HomeMy WebLinkAboutPermit Building 1977-10-29
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INFORMATION SHEET
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'C><) Building Permit
) Site Feasibility Study for SeptiC Tank Number of sites
Acrea~e or Lot Size '::<"<::S:~:z-.K / a".,!
Partltl.9n1n9 # ) Completed
( ) Pending
. APPLICANT'S NAME AND ADDRESS h/?J'IJ P /",)##,.0
OWNER'S NAME AND ADDRESS, If different from applicant's /7.Pv
CONTRACTOR'S NAME AND ADDRFC:C:
III permit or resu Its of site feasibility study to (
.<J Prefer to pick up Call
Test holes will be ready
SubdivISion
Lot .
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Phone
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STRUCTURES NOW ON THE PROPERTY
) Applicant ( ) Owner {
( owner, etc ) when ready
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) Contractor
Contractors o. s, #
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PROPOSED USE (this permit)
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WA TER SUPPLY
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(existing or proposed well, etc If publiC, name of system)
SEWAGE DISPOSA' AJ /);v';::
A.)r<J?l)f=
(existing or proposed septic tank, etc) S I 4=
PLUMBING BY
Address
) PROPERTY IS WITHIN ONE MILE OF CITY (
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** * ** ** ******** * *** **-Jt* ** ** * ** ** ***** ** ** * * 0 FF ICE USE ON L Y BE LOW TH IS Ll N E *** ** * * *... -II- * * * ** * *** ** ** * -II- * * ** * * * * ** *.. "" * **....
, I NewA'd,4:s Necessary ( ) Facility peE N~eSS';k')./?.n-/J.
~...NE--fK--_ SETBACK~ C;Z e fa;;ngS~t
(FROM c ERLINE OF ROAD)
) SpeCial Permit Area Minimum Elevation
Interior Side Yard -r/ Rear </
(FROM PROPERTY LINES)
To Planning/Building Inspector/Sanitarian/Surveyor
ThiS applicant appears to have a problem With
Your assistance will be apprecIated
By
Permit Processing Section
Response
C5512
By
DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
Permit Processing Section
125 East 8th A venue
687-4394
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LANE COUNTY PERMIT
Acreage or Lot S17P ....;2S-C::;-)( J<! 0 '
Contractor's 0 S #
APPLICANT'S NAME AND ADDR~"" 4..1(J/I p,
OWNER'S NAME AND ADDRES~ ~ -
CONTRACTOR'S NAME AND ADDRF<:<:
Mail permit to ( ) Applicant ( ) Owner ( ) Contractor ( i)_Prefer to pick up
STRUCTURE/OW ON THE PROPERTY <,j: [)
,HIS PERMIT IS FOR ~ < rhu /) O,o,./..J/.-IoA!h..t
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WATER SU'PPLY ~ '-U~
Partitioning # ( ) Completed SubdivIsion
Lot
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Call ,'1L.1t-- -< - /::J-I
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(owner, etc ) when ready,
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THIS PROPERTY IS WITHIN ONE MI LE OF THE CITY OF.
(?r7.uJ <: " ::J-o?Jn J:Jf# BEDROOM<:
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SEWAGE DISPOSAL ' .tJ.A/ ~ ,j-
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PLUMBING BY
# PLUMBING CONNECTION5......-
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I hereby certify that the above statements are true and accurate, and that I have the follOWing legal Interest In the property _owner of record,
contract purchaser, _ potential buyer, _ realtor or agent I further certify that (If not the owner) I am authorized to act for the owner of
record and that said owner IS aware and approves of thiS action I hereby agree to comply with all applicable Codes relating to thiS permit
Fee pa;d.<I: .....<<:)!t. r2.. t/ (/?J, ~60) - Signature ":;/J~_j ;,uI.-,.~jl Date--.Fh;? /; >
( ) NEW ADDRESS (') F~'cILiTy PERMIT TO TRANSPORTATION DEPT - ( ) SPECIAL P~T AREA MIN ELEVATION/
SANITATION
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BUILDING
_ - '<it! Type of Construction : / Group - '5 F Ire Zone
-" . , Use Classification
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Comments LANE COUNTY SPECIAL PERMIT AREA
MInimum Septic Tank Capacity (Gallons)
Dralnfleld ReqUired. Lineal Feet
MaXimum Depth
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By -...<:::-/ _____-:'-1 fi, Date ~ S?-J",?"-77 By 0~!5&4d h 9&~ate y- 7-7-77
PLANNINQREQUIREMENTSSATISFIED By '~-://An;/- ? Date ;7-/1-'7// Date Issued (:uM:~lI77
ZONE fI/ 4 SETBAC;KS fRONJ, / SIDE-FACINGSTREET (FROMC/L)' INT SIDE YARD C;/REAR,,, (FROMP/L).
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LANE COUNTY DEPARTMENT OF ENVIRONMENTA'L MANA"GEMENT, 125 EAST 8TH AVE, EUGENE, OREGON 97401 PHONE 6874394
POST THIS PERMIT ON MAIN BUILDING AT SITE
C5513
SLOG PERMIT - WHITE BUILDING - GREEN PLUMBING - CANARY SANITATION - GOLDENROD OFFICE COPY - WHITE
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SITE INSPECTION
ApPRovEo d DISAPPROVEO
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DATE
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INSPECTOR
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REMARKS
FOUNDATION INSPECTION
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ApPROVEO~! D'SAPPROVEO
REMARKS 1f'))Ir
DATE
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FRAMING INSPECTION
ApPRovEo ~ D'SAPPROVEO! ! DATE C. - 2-&'-71
INSPECTOR
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REMARKS
LATH OR SHEETROCK INSPECTION
ApPRovEo L:::J D'SAPPROVEO L-! DAT~
INSPECTOR
REMARKS
FINAL INSPECTION
ApPROVEO 0' DISAPPROVEO! ! DATE t -2.-,f-l.RINSPECTOR
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REMARK 5
CERTIFICATE OF OCCUPANCY
READY TO ISSUE / / NOT READY TO ISSUE / / DATE
'NSPECTOR
REMARKS
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LANE COUNTY PERMIT
Acreage or Lot Sizp
Contractor's 0.5. #
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Partitioning #
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Subdivision
Lot
Block
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(owner, etc.) when ready.
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APPLICANT'S NAME AND ADDRESf: '-:/j,.-;;
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OWNER'S NAME AND ADDRESf:
CONTRACTOR'S NAME AND ADDRES~
Mail permit to ( ) Applicant'( ) Owner
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)- STRUCTURES NOW ON THEi PROPERTY
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I HIS PERMIT IS FOR~ -< if!.>
WATER SUPPLY (,1 '..1',1./
( ) Contractor.
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L)"Prefer to pick up.
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THIS PROPERTY IS WITHIN ONE MILE OF THE CITY OF.
I hereby certify that the above statements are true and accurate, and that I have the following legal interest in the property: _owner of record;
contract purchaser; ~ potential buyer; _ realtor or agent. I further certify that (if not the owner) I am authorized to act for the owner of
record;and.that said owner is aware and approves of this action. I hereby agree to complywith all applicableCodes.relating.to.this permit.
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Fee Paid <l: ~") '" . D2 , /(;. ("'(::-'0) Signature ~. A.,"L.# j7' .<", t Datp ).t~..... ,',
( ) NEW ADDRESS ( ) F}CILlTY PERMIT TO TRANSPORTATION DEPT. (I SPECIAL PMT. AREA. MIN. ELEVATION:
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Minimum Septic Tank Capacity (Gallons)
Drainfield Required. Lineal Feet
Maximum Depth
BU?QI~G _
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Use Classification
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Comments: LA:.1'JE COUNTY SPECIAL PERMIT AREA
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Fire Zone
SANITATION
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By: Date: .. /.;;:, "7 '7
PLANNING REQUIREMENTS SATISFIED. Bv: ,/;,.,.,J-
ZONE: ,~ .4- SETBACKS:JRONJ: /. "S'lOE F'ACING STREET
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LANE COUNTY DEPARTMENTllF ENVIRONME1-JTAL MAN.A:GEMENT, 125 EAST 8TH AVE., EUGENE, OREGON 97401
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Date: .:7.. //. '''7/7 Date Issued:(1111_ . -..,I/T1
(FROM'C/U' INT. SIDE YARD '~J REAR~. " (FROM Pill
PHONE: 687-4394
C55.13
POST THIS PERMIT ON MAIN BUILDING AT SITE
BLDG. PERMIT - WHITE; BUILDING - GREEN; PLUMBING - CANARY; SANITATION - GOLDENROD- OFFICE COPY - WHITE
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MEM~RANE)UM
Idne county
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FROM
SUBJECT PffMIT J:t:. Z ~o 1- 77
DATE 8- -:5' - 7 7
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