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HomeMy WebLinkAboutPermit Building 1979-7-24 ~'Ib/~I~ ./ ~/ w . t^'/ y ,","",CO" ~cJ / J I IV 1C:1:/t;l~'~-:!'i P:J)~ App 1 ; ca t"i on for' Structures now on the property 1'11/ /'I r Ijjffl!~~,i!4Q~!lj~t'liiiiiip!l6tj* &1.!I~.j!!~ij"1mjl OI~llililWt#~I@tl Affidavit: I, j\1/c,i'lIJu,/ ,j J..-afVIB {111>!.~$il!itj!!M If this application is for an agricu'ltural building it will be used for purposes allowed by the State Building Code and Lane County Code Chapter 10' (~;ng) and for no' other purpose. I h. aye the following legal interest in the property: . owner of record; ~ contract purchaser; lessee; holder of an exclusive option to purchase; . . duly authOr'ize~.1Jz.a acctt f foo~r..tthhee 0 owwnnj~rrwhJ y> knOWledg;a~~eo'fth;s apPl.;catfon". . . Signature/Address../, ~ /\/ ~ ' ,;2.0/d-.11V/JJN.o td/lV (zio) 97'177 . ., Telephone 7J.-C- -J1J.J / or '7lf~ -/2:&0 Date Vtn:.v,)..LI, jq7C1 When permit is ready notify: I~I Applicant . ~Owner I~I Contractor ~: I~/.mail I~hone . Owner . fV7/C/..f/)eJ-. \./ LnM.J~ (zip) "'/71/71 Phone 7)..t-Ji..:l.J1 Contractor _ ~_ (zip) Phone ~'1-;20/ / Contractor's OSR# Plumbing byo.J"::J,,T-'''' .~.{) .PM .::?//..r ' . ~-=--- OU Nur WRllc blLUW THIS LINE # of emp 1 oyees .~ljl~iilHI,~i!ii /" . ~/-'). ?$~illi /p-r;Zisting, BP# 3',:, 81- '7.r /~/Proposed, SI # 1/. .:III~~I~llt,.. 'II '" . Valuation .~L-/lY~~ I DEPARTI',ENT OF ENVIRONI~ENTAL I1ANAGEMENT PSB, 125 EAST BTH AVENUE EUGENE, OREGON 97401 . .1~jj'\iXt'jilii.@ I.C -)7;t~7J27'Yn!l .. . 'A~~!ijff~!1:iijl~~n~i Oi$liistl\'~l' () , hereby certify ;that this information is true and accurate. If Commercial: Residential: SI test holes ready IiI j?' 'llii[t'\!llltJUiii \ ~~.~~ . In x WJ ({)/1!:r;;;1(J. Hlk.J/hCf ' IQ4 . J Fee ;~t.-t'. ,gs6 . Received bY~~ Water Supply . ~~. 3 Proposed ~ Ex!s~ing Ye-ar: Instailed i:l:je:t:~:~12 :~ Total Valuation: $ $ $ $ $ $ $ $ each $ $ each Subtotal. $ $ $ $ ;:2&0-0 $j';he91) /0 t/ )C II :2- ,rear 71 PHS- 4% Sta~e surcharge Plans check fee ' S f)-J itAii (lJ. .. . TOTAL '-". _..e r. '-"'-"::i'-- ~. -"'-""....'-..~J PERMIT PROCESSING Minim~m setbacks: zonet'/f/;g H; 'Part. # It, front / .. ,. . ; e~~"f- Ii. , side .Parcel # /Vii- int. Parcel Size SI . Comments CP&I . Type M.l.4-. To be typed on permit ~roup~ Fi re Zone J7 .. BY,.Ao~ O~e ./-;2..c;~t:J'. :3 Use Classification ::5Ft:>/M 14-. . r To be typed on permit- . 'Gu) Date 8/3 ,/ I' For pla-ns information call (area inspector) ~ J'J/"J.A Phone .<70 Directions to site ()(J T. 0(){)71:t J./Y[) "ff/l'Et:;7T /N .spl'Pjiycr-li:-i../J Ta /'-/IJAbf7 uli'tJt/r /''/t1J'?/^-~/iCJM r= Pn/i?/\ OIY 6pJ/lit<I.sr.je. Jt/sr P;;ST ...l.tJl..2."'lNL..JJIY./J Cjt-7p1'an7lc(CCP&ICC4.J{i:t(s) Date .Hold Slip . Date Oa.te to -. wpc. - -- set'(s) Requi red to, Ree C0I]1~1 eted . pec By o SIFO~ .y-rP& I Ef'iiPc ??I~ /-:/ Planning /~ic Works - ~vation /-/ :n/a ~res's -' / c/ raci I i ty Permit .;:/ Environmental Health .~ FOR INFOR~~TION about progress of your application call: C74-171 Permit Control Center 687-HELP (687'4357) f6/, Name LIl fr1 A I Phnnp Application II ~"'~t'- 'Jq m!t for SW/l1# WORK SHEET , Construction ',Permits & Inspection M H Type. of Construction --11.1:L- Grou p ~ Fire Zone .6 F' D Use Classification AfoTE: ArT AC,H-A en PlI ()~F. Pt_.OT PLAtd Tn T~ r- I .N6.Pl=:iC. TtlR'."'\ . G I< I=.I;JV PE R M 1"1. (.().p Ii. To B~ TYPED ON PER M IT: e.RovIOE r-OOTING:5 AN:]) PLE.RS TO (f)M,PLI.{ uJll'H ;<;-rATF; r:;.Q!lNDAnON R~QlIlt<.EMeNT.5 ~R MQRI/.F. \-\-oM'::.'" n (LA..... ~t=;r~M M':: ^,~,,=.I'" ~t/_Ti-ll= M.AAJUI=~LTUI2 f~ Ir1ATArcl=,AnAc..l4~D To TH1; JNf)/Dt: o~ THe Mo~{{c:: I-ft"lMS AJ"'o P~()\JIDr=: '<"1o[1~"TINGr A.""" i=2S::r.'!\J1I;>1=.~- .;.,~,:, f<r:;.UEt2,,,,,;: 6l0f c..ote (.Au-FD /AJ:<,-pecfloAJ:=;.. ~ l)1")/.)~ 6rrF I:'"; I~AT~CL ~A t:'u"JoD ~A3AR I) .4f2~A. ~ ~/AJJMIJM ~1^)I..;,t-l f1....ooR. r:= '-1=; \j ATICl/J r. C ~ FE t':T ,~l-+4U _ ~,::.",r:"Lut2GP A1JO /.e:;~T\ !-IED A~ QY.nllLK.&.D F-,~ Tl-tG' eJJOf)Sr-;D I :r:LC;lO D PI. &LN MAD A (., F- M. c:,.~T I. 1":1T r:=~. Mop.,\ L~. Hou F. . . .E&A./J.F i'1F=, T)()IJ'tV5 Afi?r:: 1?E:QI)/R6.o ()6r2. ~J\jLLD~'e.f': . , , )~ "iHl=" ~r<oU{UD Fott::..IJAT\o^-J TIiAT~14t=. MOP-IUS: HDru,e ___ WlLL R~ p( A.f',\:::;D D~:o;. P-.Q..l ()\..., -rH~ .Rr:::(;)lll(?j;;D' ~_.c:1l2~T ~LooR ~U:~\).ATlt'lAl. , Date' t1t1'b ii .~~?A ~~e 74-164 , t~ ...... .)oJ) FLOOD PLAIN MANAGEMENT Department of Public Works 125 East 8th Avenue Eugene, Oregon 687-4195 TO: v PERMIT PROCESSING PER~~IT NUMBER '?.... '2.bD - i"'} NtH PLAimING PUBLIC WORKS PARTITION NUMBER SUBDIVISION OTHER SITE ADDRESS 'Lalo:>., Ilo..lLr........\D vJt>.Y PERMIT VALUE IS A SUBSTANTIAL IMPROVEMENT. YES V NO SITE IN FLOOD HAZARD AREA YES ~ NO SITE LOCATION IS WITHIN A FLOOD HAZARD APPROXIMATE STUDY AREA, EXTRA PRECAUTIONS MAY BE APPROPRIATE TO ASSURE THAT THE BUILDING SITE WILL BE REASONABLY SAFE FRor1 FLOODING. MOBILE HOME TIE DOWNS REQUIRED. ,~ SITE LOCATION IS WITHIN A FLOOD HAZARD DETAIL STUDY AREA. 1. MINIMUM FIRST FLOOR ELEVATION OF 44c),o \ U1.S.L.) REQUIRED. 2. MINIMUM FOUNDATION ELEVATION OF (M.S.L.) REQUIRED. /~ 3. MOBILE HOME TIE Dmms REQUIRED IF GROUND ELEVATION THAT ~10BILE Hor~E WILL BE PLACED ON IS BELOW THE REQUIRED MINIMU~l FIRST FLOOR ELEVATION. 4. SITE LOCATED WITHIN A DESIGNATED FLOODWAY CHANNEL, BUILDING PROHIBITED. % -0 RECOMMENDATIONS: SUe,OI"\c,:>\Ot-..l t:?E:.<-,>\12IC\\ON 12E:aU\(28:'.... M\~. I'.:'.L~'J&.T\O....l Dj:: 4-4-<'). cl ~ o ol I o rJ . tJl . (}~ DATE e,- ~-/") BY C"\ \'\1\ C -j :to> x r o -j .J ..j .3 C99-21 " / '-11,. l( , ~() o . ,~. '.. .,. "... ., 4- I -' ," './ ~ 'I. J ~ _ i. 'f .. DEPARTfiEiH OF 'plVI~O~NI~ErHAL/ i1ANAGE,:-"O. PSB, 115 EAS-r:8TH AVENUE .' , EUGElIE. ORE~OII 97401 . " : Job Address ~O /,J .IIV/../J/v1J LL//JV City ..f PFt-iJ T-;;wnship, Range, Section, Tax Lot /.P- tJ3-CJ:;?,6,3-7ltf~ ~/I....ANYTLn<)(lI/E-.J7N /-//)I) Lot~ , rr J/O ...App):icatfoQ;# M It t..(... -~'" ""V./ ./--11{ rr Assigned Numbers Subdivision Block - ~ ....... Application for Structures now on 1'1,)/1 r " the property -" Proposed use of property: /YI Residential 1'1 Ie- H II e /...; J J.--/.11'1 a (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 no1other purpose. I have the following legal interest in the property: owner of record; V contractj)urcha~er;. lessee; holder of an exclusive option to purchase; duly authoriZe? )o(act fo/ the ow~er, whois knowledgeable ot this application'7 ItI, 7'177 Signature/Address;l_ ,~A./ ~ " ;2CJI,J...J.1V1J11Y4 'AY (ziol'! '" '/ Telephone 7J-~-?..i.J1 or l'f&-/"L&O Date VV/--Y- "''ti /7/7 When permit is ready notify: C/ Appl icant It! Owner I-I Contractor !!l'.: I-I mail /5.. Pho;;;"t-f..:l.:J / Owner MJt:uIUJ-\./LI1/'1.f3 - (zio)"'I7'17, Phone__ ~d. Contractor " ~ _,_ ......,~.Lz.i.ot Phorie '7'tl't ::er" Contractor's OSRI Plumbing b;~-"";>v;;:" E'i!~J .. ~ .,..r.,~ V L-/ Commercial /~/ Industrial CI Publ ic ....~ ;'~"'j Affidavit: I. , hereby certify that this information is true and accurate:' . '. . If. Commercial: '# of~stories ....:~'Residential: # of 'be'drooms 1- J ;; S1 test holes ready DO NOT WRITE BELOW THIS LINE 1# of employees # of units /' SDS: /'tr'Existing, BP.-H''',3o 8/-; 1r () Proposed. SI # " " Fee . \ , Sq. Ft. or COde~"';~..../...wZi~...l~.,it i1t9-7Z.e_..! of Sites , -. - 17 ----.1.D "r;.n I.) :J+/'V'I?:l.U 0 . ' '. . I r, J.:,71J-,i;f' 10?oJ=) v ... - J .' _, i __\, , Unit Cost Valuation Fee .~ $ -. $ $ $ each $ each $ I .... - n cashii.iti79Ob eJ..eneck H ...,,g s'6 ' Received by L-f4~ .. r Water Supply . ~ Proposed Existing Year Installed Total Valuation: $ Plumbing fixtures at $ Sewer/water conn. at $ Subtotal $ $ $ ~ - - -) $ ."Lvi'.'" _v $ 6b/TO 4% State surcharge I Plans check fee f)s u;6t/,'1I S 11 fity. Cha'tfgeof-Gccupancy C. TOTAL Comments zone-fJ! - /JJ H It. front hi', P~..'~'~ '(!..l.U' cU.... ~ U Part, # ~~'I . PERi1IT PROc'ESSING Ii, .."",~Minimum setbacks: "'t".' ~ t, side IV II-cel # int. Pa r,ce,l Size oS /0 y t" I ( ...-.. ~" ./?/'G rear /. r '" .~,. --- -y # n ~// ~a By ~ Dat~..,/--'-<-Y-/7 WATER POLLUTION"CQNTROL M{-li 3- :::>,.\.)/!vI It Installation spe~{f;cations: ~ gal. tank; Pt"I.!j,(1.Art fLfLTh4,:!infield; max, depth of trenches: . . To be typed on p~,t.-J'lW .-h, \.,poo fl'(lrnrl Vl..Q (~~A.,I JutJ-L. .f\L;~J,~L ----1IA.A 1.0/ .fo~v OJa~aJ"'1.1oIUIJ\~iI\,r/-~q,~ el/APh, I1.::CAM ,~~~) ')t< . tiM: ~i ~ "'" ;~'K (i . jj~1M .~ah.&+r~l, ", .. k1r11l ktMo..... \.C'.o..JoeO", " lM,.fln9P.." ~ , -':', . 't: _ '~elephone . ,,", "Date DI~ 7/1:- ,-Direction Slt flU J U)O(}7r1 ,,1-''',0 tJ ttf'ecrT,1'/ P/YI/Yt-/,-//;4..l)\ To r '~''''..''l''' :'.l'?tJl/r /1//'U'iIA~ /-1171"7 t= PI?If'I'I. O/Y C-P/./LJPSI7C -./r/ST ,,/Y:n ""'O/..J....JIY~JyiJ SIFO OJ.. m,s Tott't(p&! c.NJ,U(s) Date Hold Slip Date Date to wre set(s) Required to PCC Completed pec -----r- To be ~yped on perlllit i L,..CP&'!' ~ /_WPC "j / Planning L ....PI1tf1'1C Works - -- ~/.....E-levation '-/....Aa&ess 55/ -L. o Permit . /. " . v~ not ~~~ J1~~~~kt, ~oo " ~ cWo- .~ jUJ;u_ol~\ojllc1w~~\9 ~ ~~;' _ ...rw' It VV1~ ~ ~~ ~ '~J~~~ dwe1t5 ' .. i/;;;) ''-''------'' . " " . <::6/,2- <6/ c.... () n/a '. As .5.~ FOR rNFOR~~TJON about progress of your application call: Permit Control Center 6B7-HEIP (687-4357) ,I ;.' ., f'.'C~~!~ nDrr.nrl 9' 7f.../rJ 'J..--. ,ength of Lines-Ft.'" '('Trench 1 Total Sq .c:S2!!'i3. 4. 5. 6. [Width..:2- Ft.3o U 'lot Plan (see instructions): - i ~-__~,_,n'____/'~''!_~H_''_ -, --- -, 'm__.., ' - ?i'- I.( -) II':> 1 . ~ / ",~0 \'! n, ~" ~ ~ "J ',', , ') ~ _~_':/>- '-.J!/--/? / I ,!Ie i tiS i: . ft. ,6(1.. I" ., '<J', 1.(' Y I \J I / - ... - -", ~ ":J'" Q, (l -- -C" , \) '0 ,!I~>.:;; -:..-, " " (;;) '::- ~ "' ' S ~'. :j~~ 1.65 )I"l. '/tJlY/A.-C \) I{," ". /I \." , ~ <ii' - t' r ' -~r' 1I01I?<: \) ~' I' 0 l { ~ t-i ,/ -' '1"'-' 'SdJ.' W ..... ~ I 'i iJ.' JJ I ,. 'J I I , ~ t ~ I ~ ~~$ ,~I!!~' , 0 ~ (~., 1 ~ 'C Vi:o.,~] Jj ()l' /' /;v.LAf'I/~ CfllJtfi Date /- ?"?_?I:> , ,IS~LU:'R':':-;'Comp I ete top par' .....\ 'i"'~. '.._.' INSTALLER'S NAME Te/J ,)(JPJI3LIJAN lo. Living Units Bedrooms ieptlc Tank: 'to from well Steel' 0 Ft. Diameter ,side "ngth i.INER !lIME Dimensions: Width MI CHAEL LAMf3 \A I LING ,DDRESS (')\2 Ivr ST 11 TH PROPOSED of form \ PROpr~TY ADD~ESS INA'-NO I,/AY Baths Basement Ve, No Water. Supply P"bl ic J/ O~~~r-U~~ Ga 1. Capacl ty Concrete IY1 No. Compartments -'fi Ie Disposal Field: Deoth Distribution Box: Yes ~ Other Distribution-Type j/ /000 'No Feet from IIEII Lot Line Front 1Ft. ~etween Li nes / 0 Foundation Side I 0 IFiller'_IFiller Depth Type/ -;L Above T i 1 e ;L Rear / 0 ti Iler Below I ') / ' .n I e n I,n. V.J, o i / ,. .~-- , / .' ~- "I . ,,,:::,-' /, '" l7r~':'~ , t 1/ \ ,. 'Z :"w.' I-( L( 1-()f (', --\ "X', .' JAN26197G JJJ~uC/< -J ---- ~ECEIVEJ 3y L.ANE COUNTY ENVIRONMENTAL MGMT. Sionature CERTIFICATE OF SATISFACTORY '1/' ( ., -,, Co~PL~ ;'o'N ,'1' :: 1"'" i:'.-',h Date: /- ),C .. is issued at the above , , ! ~- For Sanitarian Use Only: In accordance with 1973 Oregon Laws Chapter 835. Section 214 this certificate as evidence of satisfactory completion of a subsurface sewage disposal system loe"tgg' n. Approved: System Installation conforms to current standards Disapproved: Does not conform to current standards Remarks: r // /,-;7" /--,. /p,-,< ,-" Sanitarian's Sigprture LANE COUNTY /j STATE OF OREGON DEPARTMENT OF ENVIRONMENTAL QUALITY , ~m~~~~ CS 5 - 11 ;,' , ,', .2., , ." ,\ . . . " -1.., ~ . . . . , , ..!. . ~,,' '. """:. ~ .J , . > : : "..:.," ."f', '{' ," , ;. ,",-.', , , ~ ' , . ",': " ',' ':'" ',',., ~ " '.' . .' 1 , .t, . ~, " ..! ..~ io ',- < " 12 , ;;.: '- , " ; .. . . 160" , , , J~r:~, , , ~. .' "'" . l' ij,l. " 'c> !! '. ," . " ,', " 22 ;f.. ,,' ~ ~-::. .. '. .- : '" . " .' ,". .,.IC .', ,.} >, :,;,0"", . , .. .,;"1". 28 " . ~' , " i"J . . .~, '. , ,'.; .'" U",'0 :;..:...... ,. ", " 14 13_03~6~-3---3-:79O-V, : .~ ~ . " ; '" , ".', , . -' '. " ,;. , . . ", .,' 'LANE COUNTY DEP,T ENVMGT RECEIPT . ~ 226079 DATE 072479 , " . APPLICANT LAM~, 'MICHAEL' ,J" . AD DR 2012' INLAND "WAY, Sj:'FD ,'ORE . . TL~189302i1iOl~ SUBDI,VFlLBERTGfWVE ~5TH ADD . ' ','.. .", .' '. LO,1', e<f1/BLK. 2 " NEW 'BLDG 'TYPE MH . USE,R NO' F1DRI"~ 02 NO UNIT,S 001 NO 'STORIES NO BLDGS 001. , CODE, ,APPL NO ACTION DESCRIPTION SQ FT, UNIT 'COST VALUATION FEE' DAYS 'BF' .....1 '<'f n. B" F ". cr, ,:-" ", " _;. ~..., ' ;. . BP " - BP ,BP " BP. MH. ~C 226079~H " MHPl NO. FIXHJRES: MECH " SUR , PCK, ., . - S'DS, .' !!. I'.. ~ ~I ~ , . 'L:._. "J. ..,"-' , " '..',. ," :~. " J"~ S,W 10' ,:.x 60 NO. ,CONNECTORS: .:' '., ,MECHANICAL FEE .STATE SURCHARGE Pb~N CHECK'"FEE 5:00,'EACH := ' . , , ~'30 .. 29 , ,1.0.00 5 " ;;; .' . .SDSC ~'1- 41, 0% 1:61' 54.. f r~ .t!, '. .f." .; .0' ; 0' ~ 0B 'l~ I u ~ o ~ o : ., . o ~ , ~ ~4 . 60" ~ . , ., " '. 25'.00 " , i6, ,~ i..... '8 '- '1 ,SIFO, CPI. -~rAI(EN BY SI( )().: ' WPC ~~. PLAN"'.. ELEV ADDI~ CCI!'WLETED BY FP ENVH . T()lAL"~:'EE:*'*' 66:90 CK ".,' .' i2 " . . o .~ ,. - ~ ", ".' ) " .......: .~:;;..-~.. c--?, .J' JOB ADDRESS: POST TI:IIS PERMIT ON MAIN BUILDING AT SITE CONSTRUCTION PERMIT # ~22;:0-0-;r..,=:1U +- 2@J:;l ~ !Joy. B~l1cll.c1. C'~..l . TRS TL Subdivision: , , : lr-{l~..o7.. 3.3 # i90fl ' l7illJ.!::x?ii: Girovao 5&11 ~. ll.~C l)4s Blk.~ 2 This permit for the referenced property is hereby ~ Setbacks and other conditions of approval must be strictly observed. result in revocation of this permit, citation under proC\v'i~fifri:S''5f'Lane County's Infraction Ordinance, and/or other remedies allowed by law, Appl icant/ Address: Owner/ Address: Contractor/ Address: Contractor's OS # ,- -, e;J Violation can tN"!'11'?A1 3. Lsi:::)p =:lG I I Telephone: Telephone: Telephone: 7~1/i'66--11.2~ ~ I 2Gl2 In1l:Jcl Uo}'. S~~o €J,.._ 97477. - . / Tota/Construction Value: I Construction approved by this permit: J, ", between 8:00 ' 9:0p,a.m" \7,,001.4 _~.an_~A. , '~CI 'f' , , CONSTRUCTION Type of Construction: mI Group: 9 Fire Zone: 3 lpe assl Icatlon: . Sim/J;a PERMITS/INSPECTION Instructions: ~ g&l~ asd ['doa'o m e:r::;iiJ.y ~~ otooo fl~~ ~~l!;o iZClrtr....'i:>:'!ll.e t:.,~f\ ez. DIVISION ~ Ii:to c2a. lI:lst OleG o~i:achs:1l to eha .qnAtda of ~ l2O':)Uo 1::=. ~G ~ ~ 00 ~> Boo ....""'-"''''''' 0:1&0 or ~It I?o.... ....q...,;zcd :faapaeUcms.. ,y_ aim iB 1eesll:ed vithila 0 flcl:d ll1eml!'d erea. A EllLm. fiail.ah !l1m;;r Cl!c:;;roeun of 4Cl9.0' oh:3U \llQ soem:cd & cmrtifieil Ile ~oo by tba ~Cload flDOO l?~ mml:. l1ot~. I'lli i:= dcCc::JWO = For plans information call 631-3760 between 8:00 a.m. and 9:00 a,m., Ilaln.'1 Iflmgb &'~lrei!l.. l1lce attllcl:ilCl2 For inspections (see back of this permit) call 687-4065 between 8:00 a.m. and 5:00 p,m. bne county Directions to Site: Oclll: cm3tln 2c.il S~=i:. in Spf<1 ~ l7ilr..~ GrGV'O hi POll''- Cil Orlll.-c'!c-::::!1c joo~ ~c 2012 X"',.",,d Eo ~,. - =lI: Date I d' ~19 - By' n= mnLco/ly ssue . DEPARTMENT OF ENVIRONMENTAL MANAGEMENT ' , I COURTHOUSE I PUBLIC SERVICE BUILDING , ..", C55,13 125 EAST 8TH AVENUE, EUGENE, OREGON 97401 , ..ater Supply: ""-........- ...~~- PLANNING DIVISION ~ WATER POLLUTION CONTROL DIVISION Setbacks Interior property lines Fdge of road right,of,way " ;i1ding foundation Wells, other water sources 1%5 Vi!.dt!lg Q la 8 GO 'i:ll,,",~ ll'~]n." ,...1;: Stlme~OD = <i:::ll ""''-'''''''''''1/8 = # Bedrooms:. ~~, # Plumbing Fixtu'res: -..-..... 'iF Employees: - .. l.D Zoning: Partitioning # Parcel # , .. Parcel Size: MinimumJf~i7ed structural setbacks, from: centerline of road, front:' en; centerline of road, side exterior: ; interior property lines: ;rear property line: 6loo . -.~ 50 Y l?UB Special InstructIons: " 9 , Jnlm1l S~ is..1 ~J1...."".11mn OIi' caiL >>>l SAC , For information call 687,4394, ~UI;IW.I t7f'~--: 'i ~ ll.~ n ll22 ( Site Inspection # . Installation specifications: misl:a gat'fi,inl.septic tank capacity; SIfst!ipeal feet of arainfield required; max. depth of trenches: De t>o ::;;y Speciallnstructions:m to 1:10 p~OO c::) e1c:::0lq'1.~ 50 00 W:l crdlog~ ~ end lQ~ eo the miod08 ~iGlld. ~(,: ~ the c:aJLo~ ~ ~ c."OO fu:.3""n""'1 Qrainfiel,g.adcnr 309l"'75 Ei.:U1 ....~'-' I>> TxI ~~ ooUo~y.. ~G:il rroj?lo"''''''''''''''c = b 10' hc:::J1 dc.......3w>d 'by'_ormg is: vilfu a"'...."A. op(l ooins it :C0le~. /.l.IJ l!:Ci?ll.ooc::=1.~ ~o 10' !s ~l!:Cd by !al:7 6 h!3a at b= ~v...4 CZI tld.ci: let s!::zlnlWl i~ ~~ ic alY be !!"''''''''', 10' eo ~OOD ~ ~!H"'5.. 100' For information call ('A7-,;\~O Septic Tank 1~ 10' 5' 50' "'- , " .1.. ;......,""' ~.) , " ~ / S lTE INSPECTION ApPROVED .c; i, DISAPPROVED L:::7 DATE INSPECTOR REMARKS FOUNDATION ,INSPECTION ApPROVED / / DISAPPROVED L----/ DATE REMARKS FRAMING INSPECTION REMARKS ApPROVED / / DISAPPROVED / / DATE LATH OR SHEETROCK INSPECTION INSPECTOR I NSPEC1'OR REMARK 5 A~PROVED L-I DI SAPPROVED L-I DATE INSPECTOR FINAL INSP;C~~ ApPROVED DISAPPROVED REMARKS />/J CERTIFICATE OF OCCUPANCY 1 / DATE f'1~ , 7- :?-<!t3 INSPECTDR~ ,.j .r1'J.- '{I c2 B- READY' TO ISSUE / I' NOT READY TO ISSUE ,I / DATE REMARKS INSPECTOR Baths Basement Yes No SEWAGE DISPOSAL SYSTEM RECORD , ' "11' .'. ~M~~tHf~' to signature and submit both copies with app cat 1:t~?...~~~~~~:btt'1J PERMIT NO, ,2 ~~:'~'.iii' ',~if!:'ii\ <,?j~~<YJt ~~.11U PROPERTY ADDRESS ':. ~,l'/',;!lJ1i"l' . S~"oo ~'{,'...I~;i~r~4~ I NAt. NO WA Y '~'fj~~i'~ i"'1:LiL",~~}. ..~ Water Supply Public ,/ Other-List PROPOSED ,STALLER:, Complete top part of form , , iNSTALLER'S NAME TED <)' (J PI13 L/IJ.I'I "'. Living Units Bedrooms \ ..ep,t I c Tank: , '. "f rom we II lS j de' . :ngth ,;IER i \!1E Dimensions: Widr.h Steel 0 Ft. Diameter Concrete IT No. Compartments Tile Disposal Field: Distribution Box: Yes y' Other Distribution-Type ,/ Ga 1. Capacl ty /0(;0 Oeoth No t-1!CHACL LAMB ,I LING ,IORES S p,112 \Jr" T 11TH I Feet from liE II I Lot Line Front 1Ft. Between Li nes / 0 Foundation ,,,or'l. nocj'lll 9' 7L/rJ 1-- "ngth of Line's-Ft.' 'Trench I Total Sq ;:'S2},r;3. 4. 5. 6. lIidth..2 Ft,,-f{) U lot Plan (see Instructions): - Side / 0 IFille,:,:"IFiller Depth Tvpe/;/_ Above Tile;:L Rear / 0 ~i lIeI' Below I '1 / . .n I e n In. / /0 ' . *' ~ ~ \~': . / '. ).' ",' {i~\ 0~?)~-~'/ ',-/;1 Iv I, l.l 'j; \\]1 1 ,~,J ->- I~' '), ; fi:i I ,,', (~' (~J~;v;c~c / " ,:;1 Vi' , 1 r. ---'-n 1101>71: CO ;' ~J '~' I ~J ~) _"/: I ~ f'I' c--' ~.' " ;,;~ I,i: < l < \ Sd.' ~'l '~.',} ief / '.) ,) . ,- .' "~'~ -:;1 i '" ., )i9 '~~I-}Jj ll/ I INLA/,I~' ICI/1.( 1-/;: late J- ") "?- 7b I,f I I I' 'Z ',. L (J r il L( I' -\ '~ l;' /- u C 1:( - 1 r_. ,,~.E C E ~ V E J 3y JJIN:J.::> 197G LANE COUrjTY ENVlliONMENTAL MGMT. Siqnature _,~(//,..,'("t' CERTIFICATE OF SATISFACTORY COMPLETION /' .....-h ./" I/,~ "f.'1--. Cor Sanitarian Use Only: In accordance with 1973 Oregon Laws Chapter 835, Section 214 this certificate 5 evidence of satisfactory completion of a subsurface sewage di5posal system 10("181 n. . Approved: System Installation conforms to current standards Disapproved: Does not conform to current standards Remarks: ,- ;' Date: ().C is issued at the above / (. /1 ,// /. .' /j:'Vi <, ~:~~t~~~'~~; s 5 i~7ture STATE OF OREGON DEPARTMENT OF ENVIRONMENTAL QUALITY me!1~I~~I~-'::D~dil.~~~~~~~Jtil1'\M1Mli\lJ:'ill'll'_<l!IJilllliall~<;l c):, -ll ','.:~. . I '..~~' \(-; '. ., POST THIS PERMIT ON MAIN BUILDING AT SITE '~OB ADDRESS: 2~i3 :rni"n'" eoYo S~icl.do C;:~n CONSTRUCTION PERMIT # 'LOc22cC-7\X;d TRS, TL: is.-o~o3.S.J 7C~ Subdivisian: !]i.!\Xl;re Gl<=.. .5&'11 Md~ 1.Q~ 4~o Dlccl:. a . {3 This permit far the referenced prapertyis hereby 1l,...~~"'..I)~ Setbacks and ~ther co~ditions'of approval must b,e strictly observed. Vialatian can result in revacatian af this permit, citatian under provisians of LaneCaunty's Infraction Ordinance, and/ar ather remedies allawed by law. , " Applicant/Address: Owner/Address: ' Cantracta'r! Address: Cantractar's OS # , , Telephone: Telephane: Telephane: ~ Uic'\:2c! :f. L!ri:;bo ROl2In:l.:JaCl e'ayo O~:lalldo c...~<>...., 9':iCJrJ' rt..~3 I f 72&o-$l/745~12G~ Tatal ConstruCtian. Value: I Constructian appraved by this permit: v~ater Supply: ~~ PLANNING DIVISION WATER POLLUTION CONTROL DIVISION '-"-, Setbacks ' Interiar property lines "dge of roadright,of,way"" Jilding faundatian, ' " Wells, ather water saurces' l~liS W1ld:ln @ ,10 8 6O\)/&~o ltCl?J~""";~ ..S~tux"OD 'Ct:1 Qa, t"~r;-",60JlJ. ~ " , '.\ # Bedroams: ~,. .~.~ ). " _~ ,# Plu'mbing Fixtures: ' - .. .,., # Emplayees: Q --.(... , Zaning: . . : Partitioning # Parcel' #' .' Parcel Size: , Minimumr;~qdi7ed structural setbacks, from: centerline af road, frant:,." '~ ;:centerline af road, lClJ, II 112 side exteriar: . ; interior property lines: 0 ;rear property line: '. U; , S 'I, I. """. S. 7 FOE , pecla nstructlans, """""'<>=on."""'..... "'10 .. . ... "Tn m. ft.. " .6"LW,;.:U. e.;;;...':l~ ~ " . ~Jl:y.t<".II'.uO.u ~ &#~ c:.J.C". Far infarmatian call 687,4394, _ , ~~~ Site I nspectian # . 'Installatian specificatians: -mew' gal':,lnin.'septic tank capacity;' ~Iirleal feet af Cirainfield required; max, depth af trench~s: n:3 '>,'. -: ,". ' , .. Speciallnstructians:url' to be DlBdoo ~1p'(J~, r:u!::\ 5-~ to ~1GI::i.z~,<'J t:Sl1t end 10' " i:o tI:lo adri~~!oL!. ~~ -to t/# cnio~ ~tan 'O~~ tJ:::J w.o~::.1 Drainfield!CEm' SfJ3l-75lrm1 a~ Co In r-=~ ~fc$zUYa Re~ 1:'a!?lC<'r-'l~1l: aroo il 10' bero (!coggOf..,a by ~g it tlith ~ qnd ti;l1ug ':9.1". ffor ~a"..tJ rtr,llclJ:a:l(l'llt =-~ 10' 1.s'~i:ad by,!c';7 t.,'twJt'.oe'~..",~v".J en ~ t::~ 1.l1."!l':3!dll.i goi1o :11;'00)' be n~ 10' , ~. nh'",dnu ~b d::::1lUng.' '. ,.' 100' Far infarmation call (.m'-39:;O between 8:00,9:00 a.m., rr_M f'l<1r-o'!"""'?"nU , Septic Tank' 10' 10' 5' 50' " J~. . CONSTRUCTION Type af Canstructian:!o!3 Group: mI Fire Zane: 3 ;,yse Classification: " ' Sr?Dlrm;;{. PERMITS/INSPECTION Instructians: ~ f~ !l:!2d p-la:;ro \:l3 e;r.::l!jIly \:l2t:b al:ol::(S:!CW(Q~ rct;i<fL.~!:D fCllil' Cf.)Jl.lo he::::lS Oll: . DIVISION by ~ rUB. \:I::l~ area aetD.C!~ to ~ 1nsUa H ~..:) =b:l.la l:r~ f"C<:It> ~r~oo milt&~ OS l!'~lt~"SE::;) ~...v........,a aUla fiT ~tr f(')'i" ~ fu.~~.l!Io '!crrm; site' 1'.0 looa"..ed tr.l.thiln, 0 f!i:;cl ~ ~e:lo ,ll dm. Ucl..cll ~ clC!V'alWm of M!)~O. c;1tall be ca..........3 r. ~~ltcl C3 ~:\"':ea ~ &h2 c:Jcloc....-:! eloc::1l?!oSo,l:7.z::12. lot:~4 rn f~,->o ,t1clo:liOO = Far plans infarmatian call olJ7~37GO between 8:00 a.m. and 9:00 a,m., I.bla..') l1tt'ogh . requilrod.. Se<:! otto~ Far inspectians (see back af this permit) call 687-4065 between 8:00 a.m. and 5:00 p.m. bne county Directians to. Site: 0t12: =l:Il 2td S~=t. :ID. 13pfd tt!l Filbert ~ t3 1hm\I 0':) Ci.:ll=d0-.J3C j~~ j;l:::3t 2012 rnll.cnt1 5 _'" -" ~ =i: . ~79 ' 8 ' ll:1'ro t:ll3itt:o/l:' , , Date Issued, DEPARTMENT OF ENVIRONMENTAL MANAGEMENT y, I COURTHOUSE I PUBLIC SERVICE BUILDING ~r;55-13 1?1; i=.o.C:;T AT~ .o.V~Nlll:: l=11r..l=P>.li: r'll:u:r..nM 07An1 .r.;' . , .' ..:-- 4. , ;"'., . SLAB FLOOR PLUMBING GRQUNOWORK ApP'ROVEO C/ DISAPPROVED. ~ C/ DATE INSPECTOR REMARKS GAS PIPING GROUNDWORK ApPROVED ~ DISAPPROVED C/ DATE INSPECTOR REMARK S ROUGH PLUMB I NG ApPROVED C/ DISAPPROVED, Cl DATE INSPECTOR REMARK S ROUGH GAS PIPING ApPROVED C/' DISAPPROVED C/ DATE INSPECTOR REMARK S " ~_ ~~'7tY};J"~I~ ~~L~'/.- . a;v~C/ DISAPPROVEO. C/. DATE 7-F'-5r3> INSPECTOR~ ~ _J.~ .... " '-.LlJ MJ u~"..I ~ ,,1.~ _ fJ-/ I- ~tf .f!./- 1/. , ^ -J:;J 0 /). ~J~.-(l.r'I./~~ f1~ .. REMARKS - t!l A_ '1..-~-~"':1 I - FINAL GAS PIPING ApPROVED .cJ. DISAPPROVED.' / / DATE IN~PECTOR REMARK S CERTIFICATE OF OCCUPANCY lREADY TO ISSUE C/ ./--~,,,\ NOT READY TO ISSUE ;---? DATE INSPECTOR REMARKS