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HomeMy WebLinkAboutPermit Building 1973-3-23 , 'h..; I ;, 'j~" /",-,_n,~-...._--.l'\ ~. '.. ~' .-1.-'_- , , - ~. -~.:\: -- -~""""-"""--"-~~iC_>'''''-'''''''''''-'''~~~I.~__..-,..r",/,"'~~-r.........---- ~~......,.:,......r"""",I""'i----:...r- '., ,--V~ ~../''''-'I ';--- , -/~'-^'....-^-- ~ ......'.....~~-v.....~/..... ...... ~' .....'''"''\ .6_, ,....- ';':.,~~ J>i~'ih _,)~. ,~,:' >';: .'>~q;~:;Y~/~,.-,,-a-?f7l-dv'<C~4--j'~" , ' v~~, ~";~~ I? - '~ ':'1", " tLANEC~L YBUILDING PE~MIT OR/rMO~ILEl )\E USE IE'RMIT ,I)... p '1' .:' .... .; 4",' lBUILDING [Xl, ...'MH D' PERMIT NO. 428..73 'PROPERTY OWI~IER ,;, MA,ILlNG AbDRESS ,f ,PHONEI' , I f Camerer.. Dr. &. Mrs~[ M.H.' ; , CONTRACTOR ,MAILING ADDRESS ' PHONE ,/0. t' , " Lee Bu i It,,' Const,., ",'J :.>" ,PROPERTY LOCATION - INCLUDEPbsT'ofi~icE' '* 642 MansJ te I d ' ," PROPERTY LEGAL DESCRIPTION - METES; ;BOUNDS __ , I 2ncl Add it ion ROyal' 'Delle: ' ,lot ",p'.a. Box D SprfngfiE~lds :Oregon' ,~,,~'t1:l\';.i'.;:F:, ~('-:: 726-7073 ' \i:' ~,,-:. - '.1 ' I 17 3 SECTIOr:J " '23'.3; c/ 20 'Block '5, ,TAX LOT N~ ,,<::OD~... , .Jbr 11/// t), '.,.-, 20..'U).150 ~ l EXISTING STRUCTURES ON PROPERTY NOne lEGAL ACCESS TO PROPERTY CENSUS TRACT TWP RANGE APPL NAME & MAILING ,Lee Bu il t Const. , P~l!). Box 0 Mansfield PROPERTY 'SIZE - FL ADDRESS So ring! fe Id., OreqOni FOR MOBILE HOME PERMITS ONLY No, of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT WIDTH DEPTH , AREA Connect to Existing Sewage System D Ty,tE CONSTRUCTI,ON ' ' SQ, FT, # BDRMS New System 0 VALUATION Dwell inQ Main Garage attached cened '.36 x 25, "Covered Pat 10 ,6x '8 , Frame 2400 @'12 (3) 900 @ 3.50 64 @) 2 .",;;. 28.800 3, 150 , 128 . 32,078 ,Instal) SewaQe DlsDosal System 10 P,Bumblng Fixtures' 1 ,Sewer'Connection - 1 DubJlc water connection SEWAGE DISPOSAl' PLUMBING INSTAllED BY . .....,,-...jr- . PUBLIC 0 ,/ BUILDING .../~' -"", '.. / WASTE DISP,OSAl PLUMBING PLAN REVIEy.t PARK TR.li'11'ER , r ';OTAf SEPTIC TANK ~, . ' OTHERD ~. ' 1 ()q .00 20.00 -:t ~ _ 1:\0 ' FEES dWNER'O ,,' OTHER: NAME WATER' SUPPl:Y Q'aulS Plumb.ina , , PUBLIC: .It] o OTHER ~, t~'_l\n COUNTY BUILDING & SANITATION SPECIFICATIONS DRAIN FiElD REQUIRED MIN: SEPTIC TANK CAPACITY WITH DIST. BOX: GAL 900 " lIN, FT 150 TRENCH: WIDTH FT. ',3' OR SQ, FT, ,450 " 4-t:-....t/ .I Instan as p~r new "Iot plans submitted.l{eep..;trenches.lO feet from foundat"ion ancl 10.feet from'property, '1-Ioes. 'Distance, measu'red::toc;:en~er I ine of trench. Roof drains to. street. ' c_~,- " , TYPE QF STRUCTURE , OCCUPANCY ZONE PUBLIC UTll. EASEMENT 5 N 1,& J BLDG. SETBACKS". FT, FROM CTR, OF ROAD"RIGHT OF WAY R A- ' , USE ,CLASSIFICATION FRONT. 40 I SID~ INT.' 5': SIDE EXT. _. AUTHORIZED SIGNATURE - DATE, ' Is/J~ E. ,Boss bv Harbauoh,' REAR ~I .Georae Hervford. R.S. DA1E 3-2~-n , BlDG, PERMIT ~ WHITE, OFFICE COPY,.,. WHITE ' COUNTY TAX - P,INK , PLUMBING - CANARY , BUilDING - GREEN SANITATION,.... GOLDENROD Construction to comply with uniform building code and 'covering plumbing' and sewage disposal. All, building's, ,of oc~upancy before being occupied, ' " .' '~c/ (Se,e State~ent on' Reverse Side) county ~egulations', require a ce'rtif~cate .' ,"' ~ , {; " (POST THIS PERMIT ON 'MAI,NB~~G. AT SITE) , lANE :CbUNTY,'.BlDG. & SAN;DIV" :COURT HQLJ.SE, EUGENE, OREGON 97401 1 :'i ~ORM :tt. C55:"')3' - '. I ' , NOT app I icab I e () () ( ) ( ) ( -) ( ) NOT' appl icable () () (,if () ~ () .j(> ( ) . NOT app I icab I e -.,() () ( ) () () ( ). ( ) . BUILDING SITE EVALU~TION c.,} \. -'1 ,/~ O-l ,~ .....,'" ~: .~.; ~ @uil.d'fng Permit Application No.<~F~73 CJ: S"ite .Inspection () Pre-Permit Investigation LANE COUNTY PLANNING DEPARTMENT 1. Zoning Ordinance Compliance . (Zon'e 1<-b... ) Subdivision Ordinanc~ Compl iance ( ) ( ) ( ) ( ) 2. 3.~ 4. Required Access 5. Build'ing Site (Area, Width, Frontage, Setback) Other (see comments) COMMENTS: ' BUILDING INSPECTION SECTION .6. Plans :Submitted 7. Soil Stabil ity (footings) 8. Flood Plain 9~ Other (see Comments) COMMENTS: , , ....... .'. ':... ..,.# SAN ITAT I ON SECT! ON i. 10. Sewage D i spas a 1 . II. Usable Area 12. Water Supply 13. Other (see Comments) COMMENTS :' ( ) ( ) ( ) TO APPLICANT: '. ,; T 17 R 3' s, ~...3 TAX LOT : CENSUS TRACT' . .' , "']~~ ~J'.,~~ h. .:LICAJ'lT: ~~~/-4:7;:o- ~.s- S- /\ . NAME #V~./(k/Y/tf0 .. ADORESS , PHONE, DATE ~9- /? -72 NO' YES. NAME DATE (vt (.-J ,('1' (vY' ( ) s hto \13 L\.6. /' / '/ '/. NO YES NAME DATE (II () () ( ) a ?/~~~ 3mP.~G73 -", y NO YES NAME DATE ,y(0~ /f:~/. U""':3/.2(/?3 () '.' . .' . . . Your BuildJng Permit / Site Insp~:.;i~) (~e approved. 3./':<3~7~ () Cannot be approved at this time as indicated on. item NO. .above. Questions'- and" fu'rther--i nfo{mat ion .9n., it~fl.ls ,I through 5, contact the Lane- COUNTY PLANN ING DEPARTMENT. . Quest ions and furthe'r' in,format ion on items;6 through 13 contact the Lane County Bui.lding and Sanitation Division; . () Wil I be held in this office until you can resolve the problems indicated. () Is being returned. ( ) ~our building permit appl ication fee is being returned under separate cover. U\NE COU~TY PLANN I NG DEPI\RTMENT IV; Sixth f\venue Ea:'>I, [ll~le'Ilf',. Oreqon 97401 l't/IINt: '\II~'_1 III . I Xl', :n I. . ' . ~ __ ,",.... _... ~~. ._. k I '" . LANE COUNTY BU I LD ING & SAN I TAT ION D I V rs ION\. 135 Si,xth ^venu~ East, Eugene, Oregon 9740l, PHONE:, 342-1311 EXL 41 I ~ r' ~ ~, ._-;'!~ Date \ ':~r~(,"> / .~'q . f No. ,'. t,t,l..>.,; ,r' " PERMIT IN THE BOARD OF COUNTY COMMISSIONERS OF LANE COUNTY WHEREAS, the' attached application has been fully considered by the Board of County Commissioners of Lane County, and it is the opinion and judgment of the Board that the said application should be granted, and that a permit should be issued, now, therefore, it is hereby ORDERED, that a permit be and is hereby issued to ~,d}~ ;;tl>l.J1~ COS;:-'G for the placing, building and constructing of the following facility: ~tl:1v.;:..,:'~V /j,);n:-:woeh\11tl.\ ~Ul'~~ \:14l:..{,~~:;e 1 t"e:tl;:,....l{,}t ;;,,':; i~l(1nt. ;} tu~)2 ~~~:tru~~:f,tJll(,t r~<Jl' t) n. ~L~ tof~ r.)l1~e upon the right-of-way of County Road No. 1.')()~i , in strict confOrmity to the exhibits attached thereto, and subject to all terms, conditions, agreements, stipulations and pro- visions contained in the application and permit, the Rules and Regulations Governing Facilities to be Permitted upon County Road Rights-of-Way, dated March 31, 1960 and any amendments thereto, and any other applicable regulation, law or ordinance. Special Provisions: ;i;.:t:i'\i~:OJ3Y I,y:;:'ll VU ~U:;:,;!3i;.rruct.ud :!;1 a~oo~c1u<rtf:li.\ \;;;:1th th,j 6~tc.;'.;;tc:a <1<'.;';;'1.:0',;' '. ,:, ,'~;/, S;;I\!leti 9"(\J;t:!fY.:ti:! f:iru:J1:'l8 ),!9i..~n). 2,~jfrjb;lI;.t:C', 1:.::\.1,1'1 :~,~ r.'\;fj~~tu.;1p.1.~ fml" ~h,-Il :b::;'hC)tU\,;\C(:i,"Q.CYoiV,:aJ, o~ ,,~~1kt:'$.Ul :1''t'!:1iJ r:?"e t"d",'~r:r iitl.::! rij;a: .m1; r~;[)I17 e(.~~';c~; 0~? M,tI t(;J3d"U~;;7 Ci1i..;.}~(1~ 1~ e~ 1tU~~, ~ a.f;i.ur.:;~ tatiilc e~:'ud;i4i(,Z" w ....., '""l . ~ l.lJ.k. ': ~~~.~j () _:~.,~~,'. .' ( " This permit is revocable at any time, and will be strictly adhered to and no work other than that specifically mentioned above is hereby authorized. This permit shall be void unless the work herein contemplated shall have been completed before ;:'3l:'~ ~,-tt; ">1, , 19 "'. Expires , 19 Inspected and Approved Approved by Board of CommiSSIoners By Date By Director of Public Works WHITE, OFFICE FILE PINK, PERMITTEE ORANGE. BUILDING & SANITATION DEPT, GREEN, RESIDENT ENGINEER BLUE, ROAD SUPE.RVISOR YELLOW - SURVEYOR os- 52 , - ."'''',f"' r'f~"-"~" .:!,....F_~:v' .": T"\~ ,'~ '.' "~,.":. .., ,','. "'''''''i ;:'-,~, , " ., .~"; I '* 7-!' l\'~'. . ....- '... bate, .~:1 .., :... "". ! APPLICATION FOR FACILI,I ~ PERMIT IN THE BO~~D I,QF': COUNTY COMMISSIONERS OF LANE COUNTY ;i~:>'J~.,~~f~'~r>t.::. . I Your applicant; . " " . _, "k_ 'J.' , hereby makes application under Rules and Regulations Governing Facilities to be Per- mitted Upon County Road Rights-of-Way, to construct the following facility: "I' "t . ....:d. '.. I I ' , " ~>" J ,,": ./ Upon the right-of-way of County Road No. } ~;.; ~"~:;"', at the following location: ..l'" ,f < ,,i!' . J \ . " J' . '> .... '. ~"~ .-, " as shown on, the' exhibits which are attached hereto; in strict'corifor'mify to the' state- ments ,of the exact nature and amount of work to be done, and to the description of the facilities contained in said ,exhibits. Your applicant will be the beneficial owner' of the facility as constructed, or otherwise primarily liable and responsible to members of the public for its proper maintenance, repair, operation and use. Your applicant accepts all , , terms, conditions, ,agreements, stipulations and provisions, in Rules and R~gulations , , , , Governing Facilities to be Permitted Upon County Road Rights-of-Way, dated' March ,31, 1960, and any amendments thereto, and any other applicable regulation, law ,or ordinance. ./' , r. fi.....{; i.'.' J,\J" . fl ... . ';.!~. ';.-.., iJ ,j' 7_~,., .~""~. " .. , , 'i<: -;.;S< t . " " , , " . ,r ,f } '..- ~. ..J ... , Signature j. 't ..' /f" (,/, . ~ .~.. ',,~ ., .. If ',~ r" I!-, (.-/ r I , ,- .1.;".I'~,) ::>;; i:"J." J" .~. .Address WHITE. OFFICE FILE GREEN. RESIDENT ENGINEER PINK. PERMITTEE ' BLUE. ROAD SUPERVISOR ORANGE. BUilDING AND SA,NITATION DEPT. YEllOW. SURVEYOR ;' , , .. ~. . f. ~~ i .\ .,:r . , ~; .." f ;..,... -. ,. , . ; l .; ,f ..~ . ..~.~ ~ .. 1 ; , I -;-.. :.~ Phone No. ....--r) y ----:. '''-"'VJ~-,./~,/::r",.:.J':;''' .r:.-:J/~":" 4'/~''';~ ::'-':- -'~<"r":~.f"-:,,,"....__ ... "/'h"...t'~-"'~"'~~(;lAj~'J~' ,',"",-vO~;:'-c\.v:""""":...-J""""v 2,i...,\}-"";- '/' :,- ','.' , '." ",'..,':,..{t:*'~/'~:i:fh../jU S-" ' ,." . ,LANE COL"..' Y:BUILDINGPE~MIT ,ORk MQBllE ME USE 'PERMIT ,BUILDINGffi] , ,~ MH ,0 PERMIT NO. __. n_.. __n__ MAILlN~ ADDRESS r,,~,f\~r9n >..i,.;. .---' (-tJ I , ' PROPERTY:,OWNER ." / ~ 'PHONE , .' 't~r>li"~'fi' . ~fI'. fI.,' t-'ll1"fIlt. M _ HI. ' CONTRACTOR ',' , ", .~'.h0k~'\ in co emri~{~&~:'1';J",.,'" , PROPERTY LOCATION - ,INCLUDE 'paS! OFFI<;E (oJ3-::?" .',it:lilgi(.nnlltli1 PROPERTY LEGAL DESCRIPTI,Ot'l- METES, BOUNDS Qh{] h\4~~~~tt(:"lfi\.,f2T;\VQg 00.Rn('J,,,.Q.f;)~,'-n f\.k@~'G ...._ ,'". \\ " ~ANGE~.~&~~':'" SE(;:p,ION-~,:,- ~':T-A'XI'~,6tJN.,?~~COD~~"" \~ GEN'SUS.,:j"R'ACT\~ '1,<:1' 'n ~.i ~~w.", " ,::,," ' ill tt ~1l. )>> 7 ~:.r~~~' ~/./,/..r .j..~ ~t9:~f,tF~'ldRG@ ! ,y" , EXISTING STRUCTURES: ON PROPERTY " j .,1-', I,:, MAILING ADDRESS f.)'_iL ;~~~b,' f!;)' ~11-"1'~-S~!o<:Jtn:llf:L r.n;j.;"~30';l " ' t ;-:~"~'~":/~I~J:~~~~,:' , PH9NE '71f;.(~Itb,~i(;(J.'f-, 11.:.,", :TWP APPL. NAME '& ' MAILING ADDRESS~Pl'" 0 ",,(:)0 ~0 U 01 ~ Iih?()A~1?\ FOR, MOBILE HOME PERMITS' ONLY' No. of Bedrooms R..C() Qt~ 9 D!~ r~i'ln~. ~ri'n LEGAL ACCESS TO PROPERTY r.. G). 11~JJ! ~ P.:18<<t1il .;(. 'Utt g cl PROPERTY S'IZE - FT. WIDTH , 'DEPTH AREA STRUCTURES TO BE BUILT THIS P,ERMIT. Connect to Existing Sewage System 0 TY,PE CONSTRUCTION SQ, FT, ,#, BDRMS New System 0 VALUATION ~r",i ~ n I1'lIl1 ' f:;tjj ~ .l-'I" , '-"... 0_ ~Jl'--,. _" ~, \\ \. .- <3~?OSc;} Dt~~:t~:ri~.~ noa '.3G- :;> ~~': - €.:.o\'lnll'Ga' Drill: 3tuJ ,~ ~t Q , ti'Pt"i:i~ f;lC~n,' (;JU~ tQTI ~9 ~'1~(\iJ'-' C'c--l.", (.l; f) , "n..hill.f:1 ' ;;)$1 U~~} ',' 'n~D' . '~~~ .t1:1w@Vu n~n'il'(~B n ~r:!t!'Y."'(l () ~~,~ftnM A\l'll!rc"'1 10 ,Ph~~~h19 ~i~tt~r9o. I '$Jr:7::!P ~"a~!:'Jctlili1li1\ .,. i i1'Ialtlt h: ~:/I"\r,>nU' te-f1:>lJ'itll:"'lfll'i',ilfl~ SEWAGE DISPOSAL PUBUC 0 BUILDI~G ,WAST~ DISPOSAL PLUMBING PLAN REVIEW PARK TRA!LER SEPTIC TANK ~' OTHERD $ l0{'L LT~fl! 'f)fr1 (11) 'f1'l1 ~I,i' FEES PLUMBI!':lG INSTALLED BY OWNER 0 OTHER: NAME, D.""~~(1. J)\\M-+,.fl'1:~M WATER SUPPLY PUBLlCl[] o OTHERl ,.~""" -~."" , TOTAL, ~ Ti{K9,e:~ COUNTY BUILDING & SANITATION SPECIFICATIONS I, MIN,SEPTIC TANK CAPACITY ,WITH DIST, BOX: GAL. DRAIN FIELD REQUIRED ~;tto 'v 51" OR SQ, FT. I IJ~fi ....., L1N, FT r ' , ' U 5C TRENCH WIDTH FT. hHi~()U 6S I0ClJ' l'ttl fJ~~t.:@:,Q.Ofii3':OMt;.littcd. rSC{Fi 't;r{f;tilaF.!~G~@ ,'iCCf(: vr~m, -rOON~Gt~tin ~~g fij fcot groD 8)?~;poi~y',H,~6n. ' iHo~'wa\lOO e;8pf)~'iz~ CO coo~{W;'1U~o O'~ \:i?()~oGv. ~e$Y '~U"oaHD ,tQ'$ttF'0Gt,. " I ' _.__, TYPE OF STRUCTURE , OCCUPANCY ZONE PUBUC' UTIL. EASEMENT c:, 'l'J R A .S BLDG, SETBACKS __ FT, FROM CTR, OF ROAD RIGHT OF wAy , , FRONT ~;(~:&, SIDE INT, 1.)' SIDE EXT. <<>0 ' REAR AUTHORIZED SIGNATURE...,.. DATE, lsJ .09.. r:'~ ,.Q;1~~ reM't!rw'z"hi:tt,(i:.\C1 ,n fA USE CLASSIFICATION k,1}. , DATE :f;',nftr?tt"'(l t~'zlv~rr.twdJ. Ci. gOo' 'f1",;f!-QnW~": ' " BLDG, PERMIT - WHITE, , ,OFFICE COPY"':'WHITE , COUNTY TAX - PINK PLUMBING - CANARY t ' -- . BUILDING - GREEN SAN II A TION - GOLDENROD, " Const"ruction t.o comply with uniform building. code and cO,unty, regul?tions ' covedng plum,bing and sewage disposal. All 'buildings require a cer'tifitate, "of, occupancy before,b'ei,ng occupie,d: ' , . ,: ,.; ....,. \': J' : (See ' StatelTl~nt on ,Reverse ',Side) ,,~~:," ' c; 't . . .... >'. ~ j .' '. '''~''''! . ".. t, .; . . :. .. , " ' t, (~O.sT, THIS,'PERMITOI':t MAI~, )B,LDG. ~'~','S'ITE) , , I. I': " I. .' . , ' LANE COUNTY, BLDG. & "SAN " DIV",CPURT HOUSE" EUGENE,,:QRE9pN 974Cll . .... \ .-. _. r,.',. _ .- . . , . l' . . " " ,FORM # C55.13 r" ,!}.'t I ..' ~ '. . ,.1 ~I' '/, L I " J' .-~~ SLAB FLOOR PLUMBING ,GROUNDWORK ApPROVED ,j REMARKS j DISAPPROVED / j OnE I~SPECTOR I I "I Q H~,7-"-7:3' ~, I ~,er~O .JIL~~ ~J",.,..-:" ~ GAS P I PI NG' GRo.UNDWORK, , '~:1: .' . ~ " ' ~ . ,z -.',. -/~..#~/ . ,'" ~ ~~~';,~.;. 't~":,<~: 'iJ,;;"", ~ l~ .., ~j~ (..~ ~ .. .. r ~__ -~. - ,-~- ('T) , 11'1"" ,.. '" LANE C( UY ii' , ~~" , BUILDING B ,~ ~~\"T .~}!': PROPERn"OWNER '. " '\ '~;:;~~,"~!frlJ!~t;~'''f~"?t~'"'',f i'(!!~ '~,""(J,~;~fi;~," , ~ ' ' " " ' ',' , , BUI~~N~ PEIl~~' ~'~ ";OBILL OMt U~:R~~TR:~'?2~ )" i/'\' , MAILING ADDRESS ' ' PHONE , , ,/ ,~ ....."'" ...... "" . ,t,~.v':#4t<~{1'~.... i}~D.. & f.j.~!S:... J~.i,t;6 CONTRACTOR UiJ .aU a 1~ (;;-:;ll~i::~" PROPERTY LOCATION -,INCLUDE P0SF'0F'FicE .. '(.42 H&h!<li'idrii PROPERTY LEGAL DESCRIPTION - METES, BOUNDS 2nd ,i\ddl t .on:.t~'vaJ l.'t~l ~f.i tot: :~[) f$bek ,~~ RANGE SECTION TAX LOT N,O, MAILING ADDRESS ""-. P.tj~' flox 1) ';nrr:rn!;lttlIL a"t"fl:jn J ......, 1,'),';";'WJ.tl.t f:(~, /rf PHONE " " ) ":..,' CENSUS TRACT -'_ TWP CODE I if ,if) '! <- .-::,-:f;:" tv....tu.. 11;0 EXISTING STRUCTURES ON PROPERTY '" .. \ , , , APPl. , NAME & Lei.! ;t;,1,i h. iJoltfi~;., J tkl'1<, n ~ ',( \ 'i':'l(!~~ " , - \4 'i:.. -\:'~~~\~ ADDRESS'[,odnof ie:wd.. (}'\~''."!>Jlli FOR MOBILE HOME PERMITS ONLY No. of BE!dr,ooms STRUCTURES TO BE BUILT THIS PERMIT , ;I..;~;., , , # \-. \ -:0.:...., ~~~, , LEGAL ACCESS TO PROPERTY , ~ ,;,U'!S .it', Id ,,\\ .. p"R. OPERT,y" 51'ZE -, FT, ~"~\"~ '\~~~)~ WIDTH...l DEPTH '\'- MAILING '...... AREA ,,. Connect to Existing Sewage System D TYPE CONSTRUCTION SQ, FT, # BDRMS New System D VALUATION 0Wl!-1 'I ~I/"m fl~in ~~t.t1!i~, ~~t;~~lf>' CGf~,h;'~ I1.A:'lv~r.t'd ?~J~~ :'; Ii I ---.J~ ------- fS".~-t~ 24L'?~ () \2 t~l ::tttn \,,'; 1;.;)0 '- n; (; ~, ... ~HLBOC );1) l!tC) 12E ,-;'1 n,]. r- 4.;.,,\J;, ~: :t6 7; ,2';; ~\ -.j-~ Inst-\1')ll\~~wn.!!.n' msno~;~t S""'5bf.'l'1 lU f'JtfHf.; ing j.~i};t:ur{~$ ~ tit~~'t' Connt:!!I".:e h)r~ ... ~ 'iiuVl te watct' f:OlInc~t ton SEWAGE DISPOSAL ;,'; '\ \'. . . "~ '" \.- ~ ,... . ';.' ~ \,.., ~\..., ~-', " \~l , ~~':' '.." ,:\. ',~ ~",\, '. ,,/' -':, '.' \.\\~' \'.~\' , , , , BUILDING', WASTE DISPOSAL 'PLUMBING PLAN REVIEW PARK TRAILER FEES PLUMBING INSTALLEp BY OWNER 0 OTHER: NAME WATER SUPPLY ./ PUBLIC 0 SEPTIC TANK : G;] <l; OTHERD lrl'~_ ':1tl JXL.;rin ;~l;cu~~ Phlf;\hrm , ' , PUBLIC ~~ ,0 OTHER " " ...,.....J.l \] , r::;,):L.. jj~fi TOTAL , t : l~ (~ tf:" .:;n I I i',l.' , ' ,", COUNTY BUILDING & SANITATION SPECIFICA liONS MIN,SEPTIC 'TANK CAPACITY WITH DIST, BOX: GAl. . \tr...c", ' '\ ,\l\'~\\ fnst.al1 .,~ ~)~:,~: ~1~;\i' f)tu:t St~~m,1; 10 f~~t; fruu pr~1)(,ttV I ;~~f!.S.. to $trf:t!t. DRAIN FIELD REQUIRED lIN"FT ;;.:i0 'TRENCH WIDTH FT, :H ,'; OR SQ, FT. ~"~,, '-r;\Jt ~nJ1Jm i tted. ,t<l"('[) (ti;:nch(ls fO 3'e,fit ft'\''4''; r(}~l"kt 10t1 iiiGt~lt1CQ 1;'(~~Stt~d, ~~\~~~t~i~~~'~:,\~i~t;11eh. I~~~ \ ~' ~~~H~ ~J~.~?i ,,~::: -'~ TYPE OF STRUCTURE OCCUPANCY ~ N t ~ J BLDG, SETBACKS __ FT, FROM CTR, OF ROAD RIGHT OF WAY FRONT !U). SIDE INT, ,,' ~:). SIDE EXT. _ REAR AUTHORIZED SIGNATURE - DATE l~1 J...~. ~~)SS 'L',r ii;:-:~';~;auH!i ZONE PUBLIC UTll. EASEMENT )-;. ( ),' .)1 USE CLASSIFICATION 'Ln' .." " DATE G1;QC.ttr:. l'kll~vfor~.;'..S" \... ~.,o:i. .:....~ ,~;'...;f..,-"..OW.''I''. r BLDG, PERMIT - WHITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENROD Construction' to comply with uniform .-building code and covering plumbing and"" sewage \disposal. All buildings of occupancy ,before being, occupied,' county regulati,ons require a certifitate . t 1'.-~ \, '~ (See StatelTl'ent on Rever:se Side) J-~' l,' ',...;' ,~.' :,/ .1 ~ .. ~ , ~. 1 l"oo, PERMIT ON MAIN BLD9: AT SITE) , { '~ '{POST THIS LANE COUNTY, BLDG, & SAN, DIV" COURT HOUSE, EUGENE, OREGON 97401 FORM::=C55.13 \ i . ,. - ::;'''~~ ~ ,. ,. ) i ; . SITE I NSPE'CT I ON ApPROVED '/ , t i' / : DISAPPROVED' I / DATt'. REMARKS._ .. I~). "j T {,: ,,' /: ~,' '-7 ,~., .J..?"'V (~/dJ',,"/'I.--f::.:;--,-_/ "-f _.- _J.. ,- i U ~J'<.......... . I f I I \ FOUNDATION INSPECTION ApPROVED / V / DI SAPPROVED /. / y'" .1.S. 71 DATE REMARKS INSPECTOR, INSPECTOR ..'.::-""'-', 1"-' '" . .\-. ~. .~. ... .,~ FRAMI ~G I NSRECT IQN. too, ' ,"/) Ap,"o,,, . 'l t/fJ DOS,peRO"O / / oJ, tf. {, .71 ., "'PECTOR ~ j R~rARK'S:;~~ L' J~_ ~"'.,;~ ~ '-J. ~ '" .. P/1wA{.J1/ ~J ;'I:-.1~.A G17l'~~ I ' / '/ " .. '. r . I I I LATH OR'SHEETROCK INSPECTION " ApPROV(D /' / Dt TE / DISAPPROVED / REMARKS' I I ' 1,: I F1NAL INSptCTION, 'ApPROVED / I, DI SAPPROVED / I DAT1t' REMARKS /YU);f ~ 7 .../0 "'I,J . n . v CERTIFICATE OF OCCUPANCY READY to ISSUE / I '. I NOT READY TO ISSUE / / DATE REMARKS' " .~~ 6 (){J~ . \'. ' _~~'-/?Il-d " /I I II . '11~ t-13.~b 4::1 'ffI,~ INSPECTOR I NSPECT.OR INSPECTOR ~ /-/0'0 '" :.., . ;/>. .' . ----.. .; " ".. ";:", '," 7:: ,', , ,'~,. ..,':',':".... 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",.,",' ,~,>,.,:~.~!:i,j:,:',:<<~:.tJ.'.?:~:.:""~,',;~",', ,:'.. .. ~:,L~~E.db'q~W'i:ft.~L1H,~~Ep,I~"~':0 ft ....... " , , '--' ,"" '({:""'" "'. ',,;' . ", ",', . :.' ~;.~ ':'.~,... ,;',..... -~~,~ ",':" ".. t,~;:,}'~'" \>""..,',.',':.,"~,:,: ;,!:',,"? ~':"~'~~'~':.':~\,':,(.', --:" " ,..;~~:.,~, ".. ::5''tft{jfj " ";c- ''"';, '_"f~i .. ,"'.,"'~.:,.."','" ';' ~', ' .. ': : :",',:::'~,,:,:,~;;>/~,:;:.,:,' >" . 1<:::>;", '/;" ,., ,:::::':~""'~'",,.:?,' ,':,::;,,~; ,', '/',;:.:)j--:, "":"~I~": ' : ;a",:~~:jp;?<Y~7;1 ........ .... ..":~i~;...f~i:WJf(hikrijJ!j,,ltE<R:J~;t~ For ',sanit'ar'ian :US~ Only: ~...... ," -; <', . ~ ", ~, ". J" .~~. ~J~, ~". .~t... ~.~:.:~;"; ~ .:~:--,~'.' ,. ',' ';. ~.'" .-~~~.. '"~,,, .:i. '. .:: \". ~,;: ~ .\~!. , ,:'~pp~ove~:, ~ ;' sy~te~.' In~t~rl:~~i6n: ~on~~~~~,'~ t~~:,ci~~,~e'~t:\s\~n"~~;~~,;::';.~a'~:;:;~~qOFti~:::',:,,' ".. " , , ~~~~~~:O~~~;.~~yS~r~f~~~~~~~;~~~;~,::f~ri~',;~/: .... '.. '.. "'''''''. ".., ll' ;,', .. -iJlfIx- ',:, : , Sanitarian ~"":S(ignature :~>':,> " , ~'<.'~,",'( ::'2:'0, " " '," ',' ,,~~;{.i,', ~':-:.....',:..,,',~~~',: ;:"'12",;": ';,:':: c~untY;',Buildifi"g;' & ,:,s~ni:ta tic: ept,~"~~,: ',;' ,:' .. -.'~ -. "..'., " ,. . ..:~:..~\" '.r.-, '. ~"~-'" ~.' , <,."i :~,'!' - ~ . '. '.. .. ..... . . "c .... ~. ''-J 'C55"~11 ' ..l\r. '~.' t't, - ~ ."" .,' .' ", ',1. . " LANE COUNr{ BUILDING 'PERMIT OR MOBILE HOME USE APPLICATION ", . ":,' ' " . PERMIT TYPE .:...' ~UILDIN<3 0 ',' MOBILE H~ME" 0 o"SC 'REG: #', ~. -: ,: " PERMIT # '~~? - 73 P~~ERTY OWNER, i' ,",:, , "..~ ./J' . MAILING ApDRESS / / />~ ,'. ,', " '" pHONE (~J./'r7~'-,~ V'~ I c? ,mh-<v' #-../'rJ<"" - ". , CO~T,OR , '"./?" '.. ~ ~'./~~," ;/ ,'," /7' ", ''',':, MAILING ~DD,"R.E/7SS .' '~ ' 75?'~~.-/ ~~C::z{!~:Y_4-/:' ~I'l r 'PROPERTY LO~AtfON-IN?LUDE..:~STZFIf/ ~:, ~~ .', ." : , ' PROPERTY LEG,.AL:DE, SCRIPT,I,.oN. ,~.~-,n' ',I A'#' // ,.~, .' '7' '4' /7.#/" ..7 . '.-i'- LOT - BLOCK- SUBDIV. '--, --rr!./'J'Z..4 LL4fY~ ~ ~~.-&~2c:1 TW.P , '. ' '. RANGE"" " ' ' 'SEc.~ '-,' " AX LOT # ' CO[jE : ' /7 ,::?' ", ' , ' , c9 d',:, " ,(.,', ~"': PHONE ':I .. APPLICANT h/Afff METES & BOYNDS o yES ~ ' ATTACHED' 0 NO CENSU~ TRA'f-/)' 'J '-7\ ' , () I).-~ ,G {/. " DESCRIBE E!<ISTlN!3 ',STRUCTURES , ON PROPERTY IF ,ANY . :' ., ~ . .,_' i ". ", ;,,'~~ , ~_EGAL ~.' S, S' T<:'PR,' O,~~.RT,YY :- :- R R~O;YA,D N N~A~ ORR3. #A" '~,,' .' ,-: , -~."~. V~/f~ ,',' ~ , P'RO~iY':S'~IDTH ,', DEPTH'. ' . ' ,." . EA ,:, , ,l ,NAME AND, MAILING .j ADDRESS .~ i', ;' FOR MOBILF HOME ,PERMIT" ONLY ".", ,N~mber9fB'edrooms ' ". '-:', 2o'nnectri~:::Exi'stin'g"S:;~~e'SY~tem tJi'or' N'ew 'System' Req. tJ :, :~~);?;?7'P:MI~~-2;' ,cnPE,CZ~tzZ~?O ~J!~~ ~"'~ ~.;P-~--/ ~~:;>(; X""",- /(/U . ,', "'):/.9J ~.,v...~,','.... '~, :},)~'~. 65~., ,".. hA::-- /";.;>,5' ~~/fiLVA: " ?' ::, ,;_~~'{)7Y SEWAGE DISPOSAL ;, '""',PL~M~,IN,,G,I~:sT~n~~ ,BY .",' ,/~~ PUBLIC 0" ',. S~~iIC1ANK"~ OTHER' d, " .. ' :OWNE~ 0', (jTHE~ NAME.....~;z:..--.;- -{fit ~ '~ / t1 Y t'crz;1 . WATER.SUPPLY,..'.; 'PtANS FURNISHED' ".; 'FACILITY PERMIT,' c:? :~;;E,~IS.c::;//Jt:~.,' FEESpUB~i~lf: ~ 'OTHER ,",'. ":~'ES'. "NOD ",' '~ES)(' NOD PLUMBI!,,~ ~,-::J.."y , ',~L~M, ~I~'"):EES. ,,',,' ,', I ATU,RE,OF'Aft!.:}At'j.T ,'J" DATE PLAN REVIEW " "~;/6J FD(TURES ; =?I1,;t1-d ,,', l./ ~ o~/J ~,.( ~fJ:;, . ,3-/-.5-:-~7...3 ,PARK ,TRLR, cASH d 'SE . ,'. ' . ,; , , FEE RE::~V~BY . "" , DATE CHECK 'ONNECTION FEE .,y"..... ~';,": ,.:, W.,u;,,' 3~/S-7.....d '. ' , ',PUBLIC WATER, .'"PERMfT.#A.\ " "//.; ;t>S-o CONNECTlONtEE ~ S7Ji ,',,: ~~--,7:7' , ",' 'COUNTYB.lJILDINC '&S.ANITATlQN:;'S~PECIFICAiioNS:~'~ ~ ",," MIN, SEPTIC TANK CAPACITY" '" ",<..DRAINFIEL~ .-B!'~UIRED: ,~ . ':'" :' (:;" ,<,', ::,.,. ',' ",." ':, ' "",,,,' ..wgH DIST'.B,QX:, .G, At. . ' ' / ,0',0, '. .i.,IN,: F,T.! 'j </ T,RE,N., ,C.',H WIP,r.H" F~.',;.',':' '~:'OR~SQUARE FE.!:T' ,<L 0, ^ 0 / /-. -I-'f,;t Y7;~' (( Ct: ') :>',f:eV'."I?1 ~~l3'lpI'~, I?:,lq ~ 5 5~~ 6.'~>-c',-f4~ . '/. '." --," ',.. ,..,,' , / ,..;:. ~_ J /' ~ ,;e.., -r; ,,...:A I/' ~ ' (~- ,f /.? U h. ...I c., 7? / c!) ~ [l.~e.!.!/ ' Ire? '0 C. ,t-t-.e :,li.>, 'I.!f(~ , t,...... I .. ~ ':. ~'.' r. . , - (Z:'lr",-?,'t"+,~'/J'~ ".'P'//'v,p C'y/V ',L'}h:e"i. ;,DI'5 A.,/c~ ~.d4- ~ k,;J"e",d",- t'plc:.CK'L''EJ/ ,L'th, -e c: ~~f P~.--f;:f'.~h">-A/'" . , , /Pro n. L.. ...f,/.rC:; j '" <\. ,/" V .S t r ~ e" {;. , TYPE, OF S~R~C~URE " ,-, uP''- : OoCc::UPANCY( ~ - ',. ,( "ZON~ '> - '~,' ~EAR Y~RD' ,.." ,'." " PUBLIC ,~'JIL E SEMENT , " '" tSA/." ~ ,'" ~~ '.+. , , " ' '".. . ,: " BLDG. SETBAC~.S:- FT, FROM CTR, OF ROAD RIGHT OF WAY . ,,- , USE CLASSIFICATION ' - : FRONT..4 0"" , , SIDE INT.. 5',' _ SID~, E~T, .. 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