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HomeMy WebLinkAboutPermit Building 1975-5-21 (-~1 -~~;.i-~"" .. ..,":.,-. .-'" .~ ~~'. .., ,- .- -""'. . ,. - ,. , r" . .'.. ..! -...: 1,~~ " ;., v..., , ,I. ,,)\ ...\ ) " 1 ' PR0PERTY OWNER _i Roa~~T SCtlIOEM CONTRACTOR SAME PROPERTY LOCATION - INCLUDE POST OFFICE ", y'........., ' , LANE COUN'3UILDING PERMIT OR, MOBILE BUilDING D~ MH D){X ,r MAILING ADDRESS 450 G"OODPAS,l'ORtt:, RQAD MAILING ADDRESS "'...... Hf)~ USE, PERMIT '-- PERMIT NO. ~J1H 25'4"15 PHONE EUGENE, OREGON PHONE PROPERTY LEGAL DESCRIPTION - METES,BOUNDS' 19<)4tNLAND WAY F,)6eRf ,cWP RANGE SECTION 18 3 2'13;.3 4- j:J,. #<It/' f ' 61?Od e' , j. 0 "R/Dr_i TAX LOT NO.. CODE; CENSUS TRACT rF-7tJtN:} 35..400 6' APPl. ' ."NAME & MAILING EXISTING STRUCTURES ON PROPERTY 450 GooaPASTURE ROAD" , 50s LEGAL ACCESS TO PROPERTY 1. C:' 1904 191 NI.ANn:Y~"';~") , , "ROBERT SCHOEM PROPERTY SIZE -'-,FT:' , ADDRESS EUGENE; OREGON FOR MOBilE HOME PERMITS ONLY No. of, Bedrooms STR,UCTURES TO BE BUILT THIS PERMIT WIDTH , : DEPTH AREA Connect to.',Existit;Jg Sewage System D TYPE CONSTRUCTION SQ, FT, :# BDRMS New System D VALUATION PERMIT rOR MOBlLE HOME 2 ELEVATI0W449fEET . , I ~ ":'~-i<<\~'~~1:14L~ ., "!':"~(..~ ~, fEES PLUMBING ,INSTAllED BY OWNER D '-OTHER:, NAME' WATER SUPPLY PUBlIC.o '0 OTHER " SEWAGE DISPOSAL PUBLIC D BUILDING WASTE DISPOSAL PLUMBING PLAN REVIEW PARK TRAILER SEPTIC TANK D OTHERD' 4.00 ' TOTAL ~O.OO' - ..Ol~' ~lLQ4 ~ COUNTY BUilDING & SANITATION SPECIFICATIONS' $ MIN, SEPTIC TANK CAPACITY WiTH DIST. BOX: GAl. Ex I STS 'PR.A.IN FIELD REQUIRED " , lIN. FT TRENCH WIDTH FT. OR SQ. FT. THE MOBilE H:OOllE: A MAY SE CONN,e:'CTE;,D, TO,EXISTING SEWAG'E DISPOSAL SYSTEM STAY 10 rElET FROM All PARTS ,OF' THE ORl!lINFIEl.O: TYPE OF STRUCTURE , OCCUPANCY ZONE PUBLIC UTIl. EASEMENT " , " ~ ~' BLDG, SETBACKS __ FT. FROM CTR, OF ROAD RI(3HT Of. ,WAY," , 'F' RONT (f1:f[.,'Q ~I SIDE INT. c:)", ,<''tIDE 'EX:T,:4~REAR >; AUTHORIZED siGNATU~E -:-DAr~ /S/, J. Eo Boss,sv, c. HAReA;i!J1'J!j~'" :;', , 1'r.;e.. 7' ,6 J:.. ,; , t'Bp2GH~~RMli7'fY:<~ ~T~?'(' " , ....0F~ICE COPY,:- W':lITE....P , COUNTY TAX - PINK PLUMBING - CANARY BUILDING~ GREEN , SANITATION - GOLDENROD USE CLASSIFiCATION ' I)t .'.-,1' I~ G. W. GRAV/SANITARIAN' " f A(f4L.../;;;;;?# DATE , 5/21/71' OlM :~':"C I ; IMP-ORJANT: Call 687-4065 to,:sche~ule dll required inspections. All construc- tionshall comply,.w.ith Uilif9'rm Building Code, D.E.Q. standards ,fOr subsurface sewage, di~p~saJcHl~:,;!;9unty regulations covering plumbing. ,All buildings require a 'cedificate of occupancy before being occypied. '." " " ' . (See Details, on Reverse Side) /' , (POST THIS ,PE~IT ON' M~IN BLDG~'AT 'SITE) , " 'lAt'lq:OUNTY, DEPT. OF ENVIRONMENTAL MANAq~MENT COU~THOUSE ;ANNEX, 135 EAST 6th, EUGENE, OREGON 97401, " , , FORM == C55-13 " :,:> , : ,)...., ., :. ,,;.- .:~... ~:~.,:.'.,::, ' . , . ....,; \ . C.' ~:.f) LM~EC6UNTY ENVIRONMEN1~= MANAGEMENT PLOT PLAN " Name and Address 'of OwneriO()IJE./.JT' E.' J!eAUIE/l1 L/6"-Ot:oob"ItS,IfilU5. Rh, J't),~ E~'EI1/F-4:!(':1tfp. 77'fnl "Telephone: ~,1~'tJ'= l{{j"~--'" " I" , , ,,/1IJol-(E H ol1e JEIIII6'-- ,The' buif-ding being, cons tructed under, this permi t will be used, for; /.-1""15 D f:':l?o.v, '/tboill: A-/)j)AESS TtJ 19() 't-/NLItNf) /AlPr,Y JF/lFN(; rIEL'O: {)IfEr 'Date this property was purchased /::151;1 b~ I tJ 71if' 1.7~77 Do you now, or did you ever own property adjacent to this tax lot? If so, please list those tax lot numbers or draw those properties on the plot plan below.j\LtJ Indicate on your drawing the location of all homes (including mobile tJ-omes) now on, the property, as well as the location of the new' buildin~. ..... ~~~==,:::::::,:,:",__('<./~.:..=.::::=n' ,._...,.'..'_'dd'...' 'I~h""'" ,--.'-'. , ".. ___ __ _ " ... _ _, ,. "_'P"_ ~ ~'~ --:-~_,,_ _J=-==-,'~-=-==,_.., ___, , I C-,' ''''jIJ- -, ,. - .. -- -.. --- ..- r..... ~ .~ ._~ -'.,. m:'" .. ,. -..... -! -... + .. , .. .... - .... "'.. I - .., ,.., ..,.." I '," -, '~G/"_"_' - 'i' ..,., '.' _ ..__, n..'__ _ . ___, , ......_ -"".._.__.........: ~._~__._..,,__.:__.....,_!_"'._~_.~l.... _ -- ,--C .-- r'i~.. "..:~-.r.... ~ ','. ,on .. _m . ' .___,._.._~ ._._,,__ __n n__ ._. __ '_:.- u.. ___,__ 1._.,-:. ~__ _..1__ , .". . I" I I '. _I.... ". ,.. ,-, -. ,..- ..' -".... --, -" -- ' . '<----1--,- -.,-.,--+-.... .. -- --- _.._~ I _ _u ._0 -- '--' --. . .n_' I ' ,_,.. '__'_"_ --,L-- .,~:,_',"~~!::'n ~ I ' , ' , i ' ..I , " ""I n _____!_.'...-__--.:._~_~i_ I ....:._,:_.. i. _I... I _._ ! I -- ; ... .. _.~.. 1-.. ..1"0 _. I...; _. .. ,_._ ,.... _ ._. , L-'j : .. iU ,I.. I' -. ,,' ~r-==~i~~~ -1,',','1.." !': ",.. , !', ,;, i..!, i' , ," ....- , , .. .- _.~, ,- --. ,-- ...-1-- I '~I ' :,'~' ':,' :t;~;:r:" ,.. ." , "...'ll.., '~- ,..':': ~," V: r;." I ,-- '..'" , , 4-:':';' "" , __'-_:""_ _ ',tl_.____ " " " .. .. \t\ .... :,.-:. . --I ',I" ~r!" , ,- i ' . j' - ...1-:-. I .."~:,:~~., ("~ ...,. "I,~,:. '" " ,..;. ': ,:, .,.., , ___ )."1.111.. ~=- _..__ .. _.:... -=_, ,t'I,,'r .'iE" "~.. ' I '~ 7' 'l" "IT ~1" , I ' ~l.c: f'l. "'".. : i ,., .. _,':: ,!,T I,: i_' ..., :~~2~~~:~~!_~p~~;LL~~__ ':..' ',:, ,:':~':"J... :,( :::.. :,' . I I i I "1'- ; . ,'. !.. ... " , i" , 1 , . , . . I ~. . " '''I , i '- , f,' ..~, Hi .. Hl I I. I' u L .~ --,. .- -- .-- -~__~~~2-=~~~~",,_~LL__,_. I ! ,.. '" ....,! :!' '::;"1' '-""',+r:- '. .! I U f , ...j ...1 I , ,t~ n __ ~ i, n - ;' ' : -0 -~ -'-"'~".'i '-'M' ..,::... r-- -" 1-:": :=,'...- :_,~'~~=..::~ , .,:::.., !:, ,:I. ['- <:!::"...,,;.. -c~-,' "I" u\.\ ' \~- ",' 't.. ..,'" '''I'' "_n'.....'.: __i" , ,__ ~. ~~;= ~; -- == = ~ ~ ~.: ~~ ~ ==: ~~t.: ~.:.:..: _:~.:~. -- -- ~ -- ----,---- - -- -- --.:-- tb ~ - .:.__ ~ ,__.:.: ___.. .... ._.. o_..~ , . 0 .. ..._ _. i ,Name of Applicant (if different from owner): , , Address' ' Telephone Applicant's Interest: Buyer c=J 'sellerc=J, Agent r=J M74-99 ' Map, Tax Lot, Permit II, BUILDfNG SITE!EVALUATION L~ ( ), B~ILDING PERMIT APPLICATION NO. ..## ";;Sj/- 7_<" ' 4' 'J () SITE INSPECTION "" PLANNING DIVISION ~ , ,Not , , " App 1 i cab 1 e 1. Zoning Ordinance Compl iance:Zone.~-41.4L( ) 2. Subdivision Ordinance Comp1 iance ( ) 3. Required Access ( ) 4. Building Site (Area, Width~ Frontag~) ( ) 5. Other (see comments) ( .> COMMENTS: ,/ APPL I CANT DATE ~ 0 h ~'rE'/1A. ' No Yes' T) (~,'6. ( ) ('1' ( ) (~, ( ) (, 7, ' ( ) ( ), CKID BY: ~ S-/cr-7.s- ~etbacks'from ctl of road: Front ~~ Side Exterior ~'~ Setbacks from interior/lines: Side ~ Rear' ,S- PLANNING DIVISION ACTION PENDING: Y,ES( )' NO( ) APPLlCATlON# BUtLDING INSPECTION DIVISION Not App 1 icab 1 e ( ) (0 ( ) ( ,) 7. 8. 9. 10,. Plans Submitted 'Soil Stability, (footi~gs) Flood,P1aln , Other (see comments)" " [/f~i/t/tf'# , /' COMMENTS: WATER POLUTION CONTROL Not App 1 icab1 e .W- ( ) 11. ' Meets Department of Environmental' Quality Standards. 12. Oth,er (see comments) COMMENTS: I r)V ( ) (~ ) , " ( ) (/) , ( ) (/) CK,I D By:d!J1~~/6-f6-: , (/ DATE , , No Yes l) ( ) ( ,) ( .> ' CKIO' By:~k1'S:J:.?J , ,,%;.#4' DATE u v TO APPLICANT: Your Building I Site Inspection:, )<f Can be app roved. " , "'() Cannot be approved at this time as indicated on item, NO. ' above. Questions and further information on items 1 through 6 contact the LANE- COUNTY PLANNING DIVISION. Questions and further information on. items 7 through 12 contact the LANE COUNTY BUILDING AND SANITATION DIVISION. ( ) Will be held in this office until you canres91ve the 'problems indicated. () Is being returned~ ' , , " ( ) Your building permit aeplicatiC?n..Jee tS...J?eing returned_~:~i7.!...se~ar.iite cover-. DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, , 135 Sixth Avenue East Eugene, Oregon 97401 PHONt: 687-4065 ' LANE COUNTY PLANNING DIVISION PHONE: 687-4186 fr\~G ~ C55-28 ,/ .' J.", ,--Y', ,,~:'I.C; .~ L"'.... . LANE' COUNT BUILDING Dd l)ILDING PERMIT OR MOBILE M H [j~); MAILING ADDRESS 1~5~j (i4)Ci<Ve !:t$lt-w;~i, 'WAG MAILING ADDRESS HO USE PERMIT PERMIT. NO, MH ~,l r" (t.~I'" r.J . ~ 1fHONE . -'. . PROPERT,Y OWNER . ~;:U 0:1' ::,nHtt~!r '. t..i~tN~, !)ln~~N CONTRACTOR , , PHONE ~:.' ~l-,{r PROPERTY LOCATION - INCLUDE POST OFFICE PROPERTY LEGAL DESCRIPTION - METES, BOUNDS , ;1'j(*~> ; ~Mtj) \";i~\' (} llIe,lt/ C;:)!..C) \J ~ '-IflC~1 ~ t: ,M, b TWP RANGE SECTION TAX LOT NO, CODE CENSUS TRACT ,.,'..., '~'~ .,J(,"~"'i"""r~ . ~...t -,,'~. ... '" ...i ~J ." APPL. NAME li<Jif ('1ft' ~~fF":~ ,~" ~~' "..~,\",,~::-::....Jfi~'~\. "i":t"'l ,', .~ ,., ..,~ \~t>OOP,'~'f.j.f\cC l...:tl'9 -~\'-~- ~ EXISTING STRUCTURES ON PROPERTY :Jt$- , . . LEGAL ACCESS TO PROPERTy......... ........~ t9C4 .,~...O WAY & MAILING ADDRESS rl.tGt~f:, (J.ltt~Of.J FOR MOBILE HOME PERMITS ONLY No. of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT PROPERTY SIZE - FT, WIDTH DEPTH AREA Connect to Existing Sewage System D TYPE CONSTRUCTION SQ, FT, # BDRMS New System 0 VALUATION ~r".:' It 'f !t.(l~J r,!jorULE Hat:ll: l"'ll ",", .\ " ~ 'c", I, \(1, f'jJ'~'" .I,l.,'f'"....w.'.;.,-iil..:.f ~'4" 1'jcJli,.iJ' t! FEES , '.J .~~ PLUMBING INSTAi.(E'o)BY , , OWNE~, D/;../O~HER: NA~E " ~tTER('SUPPLY , , " , ,: j, " ' , ,('" d /~UBi.IC; D D . OTHER "j. ~'- ,.,' .,..f J"- .1 .~~~, . fi, ~ .. P /ij;i~~ ." ;i" SEWAGE DISPOSAL PUBLIC D SEPTIC TANK D BUILDING t WASTE DISPOSAL PLUMBING PLAN REVIEW PARK TRAILER OTHERD ~"Qij TOT AL $ ~qr;.\ .00 .-'\1.;. j.fJ ~ ~'t,,,Q4 COUNTy"BUILDfNG & (\ ,\ :1' :,~ 1 . r\.:;,' 'ii' , J , . , f. ~, _ \. ...It '''::...},)V \1, SANIT A liON' SPECIFICA liONS I'U: Ht:~ !!~t HQMr 4, KAY DRAIN .FIELD REQUIRED ,: :1 UN:"'F1: TRENCH WIDTH FT. :. .,;,J: t 1,1 \. 'f~:: (;()~it;,~c(~ l~ It~ '$T UllP $1~At"'t( 4:H,~"~t'\1l\i4 ~Y$n44 i\,.t,~'f to ft:r.r nHl~.1 ~ '\; '\ - ~ \ - ~ ~~ ~r>~ ,\\\tw\ OR SQ. FT. MIN, SEPTIC TANK CAPACITY WITH DIST, BOX: GAL. [;<'. $.'n), ;' ;1 f....".~ I!U, ';'Af'V$ 0" "l,ft' ~.~~~t \:~r fH TYPE OF STRUCTURE OCCUPANCY ! ZONE PUBLIC UTIL. EASEMENT BLDG, SETBACKS ,_ FT, FROM CTR, OF ROAD RIGHT OF WAY USE CLASSIFICATION FRONT1J5~ SIDE INT, :~'~ SIDE EXT, 45' REAR ':Jill AUTHORIZED SIGNATURE - DATE /'f~ 'i;).:r. IJo~~, $1' t. HA~JUt"" :;:1.. [.it (J~j~.'\'la.o.jlfJ'i'~-"Ji~i DATE 5hii15 BLDG, PERMIT - WHITE OFFICE COpy - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENROD IMPORTANT: Call 687-4065 to schedule all required inspections. All construc- tion shall comply with Uniform Building Code, D.E.Q, standards for subsurface ,sewage disposal anq county regulations covering plumbing. All buildings require a'ceft'ificate of occupancy before being occupied. , ,', . , ! (See, Details" c:n Reverse, Side) .. ." I i-o';':'"t. -: '(POST THIS PERMIJ ON MAIN BLDG. AT SITE) , 'LANE COUNTY, DEPT:' OF ENVIRONMENTAL MANAGEMENT COURTHOUSE ANNEX, 135 EAST 6th, EUGENE, OREGON 9740"1 FORM :f:: C55-13 ~' " " SITE INSPECTION REMARKS ApPROVED / j DISAPPROVED / / D~TE FOUNDATION INSP~ APPROVEC?' / I/'1DI SAPPROVED / REMARKS' /, DJ[~-:J~-f~ I ' l I I FINAL INSPECTION ApPROVED / /' DISAPP;OVtD/7~/ REMARKSJ/LH, ~=?~, \v:=~'~ , INSPECTOR """TO~ INSPECTOR INSPECTOR , DATIE , _ ' ,. ,h"J INSPECTOR 6'''1,2 (,- 7<r~ ' I I CERTIFICATE OF' OCCUPANCY NOT READY TO ISSUE / I r I ! I ,,-'1 /1 I M~ It/;? fJ ~~tl- '1 Jr; 11) /~ #' I , f,,, AD .D<J {~(:,'kA1_- REMARKS READY TO ISSUE' / / / <~,'~' ~ IPt) If DATE INSPECTOR .~~ ..:" .. .' ..' ""j .' . .. > t. _ . ") , , .\ ; .~~.. , ' . '. ~.,-- . ,~-< (,j:, ;:.. " . .,' 'l,~..t ': i ':.' -'1 ...~ ~~...;: '," ' 't'>;i ", '" ; , ,', , ~!~., ," C) .1 ,,~:: ...O'!' / ~- ,,', ,y~,<"" .,',.,".' LANE COUNI"-,,,JLiILDIN'G PERMIT OR, MOBILE : ',BUILDING OrB MH d~l MAILING ADDRESS , l'(~;m{?.,r" ,<,)".\\.,)^"J.>'1Q t '"''' '" '0.1;-'kJ. \.::.1'~--\:"'\:r 10 ~'...." V '{,t1....w ,lv:,l~.2J' , MAILING ADDRESS ,r-', ' HGO'U5E PERMIT " PERMIT NO. r~~ ' PRO~~RT~"OWNER , ;~JC:nv' O@~Gfj' !!~ZJgo G:.QG.G32J , I a~t'~ 'fJ PHONE I CONTRACTOR , , . 36c.28 .~., PHONE PROPERTY LOCATION - INCLUDE P'OST OFFICE , !, PROPERTY LEGAL DESCRIPTION - METES, BOUNDS ~~,~ llc~t,['ID Unv TWP RANGE SEC:ri"ON .....,' ~ ,I ~3 3 2' TAX LOT NO, CODE CENSUS TRf'CT 35c;~9;) EXISTING, 'STRUCTURES ON PROPERTY ~ LEGAL ACCESS TO ,PROPERTY 'u~~ C1 n C2l,1IC'JD tJtl'il , APPL. NAME & MAILING ADDRESS g:e~'f;iaCo ()nllC'.O"~ F,OR ,MOB)LE HOME PERMiTS ONLY No. of Bedrooms t~C311Qtr ~@cVC~Cj, t~;~ {lC000j\Ji:rW~~H t~~!} PROPERTY. SIZE - FT" WIDTH DEPTH AREA STRUCTURES TO BE BUILT THIS PERMIT Connect to Existing Sewage System 0 TYPE,CONSTRUCTION SQ, FT, # BDRMS New 'System 0 VALUATION -PCOC1ll-f (700 ~~OO-~1I M~ ~ C::~D;\:Ji.')V~eO 't!:;lJ 1l'~IJ:V ,SEWAGE DISPOSAL FEES PLUMBING INSTALLED BY OWNER 0 OTHER: NAME WATER SUPPLY" , ,PUBLIC 0 BUILDING WASTE DISPOSAL PLUMBING PLAN' REVIEW PARK TRAILER SEPTIC TANK 0 $ OTHERD PUBLIC 0 o OTHER lJ..{E@ 'TOTAL <I: ~~o@.) - ..@t~ ~l}.,~~} COUNTY BUILDING ' & SANITATION SPECIFICA nONS DRAIN FIELD REQUIRED MIN, SEPTIC TANK CAPACITY WITH DIST, BOX, GAL.' ft;EJ W1G. , , lIN. FT " TRENCH WIDTH FT. OR SQ. FT, 108 ,~9Daba W~~J A ~~~ D~ @Q~~G~~D iO U8t091~a Ga~no8 @~oVQcn~ D~DVC~ G?~V t@ vuev vbc~ ~~t ?l~n<ilO .of? 'im~ c"o aC~WHE~@~ TYPE OF STRUCTURE OCCUPANCY ZONE PUBLIC UTIL. EASEMENT trfJ' , i BLDG, SETBACKS n FT, FROM CTR, OF ROAD RIGHT OF WAY FRONT ~J5~ SIDE INT. 5~ SIDE EXT, t~J(!' REAR AUTHORIZED SIGNATURE - DATE /U/ 00 [(> QGOG DV (f;.. ~1nQot:lG::::::J BLDG, PERMIT - WHITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUMBING,- CANARY BUILDING - GREEN SANITATION - GOLDENROD >.....~,... ,. ~.'. IMPORTANT: .,tP.:'''''''''''; DATE -< ,';;', ';, (.)~ tJo O::Jfl\JlfACJ61Af? t~(;l fj/~~/tJ r:~~~ , '. ""'1;'1\, t,', Call 687-4065 to schedule all required inspections. All: ,COr1sti'uc,< , tion shall comply with Uniform Building Code, D.E.Q. -sfa!1.qards;, ' for subsurface sewag~ disposal. Cln,q ,c,ounty regulations:>;~~~ering \~ plumbing. All buildings require a certificate of occupancy"' before being occupied. " , ' , (See Details ,on Reverse Side) USE CLASSIFICATION 90 FORM::; C55-13 (POST THIS PERMIT ON MAIN BLDG. AT SITE) LANE COUNTY, DEPT. OF ENVIRONMENTAL MANAGEMENT ,COURTHOUSE ANNEX, 135 EAST 6th, EUGENE, OREGON 97401 ' .' . ~'i-:, '<:' ~ . .. ~\ ','-. \"j ~. " SLAB 'F LOOR ' PLUMBING GROUN~ORK ApPROVED 1::>< / DISAPPROVE.O /' REMARKS GAS PIPING GROUNDNORK APPR'ovn; i' '('DISAPPROVED I REMARKS ',ROUGH PLUMB I NG ., ApPROVED / / DISAPPROVED / REMARKS ROUGH GAS PIPI NG Ap~~OVED / '/ DISAPPROVED / REMARKS 'F I NAL PLUMB I NC ApPROVED A/ / ~ \ DISAPPROVED REMARKS FINAL' GAS PIPING ApPROVED / ." . 0,. :;~ ';,1 / D",)-1 f~ 75'] ","",o~A/ ., ' V, , , 'I ,I I 1 ,. / DATE I N'S'PECTOR I I I I-. '.' -t / DATE INSPECTOR I DAlE , INSPECTOR / /~ATE9'~ Jy-?~ .]m:m~~c:::I~.. , f." ~' / 0 I SAPPROVED I I 'DATE I NSPE,CTOR REMARKS :CERTlF I CATE. OF OCCUPANCY ... ...-' ,. ',:".:.~EAini TO"ls?,UE .I REMARKS' ! NOT READr TO. rSSUE ......-, .",' 1'.,:' / / DA IE INSPECTOR .. : -:. . - " ," ,.-,{NOTE:, 'N9P~~IT WIl. ". ," -l. . .':' .PERMIT # AS,BEENAP~ROVED 11111 S4Z5 " ~...' ~ - ..... . - ~ jE, ISSUE:Q, UNTIL THIS APPLI4TI( .- _.\. .. . - ,". "," '. .:. ;- . "., '\ " " , " ,"," /" .:' , C~N~TRUCTI'~~~~~. ",,' Cl('. OWNEk,>,~~~,~N). .j --- ,\APPLICATION FOR: MOBILE 1-10$ 0" :X'l.':'. ~LAN' :REVIEW , '/" \. ",' 12~:bR\": ' 4.1h, ,-'~ ,'.Address I . "CHANGE"',OFOCCUPANCY , .- '-' . ~~d ~:,~ l~~f>_'i'id ~. :;City ~',:, ,f:Y!?' , ,I ~ )j:.QkQ Phone (j , ' ~ SY5'-IOZ..6 <::: R~~;~ng, ~7"~:~i.:.~~.A:::'::, E;: <::ui:P;~%t? : '~U~division "f=." b r~i-~ lj rtr~... " h ~ : .:ino~k b" P;6p~rty~sre,:se' j,'/ Width Depth . ACCESS TO PROPERTY (RDad N~,) ,r",k~A lA)<\y,j q o'{ , .. . 'u/ ., ','"c. Existing, S,i::~~~Ur~S?h~,roperty:'::'<,';, "Q~S,'" '-,' .~, !" ,~/,; ':. " . Prop~rty Locai:-l~ri'- '.,Addr'ess/D'irectio,ns: ' " , ': , ,"-.I,.,' ....... "or:. ;.,':."; ......._... 7,. ";~e~~w for Off~~ce',us~ ,ar:1Y~~~XX~~~~~xxi~~~~~xxxxxxxx~~';~' ~~~XXXX~XX~~~~XXXX: \..Ii \' L" " : ,,' " ; Sq'-:Ft., " "",', ~~ drooli{' Valuation', JY l 'y . ' ' . : " ,,":. " ' ;, ' Q ) " , " , '. '1,'. _-.'tJr'''~'';(\\/.',~+f ~,"" ~y ")~f:cr- , ..;;4 't:y~tfC/t? M ,':, '"" , :~Yl' SEWA,GE DIJfckAL:,. o't.L 11-3" i 7' -?I' ," .' ,(.':.V, /.. ~':,,' , '. '," ' ,~i.te Inspe.ct~on Ii~, b?-, ""), ~xis,tin~'sewa~e. fisposalC!!-~l:lIi' /.\.,,1'" :::01" New System Required 'WATER SUPPLY' ,,'; ",' ,', , ! PUllic ,{.JO)( I "'. ' , . .." ',' " " , , ,;() " '" , Well ,Sp'drig .~ Other Cor'mutkt~ I, 1 ".. , "r.~ ..', ,,~-~. ~- . PL~ING: .. <'0,-;", : Instal:~e(iJfbY" ~ ! . , , :. ' PLUMBING . " 'Wa~te Disp':' , ' ',' 'Plumbing. ' C/; '~>; , , ~.., ,'0 E Fi\xtures 0 'csoeWn' 'naegcetio'n,.' ".',' (') "..-, Wcater . to:' ././ ' y 0<....: ',' onnec 'i.on' ~. , : Pl:an, Rev-iew' ,,', ,'" , , " ,:;.. ,'" " " ' :;'~~~:~::::e ,".. 3o~,;DV' ''', " ~,~~; FU~:~S,H~D" ..'. ' ,.~' ~ ,/ACILITY PERM~T I ~ ".-CASH: ..2, ~~, 1.\/.-,' YE~ . I '. ~".".. ::: I ". ' YES', ,l, 0 I N,Q' TOTAL,! .. t?lf.S,V ' ~ 1"-1 CHECK " . . ,-:lna..", of Applican" .. ?t/Lt(fdA-fM '/ ',>, .j' .. ..~ee Received By: ___ y'" : " D~te; 5~-~ ,.MJtJ.Pji:c ~h~::Z;f~>~~;.~ "Dr,a"inA R~q~e:(';j;=., ~ .H:at~~~:r _ '~A4C) ~ !d~ .~/a-tft;;~~~-'-"~"f':(JI/- '. ';";7: co "_'V:', . ,-' . I ,.. I CONTRACTOR ,< FEES: 1.~. - . ::... )" '. ~-- :-t _ " C'., ~~meof :COn1mU~ity or p~?lic System I' Name: -Bldg. ._J, ....., ..r ,. - ;..~ -. .;1)'pe of Conshuction, , -M J-t ' Group, ,I Fire, 'Zone , ' , " uire, Cl<is'sification' , ' -~ .., . ... : .~'. r.' . ~ :.Bldg'SetbackS - :from Center ofRoad,~,i'ght ,of w::,i: ~Front '~'" ~ide, Int. l:T"'.-., ~ide Exterior' .' .. '- "V~'" .. Rear:-',r " tone ~A -/t?/-/-, ,PIA~- , .. .. , C55' 12,'