HomeMy WebLinkAboutPermit Building 1977-12-15
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t7 Ii v ( INFoflM~T10Ki SHEET
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- '?9~~// 71h?~.s1 z;--
()(l Building Permit
) Site Feasibility Study for Septic Tank Number of sites
IAcreage or Lot Size
Partitioning #
Test holes will be ready_
( ) Completed SubdlVISI ,,!~~ Lot
( ) Perldlng ~ ") A
APPLICANT'S NAME AND ADDRESS _1./) N.n,M/ " /':1.1/1 /~A'~Zv y~ ..IP:J, hLFf
OWNER'S NAME AND ADDRESS, If dlffererlt from applicant's _ L: ~-,'_- --' . I F
CONTRACTOR'S NAME AND ADDRESS _"L , ,"'</
Mail permit or results of site feasibility study to (X) Applicant ( ) Owner ( ) Contractor
( ) Prefer to pick up Call (owner, etc ) when ready
STRUCTURES NOW ON THE PROPERTY No 5+h.ULhvT L'X"' _ vnS./u.Li.-J5C.S
PROI"OSED USE (this permit) -5 F' D ~a.r0-~,~:- 0 paA-10'/ ('hLk;:r . -3 H ?Airr,r,n"
WATER SUPPLY uJ//--I/????~ P1/~ /l~ (existing or proposed well, etc If public, name of system]
(existing or proposed septic tank, etc) S I i' ~ ~-~
Block
Phonp
_ Phone
Phone
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Contractors O. S. #
SEWAGE DISPOSAl
PLUMBINGBY IAJdt:;P &~~
(
Address
) PROPERTY IS WITHIN ONE MILE OF CITY (
***** ** ************ ********* ********* ****** OFFICE USE ONLY BE LOW THIS LINE *****.. *** ***"" iHt "" *****.... ***... .....lH..... -ll-""..........oj-.. *..
( ) New Address Necessary
ZONF
) Facility Permit Necessary
SETBACKS Front Side Faclrlg Street
(FROM CENTERLINE OF ROADI
) SpeCial Permit Area
Minimum Elevation
Interior Side Yard 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
Resporlse
C5512
By
DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
Permit Processing Section
125 East 8th Avenue
687-4394
DIVISion
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ADDITIONAL INFORMATION REQUIRED
Submi t the follom.ng items to the Building Off':1.cial at least ::z y;eeks prior
to instdlJatlon. Return thls form m.th two coples of all reqUlred information.
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BlUldJ.nB Permit No.
t;333-77
Applj cant W B. F I X.
Job Location ICJ(p(;, COLe. VVA-y
BUllding Inspector -Slly\. L4MB
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Date
Qecwmber /I~~ 1"17
Permit Na
344~-77
CURB CUT
PERMIT
IN THE BOARD OF COUNTY COMMISSIONERS OF LANE COUNTY
WHEREAS, the attached application has been fully considered by the Board of County Com-
miSSioners of Lane County, and It IS the opinion and ludgment of the Board that the sOld application
should be granted, and that a permit should be Issued, now, therefore, It IS hereby
134<:&
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ORDERED, that a permit be and IS hereby Issued to G.,). ,..,) \...x- _
{l,UClh LVa5l.r ~. ~ V)"",.c. ~Irl : ~'-'. , for plaCing, bUilding
or constructing the following facility ur- - 0
I-M ..3, 6l0G~.3 of .A.101.,LnG UJLIn(JY'l E?J1-a::b-~ (10(00
cO) v
~e rlg~ay of County Road No , Mile Post
In strict confo';mh/Y'to the exhibits attached hereto, and sublect to all terms, conditions, agreements,
stipulations and prOVISions contained In the application and permit, the Rules and Regulations Gov-
erning Facilities to be Permitted upon County Road Rlghts.of.Way, os set forth by the Lane Man.
ual 50 190(2) any amendments thereto, and any other applicable regulations, law or ordinance
Special ProvIsions
Driveway Will be constructed In accordance with the attached driveway approach specifica-
tions (DraWing M98-50)
2 Permittee Will be responsible for the Immediate removal of all mud, dirt and debrIS from the
roadway and right of way caused by hiS operation, leaVing the roadway and area In a neat,
acceptable condition
3 Sldewalks wlll be constructed ln accordance wlth the attached sldewalk
speclflcatlons and drawln9 M9S-49 The Standard Curb Type shall be
constructed unless otherwlse speclfled
ThiS permit IS revocoble at any time, and will be strictly adhered to and no work other than
that speclflcolly mentioned above IS hereby authOrized
ThiS permit shall be VOid unless the work herein contemplated
J)o1'..OJmbn I~~
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shall have been completed be.
fore
, 19$
Expires
,19_
Inspected and Approved
Approved by Board of County CommiSSioners
By
Clt-DD~~P~~LAD
Datf>
By
WHITE - OFFICE FILE
YEllOW - REAL ESTATE
PINK - PERMITTEE
ORANGE - BUILDING & SANITATION DE'T
C74-129
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COLE 'lAY
JOB LOCATION
.-
LANE COUNTY PERMIT
Acreage or Lot SI7Q
Contractor's 0 S #
Partltlorllng # ) Completed
W.B. FIX 1348 CLEARWATER
APPLICANT'S NAME AND ADDRF~~
OWNER'S NAME AND ADDRES~
O CONTRACTOR'S NAME AND ADDRE~~
Mail permit to (A) Applicant ( ) Owner
) COrltractor ) Prefer to pick up Call
NONE
STRUCTURES NOW ON T~i\'lll.9J.If.~JGY
THIS PERMIT IS FOR 8~GE
- --
l.~.I:~ sq rt: .....toN~~....-. .;.,...- C1
8 SQ ft: VALUE $33,891.00
6 ,," ft".
WILLAMETTE WATER DIST
WATER SUPPLY
SEWAGE DISPOSAl
NA
THIS PROPERTY IS WITHIN ONE MI LE OF THE CITY OF
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97477
OREGOa
2~, MT \cERNON ESTATES
SubdivIsion - _
Lot .J Sloel< oJ
LANE SPRINGFIELD OREGON
PhorlQ
PhonQ
PhorlQ
(owner, etc I when ready
746-3072
3
# BEDROOM~
PROPOSED
. 14
'* PLUMBING CONNECTION5--
74-382
PLUMBING BY
S I #
WALLYS PLUMBING
I hereby certlfy'that the above statements are true and accurate, arid that I have the following legal Interest In the oroperty _owrler 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~ aware and approves of th.s actlOrl I hereby agree to comply with all applicable Codes relating to this permit .
Feeifald $ d.\cC\~ Signature '-_::::::X'yV'i, DatQ \ \~~ \.~
(V) NEW ADDRESS ( ) FAC1L1TY PERMIT TO TRANSPORTATION DEPT ( I SPECIAL PMT AREA MIN ELEVA'~rI(3N- , -..(
- ;-...,
O SANIT~T(\.f2,N B~UILDING '-2.
- Mlrllmum Septic Tarlk Capacity (Gallons) Y ^' :rype of Construction r Group ..-' ~Ire Zone
>MIU"l< '-.....9
""~ Dralnfleld ReqUired - Lineal Feet -- Ilse Classlf,catloP
-.l!O . ~ MaXimum Depth J) 4-.4 tl -I _ ,Comments $f: e !/PP1noryf+L I ~ Fo/(M /.j T fOIl{
Com merits JI~ ~ ~ d.-6d.JU~ ~ sfiec;:r /)rr4c.f-!c:. (:) 70 PI...I-}N-s'
.-........;:z&-^"-' ~iL "'^"""- "t ~~) ~ - SIZe B>Ac. H or- pe~~1\11 7="0,'\ I..lsT
j ~ a...... CU\IUl-o ~ ~'1 ~'-' cf&...d.<'"fd' or::: Re QVI'~E[? c.At-1.- 'f\(:sr~t=c.'J?O(VS
By _r6/, ~..a.-.:;Z-- Da1~(-;J.(-F' By a~/1;-x:ltt4;-'7;. zt:J Date /'1/0;<-/77
PLANN,ING-RgOUIREMENTS SATISFIED BY~O'<,""~~ Date \ \C." ~) \ \-.-. Date Issued';:' uc-c- '0, ,-... I I
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ZONE\'..)..\::'? \ SgBACKS F_RONT _~ SIDE FACING STREET (FROM elL) INT,SIDE YARD\:::J RE~R!I:~(FROM PILl
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1 l;ANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE EUGENE, OREGON 97401 PHONE 687-4394
C5513
POST THIS PERMIT ON MAIN BUILDING AT SITE
SLOG PERMIT~WHITE BUILDING-GREEN PLUMBING-CANARY SANITATION-GOLDENROD OFFICECOPY-WHtTE
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Permit No
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:"3-"44.<! -77
CURB CUT
'- .. '" i>
PERMIT
IN THE BOARD OF COUNTY COMMISSIONERS OF LANE COUNTY
WHEREAS, the attached appllcahon has been fully consIdered by the Board of County Com-'
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missioners of lane County, ond It IS the opinion and ludgment of the Board that the said application
should be granted, and that a permit should be Issued, now, therefore, It IS hereby .
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ORDERED, that a permit be and IS hereby Issued to
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or constructing the following facility
Ni/ " ) '/ (/ c~, :' (... i . ~ Ie 1 '
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u'pon the' rlght-of-~way of County Road No , Mile Post
In strict conformity to the exhib,ts attached hereto, and sublect to all terms, conditions, agreements,
shpulatlons and prOVISIons contarned In the application and permit, the Rules and Regulations Gov-
erning Facrllhes to be Permitted upon County Road Rights-of-Way, as set. forth by the lane Man.
ual 50 190(2) any amendments thereto, and any other applicable regulations, law or ordinance
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l...~I" ,,(0 I .., for
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plaCing, bUilding
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Specla I ProvIsions
/
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Driveway Will be constructed In accordance With the attached driveway approach speclflca'
tlons (DraWing M98-50)
2 Permittee will be responsible for the Immediate removal of all mud, dirt and debns from the
roadway and right of way caused by hiS operation, leaVing the roadway and area In a neat,
acceptable condlhon
3 Sldewalks wlll be constructed ln accordance,wlth,the attached sldewalk
, ... " ,.
speclflca~lons and drawlng M98-49 The-Standard 'Curb Type shall be
constructed unless otherWlse speclfled , ,
ThiS permit IS revocable at any time, and will be strictly adhered to and no work other than
that speCifically men honed above IS hereby authOrized
ThiS permit shall be VOid unless the work herein contemplated shall have been completed be.
for'"
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19.1....-
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Expires
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Inspected and Approved
Approved by Board of County CommiSSioners
By
Oat!'
By
II I )'-1 I r /
Director of PubliC Works
WHITE - OFFICE FILE
YELLOW - REAL ESTATE
PINK - PERMITTEE
ORANGE-BUILDING & SANITATION DEPT C74-129
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JOB LOCATION
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TRS, TI
LANE COUNTY PERMIT
Acreage or Lot SI?P
Contractor's 0 S #
Partitioning #
) Co mp leted
SubdiVISion
Lot .J Bloc~ ...
gpnI:;G,rI~L~ 01i.r;o::-s
Phonp
Phono
PhorlP
(owner, etc ) when ready
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APPLICANT'S NAME AND ADDREC:C:
OWNER'S NAME AND ADDRESC:
CONTRACTOR'S NAME AND ADDRESC:
Mail permit to (") Applicarlt ( ) Owner
, .-
) Contractor
) Prefer to pick up Call.
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STRUCTURES NOW ON T"H~ Pi..~\?~II(.TrY
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THIS PERMIT IS FOR !.lL:,'('
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l\lrJ r1 '7"!
v~~~: $J3,U>\.OO
# BEDROOMC: 3 # PLUMBING CONNECTION~
-~.!.LL.a';_"'-",':;'EL PA'i .tLt iJ IS'1.1
WATER SUPPLY
SEWAGE DISPOSAL
PI<C;':OSIill
THIS PROPERTY IS WITHIN ONE MI LE OF THE CITY OF
PLUMBING BY
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'lM.L'iG PLU;mr ('
7' .3f ~
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I hereby certify that the above statements are true and accurate, arid that I have the following legal Interest IrI the oroperty _owrler 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. lS<aware and approves of th,s action I hereby agree to comply with all applicable Codes relating to this permit
;::/ '-,\1 "'''-Z....U ,~
Fee Paid ~ .;.~-:.,\o'-4" -~ ' Signature '---" .. '- Datp \ \ -' - "
<<) NEW ADDRESS ) FAc1L1TY PERMIT TO TRANSPORTATION DEPT _ ) SPECIAL PMT AREA MIN ELEVA\ION -. -, --":\,,
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BUILDING
. ,it
Type of Constructlorl
Use Classlflcatlo~
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r.roup
F Ire Zone
Minimum Septic Tank Capacity (Gallons)
Dralnfleld ReqUired - Lineal Feet
MaXimum Depth
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Comments l .,~ '_ ~-AA--\.'
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PLANNING REQUIREMENTS SATISFIED By-'--,....)C ,,', '", '_ ...~-'
ZONE' "- '~" \ SETBACKS FRONT -'-. ') SIDE FACING STREET
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Da1e \ \ lLU \.~ Date Issued
(FROM'C/LI INT SIDE YARD\:=:> REAFJ.,O. '(FROM Pill
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LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE. EUGENE, OREGON 97401
POST THIS PERMIT ON MAIN BUILDING AT SITE
:;,\,,-
PHONE 687-4394
C5513
SLOG PERMIT - WHITE BUILDING - GREEN PLUMBING - CANARY SANITATION - GOLDENROD OFFICE COpy - WHITE
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SITE INSPECTION
ApPROVED ~DISAPPROVED ~
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DAT</2-2...I-'77 'INSPECTOR 9a4
REMARKS
FOUNDATION INSP~N
ApPROVEO L-::::J DISAPPROVED L-I
REMARKS~~ /Jk:. .L-,
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ApPROVED I I DATE 1-/1-7% INSPECTOR4rP
tJ~Kia....~ 1/-4~~ A-J......-r ~f' d,_, r_r7-~
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LATH OR SHEETR~INSPECTION
ApPROVEO ~I D,SAPPRDVEO
If DATE
/-7-7J
INSPECTOR
9u-L
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REMARKS
FINAL INSPECTION,
ApPRDVEO d' 01 SAPPROVEO / I DATE t, - /4- 7 ?I NSPECTOR )Jv...rt:..
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REMARKS ' It/ f2..d .A' A-"l.. ;r-..L...- _ ' ~ .,<- """J-",,-:,,- L -.. . _ 1.1
h.,pf ......../ _d".:.._~.J,___ #2t:.J':'" ~__j":=_.;? /., -7_'P ~
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CERTIFICATE OF OCCUPANCY
READY TO ISSUE ;---? NOT READV TO ISSUE I / DATE
INSPECTOR
REMARK 5
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JOB LOCATION
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974"'17
TRS, T!
LANE COUNTY PERMIT
Acreage or Lot S17~
COrlt,rartor's 0 S #
.Partltlorllrlg #
) Completed
n71 ttlliJro ESiNI?ES
APPLICANT'S NAME AND ADDRFC:C:
OWNER'S NAME AND ADDRES<:
O CONTRAC10R'S NAME AND ADDRES<:
l 'Mail permit to (...) Applicant ( ) Owner
STRUCTURES NOW ON T~...I~rP~.9.Flf..~,TGY
(',ARI',GB
THIS PERMIT IS FOR 1.ll.:t;K
~^t'f1T7
1340 CLI:Ill1!Ji\'I't:r..
;
SubdivIsion
Lot Bloc~
SroXLiGFIllLD or.rrOO~
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<J.D. FIX
L.!\OE
746-3072
) COrltractor
N~m
) Prefer 10 pick up Call
Phon~
Phono
Phon~
(owner, etc ) wherl ready
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V~E $33,a91.CO
3
# BEDROOM<:
PUOJ?03!.ill
14
# PLUMBING CONNECTION,,-------
7!}-302
WATER SUPPLY
UILUli:JITfi'Il tJ'll.'iSll DIS'1'
SEWAGE DISPOSAl
S I #
HllLLYS l?LmmIUG
nA
THIS PROPERTY IS WITHIN ONE MILE OF THE CITY OF
PLUMBING BY
I hereby certify that the above statemerlts are true and accurate, arid that I have the followmg legal mterest m thp oroperty _owrler of record,
cOrltract purchaser, _ potential buyer, _ realtor or agent I further certify that (,f not the owner) I am authorized to act for the OWrler of
record and that.sald owner,lS,aware and approves of th,s actlOrl I hereby agree to comply With all applicable Codes relating to thiS permit
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Fee Paid $ -,... .... Signature ~ Datp \ .
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I.' ) NEW ADDRESS 1 ) FACILITY PERMIT TO T-RANSPORTATION DEPT 1 ) SPECIAL PMT AREA MIN ELEVATION- -, '"'4
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O SAN IT'A'T,10N
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~ Comments
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BUILDING
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'. Type of Construction
~ Use Classlflcatlo~
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t /t. f- :::-
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Comments
M,rllmum Septic Tank Capacity (Gallons)
Dramfleld ReqUired - Llrleal Feet
MaXimum Depth
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Group
Fire Zone
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PLANNING-REQUIREMENTS SATISFIED By~l~ ,,, "~?--" Date \ V.\. Il..J \::~-Date I~sued LA"~ ''''',' ..."
~NE'.,.~\"..... \ SETBACKS FRONT _-1...) SIDEFACING~TREET IFROMC/L) INT SIDEYARD\"::;> RE,I}.R~\) -IFROMP/L)
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LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE, EUGENE, OREGON 97401 . PHONE 687-4394
POST THIS PERMIT ON MAIN BUILDING AT SITE
C5513
SLDG PERIVIli-"':WHITE BUILDING-GREEN PLUMBING-CANARY, SANITATION-GOLDENROD OFFICE COPY-WHITE
-~
SLAB FLOOR
PLUMBING GROUNDWORK
ApPROVED rt OlSAPPROVED .C1 DATEI
,
II NSPECTOR
REMARKS
GAS PIPING GROUNDWORK
ApPROVED .C1 DISAPPROVED .C1 DATE
INSPECTOR
REMARKS
ROUGH PLUMB I NG
ApPROVED /V! DISAPPROVED .C1 DATE J -/?~7fINSPECTOR P.k
REMARKS
ROUGH GAS PI PI NG
ApPROVED C1 OISAPPROVED C1 DATE
INSPECTOR
REMARKS
FINAL PLUMB I NG
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REMARKS
FINAL GAS PIPING
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CERTIFICATE OF OCCUPANCY
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Job Location (Street, mile post) 1Qbb Co....t WAy. ~Pel t-jc;;.r-, <:..1-0
SubdivIsion "1Ylot.LY1+, Ua.t-no-n E~ct.::t.L <i? Lot 3 Block' 3-
FOR SANITARIAN'S USE ON L Y %J.. System Approved D System DIsapproved D Needs Correctlorl
COMMENTS
Slgnature~
FOR INSTALLER'S USE Trench Depth ~O II Filler Depth Belo lie c.. ,\
Tarlk Capacity ICOO Marlufac1urer Eu GGt:-\E ~ AN
Measured distance to well from tarlk ,?O~L\ c., H? qrom dralrlflelrl
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INSTALLATION RECORD AND CER r1FICATE OF SATISFACTORY COMPLETION
Wherl signed by the County Sanltanarl, thiS certifIcate IS eVidence as per ORS 454 665 of sat-
Isfactory completion of a subsurface sewage disposal system at the above locatlorl
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Return thiS form to PermIt Processlrlg Section, Department of Envlrorlmental Management,
Public Service Building, 125 East 8th Avenue, Eugene 97401
C55-11
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JOB LOCATION
LANE COUNTY PERMIT
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Acreage or Lot SI7P
Contractor's 0 S #
Partition Ing #
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SubdiVISion
Lot Block
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APPLICANT'S NAME AND ADDRI=';';
OWNER'S NAME AND ADORES';
,- '\ CONTRACTOR'!?,. NAME AND ADORE';';
\ J Mail permit to ( ) Applicant ( ) Owner
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Phonp
Phonp
Phonp
(owner, etc ) when ready
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) Contractor
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THIS PERMIT IS FOR
STRUCTURES NOW ON TLH~P,~O~~~T~
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# BEDROOMS_# PLUMBING CONNECTIONS-.-
WATER SUPPLY
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SEWAGE DISPOSAl
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THIS PROPERTY IS WITHIN ONE MI LE OF THE CITY OF
_ PLUMBING BY
I hereby certify that the above statements are true arid accurate, arid that I have the following legal Interest In thp oroperty _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
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record, and that said owner IS aware and approves of th,s action I hereby agree to comply With all applicable Codes relating to thiS permit
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Fee Paid $ Signature Dat"
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(. ) NEW ADDRESS ( ) FACILITY PERMIT TO TRANSPORTATION DEPT
CI SANITA,TI9N BUILDING
M,rllmum Septic Tank Capacity (Gallons) Type of Construction
Ira r : . Dralnfleld Required - Lineal Feet I Ise Classification
Maximum Depth
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) SPECIAL PMT AREA
MIN ELEVATION
Group
Fire ZOrle
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Comments
Comments
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PLANNING REQUIREMENTS SATISFIED By
;lONE \ SETBACKS FRONT
By Date
- .' Date Date Issued
SIDE FACING STREET (FROM CIL) INT SIDE YARD' REAR.
(FROM PIL)
L:ANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE, EUGENE, OREGON 97401
POST THIS PERMIT ON MAIN BUILDING AT SITE
PHONE 687-4394
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C5513
BLDG PERMIT - WHITE BUILDING ~ GREEN PLUMBING - CANARY SANITATION - GOLDENROD OFFICE COPY - WHITE
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