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OREGON
TO r!ARBOR TO INLAlID WAY: SPRINGFIELD
1&-03-11.2.2
JOB LOCATION
SOUTH ON ?nn ST TO DORRIS
/
LANE COUNTY PERMIT
Acreage or Lot SI.70
Contractor's 0 S #
8000 sq ft:
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Partitioning #
) Completed
SubdiVISion
Lot 29
FILBERT GROVE
Block 6
5th
JOHN NIDREll ARCHER 2076 INLAN!l WAY
APPLICANT'S NAME AND ADDR"""
OWNER'S NAME AND ADDRESC: SANE _
CONTRACTOR'SNAMEANDADDRESc:alliKALIJ lKA1Ll!.R bALES WILL SET UP:
Mail permit to ( X) Applicant ( ) Owner ( ) Contractor ( ) Prefer to pick up Call
SPRINGFIFLD OREGON
Phono
Phone
Phone
(owner, etc) when ready
747-1265
EXISTING MOBILE ROliE 3 BED:
STRUCTURES NOW ON THE PROPERTY7 /
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THIS PERMIT IS FOR /&f?oftO:!;l~~f;~W!nDgR~LE WIDE NOBILE HONE
EXISTING SDS
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# BEDROOMC:"
# PLUMBING CONNECTION5-
WATER SUPPLY
EXISTING
SEWAGE DISPOSAl
EXISTING
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PRIOR
THIS PROPERTY IS WITHIN ONE MILE OF THE CITY OF
llA
PLUMBING BY
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I hereby certify that the above statements are true and accurate, and that I have the following legal Interest In thp oroperty ''''''--;;wner of record,
contract purchaser _ potential buyer _ realtor or agent I further certify that (If not the ownerl 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 comp'ly wlth.all'appllcable Codes relating to this nermlt . \..... '_'lo.",.
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Fee Paid $'. '::;;j ...... Signature (/'...... ....(.....t:.(cAz... Date ~a./" ~
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( I NEW ADDRESS ( ) FACILITY PERMIT TO TRANSPORTATION DEPT (.....) SPECIAL PMT AREA MIN ELEVATION ..n~ v-z..)
SANITATION BUILDING LA'N'l<' Cr')TTl'.T'T'Y C!'i:rli'r:Ji:\T, p~m111' A'REA-
'fi') _ M,OImum Septic Tank Capacity (Gallons) , Type of Construction (;roup Fire Zone
,,#...-v Dralnfleld ReqUired Lineal Feet , Ilse ClaSSificatIOn
" (), MaXimum ~2;/ -..okf Comments ;I10/&/t....E lh/'J.1/E
Comments f;P!~~ J.,...-t..I...0 l-~'<(! -' ~e..... ~ ~-
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By -~:_ 4~1___ Date, /-":;! -'7~ \ByQ( I~-;L. V7.-l_ _CV",n<:.. Date .,.2- / -?- '1 J?
PLANNINi3!,REQUIREMENTS SATISFIED Bv\" ~"'; ,",. ../" ~ Date ~-y!(. ,..=:::,)' \ -Date Issued~ l3-1f?
-ZONE~l-'Vf\\\~SETBACKS FROt:JT"") c::s SIDE FACI,NG STREET (FROM CILI INT SIDE YARD~REARl ",,(FROM PILI
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L!.\NE COjNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 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 - GO~LDENROD OFFICE COPY - WHITE
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INFORMATION SHEET
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l)<) BUilding Permit
\Acreage or Lot slZe---11p,(J,hy g{)()O S'/, +1
PartitIOning # ( ) Completed
( ) Pending A
~APPLlCANT'S NAME AND ADDRESS -:I,., h.\A V\d I"<f',,:)
\. -OWNER'S NAME AND ADDRESS, If different from applicant's
'CONTRACTOR'SNAMEANDADDRESS EW\p,v",--lrol lVc'1... \0"" o 0... Ie.'s'
"-Mail permit or results of sIte feasibility study to (X) Applicant ( ) Owner ( ) Contractor
( ) Prefer to pick up Call (owner, etc ) when ready ~ontractors O. S. #
"'-S');RUCTURES NOW ON THE PROPEB=r-Y-- Me hI le t-\ ow...e_ +0 \r\Q_ \!\AClued.( 3)
'i~oPosEDUSE(thlspermlt),~X Sf, )(V\o'olle.. H'D\iYocE.-, (.If:2;c) ~"""'Y'''''1OS
'-WA TER SUPPL Y ~ VV\1" V CL~rt, \ y" 0. \ \ ;S(L.\~.s ~Io -7'\- ~g or proposed well, etc If public, name of system)
'-SEWAG E DISPOSAl (existing or proposed septic tank, etc) S I '"
) Site Feasibility Study for Septic Tank Number of sites
Test holes Will be ready
SubdiVISion ;:=1/ hp.v-l-
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Lot c2Q Block
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Phone_2:'/7- 1.2(.5
Phonp
Phonp
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"-PLUMBING BY
Address
) PROPERTY IS WITHIN ONE MILE OF CITY (
"*"*.."*"* -If * **** ** ** ** ** * **** * *** ** * * *** ***** ** * 0 FF I CE USE ON L Y BE LOW TH IS LI N E **"* *.... * ** * * *.. ** *.. ** ** ** ***... ** * -11-.... *.... '*..
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( ) New Address Necessary
ZONI=
) F acil Ity Permit Necessary
SETBACKS Front Side FaCing Street
{FROM CENTERLINE OF ROADl
) Special Permit Area
Minimum Elevation
Intenor Side Yard Rear
(FROM PROPERTY LINES)
To Planm ng/B uildlng Inspector /Sanltanan/Surveyor
ThiS applicant appears to have a problem With
Your assistance will be appreciated
By
Permit Processing Section
Responsp
C5512
By
DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
Permit Processing Section
125 East 8th Avenue
6874394
nlVISlon
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LANE COUNTY PERMIT
CGI~r; oj!.. ft:
Acreage or Lot SI70
Contractor's 0 S #
Partition I ng #
) Completed
SubdiVISion
Lot ~9
~IT 3I-:'i' A:-~CT~
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Bloc~ 6
JvL ...l.l.,,-:"J h.:('~L: 70,:; !... 'L.'I:O:H nAY
APPLICANTS NAME AND ADDR':C::"
OWNER'S NAME AND ADDRES" I>.c::.:
CONTRACTOR'SNAMEANDADDR<=""'-U:".w ,.L\_'..Lt L~~:; 'J:!:")., ~~.: ;.':\::
Mail permit to ( },) Applicant ( ) Owner ( ) Contractor ( ) Prefer to pick up Call
fJ2 JL..JPICL.'l C:11 ~t.r_l
Phonp
Phone
Phonp
(owner, etc ) when ready
147-1255
STRUCTURES NOW ON THE PROPERTY
E:a:El'"t'!ilG tXl.3!L:C llo.."\t.--:: 3 BFj): IDIYSTll!G SDS
THIS PERMIT IS FOR
PF;..u:I-\ 'r0 :>T~,t'\""-~ ': ~.. JCjn74~ I'll): ;-On"F_3 ~'Oi ~
l.jur~c ~.'O ',,,; 1,J l (J ("",. ~ ~C"'1 '1,";. C;
# BEDROOM"J
# PLUMBING CONNECTION5--...
WATER SUPPLY
~lS1'1LI('!
SEWAGE DISPOSAL
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-~ cS I #
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THIS PROPERTY IS WITHIN ONE MILE OF THE CITY OF
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PLUMBING BY
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I hereby certify that the above statements are true and accurate, and that I have the following legal Interest In thp oroperty .............owner of record,
contract purchaser, ~ potential buyer, ~ realtor or agent I further certify that (,f not the owner) I am authOrized to act for the owner of
I ' ,
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 Rermlt ,-
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Fee Paid S'. '. --....... Slgnaturer,"1J! -. ,......" ~.' --- --> Dato ~,"\ ~ ," ..~ '
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) FACILITY PERMIT TO TRANSPORTATION DEPT\ (/) SPECIAL PMT AREA MIN ELEVATION /- ,dV::-.'."
BUILDINtP\NE COUN'"fY St'.tCIF:\.L PJ:!:HMl'1' AH.I:!;A
) NEW ADDRESS
SANITATION
,
Minimum Septic Tank Capacity (Gallons)
Dralnfleld ReqUired Lineal Feet
MaXimum Depth
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Type of Construction r::roup
, Ilse Classification
Comments ,!J/lOlgl't..-E /";~)/I"1E
Fire Zone
Comments
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By --e::: _J-."",_ Date ):,,::")-7).>: Bye,.;: I;?~ 1.77/!., ('I'All'(~ Date .J-/~' -7,0;_
PLANNING'.REQUIREMENTS SATISFIED Bv '{L, 'I 1 ,....."--<::,-....>-.- Date ~Q, " '. ,J' '\ "Date Issued_, ~'') /3-7?
'ZONE """ry \ \ \";-\..SETBACKS FRO~JT=') C5 SIDE FACII':'G STREET (F ROM, C/L) I NT SIDE Y ARD'-', REAR-I" (F RQrvl P/U
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LANE CO~NTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE, EUGENE, OREGON 97401 PHONE 687-4394
POST THIS PERMIT ON MAIN BUILDING AT SITE
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C5513
SLOG PERMIT-WHITE BUILDING-GREEN PLUMBING-CANARY SANITATION-GOLDENROD OFFICE COPY-WHITE
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SITE INSPECTION
ApPROVED Cl
DISAPPROVED Cl DATE
REMARKS
FOUNDATION INSPECTION
ApPROVED / / 01 SAPPROVED c:::J DATE
REMARKS
FRAMING INSPECTION
ApPROVED / / DISAPPROVED Cl DATE
REMARKS
LATH OR SHEETROCK INSPECTION
ApPROVEO L-,/ D'SAPPROVEO c:::J DATE
REMARK 5
INSPECTOR
INSPECTOR
INSPECTOR
INSPECTOR
FINAL INSPECTION
ApPROVED ~SAPPROVED Cl DATE 5 - Ie. -7:f- INSPECTOR ~ #-
REMARKS
CERTIFICATE OF OCCUPANCY
READY TO ISSUE ;---? Nor READY TO lSSUE I / DATE
REMARK 5
INSPECTOR
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LANE COUNTY PERMIT
CG1C a<j it:
Acreage or Lot SI70
Contractor's 0 S #
Partition Ing #
) Completed
SubdiVISion
Lot 1.9
FIL3W'f Gnove
Block 13
5eb
JOfiiJ A..'3Urn lillCill.ill
APPLICANT'S NAME AND ADDRE~~
OWNER'S NAME AND ADDRESS 8M);_
CON1RACTOR'S NAME AND ADDRES~LhlliUU.') illAllb{ SLl.L'?~ UlLL Sr.:;'2: UP:
l'v1ail permit to ( X) Applicant ( ) Owner ( ) Contractor ( ) Prefer to pick up Call
l.JITS'lII<G ;l!)BILl; IlG:..t; :3 Bl::lJ: r::xsnn; SlJB
2076 Xi.TL!\.",m tJiW
SPlUEGrti'LD OJ.U:GQ~
Phon~
Phon~
Phon~
,(owner, etc ) when ready
747-12$5
STRUCTURES NOW ON THE PROPERTY
pl!.p:rrr TQ PLIleR m.tJ DounLD trIDE n:mn.R ~
THIS PERMIT IS FOR i1rnl'< 'ro ..-n17'nrr'lnrn <m<:
fbuST!~;r.
WATER SUPPLY T
# BEDROOMc:3
# PLUMBI NG CONNECTION&....-
SEWAGE DISPOSAl
t:XJJ!'i'P}~ _ __
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-, .S I #
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PI:1:CI
THIS PROPERTY IS WITHIN ONE MILE OF THE CITY OF
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PLUMBING BY
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I hereby certify that the above statements are true and accurate, and that I have the follOWing legal Interest In thp oroperty '/owner of record,
contract purchaser, _ potential buyer, _ realtor or agent I further cert.fy that (.f not the owner) I am authOrized to act for the owner of
record, and that.sald owner IS aware and approves of th,s action I hereby agree to cc5mply With all applicable Codes relating to this germlt :'
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Fee Paid :t ~ - ~ Signature, ~-'- ~- ... Dato ~,' . , ,'. '
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) FACILITY PERMIT TO TRANSPORTATION DEPT (.....) SPECIAL PMT AREA
MIN ELEVATION ,hc.':'--"_
) NEW ADDRESS (
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SANITATION
4/
Minimum Septic Tank Capacity (Gallons)
Dralnfleld ReqUired, Lineal Feet
MaXimum Depth
BUILDI!I!.9\.NE COUNTY SPECIAL PERMIT AREA
Type of Construction Group Fire Zone
I Jse Classlflcatlo~
Comments 11/"1',1 /L. f.3 1.(... 1'/ t,-
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PLANNING:.REQUIREMENTS SATISFIED By 't, \.........' _'-- Date
ZONE,' '.1"\.- \ \ \'t-\.SETBACKS FRO,~n.-'lL ;;,SIDE FACIN~STREET
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(FROM CILl INT SIDE YARD\- ,REAR i (FROM PILI
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LANE CO~NTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE ,-EUGENE, OREGON 97401 PHONE 687-4394
POST THIS PERMIT ON MAIN BUILDING AT SITE
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C5513
SLOG pERMIT -WHITE BUILDING - GREEN PLUMBING - CANARY SANITATION - GOLDENROD OFFICE COpy - WHITE
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SLAB FLOOR
PLUMBING GROUNDWORK
ApPROVED .c; DISAPPROVED .c; DATE
INSPECTOR
REMARKS
GAS PIPING GROUNDWORK
ApPROVED / / DISAPPROVEb .c; DATE
INSPECTOR
REMARKS
ROUGH PLUMB I NG
ApPROVED / / OISAPPROVED .C1 DATE
INSPECTOR
REMARKS
ROUGH GAS PIPING
ApPROVED .c; DISAPPROVED .C1 DATE
INSPECTOR
REMARKS
FINAL PLUMBING
ApPROVED !EJ DISAPPROVED .C1 DATE J-/~-l,r INSPECTOR
REMARKS ~ ~/{
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FINAL GAS PIPING
ApPROVED .C1 DISAPPROVED / / DATE
INSPECTOR
REMARKS
CERTIFICATE OF OCCUPANCY
READY TO ISSUE 17 NOT READY TO ISSUE / / DATE
REMARK 5
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