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HomeMy WebLinkAboutPermit Building 1973-7-6 ~""{;:;t. 4 ...........r { t _ _I :........<....--'- l ~_j,;t /.......... ;\......~--"!:....:-~~ ,(' ~ 1 ~ ~ "- 1IfJ!1 ..731(~ t.! - 7 ?~I USE PERMIT I" '~ PERMIT NO ~: l 1.0~,.". i'"'. PHONE " . LANE COUNTY BUILDING PERMIT OR MOBILE HOME BUILDING 0 MH N]( ) MAILING ADDRESS I 326, Tlllms7OPJ: f(GJ.AD. 5p-nir~r~~CI_D^ 01EGlDN MAILING ADDRESS I I f !~G~ "'if.2") , PHONE ~ 1 .. PROPERT". OWNeR ~~7ILCSv TAl:jl'rOQE CONTRACTOR PROPERTY lOCATION - INCLUDE POST OFFICE I ~~lM,D U^V \ Cl D Y. PROPERTV lEGAL DESCRipTION - METES, BOUNDS FILOCRT G~ovc 4 TH ADDlflON LOT 6 ~lOCK 6 TWP RAI'<GE SECTION 18 OJ 02 APPL NAME IM.MAINM: STILES & 8265 TMU~STIN ~D. TAX LOT NO , I I I CODE CENSUS TRACT MAILING ADDRESS 5PR IrJCF I EL D, O"iEGON FOR MOBILE HOME PERMITS ONLY No of Bedrooms (2) STRUCTURES TO BE BUILT THIS PERMIT 1f)~4co EXISTING STRUCTURES ON PROPERTY Mot'~c LEGAL ACCESS TO PROPERTY I t'R AIM'> t.JtiV PROPERTY SIZE - FT WIDTH DEPTH AREA Connect to EXisting Sewage System D TYPE CONSTRUCTION SQ FT # BDRMS New System ~, VALUATION CLGVAliCr'l !}J;S) n. AGOVE SeA LClJCl. SEWAGE DISPOSAL PUBLIC 0 BUILDING WASTE DISPOSAL PLUMBING PLAr~ REVIEW Pt\Rr< TRAilER <I: FEES PLUMBING INSTALLED BY OWNER 0 OTHER NAME WATER SUPPLY SEPTIC TANK 0 OTHERD 20.00 q.t)O PUBLIC GO, o OTHER ,-3.Q..... 00 lOTAl $ -51.59- ________'____,__, -- -(".OUM,f-,~-B~II_D!N_G-B;--S_AN!_'fA-n\)N-SPEOFCAT!ONS-- --- ,- - N,I~1 '>EPTiC 7MJ/< CAPA:ITY D"-A,,">! Fli'1 () REG~IIRED UN FT 1301 TPcN'H "'I'D fH fT I 3 OR SQ FT 3~a WIlH [,1~r BO'( GAL 900 ~- -- - --- -- ------ - ",'OL.D 7~"'N"""""l'J TO A 211 '''l''"'l Mt"li1UM "'cr"'"H. ST'^Y '10....... """'0"1 ""r">f'I"'cnTY LIME IlMD TRAIL-n ".. ..n"'.... "V I......' 1-"'" u.... "'. ~.. r I. .... 1 .-......... " ". .", ..... Pinl All PA~lS OF D~AINflr:LD.. , , I I ----1- --- --- i I I TV!'F Of STRUC7URL '-1:-1 fl(CUPMKY ZONE PUBLIC UTIL EASEMENT II ~upg~ ~EJB4..C~~u FT FRONT 45 /s/ J. E. SOSS BY CNARf.E"S HAREt\~Cill FROM CTR OF ROAD RIGHT OF WAY I NLAt~D \! A Y SIDE INT 5 SIDE EXT ~O REAR I AUTHORIZED SIGNATURE - DATE USE CLASSIFICATION '5 DATE G.V. GRAY~ SANITARIAN 7/6/7i so BLDG PERMIT - WHITE OFFICE COPY - WHITE COUNTY TAX - Plt-iK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENROD Constructlonj to comply With uniform budding code and county regulations covering plumbing and sewage disposal All buddlngs require a certificate I of occupancy before being occupied (See Statement on Reverse Side) .\ \ FOPM -= l. 'ill - n (POST THIS PERMiT 'ON MAIN BLDG AT SITE) I LANE COUN1Y, BLDG & SAN DIV, COURT HOUSE, EUGENE, OREGON 97401 I -I \ ~~~---" ':.-,- ~ ,.~~-j. .... ...._. -' tt .) _..r~ ~_ .. -- "r' j~ ,; ~ \' ~ '. ~' "\,,~;;.{~:.\'_. ' ,.,' , , I ~.~,;-~~"; / "LANE CO~NTY ~~l:I,llDING:.~ERMIT" 'OR ,/ BUILDING D", ,,', ,"MH rvJIr, '\ ' i ...1 ~ PROP~Rn. GWt:fEit.: ... ,~AILIN"G ADpRESS \ ' " ~ ' f:'1'u..t:tt. TAi..Ilf.\_~, t" 'f~€fl 'ft'IUW.~?'~t Rf1iU... ~;'\H~~".Ii.:~HU.~..., CONT~ACTOR \ " .>\, \ MAlLIN? ADDRESS '\ ,"," \, r"".~ " ,io ',.,' ~ \"1" ,'10. " \. .1r..U. '~'j t.\. .~. r: 1\ . PROPERTY lOCATION - INCllTDE~P6'S,kOFFlCE "- \ '4 '~~ \ ,.' , \ O'....D~"'\ I,~" \ .. ~. , "'-...:.., j/ , ~/\l^Nt) ~JA~' I,!,"\' : J::'':- ~F'..... w t' __" ,~,"",~",\.."",,-~""ll.~ ,~~~,'" , PROPERTY lEGAL DESCRI:TI~N'- MET,E~,~ BOUNDS \ " ., ~ i. - s:.. " ~ ~' ~ \ \. f !j~.,t'tt~t. GHClit .b t~ Al):tH'n ca lo-T' :0 l~.GCt~ (; \ \.' ~1' \ ,'," TU~))P ~;NGE SE;,ON TAXI LOT NO, ,CODE \CEN~~;~~CT . EXISTING STRUCTURES ON PROPERTY COUNTY BUILDING & SANI1;ATlON ~P~~IFICAnoN$ DRAIN FiElD R:~UIRED \ i,} ~' ,'\i i ".<:t' UN, FT 1..::,0 1"" JTRE~CH WIDTH FT, -:J OR SQ. FT, 1 ,. '. ~ - ,~ r f ... I $;~y UJ "'1l*' ~:dfJfi ~~~~~.v'/ L Hilt ANti t'fP tt.U'~ " ' " ' "': ,.\ ,~}'~ ~.. "\ ,- ",i')', ' ' '. . . _J I .. r/' ~ . . ;.,.,.: IO~/ f-: : . '\ n ZONE' ~, - "-..,...{~'''''' ... ~..;. l; APPl. NAME 'f""'Mi\~ [;1 U..~ti>' & t265, r;'~JS;:'Jl' ~ to a~ MAllI'NG ADDRESS fS"R. NG'.V' 8 i1w;>' '(;7,1:('>Il,N ;FOR MOBILE HOME PERMITS ONLY '.. No. ~f Bedrooms (2) '" ',)" STRUCTURES TO BE BUILT THIS PERMIT " , ~C~..C\;i:~'f~Qti, ri~9 ~1. Aao~\ SeA ...E.!:.... ~ c\,. ~ \ -~. .... ~ .' .'-- ..f; -:'~ i' SEWAGE DISPOSAL PUBLIC D BUilDING WASTE DISPOSAL PLUMBING, PLAN REVIEW , PARK ,TRAilER , SEPTIC TANK D OTHERD 'I:. FEES !2~. 00 ~ . (~t) '1.n..r~ TOTAL 1l",%I. ~O $ -, i MIN,SEPTIC TANK CAPACITY WI;rH DIST, BOX: GAL 900 ~" Cln,o 'fn~:t'flI!:S f~ It 24 ~'~(J~ MAKJWl,IM ot""tt~ i :- \ ' ':~~, \;,?~t.~~ &;&.t.. ('}/dtt!1-. Qf' .lJ~r.Hi~H:LOi! It TYPE OF STRUCTURE '\"'~ . \> '~':.{',. :.,,'-;~ ..,.,', (: of '~."i>"l'" ...""".~ p~ f'/,; ( ~...; OCCUP.ANCY tt BLQ'G}'SEJ,BA'G!<.S:, F\, FROM eTR, 0~..R9AD RIGHT OF, vif:..y , UU.A"JD -WIiV FR6.NT ' li:J", ,-,SIDE IN~~ I/",~"/t 'SIDE EX;','" lkl . REAR'" \, AUTI'fORIZED :SIGNATURE - DATE'- ,,",.',; , ,1-~/ '>>orL $ eJ.j:1t~ t\'f '.fAP"~~tl t1!~Rf3A"Qtt \', BlDG;~,PERMIT -.WHITE OFFICE, COPY - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUilDING - GREEN SAN'TA"\ - GQ"'NRQC \ '\. FORM == C'SS. 11 .. '\ "" '~.~ ~.~, ...- , ."" ", , "t' , ,'It, . ",' \',~ MdBi~E HOME ", "-- .' \ USE PERMIT /J) ti ' .~'i: 1: plRMIT No. '~~ '<6h,,,',i'>':" i ,', (,l'tf:CON, ,\ r)' r''',. PHONE 14& < 'I' ~(\';~~ ~. l 'P;t-ioN E ,;. ..~ 'ft .'v"" , .I .;~.:' , i.- , 1 / , I "1 I ' , I I \ \ I \ r-;,OUE , ,;::: ,LEGAL ACCESS TO PROPERTY , G Nl.I.'NO ,W4V PROPERTY SIZE.:... FT. WIDTH ,\ ~ 1 . i : i ~, ARE,A ,~ Sewag'e ~ystem 0 SQ, FT, :# BDRMS DEPTH , , I I New Syst~m VALUATION . . j ~l Connect 'to Existing TYPE CONSTRUCTION } \,'/.< \ "," I .- 4 j t' . (~ :~\, a ~\~~\ ..-....... \ ;...f'" r i, '. j, : i -- , ,1 PLUMBING INSTAllED BY OWNER c:J' OTHER: NAME WATER SUPPLY PUBLIC []IX " D' OTHER It,...' ~ \,-;/ )' ..' . .......it;;.-:. II' .,C{'\ ,'r' ~(:: ." " , ':.!:.: "-. , , \. ,'. . . ~.;. ".. '" -, PUBLIC UTll. EASEMENT ., , , USE ClASSIFICATION ,'1 ~, of" .iI f"I'W~., ;' j .. /' ,," r,"', , ,', DATE {i~~!i'" (~M't;, ~~MHTMJjtAN ' ilfJ/1l3 ;$$ 'Construction to c~;m~iy with uniform building code and county regul6ti01ilS covering plumbing d,nd' sewage disposal. AU buildings, require a of occupancy, before being occupied. , ,I (POST THIS PERMIT ON MAI~ BLDG. !,-T SITE) lANE COUNTY, BlDG, &, SAN. DIV" COURT,HOUSE; EUGENE, OREGON 97401 "', .., ,,'. ,':'.~"<':~~":.\":', ' -.-- ;".. (See Statement on Reverse Side) '{ .....; ."-- >1.'."1'" ..' .., -;-:-~.::-;~~-;: ~.. \ I , \ I \ \ \ \ ( I I I I ~ .-- SITE INSPECTION ApPROVED I I DISAPPROVED I I DATE INSPECTOR REMARKS ~-P~ 4'fYAtliut~ 7-~ 4"'?'J~ I i,--"L I ~ 'q../;J. "Yi) ~/;2-/~7J ~n ,-JtJ.-llf " I FOUNDATION INSPECTION ApPROVED I I DI SAPPROVED I I DATE INSPECTOR REMARKS FRAMING INSPECTION ApPROVED I I DISAPPROVED I I DATE INSPECTOR REMARKS LATH OR SHEETROCK INSPECTION ApPROVED I I DISAPPROVED / I DATE INSPECTOR REMARKS FINAL INSPECTION ApPROVED ! I DI SAOVED I( I DATE I N,SPECTOR RE""" ~/( ~~dkr~ ?~a.-2~ ..M(jUx;r I r.r 0& rV~?7, '7-/2 -"'1'ftl_ v CERTIFICATE OF OCCUPANCY READY TO ISSUE / I NOT READY TO ISSUE / I DATE INSPECTOR REMARKS /VI It 3~41.~ -D/tIA ~ r.r ~ Jfctr;~iY~ SJ",.I{t)7) -----~- ----:::- ~ c -- ........... c- ,. ~ c (j' (~Bu"dlng Permit Application No~ff "3ttf-71 JI't.h.r6Hn. L.~ '1 T---,R ~ S 'Z. TAX LOT CENSUS TRACT BUILDING SITE EVALUATION ~ () Site Inspect ion () Pre-Permit Investigation APPLICANT: N/\M E c; 7 _. L~--S ADDRESS PHONE DATE ,-.1. ..~, ... ."._,. LANE COUNTY PLANNING DEPARTMENT I. Zoning Ordinance Compliance (Zone ~~ ~H ~ SubdivIsion Ordinance Compl lance NOT app I icab I e () () ( ) ( ) ( ) ( ) NO YES NAME DATE 3. 4. ReqUired Access ( ) ( ) ( ) ( ) (,..r- ~~ .. ( .-)---- ~- C-r ( ) ~-I2-7.3 2. BUIlding Site (Area. Width, Frontage, Setback) Other (see comments) 5. COMMENTS: BUILDING INSPECTION SECTION NOT NO ~ NAME DATE app I icab I e 6. Plans Submitted ( ) ( ) 7. Soil Stab" ity (foot i ngs) ~ ( ) ( ) 8. Flood Plain (X) ( ) ( ) ~7/~7L 9. o the r (see Comments) ~ ( ) ( ) 'T.. J---?" ---..- COMMENTS: SANITATION SECTION NOT NO YES NAME DATE app I icab I e 10. Sewage Disposal ( ) ( ) :~ II. Usable Area ( ) ( ) A~ 12. Water Supply ( ) ( ) ( ) ;/W. ~ U _~"7 13. Other (see Comments) ( ) ( ) (I ) / 1/S"'" I~ COMMENTS TO APPLICANT: ( ) ( ) ( ) BUIlding Permit / Site Inspection Can be approved. Cannot be approved at this time as Indicated on Item NO. above. Questions and further Information on Items I through 5 contact the Lane- COUNTY PLANNING DEPARTMENT. Questions and further Information on items 6 through 13 contact the Lane County Buildlnq and Sanitation D,VISion. WII I be held In this offIce until you can resolve the problems Indicated. Is being returned. Your bUilding permit application fee IS being returned under separate cuver. U\NE COUNTY PLI\NN I NG DEPARTMENT I I~ Sixth Avcnup ~a~t, Euqenp, Oregon g7401 I' 1111 N I Ill} - I ~ I I rx I :> ')1 LANE COUNTY BUILDING & SANITATION DIVISION 135 Sixth Avenue East, Eugene, Oregon 97401 PHONE 342-1311 EXT. 411 ',- , , ..~~ J"):: ::l~ ~' . ,"' J '; " ,.,-,i~ i...:">".:" ;// "'",~'->;~,~'-~':1r. USE' ,PERMIT Illr,' '_l~O" ,~ .~~ 'PE,,-R, MIT, :N,O,., "..,,~ "'l/~'~ , ,~....-.....(, fll..;./,.-e \ ._- '! . \ i;...'t",,;('" ~ ,,!--..___ f!....'Z:P., !.t'Oe:;.i,) ,~ ~PHONE' PHONE f.' T~.j":'''' ~-,~""# ,T .......-._; .-.~. ,'.-..........-.-' ~~. .'.~ . t . 1. /. , , ;i .," . ,.. -. " . r "LANE COUNTY' BUILDINGPERl'ftlro'R ,MC)BILE HOME BUILDING 0;' M'H~'m~,~ I,..",",' MAILlN?ADD~ES,S " ' ,_ fk'(v"t;:';'}';;'h~'lt.i',,,,,.:?ifftl\lif:;,., t'Dt1~li,,;,:;,r,.".,'7";.q.ll "-,;. ,f"t,,,,." ",:"",,,;' .J.L~\&1.iJ. ..lJ.uic....,uJ '.l...",j .:,,,..~....'/ ....l:.:J':I"o\ _~ ......1 ,1.;':.:'.11' .,-t' l;31~P,-.. \ifr.l!:"llil:~",":; , <. ,~MAILlNG'AD~~ESS' .. " . :/.1- ..; _., '_'I ft..;: ',:<{ , .' PROPERTY OWNER S~ au~(!\" 1ilL&.t1~~ CONTRACTOR PROPERTY LOCATION - INCLUDE POST OFFICE ,0 G'1h4,;i5 tjt:,"J . "- ..... '.\ PROPERTY ,LEGAL DESC~IPTION - M,ETES, BOUNDS '1&.:r;ENJ? A)nO~t-a~j~t~"~f):3t Y lore lOY(; G~~tt ~ TWP RANGE SECTION "U' 'i, ~8 03' qj~ TAX'IL6T NO, CEN9US TRACT ,-;q~1iUj) , EXISTING STRUCTURES' ON PROPERTY CODE MPl. NAME Tt:lM,mene SVU,lrO r~~(t · ,LEGAL ACC:ESS TO' PROPERTY 1~A'.\lfj .t!?!'8", PROPERTY SIZE -.FT. 'J &. fjzd5 rW~1p!"'i.7 i,n "n~.. 'MAILING, , " ADDRESS ~Pti~fJor;~:lia,d)p (tl~JR(l0~', ,,', FOR MOBILE HOME ,PERMITS ONLY . No. of B~droo,~s" tt!) ,'; STRUCTURES TO BE BUILT THIS PERMIT .;f". ,"'J. WIDTH DEPTH 'AREA ' Co\'nect to Existing Sewage" System 0 New 'System TYPE CONSTRUCTION SQ, FT, ,#...,I?~,RMS' VALUATION m~ ~\. 'f!' t!i.c;~u~nv~ ~J~ '~.j'P: A~t1~ seA L~me~. , .'., ",'" " SEWAGE DISPOSAL)' PUBLIC. D ' BUILDING ~'. . ,WASTE DISPOSAL PLUMBIl':!G PLAN REVIEW , PARK TRAILER , SEPTIC TANK 'I. D OTHERD, $' aw.,~Z} , , ~~SfW fEES PLUMBING INSTALLED BY OWNER D' OTHER: NAME WATER SUPPLY PUBLIC "'~1 []I.... D OTHER .., of ~..,OO 'TOT AL " 5:1. ~ COUNTY BUILDING & SANITATI,bN, SPECIFICATIONS DRAIN fiElD REQUIRED UN. fT tj;!)1 TRENCH W;DTH H, .3 OR SQ, fT, . c-~/,1"<n j};'" MIN. SEPTIC TANK CAPACITY WITH DIST, BOX: GAl. .. S1UO ~ ' '~n~il.l!) 'VfJ.El!)J~t~(C6' to A ti;cJ H~e~ M~ ~Out.~11;;ll:l:tp'f!i.. S:r,~v '0: f'l..~Qe~' Wtill;'JPt;Q'i''a' a. O~U Af\1ti TI1A tIl.t;~] " tv h'W: tlt.l\, ?~fl'ii'lcl @\?' C~tlB iiW' , ~~ tl~ TYPE Of STRUCTURE , C(N ~1' OCCUPANCY DO Dt~l\.l\m;) ~,~V ll';t} . REAR i '\ ZONE PUBLIC UTll. EASEMENT ~~, ,...J" Ell b:G ,dSE:l:B",t(G (('S;. fR;NT' ~' Idl J..~\) fT, fROM CTR: Of ROAD RIGHT Of WAY G ':,\ -SIDE INT\ " SIDE EXT, AUTHORIZED SIGNATURE'- DATE ' ~O'BY tM(jQl\,€S t04~OC>~~, 'L 5 USE CLASSifiCATION If .. , / '. .,":'0.'-' ;':t:~~~t~f~i;ij~ BLDG, PERMIT - WHITE OFfiCE COpy - WHITE COUNTY TAX - PINK ," PLUMBING - CANARY BUILDING - GREEN SANITATION - Go.LD,ENROD -: '~"~ '. G.,.~ii, ~tl'\I'!i SMH'?A~t A\l:.\, '("1,', ~t1i;f.11f,' ,~; '~~ t' '/:' .w, " , ", Construction t~;':;'comply with uniform building code a~~""COl'J;'tx'!.,~;:~~~W~K/;:t covering -plumbing and. sewag~ .disposql. All building~,,;,{~~ui,r~, /~~,ate ;,:: of occupancy before being occupied. , '" ,<:;~..;><t. ,'\/',-" . ""l'''' (See'Stat.e'ment on Reverse Side), >.,' "i:~ . ~. . ~"r" ""':1... (POST THIS' PERMIT (i)N MAIN BLDG. AT 'SITE) LANE COUNTY, BLDG, & SAN. DIV,! COURT HOUSE, EUGENE, 'ORE~ON 97401 , ,I, ',' . ,,' ." :,' " <'. ~." . F6~M',.:.it':r:~l:j ~'1,.' .,."," t'.,~" ApPROVED / / DISAPPROVED I I I I I I I I I I DATE I , . 4 SLAB FLOOR PLUMBING GROUNDWORK / / INSPECTOR REMARKS GAS PIPING GROUNDWORK ApPROVED / / DISAPPROVED / / I DhTE I INSPECTOR REMARKS ApPROVED / / DISAPPROVED / I I I I / DdT E I I ~ Ii- /J ( / f""/.-/" ~; l INSPECTOR ROUGH PLUMBING REMARKS /' -;)1 .--? I ~ - f /-../ y/ ,--_L I ,... ROUGH GAS PIPING ApPROVED / / DISAPPROVED / I / DATE INSPECTOR REMARKS I FINAL PLUMBING \ I ApPROVED / / DISAPPROVED / / DATIE INSPECTOR I I REMARKS I I I 1 FINAL GAS PIPING I I i ApPROVED / / DISAPPROVED / / DAT~ INSPECTOR i REMARKS I I I . CERTIFICATE OF OCCUPANCY I , I READY TO ISSUE / / NOT READY TO ISSUE! / / DATE INSPECTOR I I REMARKS /J; rt~ r/ller'S No .l:i v~ng Uni ts ( Septic Tank: Ft. from well Steel LJ InS~de D.unens~ons: t't. Length ?t W~dth .5 Appl1cant Name TALMADGE STILES I I ~DIVIDUAL SE~AGE DISPOSAL SYST~ RECORD _/ ~ Installer: Complete top part of form to 7 Y b - 0'1 J () s~gnature and \ return both cop~es to Lane ~ Al l. 1 r County BU~ld~~.9 San~tatwn Depar~~t.~ @ ~ ~ ~n.~ ,"!U ~ (JJt:fAt{( ti~: ' - J Pr RM I T tiJo. if .s : 1~1il Name Property Address '\' \ GRAy ""/ I NLAND WAY I . III I 1 7 lQ71 - Basement IWater Supply Yes 0 No 0 :Publ1c ~Other-L~st . ., \. .0 364-73 Bedrooms Baths D~ameter No. Compartments I ~epth ..s LAN2 C:U~-:-v p.mLHl DEPT, I Gal. Capac~ty jdOO . T~le D~sposal F~eld: D~str~but~on Box:Yes ~ No 0 Other D~str~but~on- Type Concrete m- C;PR1W~.I.1 ["l. (lRffio" Leng~ of L~nes - Ft.~o'.( If~" Trench 1. CV 3. 4. 5. 6. W~dth ' Sketch (See ~nstruct~ons): Feet from Well Foundat~on Lot L~ne 'Front V S~de Rear Total sq. Ft.between F~ller I. F,1.ller-deoth F~lierd.epth f /{t:'6 1 C'/ I ~ above below . t. tJ I ~nes -a ,Type j. , tlle ~ ~n. ' b,le (1 lQ..... M a~l~ng I R?h!:i THIJR~TON ROAD Address ~ I I { \ J J \ ( I I ---. ~ ---- --- 11 -7" ~---. -- '~ : { I ,,-::- IJ IJ f t - ~ r'" ~ ! - , / :) ,,' Date 7 - 1-:3 ..... 7) I , I ~~J~a;*,! ." ~ignatur: _~/ 13~ I / /- , Conforms to :curreA1( Standards Date: to Current Standards .:r~13c1 M~ ~~ 7-A-7J rb .I- ' 0/j J A 1.AV4/" Sanltar~an's s~g2J1ure For S~ar~an Use Only: ~pproved: System Installat~on 00 D~sapproved: Does Not Conform Remarks: I Lane County Bu~ld~ng &: San~tat~on Dept. C55-" LANE COUNTY _JILDING PERMIT 0 R MOBILE HOfv._ \JSE APPLICATION PERMIT TYPE - BUILDING 0 MOBILE HOME Mosc REG # PERMIT # LJJ/I.3d;4-7.$ PROPERTj OWNER MAILING ADDRESS r j, // PHONE' .-0~#~~} d ~___ _./--- j7;;2/0~~//)~./)~\ ~..J4~?~-50.::6 CONTRACTOR"./ ----&;rIL~G ADDRESS :./,/ 'Y (/ / PHONE PROPERTY LOCATION - INCLUDE POST OFFICE ~ \. L_tl-~J 'ZU~ PROPERTY LEGAL DESCRIPTION,...':;t ~./ ~ /, // ~/-&t/7 /,. ./ : -e:J. ~ -L / LOT - BLOCK - SUBDIV 7/~ A'.L./7 .r-~, ,-?L- ~ ~ ~ e; TWP RANGE' S'EC - "fAX LOT # CODE' Iff CJ3 0;< lI.!? ~ /2 ~ METES & BOUNDS 0 YES ~,V? ATTACHED 0 NO CENSUS TRACT '- -r..1) - #tJO DESCRIBE EXISTING STRUCTURES ON PROPERTY IF ANY '-.?2v/t-R~ LEGAL ACCESS TJPERTY - ROAD NAME OR # ~~~%H ~ AREA APPLICANT NAME AND O~ MAILING ~ ADDRESS ." " I ~ FOR MOBILE OME PERMIT ONLY ':I Number of Bedrooms .;:2.... STRUCTURES TO BE BUILT THIS PERMIT Connect to EXisting Sewage System 0 TYPE CONSTRUCTION SQ FT or New System Req)(( # 8'EDROOMS VALUATIOtc'l .. / / / PLAN REVIEW PARK TRLR PLUMBING INSTALLED BY ~ OWNER 0 OTHER 0 NAME PLANS FURNISHED FACILlT. PERMIT Y~~,,,~"{.. NO 0 YES NO ~ VA~:U::~:LI~~ Co _ ;/~?~ (~ FEE RE~~~ / DATE ~ Lb~ __ 6-//-;?d. - PERMIT # I Olhl-.$~ -7-2 COUNTY BUILDING & SANITATION SPECIFICATIONS I DRAIN FIELD REQUIRED / 9' () 0 LlN FT /g() TRENCH WIDTH FT 3 OR Sr/UARE FEET !J;1o 4-fl ~ ~C1~ ~t/II-?nd&~A~~ d~/ LJ /!)// L~/' ~Z: ~2-/ -J 7:~",jJp~-{~ 4//1- :z./cr-/- ~!AAL,~j tI ( I ~./ '!"" - / ~.tf' tI TYPE OF STRUCTURE .11 H OCCUPA1CY ZONE REAR YARD PUBLIC UTIL EASEMENT PUBLIC 0 SEPTIC TANK 0 SEWAGE DISPOSAL BLOG WASTE DIS PLUMBING $ FEES OTHER 0 WATER SUPPLY PUBLIC ~ PLUMBIN'G FEES OTH ER ~ /t'J tJ A,~r7 FIXTURES "'- ;;g CJ uJ cJ CASH V. SEWER CHECKIcl CONNECTION FEE TOTAL .;C) .E , 11 /J PUBLIC WATER CONNECTION FEE MIN SEPTIC TANK CAPACITY WITH DIST BOX GAL BLOG SETBACKS - FT FROM CTR OF ROAD RIGHT 19~ Vj A_Y_ 4t)"'" c:..vl...C2:.-~ ""'~ I FRONT 4~ SIDE INT S- SIDE EXT ;:!)/;)~~ 7-;;~ D~ectlons .to VFlnf Property .. USE CLASSIFICATION REAR ~ Date BLOG INSP II ~ ~ J /J ~?_ ,,';''' (-"9-1 "l"=7"'i#.'..,,, R-/.>,,-..-y ~ (!IL Ij .,V {J . I Date COpy I - OFFICE COPY 2 - JOURNAL COpy 3 - AUDIT Form :if: C55' 1 Z