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HomeMy WebLinkAboutPermit Building 1978-2-28 \1 N" , -- -G""7, L-..( ".," '" ' ;J TRS~r /i- 3-//.8.0/. 000 JOB LOCATION ;20Ct;{ (). . _ (~.t-?Lf o-rt..-dL U) =--<--f rrL U ~- . //0// I LI Subdivision ,--7.k-(' t/--U( r -#L,....~ _ , Lot S' "'-..::>, Bloc~ ~'2" f "'J' <>or/)6 y- , /1) .s; ., /f -c-;./;-. =,073 J/-n f/Jnl1' C/Ahp.ho,?u'?i/ 7-dJ'cY/ ;j //Phon~' v ' Phonp (owner, etc,) when readY'~ (/C//-7 t Acreage or Lot Si7P Contractor's O.S, # APPLICANT'S NAME AND ADDR~c::;-m~-~.J.s 0~-1.....- OWNER'S NAME AND ADDRESC:: ' I CONTRACTOR'S NAME AND ADDRFC::C:: I r Mail permit to (t.)"'APPlicant ( ) Owner ( ) Contractor. ) Prefer to pick up. Call. STRUCTURES NOW ON THE PROPERTY rn.p{ OHIS PERMIT IS FOR (.'~Jl--4..--..)/7.../>.J (J. Ov-,i-")o'>,._~-1../ cf:)LJO /:?f" . WATER SUPPLY ~ I'YI.L~/~h/u SEWAGE DISPOSAL (j THIS PROPERTY IS WITHIN ONE MILE OF THE CITY OF Partitioning 4' LANE COUNTY PERMIT /) / "C.l /1/ / 7 ( ) Completed / / / -c _ .-1._.. /J /7 '<or- U{Xt.lCtLcC~ # BEDROOMC:: # PLUMBING CONNECTIONS- \. ~~-d.rI-..s S.I, # / .,7\ '-' PLUMBING BY 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 o)IVner is aware and approves of this action, I hereby agree to comply with all applicable Codes relating to this permit, Fee Paid~. 1 r-] t' / b 7;;l.... \ . Signaturp /7//,a,. . ,...... A;u)~ Dw..2. -.2) - '/1'" , ~- ~ , ( ) NEW ADDRESS ( ) FACILITY PERMIT TO TRANSPORTATION DEPT ( ) SPECIAL PMT..AREA. MIN. ELEVATION: SANITATION . ,Oomments: Minimum Septic Tank Capacity (Gallons) Drainfield Required, Lineal Feet Maximum Depth 170-1' ~&~ ,-I BUILDING . "l A./ Type of Construction 7r;roup a..'A A - ..11 j'~n'----'Use Classification Q;~;n;s:' cr- ' ,? Fire Zone \ ,/~ ~I!~- / , -r-~~:, , d ~~. Date: ;;t..,~ 7. '7(" .By: cJ: ~ ~ G.r.I! Date:'...:J .::.2-,;;'- 7;1 , PLANNING REQUIREMENTS SATISFIED. By: '--k7.L/h.( ;/-. / w-;- J/ Date: o? -d</-1Vd"" y Dat;lssued: (;)-05-78 'ZONE: 1~/J-fY7 AI- SETBACKS:...FRONT ~' I SIDE fA91I>1G,STREET - (FROM C!Ll . INT, SI~RD51 REA~S / (FROM P!.!:l , LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE" EUGENE, OREGON 97401 PHONE: 687-4394 . I.' , . . "\. ~ : POST T,HIS f'ERMIT ON MAIN .BUILDING.AT SITE BLDG. PERMiT .:-WHITE; BUILDING .-;=-GREEN; 'PLUMBING - CAN;'RY; SANITATlON- GOLDEN ROr::'; OFFICE COPY -. WS::!.!l.~~~"'~ ~ ,". ,..:.~ .. - ~:.:-:...:'.~...":1-~.;';~~~"':~ . <3 B'y: // ~,-- C55,13 ..... . TRS;fl"> / x: ~ ']- J f-Z 2- ~itten Directions q.,.. f/ g- () () C_ ~ ....-. ~ Job Location -;i/-c.Y . /~F~~~T~N s~;.:r~;/",/,/ :G !cvru;:{-- c/c/(~76 W~ ,4'MI't'" utu:,.~ ~ 'fl-~&~, (/ {/ ?: ( ~ng Permit ) Site Feasibility Study for Septic Tank, Number of sites ,.fIc..?O ft- ( ) Completed ( ) Pending APPLICANT'S NAME AND ADDRESS ~ Au 1;{,J;.eC I... J ARNcl<- ,,2(J7~ OWNER'S NAME AND ADDRESS, if differentfr@1_apF,lir;pnt's-LaJYY7 (l -' '/ CONTRACTOR'S NAME AND ADDRESS ~ Mail permit or results of site feasibility study to (~pplicant ( ) Owner ( ) Contractor. (, ) Prefer to pick up, Call (owner, etc,) when ready, Acreage or Lot.Sizp Partitioning # Test holes will be ready Subdivision c7!-;/ t.,A-' -ii.~. ~ "/.V .., 7;7:l.aA'.d,~ LOL~-J Blocl< Z- W f1/Y/d (j )tf..J.1~ho ne -?//? ...2Y J't" V Phono' . Phone STRUCTURES NOW ON THE PROPERTY ~ PROPOSED USE (this permit) ("" ~<-r ~II V' WA TER SUPPLY - -':.. f'tl/J/ kh "Xf))1ArhJJ7c~ Contractors O. S. # r:;...,......" /"~__ :H:~,...,....,..-vns (exist'lng or proposed well, etc, If public, name of system/ SEWAGE DISPOSAl ('existing or proposed septic tank, etc,) S,I. ;: PLUMBING BY ) PROPERTY IS WITHIN ONE MILE OF CITY ( Sf'rl~'7~':" /.{ ,---- Address ") **************************-ll:**************** OFFICE USE ONLY BELOW THIS LINE iHf**********.*-IHI-*********************ll-****r ( ) New Address Necessary ZONF } Facility Permit Necessary SETBACKS: Front _ Side Faci ng Street (FROM CENTERLINE OF ROAD) ) Special Permit Area, Minimum Elevation- I nterior 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 Response' ~b \ By DEPARTMENT OF ENVIRONMENTAL MANAGEMENT Permit Processing Section 125 East 8th Avenue 687-4394 nivision , CSS,12 L' ..:--. Fi//;,o-I Urvv.J: No SJP('L 'This )..., 1..01.[,3, , ,. ;" l' ~ ~ ~ ~. r; '..... =-a... /J I I '~ , S' - vr.. c' cI I / I 0' ,., (' ti .., "...J pc>...., I -;227'~ -L +1~,J I~ NI.b,! H.""'-f + c. 0"" ..... ~ .. .~ 7S/~,~,'- - .' . ' ,