, [),ISPOSAL: PUBLIC [r SEPTIC TANK [] OTHER [ ] ,BUILDING 18JLOO ,/ PLUMB ING ~Lfl-n ~S3%SURCHARGE 'L~ MOBILE HOME ......v>-. . WASTE DISPOSAl PLAN REVIEW PLUMBING INSTALLED BY: OWNER [] OTHER [] NAME WATER SUPPLY: P.ROPOSED [ ] EXISTING [] [ ] PUBLIC [ ]COMMUNI;ry: NAME: [ ] PR IVATE WELL ,[] OTHER-SPECIFY: t' TOTAL (!1 ~ 1tq ~.,,"::" - ~ \ ..) .,;""" )....,~... .--......_~-:! ....." CON,STRUCTLO,N'PERMITS &INSPECTIONSANO WATER POLLUTION CONTROL SPECIFICATIO!\l$" \';" MIN,SEPTICTANK'CAPACITY:"" " :i\' ",::.'\' ~.....J "":.,l.~~j GALS, MIN, DRAINFIELD ,I ,IN., FT, MAX. TR~NCH DEPTH INCHES'\ 'ir1. (,!T?I."t~6V~i()leJ ~iil10&A'Rn n2>~A'kf t\li'lV ~4tm~ rl!il'lll '~ti.a'lllil'''''''' .~ ,,,,,,,,,,,,,,,<it'> ;.m."'~' !I.."" (~",n.",,_ "''''~'''''Adl 0/\>"'.... ,.,...r\.6~~ ir"1('"'",~i~~~ _-0. -'~'CI. --v--""--- t--'...-"'-_.......r-.:-.~.~:~- '..,~~_~- -'-Jl'.....v.\I 'l:l'.'W~\;Jo....J#~ ~1\rV Vii/l4.1Il;'lo.:,l'lH ..... )J \ 'oj , , TYPE OF CONSTRUCTION ~t;,\1 GROUP Y FIRE ZONF STAY 100' FROM ALL WELLS' U~E CL~SSIF. SETBACKS. FT, FROM CTR, OF r!W: 'FRONT 0 tlf5 SIDE EXT. ..'" FT. FROM PROP. LINE: SIDE INT. S REAR!5 ZONF PJi AUTHORIZED SIGNATURES: /s/, JoE.. OO$~Ll $l\ C" !1AutftwGW Joft~ttfl~y ffJ~ ~y II $a!JDitnr~a8 ISSUANCE DATE: '1",2'",:P{) jt1 BLDG, PERMIT - WHITE OFFICE COpy - WenTE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENROD , , IMPORTANT: ... ." Call 687-4065 to schedule all required construction inspections, Call 687:4061 to schedule all required septic system inspections, All construction shall comply with the State Buidling Code, D,E,Q, standards , for' subsurface sewage disposal and ',the State Plumbing Code..,AII buildings require a certificate of. occupancy before bei ng occupied, (See Details'on Reverse Side) C55.13 LANE COUNTY, DEPT, OF ENVIRONMENTAtMANAGEMENT COURTHOUSE ANNEX, 135 EAST 6th, EUGENE, OREGON 97401 \ . (POST THIS PERMIT ON MAIN BLDG. AT SITE) J. ,'l.rt' ,-", .. '--...;,J" ~,/ ~ "/'~ ,',~,,~,:~v:~~M;IN:'::':~:~';'}~~PROVED' ~7f '. '-'~ .,' , -< ,- '. " " '-REMARKS , "_'r. t . FINAL GAS PIP I NG ' ';f. ' <".,- ,"_ "::,o,... f .lr r 'Ij, ~ "". ... ';'>;\, ." ~' ~'_ .17,~ ~ ~~'~ .. . .~~. ' .T' "\ ~"'. '. ;( ~;../." '1" , ' " , INSPECTOR , '1: INSPECTOR, ' INS'PECTOR, 1_ ~ INSPECTOR " ' ,. ,i, ,<4,?;~~,rf. ",' C.~iI.\ /' ,/ DAT["~ " -: ., .', I NSPECT ,_H~_',._"-".::r. .. ..' "':~~":'"------~~:"-~~'~~3;' ", ~.::..-;;: ;V.--;-' ~:'~~~-=:::~:.:" , I, '." ,C', ", 1 " . I, . "--,:t. I 1':":- __".'j,'" ~. ApPROVED J . /' DISAPPROVED '/, /' D'nE REMARKS -, r , CERTI F:lCATE OF' OCCUPANCY' : " :~ t.~.' , :", '~~,EA by..;i:e)s:s U,E . i ' I ""," 1 . REMA'RKS '/ :NOT",READYTO' :!,SS~,E ',-". . . , : ,,' 'to. ' ~ '" .,", '-' '-.' ~ ' '..t ',., '.'.",~, ..,. , ~.~'. 'c'~ '. ( :' ) ,} INSPECTOR I ' , / INSPECTOR /., DATE "I . ~~~~J'ii~\~'.,:~'-- i .'\ ..,.' '~; , ' Existing Structures on Property:, . ~ t'. " ~i .., .,,' t:r~_ "j" ";::.t-,,., ~:~.:'k:'~~':'~' >::ir:~':::;'~~Y1.~ ! ' I PEAMITiNO. "i;,';";r{.<'9j ! ':" I ; I" . ( . ~ ~.e.....~~~ .~~';(-ffo' ~': _' t .~ "' . II; : ~."' ", " . f. ,I 'I' ," ", '"'f J ' C,HANGE OF OCCUPANCY [~} ,j:, " :' 'I''' l: ,717- ~)()1-.: t,;t:"'7{q~,}f~l~t,,.t,d. nfl~. ItJ'Jt}'i( 1.'\~I.,.l"'~"JH'" .,,,, CITY; !' ,'Z P.CODE ,,"\>".~~,ON,E:y,:-' f . t ',.,' ., I . . . . ' '.... ,::. r;- 't~ ,-. )\ :- "',/ ~. ''"' ~~ANE .. i ~, ~ 0 }, " ; I f'-. COUNTY PERMIT FOR:' ~ ';, " o Owri~r \ 1\~'!~ '11\,:t In. ,i ~~ ~,i ~~'\\y~l NAME i MOBILE HOME [) PL~N REVIEW!' [ I ' ,cf},$ it.d ~' ):,:r} ) ',,-; , ADDRESS, ,.i, ,~ :1., , , CONS!,RYCTION [Ii] o Contractor I)lAME, 1 ADDRESS I I . ; , ~ I p. ~~,D ~';t~~:~i:;gi~~; . . i '. ~ :t' O.S: Reg, # Twp ~1 Range ;1/.11 \ ,; Section 5?~h'\ '~''L :~ .", . ~' Tax Lot i .' I l,i "I j. '( t":(P:t i , ' '. ~; :: '," ,I' ,_ _ , t I Cehsu~. Tr'act', 'I L' :[' ,'.'i :'.1, ~I"l "~1~;' ~-~'l"i,"" J :!: .WiHtr(:'!" ":~~}it,~,~':",f;W:f':~~/", ~,' i:. ''',':-.'' Death ' J<':-:"':~,.>>.t; 1,'; ,~;-:. ;" ~1.~.ff:,; ~t-. Y'.'.'~d "- ~~1';,~~:~:t~J~~~~~ .'. ':>;,~ " -;.,..;. .,>,' Subdivision Lot ",[3I~)Ck - .~, f- '~~~.r. 1'I::1.'f~;t!n~! ;ni~'h1it'l :. ,", :,:'j,~~;~c",' i, 'i$O~1.i~'ii:)'~r~~l!l 'I" , , , Access to P.roperty (Roa~ Namef . .; I Directions to Proper,ty - 'Address: 2rigt.~~ 'i. \ .' .,oj. .;,. ~ <." '".,:L . .~ i ~'-. "". r . - :',' SQ FT! ',,:'1 r :"'VAuJATION ;" ':, ",~, , " 'If;fi,' ',~~r:.. ~",:',',.t,,.'i."..{,,.,.,,'L/ 'i~J,18,k'" ;', ,',' "t..Jl.i',~h~4,jl}") ',:J,":;";,,'L,",~,,:'{' a,<'tt1.[J.. .-' ," ~:M'h~tiy.t;J I),!~,:tt~il~~t'~{'i~..t)'@!" k~l~t'! ~1'iHi &'t~,:~'ff~~~;~"..;', t:: "','. :},..>" ',..3:; }:' . . ,. . ~. 54"~' 'i, STRUCTURE (# BEDROOMS), , ; .~- ~ , , '. '. I:,/~ ,:~c,"t-('l~ ,BUILD lNG PLUMBING 3% SURCHARGf MOBILE HOMF WASTE DISPOSAL PLAN R~VIEW f' '~PLUMBING'INSTAL'L'ED BY:' '',- 'i . I, ,ii'" , , ',' bWNER ['1 ::on{ER[ J' NAME 1 w~i,~'R~u~pL Y: P~9POSED ' (; J ,', , i ',.,,/'v '::' : \' EXISTING '( r '! I'" '",', f :,rUBLlC, .'.", : I :~:' ,: 'COMMUNITY, NAME: ! " I , '," ,PRIVATEWELL . OTHER, SPECIFY: r {', ',: , ,j, t I .r l' t , ,', . ~t.- . t\' '.~ ~'; ,;'" CONSTRUCTION PERMITS & INSPECTIONS AND'WATER POLLUTION CONTROL SPECIFICATIONS ,,..., MIN, SEPTIC,TANK CAPACITY:' ," i " ,In. ,,'.':', ";,~~>.~:;~t,, :1,: ,':' :t:.\;~,(<", "!,::, GALS MIN, DRAINFIELD .' L1N, FL" ,:-',:,,',iMAX, TRENC.H DEPTH' I ,,'dINGHES ,,' ',} . '~'};\\.", .-;:', ,f';~"" ~1I1~ ~,?~itr:,~;f. ";'Ii~ ';H;l~~io: ;^q;;:~.'\>-Q'h~~. ,~. ~.1t~~~A;~l'1.)?1~~i'i~~t..~:i'i~:ii';~ ~~~+)'i,i:,~~~~,j;'E";''';;:~(:,N~o:'",''jl ~ ,; 1 ~" "~r:' ' : f '-'r-'~":.}.,~ti~;_c~':C,:.;:I-",~..;: ! ~~. .':' 'rF~'~~ ,'i '>'STA ,{(lOO', F;ROM ALL WELLS . Ii .; '.f' ~. SEWAGE DISPOSAL: PUBLIC (J SEPTIC TANK [ J OTHER [ ] IH.,:'J) F, n:~ i.. ~ , 'L '" ( J, :T J . ( J ( ] of "" :~ . ., .r ~ TOTAL (~.;1 -.. 3~(~ .( '1.:'-' , ,.j; ',' \. G70U,~' . FiR E: Z'o'N'F: , .-; ....~1_~.j~~:;.; ., , , " TYPE OF CONSTRUCTION i f.;,j ! , SETBACKS, FT. FROM CTR, OF r/W: FRONT SIDE EXT, ." . ; ..~ , 'FT ~'R' 'OM' P'R'O' p' "N'~ E":':':::~ '.;,',,> ',i:::'l",~, ;:;, .': " "!i ., ", ' L1,. .~"..;:,.' Y,.l,:";,'~,<,},,, "'l,: I, '''''13 :SIDE INT, , &': ';}?';;-REAR ~"J., ';1 ;!:;-.,ti6Nj::'f'~+ "1 ' , r .,", , ,i'V,',~{:i:~' " i" .':; ':1' " " ~.~4: t.t4~ AUTHOR IZED SIGNATURES: ,'. ',' ,'.: ,: '.'~,f ".' 1)1" rc'~(-"-;'.j /s/ ,',,\,,-, ; ,,,'. "'> "q,~ ...." .,1...\'" "',1 , .," 1 f."', .;"i':,,' ! ISS~~~r~r~tTE: , 't1'"W::/;;lV ~jni~ ,~;8ViV I' S~,F~Hii~~i~\~t :" ';W.r~~~~f'l~ "" 4i~., '. '-'-. ~ ~,l:,., ...j:: 'i}': -;'.'~ ,: ''';'~~'J;~~~:~;;1~,"4:~r~f,.,,_ '.' '. ~-,' '> ~ ~ }', ~ Call 687.4065 to schedule all required co'nstruction' inspecti6ns,:Calli 687.4061 'to" schedule all 'required' , "septic system inspections, All construction shall comply with'the State,Buidling Code. D,E,O: standards < for subsurface sewage; disposal and the St!lte Plumbing Code, .All' buildings require a certificate of: cx:c~panc~ ~efore beln~ cx:cupled, ' " " : .. , .. ., ,.: " \' " " ' . (See Detaqs On Reverse Side) .' " ~ ':' , , , . , " , " BLDG, PERMIT - WHITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUMBING ~ CANARY , BUILDING -' GREEN SANIT A T1o'N - GOLDENROD IMPORTANT: \~~, h i.,., l' -J .~. . ~\~~~y~:~. r ". ;. . . ". ~ i '_' ~!,:r , (ro,('T THIS PERMIT ON MAIN BLDG.ATisrtE), .' ~ 'I " ,'. "'~c.i1':,"",;;:,.; c"'''t': '_v,~ ".' O~T. O;;'ENV1R0N'ME"NTAL MANAGEME'NT ' , - "~,;o. cou!'!', tqps~ ~~Ntllt;-l:l~ ~~~1 ~f.~' ,E\:!6ENE., 0REGON 97401. .. . -... . I' ',: '~'~~''v:.1-; /,\, ~ ~'" '. :,'~-: ~ \i)"';.'.~~~\' : ,i' ~ ""..' ~~1 ".; I ,\ .. ~. , ,,:t ';~"k,:\) , } ~"" 1 . ,',' t I ' ,{, \ . I1A () "-~ 4 4. '. 5-/.;;.7!/7 '6 ~-i'//UJ~ "~" '-"C . 31 d 7 / l ,f-' ~.d; ./~ ~~: . , . 3/~~1 /cf' ~.pf.JJ ~ ~,--~ 7? tCJ-J ' , AI_ ' ;:J 'l rrfr' ~ ~~~ p~, ~ -uR, 0r';;(;~ '7g /P;J+- .~~,tU t-2~-~~ .~ v- . .:t , :. - ./" , " . . I . ,. ' !, .,' ' " iI' 1,\ ' -,,>""~ "..- '. , I LANE 'COUNTY j INSPECTION RECORD. '", , . TRS# 17 - 03-2.3.3.3 /1l"O lJ ' , OWNER I S NAME DATE ISSUED: PERM?'~#tB1;'~-1 :PHONE NuNBER , PHONE NUMBER # PLUMBING FI XTURES . \ CONTRACTOR'S NAME :.:';:.~.;,.;"ri~.,~t;1t. SET BACK REQUIREMENTS C. . C L, fRONT, L, SIDE ,WORK AUTHORIZED BY PERMIT 'DIRECTIONS TO SITE INTERIOR j' REAR .-.J SDS APPROVAL REQUIRED ,. ,; ". ,J' ~'. , SITE ADDRESS' , . Z5~e M AIJ~e.. U'I 5f:e1JJC:,F/eLD FOOTING I FOUNDATION 0 IMOBlLE HOME PLACEMENff 0 INSPECTION Approved Date' ICorrection Date, Inspector " PLUMBING GROUNDWORK INSPECTION Approved Date ICorrection I I' Date Inspector , , , I UNDERSLAB PLBG~[] IUNDERFLR PLBG.D INSPEC~ION Approved Date: ICorrection - ~PT~ER 'INSPECyION-' ra:utrloL,tvta.l1 ' > ,-~ved ~,/' 'Da te 2~ ) =3 -~.s- ICorrecti on " - 'ROUGH ~ttMtINt1Tofo~'~PE~;ibf- .Approved Date ICorrection : D,ate , Inspector 'Date Inspector ct..rL- '. f . , Date Inspector FRAMING INSPECTION Approved Date ICorrection I Date I ROUGH MECHANICAL , Approved Date ICorrection ,Date , , Inspector Inspector, INSULATION / VAPOR BARRIER INSPECTION I Approved Date /Correction! ,Date Inspector LATH / GYPSUM BOARD INSPECTION Approved Date /Correction Date Inspector fINAL MECHANICAL 0 /WOOD STOVE 0 , ,Approved ' Date /Correction Date r':FINAL.~~~~-INsPE'cTION"-/, " ' ',',' , "'~'~p'p'roved ,- "1 Dafe i:.." 1" Y0Correction Date : , I " 'FINAL INSPECTION BUILDING D /MOBILE HOME [] lAG PLACEMEN~[] ,Approved "Date /Correction f)ate Inspector .. 'Inspector ,~ tJ Irlspector 'CERTIFICATEOF, OCCUPANCY D Approved ,Date ' Insp. lEMPORARYCERTIFICATE OF OCCUPANCY D ' Approved Date' Insp. ~ . . ',- . M74-197