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HomeMy WebLinkAboutPermit Building 1978-3-8 ~~'f' ;- ...::p V ~ ~. ;..~ ~I - TRS T' - ' " \ //t113 (!;J2.e., u)~ u ~/LJ!.. SubdivISion /tl.;;,t. th-1tW.)'l t4lo.-iLs Lot 7 . / Block c:.L ~ OA-VJO.:ieA...J zll1.../ :;;fdr(cf}. Phone/$ - 30 7OJ.. Phone Phone (owner, etc ) when ready ~3C-r 7!? 37Co-78 " )' j, d- ~ ;;r. t/ , ~ \ i 1f- (9tJt) JOB LOCATION , -, ~'\,. .J,}" -' Acreage or Lot Size Contractor's 0 S # I DJ &00 .If /V -"T LANE COUNTY PERMIT Partitioning # /VA- ( ) Completed "... ".' .J ' APPLICANT'S NAME AND ADDR1=C:C: OWNER'S NAME AND ADDRESS CONTRACTOR'S NAME AND ADDR1=C:C: Mail permit to (I..-)-Kpplicant ( ) Owner -&~ ___.:/~ 1~c./8 , f , " ) Contractor ) Prefer to pick up Call 1- STRUCTURES NOW ON THE PROPERTY 0 . THISPERMITISFOR .:5 P.o ;Y7:?8', ,q,..-", ,t./,s0.Q, ~f/n.::;tuL~~~ROOMS3#PLUMBINGCONNECTIONS/~ WATER SUPPLY !J~ tIl::t~~- ~. S~WAGE DISPOSAL S I # 7<1 3o::f e,;z THIS PROPERTY IS WITHIN ONE MILE OF THE CITY OF . PLUMBING BY ~ , (I hereby certify that the above statements are true and accurate, and that I have the follOWing legal Interest In the Droperty _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 th,s action I hereby agree to comply with all aP?..!!5able Cod~s relating to this perl;:"t / Feept,;;$ c:20r;.,.~ro (31;7cfs..~ Signature ~~~p--<c~~ Date 2.-//?o/7:Y (Vi NEW ADDRESS ( ) FACILITY PERMIT TO TRANSPORTATION DEPT ~SPECIAL PMT AREA MIN ELEVATION *'....... ' SANITATION BUILDING i=Looc> RLAIW AReA /{J1:1O MInimum Septic Tank Capacity (Gallons) If N T e ~f Construction I Group .5 Fire Zon ,,(,/0 Dralnfleld Required. Lineal Feet . J Wet..L, /./(", Ilse ClaSSlflcatlo~ 3D" Maximum Depth -+ t'.;r . Comments Comm-;nts Jl"'l<.J::'4<<"- ",-"" ~ -:Rd.~ ~E.G NOTE? D4 FL.-fl./{'s ~o!-~ /~~i;\';): Z; ;-t.cl /~t.... (It/' of ~/ *' f 10 IS ,., F t.. D (J /l. e t.. e tJ Art 0 AI TO & e U 'It<<MPT k /ViWu..J.. j.,-t.. .--<~~ ~ 1- . ~ e ~. {> 0 ,_ B 2 ASS C A F;> IIJ ).J. E'. c cJ It. S ....:t.lt'u c&.ctr^~.f.-.: (J n A L F.... ... . . ,I '5 iW'A~ fElJ~V.'~ DElvE CI CDt.€lUAy By .4 ..4~__ Date .;l~?<f' By ..L~ f/U4T~< t.. V AT/OA./Daf? ~ fl~~kQ3' PLANNING_REQUIRIEMENTSSATISFIED By LjCt.ru....;t:;' Date 0)-/'/-7% Date Issued .:;;-21-/,0 ZONE JGff SETBACKS FRONT&0' <SJ@"EtFJ':CINGSTREET - (FROM CILI INT SIDE YARDS; REAR-/ ~),(FRQM PILI f"" I lf7Y1 Ck<..--t.-.. f Vl C LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE, EUGENE, OREGON 97401 PHONE 687\4394 POST THIS PERMIT ON MAIN BUILDING AT SITE "3-Sn~ 7 C- "~ ./ (' C5513 SLOG PERMIT-WHITE, BUILDING~GR.EEN PLUMBING-CANARY SANITATION-GOLDENROD OFFICECO'l!"'Y-(,~E O.;::,~ Acreaqe or Lot Slle Contractor's 0 S # If(, I'H7r) 4' /1/A- 08d~s JOB LOCATION / t'J 7 3 (~L t{) ~ jj--'/-~e.. Partitioning # /l/ ft ( ) Completed SubdivIsion "/7-<--<.C {~./..-<J7't t;,A:lrJ_c; Lot Y Block ~ J}~<J8 (!t-t Q/LL-z)o.~ dIU ~4fAJ. PERMIT #3'1fr-78' ~' V ~. j . TRS TI '. ,-/ / J ,-)-s LANE COUNTY PERMIT APPLICANT'S "JAME AND ADDRESS ~-^ -.I /' .,. OWNER'S NAME AND ADDRESS CONTRACTOR'S NAME AND ADDRESS Mail permit to (L-l-Al'iplicant ( ) Owner ~-f~ If ) Contractor ( ) Prefer to pick up Call. Phone-:Lck, - 307~ Phono Phono (owner, etc ) when ready If STRUCTURES NOW ON THE PROPERTY ,r; /J _.k 'I'.-1S . THIS PERMIT IS FOR :s F/J /'-l2l?8') f}1JLA..., d~t..~. 1\j:7ncJ.!:I/jJ.~ BEDROOMS ~ "PLUMBING CONNECTION~ WATER SUPPLY kl/~p-no)I.D:rrl!-{}A'~' . SEWAGE DISPOSAL SI #Lc.J<=V?r).. THISPROPERTYISWITHINONEMILEOFTHECITYOF - - PLUMBING BY (fhf~~ I hereby certify that the above statements are true and accurate, and that I have the following legal Interest m thp orope, y -_owner of record, contract purchaser, -- potential buyer, _ realtor or agent I further certify tl,al (If not the owner) I am authOrized to act for the owner of record, and that said owner IS awarynd approves of this actlor> I hereby agree to comply With all applicable Codes relating to this permit Fee Paid $ ~0.b3..(r< (:!}1;7CfD Slgnaturo ~~~ Date "?-//V7~/ I ) NEW ADDRESS ( ) FACILITY PERMIT TO TRANSPORTATION DEPT ( ) SPECIAL PMT AREA MIN EL,EVATlON SANITATION Minimum Septic Tank Capacity (Gallons) Dralnfleld ReqUired. Lineal Feet MaXimum Depth BUILDING Type of Conl,'tl uctlon I'se Classlflcatlor> Group Fire Zone Comments Comments By DMe PLANNING_REQUIREMENTS SATISFIED By ?ONE Ie-:.. It SETBACKS FRONT By Ddte Oate Date Issued SIDE FACING STREET (FROM C/Ll INT SIDE YARD REAR (FROM PILl LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE, EUGENE, OREGON 97401 POST THIS PERMIT ON MAIN BUILDING AT SITE PHONE 6874394 CS513 SLOG PERMIT - WHITE BUILDING - GREeN PLUMBING - CANARY SANITATION - GOLDENROD OFFICE COPY _ WHITE ..... t " y //" ./ ~tl p- --I u I ~J t'tj g~1 In I , ~ \'?-~ ,/ 12. 0 .l,oPuE'., " " " ....~ I ... ,-- , , t... -' , 'i:-...,~ ~ \1 '["=1 ~ \~~ t N .~, ~~ ~t ~1i_""""'-""-''I''.''l 18' C-Cl-JC.. PRJ~? /'" \"F ~ k ,.. ~. r ...c;:~ ~ ,p/ ,./ / ;0.,. , // /' - '- ..---- ::,A'''/ ..-/ ~ u." ':?I, ~ cr K 2- MT ~O~-l E~IATe.:::;, 1M1R.D 1>...0\::>11101>-1 !J>.wc;;: c..ouu-ry J a~o~ v /" ..---- ~./ ~o ..---- ~ -""':'Q' "~ '- <2<:;:" -....:::: :3<" ./ /" ..-r' ?-'b' ..---- ;.-- '- " ---. .... ~' ~ r;"'~-~---~.~ ~-~- ----=-... i'~~-E;'~~ l- IX' /' ,- - -.. - ~ ('10TI(;"[: ,-~,:~ .~6 ;,/ ~ ,~- ~:) ~ :=:%-. - - --~ p~ ~- - - -* - - ~---~ ----. 'Ir , _ t,l ~ r: ,~ Ilf, )\)l /:' ~JTE. R_AJ,J:j , , ' ,I ,/ " f;fI'/-,,: \ I ,l l..F ---.:.-.::_-~-____~. _ J ,,' 11'" '" 1,1 '[ l2Ao ,-- ....-. ) ... , -....- -- ,--- ~ ~ f ~ ...~_.. II.'; Y:: l ' ) 'p.\ \ )'1' /"==2..d I" ~ l> c:: ." <-.;) 7~",-_ _ '--' - -. -- --- ~-- --- .~~- ~~~~~h~~ ~",_.,,,,,.,.,.,,,~~.~",;,-'; "'~H"'"",,^~~ ...~_~''''''' ~""'~"-'f><"" ~'~".-M"<";"_''''''""A>'''''''~;C':''S'C;, .........." ''''m'~''','' ... ... ........, '''''''''''H''~'''','''' ~.o.i',~.III~~ Date fflarC.h.. Zl~. 107'8 Permit No :~'76-r /8 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 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 ~CJL..J-Ut., J 1348 ~cu.wn-t" r- L..oJno,: 5.olu./Y"1CyriJLJ.ci" 0t0<;(bY'\. for placing, bUlldmg or constructing the follOWing facility I U Lr.v( 0: BLade.. Z i C'tJ '-fI'\s V.u-n~ &a+a_:tL~ 00'1.3 Ccnx..~) upon the right-of-way of County Road No . Mile Post In strict conformity 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 Rights-of-Way, as set forth by the Lane Man- ual 50 190(2) any amendments thereto, and any other appl.cable regulations, law or ordmance Special PrOVISions Driveway WIll be constructed In accordance With the attached driveway approach speCifica- tions (DraWing M9B-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 0 peratlon, leaVing the roadway and area In a neat, acceptable condition 3 Sldewalks w1ll be constructed In accordance w1th the attached sldewalk spec1f1cat1ons and draw1ng M98-49 The Standard Curb Type shall be constructed unless otherw1se spec1f1ed ThiS permit IS revocable at any time, and wdl 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 be- fore ~c..h..- Z, I~ ,1912. Expires 19_ Inspected and Approved Approved by Board of County CommiSSioners By - ~ ~bl~~ CAD Datf' By WHITE - OFFICE FilE YEllOW - REAL ESTATE . PINK - PERMITTEE ORANGE - BUILDING & SANITATION DE'T C74-129 " I .... . ~ 7'1 - J'b -2:- - " ~ I ..~ ' ',~ ' I J ( For Orr.ce _tJ.41;17/./ _ II-/~ -, . Yc~ 110 .~ Use Only CT. tlumGcr I:' Hcc!!Tvcd by' (ode Spccl,,1 Penn I t Area UrbilnlZlnq ^re~ , , TillS IS A PRELIMIIIAI\Y,nrpoRT WIIICn1 Il ESAWT-'IIsURE TIlE IsSUAllC,E OF A FUTURE BUILDING PERMIT. PLANS OR EXPEND nURES ;MADE IN f).!;,!; I CE UPON TH I S REPORT ARE AT YOUR OliN RISK. I, . , ", ~8rj,A~, P lEA S E P R I N T elk JC'-2S-?t;).,' , I,,',f!oubdlvlslon-Ilame 'HI. '~l~'-M-I7""N Elk 2 ({-11.)811rI(g'9ta)ot/li9' BlockH l~l8 .3 R 2 W ,I)' b !1,..u.--<T. 1=.. v '~ No" .Townshlp Range .Sect Ion Tax Lot No. Owner of Property , Owner's Consent ...tf I I '1/:5",.Ir-:((_ F,'){ , , :: No. of Sites la ;, Name L' i ':."1, "f-,,q r:;/fZ.dI-IA/d-TfZ-J- Ld"rl?, No. of Acres 4- ,', /:Ial'lln9 Address, ' " f:..'~bf"'jf'.'",(,,( . I Total , Ii' ,~~ ' _ Cash '7#6':'3072- x~ ..Y~-ce 71"'--V4<//-.7y'/check ,;i:eiephone Ii slgl1atur" of ApplIcant Date /- , I ..../ I ~ I I]' , . . I" '~p'roposed Use , App I I cant I s I nteres t: Buyer - 'of Property Ra-5.'dd-"f-,..;.; In Property, Other (SpecI fy): 'i .... I I , I ' , ' ~I~ .L.. - $ j ;o~ C <nl'~ ,> -< " r- " 'It $ '<;JS_Cn $ :;315 0", - . Owner se ller Rea I tor ,P,roperty Size r, Legal Access i ,; Road'Name EXistIng Structures on Property . , 'I's Property IIlthln One Mile of Yes y IIhat C, ty? c; 1'''[:'/ No - i City 7 Proposed lIater Supply Public V DIstrict. Spring lie II Other (Specify)' j HJ " 1(lf' .It). I ~ ~... I,' . .' /"/ IIhel1 11111 MARK TES T ,) St'lM j ,<),-,-,P ~ t.,t 2!!Ji <=I- (IdS! 'Zf f( cI. Sf4"~)- /;,J.f d..uu-<,~rJ.PAV kIJ/1 I'h'/~ Property LocatIon (Illrect,ons) " ~ Test Holes 8e Ready? HOLES IIITH OUR FLAGS (Date) " " 'I' hllll II " Location of Test Holes 011 Propelty , , .('l ......... ..: l~ t 11[1'4 '.. , , II... , . Drm" diagram of property showing locatIOn of any landmarks }nd relationship these landmarks of test holes to - \ -"'- " ~.,- :P""'- ' , <>~k:$ " "?-;\) ~ >>1 J'. /III~ ~ - i 'If V ~ f{~.<t ~ " .f'" , ~ J2','. '1/7,' <t, ; { ,() ~ ~t. ~ tc-r- r i-r:---rr- , - ~7- - ~ I, II Ill' ~ u~ .' I I )j q II' , " " I " 'I MAKE CHECK PAYABLE TO HEAL Tft MID SAN ITATION MAIL TO LANE, COUNTY BUILDING fIND SANITATION DIVISION. 135 E CS5-SS 6 th Ave., Eugene, Oregon 97401 . ~, , I' , "".J~.:{fl."''' <J ; '~~~- #~~~, '!rI' h>:\\ '\'i-ljf~~i~...!.~."'~ 1i'" ~ to ;,i.)iI~~~~m~:; ~ ',~.::.i~"~~~~~$.~~t 1 Tl- ~IY\ ,\ ~$~~,~ " {ii, ~. <c - , , . ,,/ ',' ' ~"&Iwm:<;1"J.1l' "l" ~~t $;<<!r)~~1i;~~~d.~Jt~ ... l..()t '? e.-IA. / . . -L------------______r .- ffl rr'CCJt Ifole \ ~ -;,;----;;- .------------k-~-I :{,o ,.(Oq~""~,",~" f:,( ---- --- - .----- . '. .____lQf _L!l!.f J __I!.L.T~I~,,- 0" - f^" 'f W k~" (i'.., fI,J r'/, ---- ~-- I I I 4, 1 '6 &/ ~ :l- -----ilf -;;tll~le 0" -1) /-,f)C[ m ---- -- M+ V~f~O~ / 0 "1~ v 7 <( f nf 11 () r /lOLl 10 SULT') - loT'? _~/IS-(--- #2 'Ie',r 1101" 0" & Oiil~:. ~ ~~,., R.;iti1 I -. TI;ST !lOLl m'SlJLTS Lot t&i/ - 'i- #2 Test Hole 0" - lS 'fll.or;;;;-!~~' I - ' 7 #2 Test r - ;51 ~_ I I I JE,d,j("~ lIole loa"" / J s.L 7'i - .Jtr ;V \ I r <:.LLo_:f!I, I Ii) Te"t Hole / OK Lt.""'" ~ ell.l,r/ f ,..If (p p, / 0" , , 0" , '-cL.L elk 2- II) Te"t Hole - 7S' /.Cti h1 , . t ,I , j J J." f ~ (f7 k '--- Ii) Te"t Hole 0" - 10 /0<7,> J ~ .. " , \~'O'l. -c~,z.-4 L beo MAP TO LANE COUNTY PLANNING ~ CONSTRUCTION PERMITS & INSPECTION c::, ME:..E.D OTHER FROM SURVEYORS OFFICE - FLOOD PLAIN MANAGEMENT DEPARTMENT OF PUBLIC LANDS PHONE 687-4195 SUBJECT PARTITION NUMBER SUBD I V I S ION BUILDING PERMIT NUMBER 3Ib.le, OTHER RECOMMENDATION THE ABOVE SUBJECT IS IN A SPECIAL PERMIT AREA THE ABOVE SUBJECT IS INCLUDED IN THE H U D FLOOD INSURANCE AREA , REMARKS ~"..1\~ J:~O~ F' J:'-lA..Tlot-.l 'TO ~ 4&6..00. E",(Uo..SS , - - --- -- .. C-AP 1"'-1. },JE, c::..ua.p., IZA.nILl~ of OI'lLIE:.. DI2. E.. c.oLE:... '-N~'< I Ie:- A.\ A..t...l '='.LE...'-L. o\=- 4-&o:;r" ~~ I 'PE.tZMrr v..L1:o..c;;, MO\ ~1:o..M.'Pt::b - ..R~A.L ?E:.RM.IT. ~Ut:> . 'I-L~":IU'T s.c.t.rr "\0 -n-w=;) ('%.t::\.c..~ DATE ~ - 2.1-1B BY c:::;,/J1c..... ) Building Permit ) Site Feasibility Study for Septic Tank " . TRS " I q J ,," ;- Wr1~ten DJ.rect~J Co Ie ..." '" 11/O',r' I c _0-.... Job Location ,) ) CI: -1- v, y" ,',.. I/(.~ 01;- I..... C/5b (l.r- INFORMATION SHEET / Acreage or Lot S,ZP /n.Ooo Oartltlonlng # 0' Test holes will be ready SubdivIsion /"7f- 110- N /- r, !:s fryh.'..5 ~< d A ,/ / --./ /7-cr-l=I. Lot '1 Block 2. ) Completed ( ) Pending APPLICANT'S NAME AND ADDRESS 1.{"wCr7 r < /=;./;:. C/-.-" , OWNER'S NAME AND ADDRESS, If different from applicant". CONTRACTOR'S NAME AND ADDRESS Mail permit or results of site feasibility study to (x,) Applicant ( ) Owner ( ( ) Prefer to pick up Call (owner, etc ) when ready ..,,- ~ .. !.,.YhZ 56 I' /,,.,. r: c I~.( , 1 C j-r:z,/.--,,,.,,, , . Phone /1/(. - 30'" -~ Phonp Phone ) Contractor Contractors 0, S # .:..,t, / "STRUCTURES NOW ON THE PROPERTY /Ii r. /7 u PROPOSED USE (this permit) Dwz./I ,~,y 1'17/3 t::J' G,,>'I-qdc:: /L8';:::: .. I -.- ~ WATER SUPPLY W /IC//77c7'fe. I"/dr-c I- Cc? SEWAGE DISPOSA' it RFDrrnmc::. 3 .(exlstlng or proposed well, etc If public, name of system) lo"'stlng or proposed septic tank, etc I S I =1t1- 382.. "LUMBING BY c~ vl...,.//:.., ~ / IOIt,.. 'n~.. Fe/ / 12. /"". t j"l-aP, Address ) PROPERTY IS WITHIN ONE MILE OF CITY (_ t..I6T .:;rAMPED I ) New Address Necessary ZONF ........it*****....*******..**********************.....OFFICE USE ONLY BELO\~::I..nlt..: C - ) Special Permit Area LINE "1-***..****..-11**"....***,..." ~ ~*..."**....+,,...... ) Facility Permit Necessary SETBACKS Front Side Facl ng Street (FROM CENTERLINE OF ROADl I ntenor Side Yard Rear {FROM PROPERTY UhESl Minimum E:1p.vatlOn _ ~ /'7~CZF 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 Avenue co-' ",")0.., nlVISlon . , ~-- ~ / ,/ r 12. 0 .l(L~ .' .r -..jf>'--I , u I\, ~- I 0B' Cou:. r~ I 0R.Ive. ? g~ I I If) I / ..-/ / ,p..-/ ..-/ / .-/ / A'/ )J /" . \0 /" ~----!O /" ~......../O' -~ '---- "'I;; -.....;: .-/ .-/ :!;.\' /' /" ~ I ~I ....... , LoT 91~2- MT ~ 0 "-l E~ IA-re...:::, Il'iII<.D A,bt:>\\lO~ LAI..le: ~UIJr')I ) TOI-..I '3<<:, ""1. '3'<:;, , '-3& "~ , /' 3rt> ,/ /' .... .... ~, ----... '----, . t, ~ -.. t, . -....: ~-=----=---:; -.:z -.::.-=_ I Fc>C' 5 RUc...E.. F, x ,I I i' ~ITE --- ------r I';. ~ ), t ~ +11 ~ ~r ( R...A.\J 1 II ICAO , (",.TIC" '> \0, _, ,-, I"V1 J..........,.... \1 _ _ .=:_~---_:.._- ---+--- " I (~~\ ,. -, . LF ',lll=W 2.3-78 -5 .: ;=- _ (_~ d . MEMORKNDUM"" (~ \c.) lane c~unt/-' ca' TO FROM SUBJECT JOHN SMEED GEORGE CURRIN SPECIAL PER~lITS DATE MARCH 28, 1978 Mt Vernon Estates Thlrd Add1tlon 1S located 1n the Coast Fork and Upper W1llamette Spec1al Perm1t Area as des1gnated 1n Chapter 11 of the Lane Code The Lane Code 1n Chapter 11 510, requ1res th1S off1ce to determlne the m1n1mum f1n1shed floor elevatlon prlor to the 1ssuance of perm1ts Dur1ng the course of determ1n1ng the f1n1shed floor elevat10n for Perm1ts Number 466-78 and 467-78, 1t was found that t OW1n9 perm1ts were not referred to th1S off1ce 2857-77, 3464-77, 285-78 and 7 -78 Perm1t Number 2857-77 1S bU1lt and occup1ed, Perm1t Number 3464-77 1S 80% f1n1s ed Construct1on has not started on the others Th1S off1ce has checked the elevat10n on that both are above the 100-year flood le Number 2857-77 and 3464-77 and f1nd Th1S off1ce would recommend that a reV1ew )f your assessor's maps and subd1v1s1ons be made to assure they have been stamped as pec1al perm1t areas If th1S off1ce may ass1st you ln ldent Y1ng these speclal permlt areas, please feel free to call ~ ~ ~ 3-50-7~ , ~~ ~3t1~ ~I~ ;::;;::;;::.7.." ~~~ ~Q~ ~ CLI .1( 2}1? GMC gc 14 ::f~~l'l\jj'd-? : v' I..., ~ - ,- i \ . ..;:..,..: JOB LOCATION /.11?3 . /) ",1 L--f?..J: .c. , !/..J t2--<,:-... (j LANE COUNTY PERMIT /VA I 1 Completed /j :::J-'1''(. d v ~ =~I/ r7'/ ~'lC"- IG\ "3 7~-7a .' .' Do 0-00 /. /vr+ PartltlOnmg # SubdiVISion -)ILrC Lot -; /-;.. /..-1 ~~ O/LVJO -r:.f..A...... L/ /c) U-&l ~ rl t:a 10.. ill S Bloc~ cL ~ -~ -, .-/; (_) i::')Ii~.,.r; . --J ,/,' _ 7():; :> Phon"" I Y(" __/J c...., Phon" Phonp (owner, etc) when ready "Atreag~ or Lot Size Contractor's 0 S # ,.( ___._-1 /~ , { ;.;:c..!,' -="V ......: APPLICANT'S NAME AND ADDRESC: ,,-),1 './ ,(!~-" OWNER~NAMEANDADDRESC: CONTRACTOR'S NAME AND ADDRESS Mail permIt to (L) 'Applicant ( ) Owner " ) Contractor ( ) Prefer to pick up Call . STRUCTURES NOW ON THE PROPERTY --9- . .. . '. j ~ '/' " - ~ <:- T-/\ )</7 -.0' ,r", {'J /.~ y'---";' '-,r--'-- ---< / .-) THIS PERMIT IS FOR ...d r- u > ~( ) '~'v<--v. ('~ (,-, "",,'. '....!. '-' # BEDROOM" -,,_c!# PLUMBING CONNECTION~'- I J I~ j /..,,, ~_,A..-:-t / ,,-, -,:t. r.../ /?. r-;" l. ? ;- -.., WATER SUPPLY ./ VU,ff.J' ,. 1, - '/ ,:. _ ~ /~J (. "J SEWAG E DISPOSA' S I # / '-' --'.... , " ". .-. n' THIS PROPERTY IS WITHIN ONE MILE OF THE CITY OF PLUMBING BY - ....,>j'-"-,~- , I hereby certify that the above statements are true and accurate, and that I have the follOWing legal Interest In thp properly _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 appl~cable Codes relating to this permit , ""/,/?/ 1:;;~/7r-c-'>) ......___.--,=- Fee Paid c: - - ,'-- r ~., / ' -, -- ___ S,gnature.' 'Oatp (~~ NEW ADDRESS ) FACILITY PERMIT TO TRANSPORTATION OEPT ~SPECIAL PMT AREA MIN ELEVATION *....... . SANITAn~~_ Mmlmum Septic Tank Capacity (Gallons) BUJ-L~I~~~ ~ 1;n~u~lo~ p '- ~rL~ ~ ~re~o~ ,,, ( , Dramf,eld ReqUired - Lmeal Feet I ;./ f' , " Use ClaSSification . ....\Pt ' MaXimum Depth Comments Commen?srrHI:> PErMlT "'-JA$"I,~suet) IIJ e~!t~~ ~IWc.e r~E PE~lT .I>.D NoT ItJCL IJCIa 1'U/i F'A}'SH FL.OO~eL.EVATIOIl/ ./~~- '-;.' ,': ." - "e~lJlI~e.C>_FoIl.Ttle,S?ec.'Ac.: Pe~N\I'" A-ReA' ~ " fl. 8. C.Ft..~O.D PI.AJIJ)-Tlili P6i2M/'J" HAS ~e-l:,AJ hMl;Albl:OIr f 'AJ'~F'l F LDfJ E:LE:IJAilO AI TO l: AAH::'_AlIICA) IAJC,-V oes/T" He, M"NI,MUN\-FIPlISH FL.oo~ <\8~, 00'- B~ASS CAP IAJ IV. e. c::: vf(.8 ~;:'~~~';t ~:~~ bR.i:c;.A~';,~;::'-s,~~oXtiIJTtA~W\ ~ ~'~ S>A Z J=~~ b)(' ~ DE tilE" a Cof..E Lv lIy ~jA)~~ ~~oo~~L:e,~AnOI\J- ~ /, By _ , "" c;;-...t;;"VJi:\TIOAJDaf?F.~.~.~~Q31 PLANNING REQUIREMENTS SATISFIED By / _, ,Date Date Issued ZONE' SETBACKS FRONT' SIDE,FACING STREET (FROM CILI INT SIDE YARD.., REAR , - (FROM PILI , LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE, EUGENE, OREGON 97401 PHONE 687\4394 POST THIS PERMIT ON MAIN BUILDING AT SITE "3-$ '7 ~ <:::::'I C5513 BLOC PERMIT -WHITE BUILDING -GREEN PLUMBING - CANARY SANITATION ~ GOLDENROD OFFICE co~ :"{.~E Cl~"s / lIRe; .... "u.:t: .,,-. " . "';"..; 5 '&"1". ' . t'.11'.. T RS TL . / J. eJ. " .' JOB LOCATION , /i.J7.5 U j}/lJ!.. ) u.J aA,4---. U ,.,..-.'--'-.:--,.,1' ~__.._ .s"~ ..C~ ..,- ~.'-.r-'~' ~t.l "3 7"~ 78 II , . " " .' ,." Acreage or Lot Si?p Contractor's O.S. # Ii); eJ'OO Jff /l/ rr Partitioning 'if " APPLICANT'S NAME AND ADDRI=C::C:: ~ OWNER'S NAME AND ADDRESC:: CONTRACTOR'S NAME AND ADDR"C::C:: Mail permit to ("-)-Applicant ( ) Owner .:t. ____ /---J-- -.r: , " , ) Contra~tor. ( , ) Prefer to pick up. Call S.1. # 7<1- 3g~ THIS PROPERTY IS WITHIN ONE MILE.OF THE CITY OF .. PLUMBING BY Li~~~. I hereby certify that the above statements are true and accurate, and that I have th.e following legal interest in the propefl/ ~owner of record; contract purchaser; _ potential~buyer; _ realtor o( agent: I further certify that .(if not the'owner) I am authoriz,ed 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 applj3able Cod~s re~ating to this.permi(--: / '"y" . FeeP{;d$ct20e:,.~(o (3~7cfS~ /' Signature < t""'7-"'" 7---- .;>--"'-Sr Date ""-:;:.//1..'/ ),1...) (VI NEW ADDRESS ( ) FACILITY PERMIT TO TRANSPORTATION DEPT. ) SPECIAL PMT. AREA. MIN. ELEVATION>:; " 'Ul -""' STRUCTURES NOW ON THE PROPERTY \v . - THIS PERMIT IS FOR ..:s F" 0 J Y7(j'UJ '(::}Ovvt/.,gt::/:?) 'V}6W'-c ~~~ROOM<; 3 #PLUMBING CONNECTIONS / d... WATER SUPPLY k)U/b.-.nu1k.,.ifh..'i.ii d, ' SEWAGE DISPOSAl ~. . SANITATION ,. ~:' . I ~ Minimum Septic Tank Cap' acity (Gallon. s) ., ~(U Drainfield Required ~ Lin.eal Feet '.' :;0" Maximum Depth r ~ - -- ,..;. "- Comm~nts: J..,P~14.-:t",-/.:t. ~<'\. .*f~f..--~~:.6VA'/ .<.~~J~~" ____ 'I. ~.' .": . 4. ".< (W<-. ,..:c~ ".,~,. ~. .;,.Y' 1 "'g".... . 4.1 ...:. Afh-tr ' .. .. /..-;. (""""'-'. I"""" ,.. r'''''':;''- ~.".-1 ' ( ~/I'lJ' < 1/.. . ~ ...J i. :h rdU,'/t-;.-{.a ,<c. .oO"<'^-- t-..... '" OC&'U.(~,,",",~ _ <y:,-'/L ~ . ',' 'I ,:." .7 r;; .,', ~ ,.' F 1. . ,.... ~ -... ~ ~,~....,,,,-V''''\.J..'' t~ BUILDING 1;' N Type of Construc~.ion I I L N"LI /1/1_ Use Classification Comments: . , "'roup 1 Fire Zone ~G- NO:] E.,? DV F"lvV.s " /' By: J\.,;J I-~L~Yztl PLANNING.REQUIR'EMENTSSATISFIED. B.y: '-/CV~ . Date:O/-/'l-I'd" _ Date Issued: .a.-;c./- /15 ZONE: JGII SETBACKS: 'FRONT(;9&' C~L(!)EtE..6CING STREET - (FROM C/U INT. SIDE YARD..5V REAR-/ .:0,(fRQ,M PILl (/) J V7"'f1~ I VI, c:: . LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE., EUGENE, OREGON 97401 . PHONE: 687-4394 By: x: ~;.,. \.;;tt.....:......-- Date: '? - ;r-.' '?P-,- ~-l f(J. Date: <:,. :70. 7Y C55-13 POST THIS PERMIT ON MAIN BUILDING AT.SITE BLDG. PERMIT - WHITE, BUIL"DING -GREEN; PLUMBING--': CANARY; SANfTAT'ION - GOLDEN~ODj OFFICE COPY -.WtHTE . .. .J(;.... "._ .... . -" ........... ~ ~":i . , ,. .( SITE INSPECTION /' ApPROVED ~ DISAPPROVEO INSPECTOR ~rL CJ DATE t, -2-71 v REMARKS FOUNDATION INSPEC ON DISAPPROVEO 1--/ DATE /0 -1/-7% INSPECTO~ REMARKS y;:t;;..... I'7K *-> ~ /. -'2--7Y Ok~ / .~. {lI-O t'.A -'e.' oJ ~. ~#.J~ ur-tt.6'Jp .,. dA-" ~"~i ~.,..,.~ ApPROVED I O~II-l9 ~ FRAMING INSPECTjPIf' , .J ApPROVEO iD DISAPPROVEO / ! DAToE //-3 -101 NSPECTOR <r' ~ ./ y Rp~{RK's a; . ~ J ; ~ciz ,0..) . -,t "-, od1.1:r1~__~1- l>Gc.._ _ __ /_ _ ,,_ '7 J? ,..p / IJ / ( -. - /' . 1':/ / f1.-.-. (a.V'./71 ......- "t:/n - "1/...-...-...... /7. .-. --'-'" ..-r._~/o-/~ b>;9w<- /) 5! S' I; Vf.-~ QArK LATH OR S~EE::~INSPECTION ApPROVEO DISAPPROVEO II DATE //-/.)'-7gINSPECTOR ,t)/<.S REMARKS r-./: -~..-rZ~ - OK" 4 (Y ~___ //_1'>-7l? FINAL INSPECTION ApPROVED ~OISAPPROVED I CJ DATE ~ :2-f./-7'lINSPECTOR Qd [.I REMARKS CERTIFICATE OF OCCUPANCY REAOY TO ISSUE ;---7 NOT REAOY TO ISSUE I / DATE INSPECTOR REMARK 5 ~, .",-"" .... , ADDITIONAL INFORMATION REQUIRED <.;- .' <\ Subffilt the follo~ng items to the BUlldlng Official at least ~ weeks prior to lnstallatlon. Return tlus form ylith tv.u coples of all required information.' Jl1AN U~;tJ~ ~(j,j5 P€SI l:lN5 ~ 6:At:.~ PI r::~€ebtT TR.cJ..$5 (. riNK., ~If</)€f<, tEjC.) FLOl::f< IN;vLAnON TYPe ;. ~()Pfo(l.T P~/L . , . Slgnp-d: J)'~;Y{~ Btnldlng PerllU t No. 37~-7~ Apphcant E:1<.cJL€. ~I'(. .~ -0 Job Locatlon Cc'-€ WAil " Bmlding Inspector .J L r ... .'-' . . ~~..,..... 'r.. Date (I'flU", ~;l .--1 , 1')78 Permit No. -g'/(~- 'Irs CURB CUT . . . ,. . . i....../ 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 judgment of the Board that the said application should be granted, and that a permit should be issued, now, therefore, it is hereby. tC:iI'tc I' C.. 4 \~ v. 13 y .) ORDERED, that a permit be and is hereby issued to , ,{ I UIt ( ua.-U r- L{1 \ '(',. ~::-:1.L.tI"U.. 1',.(/ C J (''l .. O("'-:-'h'Y\ for placing, building or constructing the following facility: ..J J (J. Lr,.., r). l/)(od.:.: 2". OL t I ,c. v'~J'non f - INk .., } (ID'/'':) C'C1l.2..lJ..~') , ..._"" .I \.' .......J upon the right-of-way of County Road No. Mile Post , in strict conformity to the exhibits attached hereto, and subject to all terms, conditions, agreements, stipulations and provisions contained in the appl ication and permit, the Rules and. Regulations Gov- erning Facilities 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. Special Provisions: 1. 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. ,,-._, .....: '.~r-"" ,- ":. 6 .. 3, Si dewa 1 ks wi 11 be constructed in accordari.d with...the attached -s.i dewa 1 k speci fi cat ions and drawi ng M98-49. The Stani:lard ....Curb Typ..e .sha 11,. be constructed unless otherwise specifie(L~ -'':\.;;, ~', ../' tr--<: ~." '. ~ ~~ .'>::..... ~ ..... .....;.-i.. \-"- - -- >-- -- .~ -' ~ - .. . .VZ' .. ~. ~, :::> .....~'- -;,... '.. :.-} ...-,.:::. /. r This permit is revocable at any time, and will be strictly cidh~ed to dhd:>"o)work other than that specifically mentioned above is hereby authorized, ,- '.. \~.;; fore This permit shall be void unless the work herein .contemplated -)')\o..cl,", ;?..ivi" ,19'(9. 'Expires \,- "'~.. shall have been completed be- ,19_. Inspected and Approved Approved by Board of County Commissioners -By. \ , r'L I,r-u \Gr ;' r).;. Gt\L.) Director of Public Works-~ Dati' By WHITE - OFFICE FILE YEllOW - REAL ESTATE PINK - PERMITTEE ORANGE - BUILDING & SANITATION DEPT. ~., C74~-l29 . , ...... .~...,., ';-,"-..--. .,.' ".--.....-... ',."-,.,.,,, ..- '.', ..l... " .". -' \, .' .~\. .~-/ j ~-' 1-1 . . ~ "'_'" <.\7',~. ~~ l CORRECTION NOTICE LANE COUNTY DEPT. OF ENVIRONMENTAL MANAGEMENT Construction Permits & Inspections Division EUGENE, OREGON This building or'structure does not conform to lane County building regulationsr ordinances or codes as noted below: A )l '/1 ^ ,'1 ,,,-/poC-f ~-nn:,..-"..c.F P1a L.k/'l.-r-.'" Ut; 1?...,~.Ls: d / U'A. 2.'''//'-'' = / /7/L 'f. _...._J ...:;;pc~=::. //fL /i c-ud~~---b..,," - / R.... ...;.i.. .,. ..J. ~ -~J"~ ~ - ..;-yp,.....:z::7~~-~ - /\.,~(~l<'l/V'l.__~~ /-rJ:T: -~:-w' ~ ~':c.,r.-, ',~j v~ ..~ 1/1/,)//. /.::. a;;-/~/.</J/)IO , , v f ',...'-,. /1 8/JJrI I ~,(A<r-,R , ,ivt....;:-r.;tA.L;,!-L_ 01 ~,''Y7 <fL /h C'.12.-tf/<."-1' ( U tA/J A P' /' Vr7f" 6 /r7/ --A'- A> - J - ~ .,... ~ /\ <-V L.JV/~ I I I I n spector . I Building P~rmit # _ , _' . I . .:~<:" -r.': ,;.6 '~-n~.:<;\.>~ ,~~~;;:h;;._,:";;;~~~'L~it,,,~~; ~:';.'i:L.:~~~ .~,~-.~..;~1;.'l't.:::-',~~1 ~ , _ : C55-7.3 RE"INSPECTION REQUIRED FOR APPROVAL Oat'" ..' .JiI , , CORRECTION NOTICE LANE COUNTY DEPT OF ENVIRONMENTAL MANAGEMENT Construction Permits & Inspections DIvIsion EUGENE, OREGON J~ /J This buddmg or structure does not conform to lane County bUilding regulations, ordinances or codes as noted below ;1/9#/7./,' -~---- <::;;'". L-c". /) a -L./;;:;- <4,LLA ~ / I . ~ q ~~ A _ # J!//./~~ ,= C55-73 RE-INSPECTION REQUIRED FOR APPROVAL ~-~~-.",.-- ~ /-7 /' (J'AJ~..-r~ _ ilj' - v Inspector _ l...: l<. )05; ~-< Jf Date /0- I g -7P , I , OJ BUilding Permit # .-/::1" 'V f II"" ~ IRa(/.) .;;(Ai3 FLOOR PLUMBING GROUNDWORK ApPROVEO I vi 01 SAPPROVEO C1 DATE 7' -;2& '#1 NSPECTOR fP ;/- - RntARK 5 ""-J . GAS PIPING GROUNDWORK ApPROVED / I DISAPPROVED C1 DATE INSPECTOR REMARKS ROUGH PLUMBING ApPROVEO fLj D,SAPPROVEO r; DATE //-,;)-71'- INSPECTOR If;./- REMARKS ROUGH GAS PIPING REMARKS ~""'4 ~~.~~,~~ ;p;+- I-I f- 7f? /Pi/- ApPROVED m 01 SAPPROVED C1 DATE J -~;;). f'l1\ NSPECTOR FINAL PLUMBING ApPROVED C1 OISAPPROVED C1 DATE INSPECTOR REMARKS FINAL GAS PIPING ApPROVED C1 DISAPPROVED r; DATE INSPECTOR REMARKS CERTIFICATE OF OCCUPANCY READY TO ISSUE C1 NOT READY TO ISSUE r; DATE INSPECTOR REMARKS ~/ .... ~ j, ,. /5 " .'/ ;/;;. ~,., --' , J....., ," .~ .." -.11 JOB LOCATION. 7'"'6"'73.. /J ,,' ... ,/1 I~'" -----':.. ""~-'" v./ .." ., '_ <..<<- ,f . oJ _<-,-:.J:'fo" _.-~ N",",-' ( 'I'. _~--:C-_" <.... ....... ~r ,,-;..J- {/ .'/ .t . '3 7~-7,::? (, TRS, TI .~ : ;.... .1:'" 1:1'- , ' APPLlCANT'S'NAME AND ADDRESC:: ~,....ie...-,,-' OWNER'S NAME AND ADDRI=C::C:: CONTRACTOR'S NAME AND ADDRESc:: Mail permit to (\..)-Applicant ( ) Owner /.., <""'0 A ,J) t.. '-'" /V,,<f Partitioning *' LANE COUNTY PERMIT '/ " /v/r '-',.-: .', S bd' . . /' j' L u IVISlon - ...."1 LotI ;(,/c- //8 . I " l"" 't <1 LA.? 0.. '-t.-'L, c.' r../~ 'J .' /U , Ii y~'A t,"-. c-:-' ~' ;, { U'.1JA/ ,,' /:, C-<} /(j ,.1,' S B loc~ 0.:.. .<" f' , , ./......, . '_/ "-'1' ~ . " 'Acreage or Lot Si?O Contractor's O,S. # ) Co mp leted " Y{,I . --...J' ,-A....y.- ) Contractor. ) Prefer to pick up. Call. -'J/' ::;; 7 Phono 1:;4(:'" ~ ~ .. Ol. Phonp ;' "' Phono (owner, etc,) when ready. .' " " e --" STRUCTURES NOW ON THE PROPERTY"-' .,-. f :j "" I 4' './' f. ,,' ~2J.j..J <:? / ::J " THIS PERMIT IS FOR";;' . U J ( 70' -0) /'i~ L/-r-!?fo ) .\. I' 'yU!:::", # BEDROOMS =) #PLUMBING CONNECTION~~ , j )' fl, --rl ", '/ " /'i ' ",/i., 0:) WATER SUPPLY lI/Ul;'u,r,t,,' t.u~, j OIJ!,A.,.. C3. SEWAGE DISPOSAL S.1. # /L -' 3o...x. ,- -. / ') .., /! ~ , THIS PROPERTY IS WITHIN ONE MILE OF THE CITY OF PLUMBING BY lJl"OJ, ,L-<--h~ . .. t~ 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 p,urchaser; _ potential buyer; _ realtor or agent. I further certify that (if not the owner) I, am authori"ed to act for the owner of -record, and that said owner isaware,and. approves. of this.action..Lhereby agree. to comply with.all.applicable_Codes,celating to. this permit. _ . /. , / '. ..., //- '2 / (;:;471"- '\ ' ~.,. ,-.,- " ! , // Fee Paid.~ ~ ~V;-" d~O ~) -J.-/' Signature ',. / 'r Dato. . ( V) NEW. ADDRESS ( ) FACILITY PERMIT TO T~ANSPOHTATION DEPT, ( ) SPECIAL PMT, AREA. MIN. ELEVATION: ., ,. Comments: , Minimum Septic Tank Capacity (Gallons) Drainfield Required. Lineal Feet \,- Maximum Depth '}'4"1~l 1.. ,/,{". .... \ _" -;'.r",(,..iJo;..l BUILDING ~ Ar Type of Construction I I ." ;r: I~( Illi~ Use Classification Comments: (:;roup '.. Fire Zone )' SANITATION l'tY,,) j </1".) - .. ~ . '.-t.r'.~.................' .,'t '1 ,', .~. _A'. l....... ~,: .,.i:-v,.. ""'" ~~~".r~ t7Lb J./v;/l.;..' r-V rt../ll'.l5 .c. , ",\. " ~~ ,~~ .' lL .~" , '- .(.. (~ :c;.' "l "'..' ~'" , .^ . ..~,.. ~ ".... ~ ".~ ,~_. J' ~-~ J - By:. ~,,:" .,' -i' ~?:- II' ,-.f) ,/ J ,t'~__. Date: """.,,' _ J By: -' k.;-vI. /-", ~~ Date: ". 'cc. 7;/ . I PLANNING_REQUIREMENTS SATISFIED. By: '/0 f":,.,.....C Date:d-/'j-/'.,r' Date Issued: .:;)-t:./-/6 ZONE: Je.... rr SETBACKS.:"FRONT (&'tC . <SLEl.EtEACING STREET - (FROM C/U INT. SIDE Y ARD.:v REAR' I; JF RQ,M P/U (-""" I V-;-'lC~--1_ J. \.A C- o LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE., EUGENE, OREGON 97401 PHONE' 687-4394 POST THIS PERMIT ON MAIN BUILDING AT SITE 'f ;, C55,13 BLDG. PERMIT ':"'WHITE; BUILDING - GRE~'N; PLUMBI!'JG.- CANARY; SANITATION - GOLDENROD; OFFICE COPy'- WHI}"E . ., !.! ._..... '" ,. "'c,"" '-'_...."<'1-,. _".~.," .,,'. . .... ,,"'0.'; _t, ,. .....,'.,:,..:'>... ...:..'....._... . .~.". ..... {"". ;.-""-" ,'..'_ "N ,.:,. , .~. ". _'" ':'..;<:-._'1':...,: .,..."..__"' .v" -,,-," . .. _..' "~.,'....c....,, -..:: ~,-_:,'--.h "'\'.,_".,~ ..' . ). ,,,,,,. __.. J '.' CC.' .~.-_ .'. ,,~;, .. ". #1... "/ ~\ , J~'i'T' Plat Plan r- ASP'BZ 16.- VI ~5g o ::z N -.:i- -~ ~ r: C:Q 5j~~ .J ~ <I: -in ~fi d:C4 ~~ ~ > c Cll 1~~2.-5 Job Location (Street, mile PO,STI, 1073 C.D1..-B <:: LJ...:A>::) SubdiVISion .~eo ndr:iJ_.:t.ICTr\.) .zo ALL .\fQmr'1'\"\ ~t '3 ~PFfP Block Z FOR SANITARIAN'S USE ONLY COMMENTS $ SY;;::;Jroved o System Disapproved 0 Needs Correction 012. Slgnature~ / b/ FOR INSTALLER'S USE Trench Depth '30 ,. Filler Depth Below T-;!; G:, II Tank CapacltylGOO Manufacture' UJ \ LL II t7l EO r:n;:; (; e A V~'1CJ III F=: Measured distance to well from tank l'usu c.. 'vJJ9-f~alnflelr1 Date ~~ . . r I --- - -- - --:-t;"""-~--\ 2.-} ( r L,' ( I \~~ ;: 10 I ..., 1.0,-" 1, , I / 11\1<' 1+ .-g €. \=' ...:A L E. ~vse. 3 ~J , ~ ~ ~ g-o ! _~ 3 J-ro co cS a vD~ c. <{ ,000 'is 0'\ \COYlc, rCJYl'L /' \ \ ) -----, \~CD .,..." ,"" ~ ~ ' . / .t ...... . r -. /r .- ,r";<t.,., '(.... ~ ' \ 'I \,~.. ....,..\ I 1..1 <;.... .~ ., 1(9 ~ "'~ r7 - ,I , ; ~. - "'4 y I _' ~_ "'........ ~ '\~ VI I~. ~ "\; r' ! '\ c <.: ~ '- \ \,) "\ "0 ... j ~ ~ ? h " 11.0., .IV. z; -< "- -..., ~ l'r-rt--rt:0- INSTALLATION RECORD AND CERTIFICATE OF SATISFACTORY COMPtHION When signed by the County Sanitarian, this certificate IS eVidence as per ORS 454 665 of sat. Isfactory completion of a subsurface sewage disposal system at the above location COLE WiI- Y Scale ~01-l'E Box. - ~, C5511 Return this form to Permit Processing Section, Department of EnVironmental Management, Public Service BUilding, 125 East 8th Avenue, Eugene 97401 . ~.~.~ . ",--.l,- ....y,1 .\ 'IX . l-. '., )#j v.C" T,RS, TI . ./. .. e- ...1 1 '-~' ...,." J .... .; ....~ ., ! ( _::__.':~_1;. . .l.r. 4f'.'Y'O' . . ~" '.-'l$:C(lo"lt"'l-"'- ~. \. ..... .....r.. , _ "';1'.",,~ .C-' :-0., --l'. ~ ....;1., &' \~"_' JOB LOCATION . . // ....-,. .; ~.~/ .~. ~I" ", ..... " 7 " ). ., i. I ~.- ,i.r\ if' ',I.... . '11\, LANE COUNTY PERMIT , i.... . .'" A I- ,,'1,,-,- ,f' ~. J" i Subdivision 'J- Lot I ,.<:...f.t/J : ;:;'/2 -f;/fv-;i ;" . l..6I' ..... l , . .. 1 .... .t,i.# f , . Acreage or Lot Silo Contractor's O.S. # ''. . . ,," ~ ) Completed /' ......~-... ',Partitioning # APPLICANT'S NAME AND'ADDRESC: . t: iJ:.r, . OWNER'S NAME AND ADDRESC: CONTRACTOR'S NAME AND ADDRESC: Mail permit to ('-)'Applicant ( ) Owner ,.~. : I . /__. 'I "-' Block I .,...,:' .~ ~- ) Contractor. ) Prefer to pick up. Call Phone Phono Phone (owner, etc.) when ready. j,...;.~ ~? 7~:).. ., rJI' ;J.'jJ;;~ .~ ---'-..- STRUCTURES NOW ON THE PROPERTY - ~. " . ~ , .. / ' 'II THISPERMITISFOR'- , -' .. 'I r . / I '~r-"" WATER SUPPLY'>' ./. .! ;);i;: ,,, ) ...Jt- '~..-" t/. ~ I .1:' , . .' ~ t' .... :.: .". _.) ",,- J' - , , , # BEDROOMC: ,','. # PLUMBING CONNECTION~'''''' ,/'1- ;';-'.:.;-,z S,l. # - -~ i :," I.;, . .. SEWAGE DISPOSAl THIS PROPERTY IS WITHIN ONE MILE OF THE CITY OF . PLUMBING BY .2-:'" -"" ~. 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. -- - .r; / ". _ 'J / t~) 1J 7./' - ') " . - / " Fee P~id $ "J'; t I,r" ~.."..to '. - /. . ....~, -- Signature' ',- DatA ( 11; NEW ADDRESS ) FACILITY PERMIT TO TRANSPORTATION DEPT. I SPECIAL PMT. AREA. MIN. ELEVATION: 1 Minimum Septic Tank Capacity (Gallonsl Drainfield Required. Lineal Feet Maximum Depth BUILDING <: lei . Type of Construction I !J. _/l:.I-I. ,\}J(~ Use Classification Comments: Group Fire Zone {I SANITATION i . "fJ_j Comme,nts: ,.1,; ~. . ~ '1-"""': , , . 'I h u' I~=.,.t:- (;:::.. ,.:......'-..,! '-............ ~ .t',,, ,r.. f"'/\/__ , -~ f .~ ..... - C55:,3 POST THIS PERMIT ON MA.IN BUILDING. ATSiTE ., ..... BLDG. PERMIT -WHITE; BUILDING - GREEN; .PLUMBING - CANARY; SANITATlo.r:'J ';-~GOI".DENROD; OFFICE COPY - WHITE '.' 't.....: . , . , r"'l 'l , A / C /" I -\ N PUB t~<~. I . " tI I ~=-' r-"'"I g~1 If) I ....A :) ...t-l f>,:-l y~ cP / ....... /" -4,' //" !?l1/' .;A /'/' /"/' \\0 / 4P//" "..-/' /' /' ....... \d /" / -- ....... ~tI /' ..... '~/' /-- ~ /' /' -- /' / <.............. ///" -< ...... ..........'............... "..... ...... ....... LDT '=> J = ,-v- K 2- MT \IE.RJ.-lo f.-l E~ \A~ '"THII<!::> .....Oc,,.,Ot--.l ~E c...ou"-lTY I a~o~ \S((, "'>. -S<;" -J &,'~ ..... :b'RA.I~Flap - $115 fT ~~/Af::.~I- ZIr:? Fr .... 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