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HomeMy WebLinkAboutPermit Septic Tank 1979-4-5 SUbdiVision:~-~'l Lot ."3- Block ,;).. . " . '. fl S.1. #1(7- 79-::<.t/L.j Job Location~(r7'2..~~~; l-o~ 1 k.;../TlO14<J..fllV ~~,. . yon ~- ~- (r~,- . Written Directions. ,.}-.It.Q~ ~ . -' .))Jo: 1; -TWvv-..., ~? -v-JD.~ o'bddd .J1.al~) ~.i.w'i!LVvYu J~.:t-I- '1:ll.Q--./YIO~ 1~1Cu,.A, JlcUJ- Q...c.J.. &.a- )l a-.c..., . ~ ~,/I . . () . , TRS:TI /,(~lJ 3 -;) "i-/J SITE FEASIBILlTYREPo.RT Fo.R SUBSURFACE AND ALTERNATIVE SEWAGE DISPo.SAL APPLICANT'S NAME AND ADDRESS ./l@~ U 1. {;)41~.PA~,_,.il~ 7.~ Ji,tn AVYQ 1 AJ CCf.' ~ (}z o.WNER'S NAME AND ADDRESS 4/)./J'l/p -. . Phone /)41-:JfR/ Mail report to ( ) Applicant () o.wner (.) Prefer to pick up. Call STRUCTURES No.W o.N T~E PR~PERTY (1LJ/'h7fl..P/I.' ~, ._ r 'Po.SED USE o.F. PRo.PERT'y /J /' ..t)dL.--r1~~ ;. ,..' , ..' . 'c WATER SUPPL Y ~ ~ lJ:,,;. .:,(.. '''~~''':'' >~., -- ":.; .' WI~HI~:~~E'MILE bF"ni~'~~;~. ~'~:' " Phone (owner, e~c.) when ready. (NO.) 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. !"further-certify that (if not the .owner) I am authorizeil to. act for the owner of record, and. that said owner jJaware,and approves of.this action. ~.. .. '.,. ..: ' . TESTHo.LESREADY .j'J.-fl;4/~',., ' . Signature"*.JaJIZOhLA.J2..liUM/,Y'J! Datp 4"///71 .., , , , , , , , , , , , , , , r, ,', " , , '.', OF "CE US ON L Y mow T"" U NE ' , , , , , , , , , . , H , , , , , , , , , , , , , SITE: ~MEETS STATE STANDAHDS .GDOE~ NO,T.;MEET. STATE STANDARDS. ...".,1''''. rr.:'...., _. "qANs...U$LCQ.~ PLlANCE . ~ ~'~ 'ft-.;.. k( ~.~:;:rtcu 'k<i~~ Zonm1 ,k"A.. I71ti . ~; o?~.u,:...." ,...... "'A'(r "'~'\.<'.,iJ'~: !Acieage'orLotSizeI?~'(/4.:2X'"q5X3{"(TOTAL) ,. <4-~,.A--o-1 ~A =tJ~ ~ ,>:>-,v,0;_ J.~ . ..... ..~, .. . /. (.) Completed ,0 . __ O.~ :...J. . , !artltl~nlOg# .~~ ~ , (.) Pending . ~~ -.. ... ~~~~ parcel#'~~... ~. ~~/~_ ~ 0<-'-' . , . ~ ~~-oF'f)~ (),.~", IT ~:::O:-r ~ ~1-. . ~.~/~I ' .' () , THis IS A PRElIMIr-J'ARY BtPORT WHICH DOES NOT ENSURE THE ISSUANCE OF A FUTURE BUILDING PERMIT. ANY PLANS OR EXPENDI. TURES MADE IN RELIANCE UPON THIS REPORT ARE AT YOUR OWN RISK, IF SITE IS APPROVED, SEE REVERSE SIDE. ,. . ~~-i-- 4~1J-7( .- AUTHORIZED SIGNA~E . " DATE. . . Division of Water Pollution Control _.--".r_"':\l.INJ"-Y_DE~ARTMENT OF ENVIRONMENTAL MANI;\GEMENT .~eU.~' 4~5-79 AU!HORIZED ~~'fi-URE DATE Permit Processing Section 125 EAST 8TH AVENUE,EUGENE, OREGON 97401 687-4061 , . " .~. " \~.I ,," - " '\ ... ~\.- '" "'-'\ . \ . , . r, {~ .' .' , \" ., .\.,. '. ... \ , {",(t. '1-,' k ~ , .v ., ". .'\ \ ... . i:\ '''.' Y... .,_..,.;1 '. , ~ '"," ,: ~:- ~) .,....., '.. .. .~ . t~.i; . ,j ,\~,- .:. " " ..':'. , ''':'j ,. - ~ ".1,' '.' ! ~ I , l,' . , '. " , " .' " ... , )' . , ... , . .... '-~. . - " " ~.' , ,- ':1 - ,t' 0'': .', -\ .... - "\ . " ...':. ."l ',' " . ". . . OAR 'Chapter 340, Division 7, Section 72.020(6), This report shall re'main'in effect until issuance'of a permit to construct, unless in the meantime conditions on this or adjac'ent, properties have been altered in any maririerwhich would prohibit issuance of a .permit, in which "case this. evaluation '~ep~rtshall be ~on. , . sidered null and, voi,d,.iechnical rul!, changes.'^!ill.not invalidate. any evaluation report issued pursuant .~n ' . this section.. . . .1, , ,_Before"construction-isstarted.bring this fOrm to, the Department of Envir.onmental Management and apply. 'u' - for a building permit, Exact specifications'for the sewage disposal system will appear on the permit.. . , ',. -, .." '. If 'the propertY'isonly.a permit will be issued, portion .of'a,tax'lot; a partitioning or subdivision musi.be approved before the . . ..... ..' . ../ .: . -':..:'~~'. - -. . .. . "Only persons having a valid license issued by the' DepartmentofEnviron.mental'0,jalityunder~ORS 454:695 ' . '" ~ , ... ' ~.: . ' . ". . . to Install sUDsurface sewage' disposal systems or an owner or contract purchaser 9r .hls regular.employees ,may inst~II,subsurface sewage disposal systems. A certificate of satisfactory completion will not be issued if peiso~s. other than the above perform'the.installation. .'.. " ..'. . . ' . -l' ...."\. " : , I. , .: .' ." .. .' .i'jl" " ., ,: ,'" .) - 't.,) i /,':: .;.):., "':10, -' ',), ::'i " !ill -.J -p.. T' , <- ", . ~'. I "'-: .). \ ~:\.. , ..; '" -\', ;,' .., .._f ~.:r. :/',. '. .1. " -,I..'," ".- .-~, ", '''\ " -. I' L I'. ~ ~ -' .~ J ;.... , '- ''lI', ,,_ . " ., . " ':,. " " " '~. . ," J', ~..! '_!;i -:~ - ',1- ..I" ,":':_#'11 . -i. \: \ .;' ~ ,,'." "I '..... : ,- . ~.~ '. 'i - ,.. - " .. I ~ I I I SI# LC.... 7 9" - c2. cj{ SITE EVALUATION WORKSHEET LOCATION: tV RANGE !'\"3 SECTION' ::L . TAX LOT # '~.J TWP, ZONING: PROPOSED USE: ~~,D SIZE OF PROPERTY: AMOUNT USABLE AREA: ~~ WATER SUPPLY: COMMUNITY ~. PUBLIC 0 INDIVIDUAL 0 SUBDIVISION/PARTITION PARCEL LOT BLOCK IF SITE MEETS STANDARDS FILL OUT: Type of structure and approximate s~wage flow: Single Family _~ Multi-family gpd Industrial Connnercial gpd Institutional MINIMUM DESIGN REQUIREMENTS: Length of disposal trench Distribution Method: Curtain drain required: Othe.r: required I (if) ~d:-- Equal ~ ~e:ial D Yes 0 No ~ SPECIAL. SITE CONSIDERATIONS OR VARIANCE OPTIONS OR OTHER ALTERNATIVES: NAME: A.~_ {I t/--t/-7 'j' DATE OF EVALUATION: C74-l26 ~k.L gpd gpd gpd /150 gal, SLOPE .~\ :d--- % 60 . {\ / SLOPE ~ % ir^ 'r 1/ SITE DOES ~ DOES NOT c=J MEET MINIMUM STANDARDS, ADMINISTRATIVE RULES REQUIRE ~ MINIMUM DEPTH OF: 36 inches to an impermeable la1er 30 inches to a restrictive layJr \ 60 inches to a permanent water table 24 inches to a temporarily perc~ed water table \ \ I: 1 f+-: i : I tl ~' \.1': It,-I ~, : I ijlt'__f'J' -j.J-H+I+Li I !f:+i+"i+ - ::t! - -0-- += -1- -1'- , : t::r L, l..L - -1-1- , - - - ~-I-+-i-' - I - -f' -Hn' , +- , ~ -H-- - - -,~ =-- ~l--l-l 1 -t! t I -H+- 1- I; 'it--i--f-j --H-+--- . = J:=I== -:=J:: -=fi:4HI_'~=I- 1_, ttL -t' _~' 1 ~,,~ '~_:Ij--+ =1+r-I'i-:+: i: 1--+1'::lt __"I I ,- - +- - , 11 ' I - - I 'I I I /'+IT -1- ~ j I 1'1 :: 1 ut- -T' I' I ,i\+l-:: 'r,--+t!---t '+-1 -'I++I-t I -, : lil"J'! "-I-,-+-I--iH::IU4::1_lllcH! ::,++-;1; 1,1 I'; '::-I-j 1'11- '_ I II ~L+ ,_ 4-W' Lt.!' I ~~J:tL" I '1+--1/11' I" Road ::d 1_+_11 THi:t:: ,~~' ,I_t:, II qQJI::h+,-' ,I I-::H-H-I+~ - - - - m - -, ",4-f;Cffti: 'f' ::t\i- I ! 'I ! II 1+ -~" I I', Cf-t++ll- j Test H~le ~ ' ,L='(-~_U-1+I.:tt '- -FJ't +::tl' i :1-: i 1-- lIt : : L(I ,I - -m+-1+ti, 1'--1-: ++-I---=J= 1111111' I '11,1-,,11 I' -,-11 1"I'f' -H+tL..L I ,L \ --11-++-,\, I+-Ti-i I II': III i 1'1'1':': ~ 7. Slope -'~+'--'II ::1~1'-'-J=:t::-- - _'__,', ::::', I L JJ'_--t,_,_~J' I 1', I IT- :: ::+tH-tt1-t:: f $!J - -,-+- - ,- - - =l= :wt -H-t:t::i::::: = ::1- '. _'_ ! +;- - I !tl I Cu t Bank I I , U.LI I -1+t It" - -1- $ -rl+ - - - - - - t 1. - - - I I ;;#;" ==::TI-H+-q::-l+:-~'~---~ ~:::-,-,-, :-:..=ffr~-::::::I~:'i-::::=FI-I II! l-ftul :e:: )C-)f :::: - ::illil :::l:: ~ t ~ ~ T.I ~i- t~-'j~ ~ =j= n+ - ~ -f:- =':::: ,~- =p~:[, l' ,11 = '- --~=Rt::=l::=::::~:'L_'- __, I i 1>::-11+ -:::: - ~=rl-+-: - ,_1__ *i--I-:II' :\1-++-i ~t~tl-+i\~:f=U : LU;-- -Lj-Tt I \11 il i-~-iT'-li-:l;,=-l -: , , H+, ' " . ,-H-+f,\-t,: :. :-+ +: ,': II ! :- ,,-1-1, ,II "Tj .# 1 T EST -. PERCHED WATER Predicted Observed Date in. in. SATURATED ZONE Predicted Observed Date in. in. Restrictive Layer An. Impervious Layer ~ in, Mottling~ \ill~'~n, o o o o OTHER REASONS FOR DENIAL PLOT PLAN: Stream Drainage or pond ..,............... \ I H ( IE J;'ROFILE In'ch , \ " 1\ -)~ , 24- i;..r 31 J I S1# #2 TE .- PREDICTED WATER H 0 L E PROFILE Predicted Observed Date in. in. Inch 12- ~r, SATURATED ZONE / 24-~ Predicted Observed Date in in ! 36 - / Restrictive Layer ~ Impervious Layer~- in Mo tt ling ,.:.-y..r in 48 - 60"'~/ ON YOUR PROPERTY THE DEPTH ~:. inches inches inches inches J r> .----. ,-----,I DEPARTrlENT OF ENVIRONi1EiHAL I1ANAG~I'1FIJ.T PSG, 125 EAST 8TH AVEfIUE EUGEitE, OREGon 97401 Job Address .!J.11-? ~ T~ 1_ ~ j h)",,! Township, Range, Section, Tax Lot I c;.._ .1)"7 d.., -'-- n Subdivision ",,;._.....,.. IC.#t..... "'1..~7::f;'-J) . '.~ Lot ~'"l Block t:l Application lor _(...n 7="~ it..:- ,.,=--- -./1./ ~...iLn~-:"~ "....../..;,h~ Structures now on the pr4,erty ~ / A.. d:iA__ ;- _ ,........ -'r - .. . Proposed use of property: /~/_Res'idential L/ Commercial Affidavit: I, ,AlILJuo;,.,,: { t.)4cr2.""""_ , (please print)" . -.... If this application 1S for an agricultural building it will be used for purposes allowed by the State Building Code and Lane County Code Chapter 10 (zoning) and for no other purpose. I have the fal lowing legal interest in the property: owner of record; ~~contract purchaser; lessee; holder of an exclusive option to purchase; duly authorized to act for the owner, who is knowledgeable of this application. Signature/Address.~;c_,~'_, ft1f:...0A_:_. t'~?3_.J;,/....,../ ~u Telephone /]I/"} 7.YP1 or DaJ6" When pennit is ready notify: tLl-Appl icant /~/ Owner C/ Contractor Qy: /i1-mail Owner (',.._ ___ ~L_-_ (zip) ,. -:4' ' '" (zio) CitY_(iP"/I~ t-.1J~/cI ''.I Appl ication if t..C --79_.:2 C/ /Z Assigned Numbers () Industrial LI Publ ic . hereby certify that this information is true and accurate. (a""~~({iD) ?P~7? J't a~'h4' . ' , It/ (r,o~" Phone Con trac tor Phone Contractor's. OSR# Plumbing by DO NOT WRITE BELUW THIS LINE If Commercial: # of stories Residential: # of bedrooms # of employees # of un i ts SDS: CI CI Existing, BP # Proposed, 51 # Unit Cost Va 1 ua ti on Fee Fee Code SI test holes ready r-?.I" _ ~j ,--- p Description Sq, Ft, or # of Sites /. 7~0?? $ $?'5/dr) $ $ /7 ^ ~.z; ; ~1"':!.:U A?h/r .;C./.-A--7 ___ -/ ,/--.0'./,0'7-' i' 0??A4/tp'J '~~ 7 ~" .... - - --- , ... - ".. - [/ , TOTAL $ each $ each $ $ $ $ $ $,~,~ Size 1J?t. X' J tJ,2. \('9.<:-.(35 , C/ Cash I~"i..eneck # Received bv ~X7'~ ~J~ A.o{h J '." Total Valuation: $ Plumbing fixtures at S Sewer/water conn. at S Subtota 1 Water Supply Proposed Year Installed Existing 4% State surcharge Plans check fee Change of Occupancy PERMIT PROCESSING Minimum setbacks: zone1( tJ...../J1 jj. G..,fr~nt' 'f part. # Parcel # . Parcel 1., side into ; t'ear Comments To be typed on permit By; --1.:: / A"~ Date L/ -.:2- 7 q 7 - , / WATER POLLUTION CONTROL Installation specifications: To be typed on permit gal. tank; ft. of drainfield; max. depth of trenches: ,. . Telephone _ By. Date , T Directions to site.~hA_..bh""A' 7':-, ,!2~Af.,f- ~jI_ ---4tA~, A/~./+-5l-t1-Z;:; Jh.A ~ , '~'TJ/J/.AA & - -I7'/A,-,"" , /L./-?L--~ ..(h,/.-d1.......~AI /R./H'./,V''/''~ ~-~ ~-IF~ - - P1an~ -to~ CPtl s;t(s) - - - - toat: - - Hold Slip . - .. Date t1 - - Date to - wrc set(s) Required to pee Completed pee i;'/ CP7 10wpC L/ /.:2 -,z 1:/ Planning t:/ Publ ic Works CI EI eva tion CI n/a CI Address 1:/ Facility Permit I~I Environmenta1 Health FOR INFOR:.lATlON about progress of. your appl ication call:' Mk-~~~ . Permit Control Center 687.HELP (687-4357) OEPARTnENT OF ENVIRONIIENTAL rlANAGEMENT.. PSB, 12S EAST 8TH AVENUE . EUGENE, OREGON 97401 1;';1111~tjHlJHt!iB t..C ':''''::3J.c,t~ . L~~!"~~;i~jjm~m:~,\ I'fu~~;~;d~:'~,~n;;~~~i~n;',[~~~~a 7 t- t> ~ir '{~ct-II ~JF$fJfr; ~ ~ {, ~ M I:::~:'::,:~~~ Z'lhNt..:~~"'/~/:::~-<u~ p!~~~!;!-~ l~~;~~[ij~,i;i?i;~~~~~ir~ !!tIit~t u. ";5L\.~;;i; ,. 0 fj~fimfD1Wlil. 0 ~~ijp0 Affidavit: I. MA Li R it'. J:... ,f/~)1~ Ne-a . . hereb~ certify that this information is true and accurate:--' lM~~~!lLl!nlntl. ..... '. . . ' If this application is for an agricultural building it will be used for purposes allowed' by the State Building Code and Lane County Code Chapter 10 (zoning). and 'for no other purpose. I have the following legal lnterest In the property: owner of record; ~contract purchaser; lessee; holder of an excluslve option to purchase; . . duly author,ized, to ac~ for the ownert w~O is knowledgeable of t~ ~PPlication.~. Slgnature/Address ~/i L_Jo_ ~, ...f' ~ '//.l/IA,.:. ~ _~.Jl"" _7 .1.._.:/-.:__"/ ~y ... Telephone '/} Y-? ;2tf"1'1 or . Dal!'e When permit is ready notify: ll/-A!Jplicant () Owner CI Contractor !!l.: ~i1 . Owner S ~..... d- C L!:?.{......;.......,-. (zip) Contractor ., "t ." (zip) Contractor's OSR# {;>~I,!~~('iP)tPf? ;? ft?1~9' Itl tt,one' Phone Phone Pl,umb i ~~ hy If Commercial: Residential: ~ 51 test holes ready . J:.A/~ ~Fl@ r t&iii .m;~l\H!iii1i!li' .... , ~O~ 7UU~' ~r~ DO NOT WRITE BELOW # of e~p 1 oyees [HIS LINE !i~;j~l!j!,% i~O$if I~I Existing. BP, #, I~I Proposed, SI # fII~; Valuation Fee :~~~~ni:i. Subtotal '$ $76/ cJ'r.} $ $ $ $. $ $ $ $ $ $ ,%7..tfr) size/36 X 1</,), X rS)"3S 'each '.each '/ 75/00 rl "cuw!??' . :::-,~....,..,........"...,......~.."........., ""l l~tiii2~{* &r;. .,,- . .' Received b ~.. ,. I?r.-/~ Tota] Valuation: $ tr~J!~~n0~~~~;~ : ~ : Water Supply Proposed Ye.ar Installed Existing . 4% State surcharge Plans check fee Change of Occupancy TOTAL PERMIT PROCESSING Minimum setbacks: Zone -:ii-ll-- /Iil 7J Pa rt. # c . '. 1.., fron t. . ~; Parcel # Parcel <t. side into , rear Corrments To be typed on permit CP&I Type To be typed on permit Group Fire Zone -' By ...-1-" / ./7,~ Use Cl ass i'fi Ci}t-j().1 Me -.!/ ~..;J.::..7 ,,,9 . By .______-"--___~_, For plans informat~'on all Jarea lnspector),' ~~.n '. I ~ T?ir/''l'ons)o s,te. __-.z?7 i(!/7U(. _ _ I ~/ ~-.=hh/Yl..l ~ >1 SIFO Plans to. CP&I ~ set(s) '" Pf,at;. Hold'Slip - WPC ~ seds} Required t.o pee Date . cP/1ol')e -~- ~- , . lj "'-~r' Da te {;LL.' Oa ~~'~~--;-- Completed pee ~/ C/ Planning C/ Public,Wocks CI Elevation CI n/a C/ Address /~/ Fac il i ty. Pennit /~/ Environmental Health LI / ,:;,-z... " -:: FOR INFOR~1ATlON about progress of Xour dpp11catlOn ,ca 1 1: &:;J~~~~ . : Permi t Contl"ol C~nl;er EB7-HELP (687-4357) 1977 I ~~."..:---~" MAY JUNE JULY AUGUST SEPTEMBER 'OCTOBER NOYEMBER DECEMBER , T W T F SSM T W T F SSM T W T F SSM T W T F SSM TWIT F SSM T 'W T F SSM T W T F SSM T W T F S 234.56.7 ll34.1.2 12.345.6 '.11'23 1 .12345 1.23 , 10 11 121314 5 '6 7 8 9 10 11 3 4 5 6 7 8 9 .7 8 9 10 11 12 13 .4 5 6 7 8 910 2 3 4 5 6 7 8 6 7.8' 9 10 11 12 4 5 6 7' 8 910 ; 17 18 19 20 21 121314151617 18 10 11 12 13 14 15 16 14 15 16 17 18,19 20 11 12 13 14 15 16 17 910 11 12'13 14 15 13 14 15'16 17 Is 19 11 12 13 14 15 16 17 I 24 25 26 27 2S 19 20 21 22 23 24 25 17 18 19,20 21 22 23 21 22 23 2425 2627 18 19 20 21 22 23 24 16 17 18 19 20 21 22 20 21 22 23 24 25 26 18 19 20 21 22 23 24 o 31 . 26 27' 28 29 30 . 24 25.26 27 28 29 30 28 29 30 31 25,26 27 2829 30 23 24 25 26 27 28 29 27,28 29 30 25 26 27 28 29 30 31 31. . , .. I 30.31 . 4; , , ./ "1)0-:- . , L r A /e-lif-1~.~'+J-tt,o-el \~, ". l' I I -'-" !.2-X/'O I ,\'!J~ ~ "- . qol . I 6ry fI/bo<-vl G~D" ~ .j.. -. .5 '3 , I ~ - 0 '1. ~ 4--1/ .,,- I- 6 (pi 1\1\ H ~ \ Sf' J , JANUARY SMTWTFS 123456.; 8 9 10 11 12 13 l' 15 16 1718 19 20 2' 22 23 24 25 26 27 21 29 30 31 +-I?'~ f. 11> ,4 l I Cf " 1 , J ' -,.:,r . . i! . ,.,.;;..,. , -/JAY I JUNE JULY_ ~.; 'H T F ~JSM -! Vi' I" '=;- ;S' s-;; I W T .. 5 3 . 5 6 7 1 ~ 3 4 1 2 10 11 12 13 14 5 6 7 8 9 10 11 3 4 5 8 7 8 9 17 18 19 20 21 12 13 14 15 16 17 18 10 11 12 13 14 15 16 .. 25 26 27 28 19 20 21 22 23 24 25 17 18 1s20 21 22 23 " ~VU~W ~~~VU~W 31 AUGUST SEPTEMBER - -.- - .-- SMfWTf-5~MIWI~~ 123 456 123 7 8 9 10 11 12 13 4 5 6 7 8 9 10 141516 17 18 19 20 11 1213 14 15 16 17 21 22 23 24 25 26 27 18 19 20 21 22 23 24 28 29 30 31 25 26 27 28 29 30 OCTOBER SMrWTFS 1 2345678 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 NOVEMBER SMTWTFSS , 2 3 4 5 6 7 8 9 10 11 12 13 14 1S 18 17 18 19 20 21 22 23 24 25 2B 27 28 29 30 .~ ~ {'( -1+-7 '-+ ~-tt i>-t/ \~ ,I' I I / I \ 4 / '''':- / '~ '" "" "'" '" " I \ ')~ fI / pO-- T G-,..o v ~ ST~ tl j J . . j--[, "3 1~-()7 ?-+II I "/;L-S" I l- i' 6 e:/ /;2..X/'O /'V\H RJ:1l -1-e.€ ,f0~ lItfi""v ~ /'- ~ -3 ., 10' DECEMBER MTWTFS' 123 4 S 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 2S 26 27 28 29 30 31 JANUARY S,.JM T W T F !: 123456. 8 9 10 11 12 13 1 1S 16 17 18 19 20 2 22 23 24 25 26 27 2 29 30 31 >l ~1-/7( -1 /i I c; t ' tl ~ ~ ~ I STRUCTURES NOW ON THE PROPERTY I .~ /r L>>' "7 A' "... ;.. A ~ ", ., """ TH IS PERM IT IS FOR t.--<' Y~''-.', r--< ("-'"....J (, ," r-r ~./ .c:;i (.. (r> , 1 ' ') 1/. ,'../: "-~ "WATER SUPPLY - .0 J71 r'Yc-<A.-,.-r.A.. 1<1.... \.. iJ . THIS PROPERTY IS WITHIN ONE MILE OF THE CITY OF ( , I hereby certify that the above statements are true an~ a<;curate, and that I have the following legal interest in the property: _owner of record; contract purchaser; _ potential buyer; _ re~ltor ,or agent. I further certify that (if not the owner) I am authorized to act for the owner of record, and ~t .saidr5'wne/i~ a'^:~::Jand.:pproves of this ,i!~tio'1.:. I hereby agre.(,to C?mply with :" appliJa~le Codes relating t6 this p~rmit. ,. Fee Paid $ Zd (; ~....-?,; <-''''; ~ Signatl1re/I,.0!~ /j 4J~-'\ Dat~ .< - 2)- 7./ ( ) NEW ADDRESS ( ) FACILITY PERMIT TO TRAN'S.PORTATION DEh. ( ) SPECIAL PMT. AREA. MIN. ELEVATION: ...... I, . ',', i V ,. /~". TRS, Tjlf- 3-1/...9.;J. JOB LOCATION ~o13 :Jeo Acreage or Lot Siz~ Contractor's O.S. # Partitioning # LANE COUNTY PERMIT /'V 4 .( ) Completed APPLICANT'S NAME AND ADDRFC:" 11")O..-u--"<',,/ .CA'......J.::: OWNER'S NAME AND ADDRES" ' , " CONTRACTOR'S NAME AND ADDRESS Mail permit to (Z)"APplicant ( ) Owner , I.z '(kv~.-C.-t... ( ,..j) Contractor. ;, rn o:fr{ ) Prefer to pick up. Call ( SEWAGE,DISPOSAI " " \. SANITATION r. . I. ,.. 1\\.,.~.J' /U ~ j. I' \ 6.:.- ~({.//- I II' U . =- <-.1_ ".J ,e' '/..~ -. ~ .::..:; 1._, ; I ).,( Subdivision - L.. J:.:.? '-, ?At ': A ':..-/ ~ '.. Lot~",;) Block .-2__ ( ..,' ""73 v;...:;;, l7. /;, /) .;j' ,/ D ='(. "-"f"I' /')/ ." t/.u:..('Phon~ '7'/ /-'Jt"t./ / Phon~ Phon~O (owner, etc.) when ready. : ~..LL.. f' t'--> UJ.Uc'..(/r'( ( f\..... # BEDROOMS_# PLUMBING CONNECTION~ ,e, '...kl-./)J.. 'il.,/ i:S , S.1. # /, . PLUMB'ING BY ~ Comments: ,/...,;... , " Minimum Septic Tank Capacity (Gallons) \,' Drainfield Required. Lineal Feet ~. Maximum Deptl) "i ~, Ii BUIL01NG ... "f.Jt/ Type of Construction r r;roup a,<:' ~ '" A...:L~ I Jse Classification Comments: 't1 ~- ~ t ~r ~i'~ Date: ..:;....".;, '..7;/ '. ,ByG"t 4e,-,.-4 J h :;I.w;e Date:'07 <28'- 7'% PLANNII~'-G REQUI REMENTS SATISFI ED. By: "-Ia.-~/ 'If G?/ Date:"':< -OI~ ?<r- Date Issued:O! -dO-It> ZONE:I<::/lmH SETBACKS: FRONTb1b" SIDEF~e-INGSTREET- (FROMC/U INT.SIDEYARD~I REAR"':;-I (FROMP/L) . ( " , , ./ /, -'b' If., ,'. ...~....."'--" ~~^' ~~ '" ... \ \' . .'. \, '. By: '". , ~_.. .... ,~--- . ~ ~A-'- '-' F ire Zone 7<-C4~ -<1. , LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE., EUGENE, OREGON 97401 PHONE: 687-4394 POST THIS PERMIT ON MAIN BUILDING AT SITE r\ ~- .~ \ ? ------ SITE INSPECTlON/ i ApPROVED .0 DISAPPROVE~ C7 DATE U- S - 72 INSPECTOR -, , YL<rK REMARKS FOUNDATION INSPECTION REMARKS I 01 SAPPROV'ED 'c:::J f'l./) (!,A ~ ,..., --..- ApPROVEO / DATE INSPECTOR '7f 1;~j-, h-J? I d#.~ ~/' /""'f .-?./'.t" - J /l~l . I FRAMING INSPECTION ApPRovEo /~ D,SAPPROVEO :/7 DATE "7 -/-J?'.5 INSPECTOR Q l~ REMAR."S /f..-LP_ ~.. ,0 _ Ie' -",,---7'~ 'e.. r .:- ."', /. - 1- "L~ ~ -'A-_...f~ =- / ._ i '. "'7A!:'--./ ~ ,..,0./ r- n'" d- ,"7 ~ . OA' ~ LATH OR SHEETROCK INSPECTION ApPROVED / / DISAPPROVED if I DATE INSPECTOR REMARKS h ".-,. t? " , FINAL INSPECTION ApPROVED !:Zf DISAPPROVED REMARKS 5c.- L.-.- ' I I I 'C7 DATE...,:2.-/-515 INSPECTOR~~ ~i'-#:-..,,' 1_ L_7'1 ~ I , I ! CERTIFICATE OF OCCUPANCY READY TO ISSUE /7 NOT REAqr TO ISSUE I / DATE INSPECTOR REMARKS 11'7" :j . , ;:\ i' \.,- '. / " .t CORRECTI:ON NOTICE " LANE COUNTY DEPT. OF ENVIRONMENTAL MANAGEMENT Construction Permits &. Inspections Division EUGENE, OREGON . \ This buildil"'!9 or structure does not conform to ~ane County building regulations, ,ordinances or codes as noted below:. . i sf" . -' /, II ~ 1- '-'~>>-.....,.<-L~ tr'-. q..-3..,7.2 . ..f!...PY t --~', ;,:~~ ~:~l "i 'W"~. ~w.d Olf~-; ~ ~-,,; --1,5" !:; I . I, , ~ I I __ 1 ,,cf~~ '..A~._ m:t!4r.~~ ~1i~ 'e~~-: ~ tL,_~'A /V'~<-~., C55 -7 3 RE-INSPECTION REQUIRED I~spector ~ ) ~~ -- Lr Datel:, - I:, -79 FOR APPROVAL I - Building Permit # tlJA..h. ~.r- 4...4/ -7R' \ (,~ ~ l!~.. ;t'--r-J