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HomeMy WebLinkAboutPermit Building 1976-11-29 .; ,/ , ~ANE COUNTY PERMIT. F,E\R: ..1 ...,.. :.:\ ADDRESS PERMIT NO. ~~ 8<=\''\\0 PLAN REVIEW [J CHANGE OF OCCUPANCY [ ] \( ?\'l \<" ,+-".. \Q' ~,",,,,'.. , , CITY~ . \ ZIP COOE ~ 'W~r-... \ ~ ".,..~ CITY -- ZIP CODE \..;,,'e::,I-\ -C\o..~~ " r._ '",.... " . .CONSTRUCTION '0 OvJner'Q.. (~\-,..,.. -\ J' NAME o Co~tra~tor \..\.. C", (' ,~" c...\.. NAME \ (-"' I~, ""'.'\ [)(l MOBILE HOME [ ] ''-::::1,\ -P C" ,~ ' r. " \ f'",,<-H~ AOORESS PHONE " PHONE O.S. Reg, # Twn\ ~ Range( "I ~ , Section I~,I-\ '-..., ("'\l:- Tax Lot-'" I.I..C")C...., Code Census Tract , "- Subdivision'~ Lot Bloc~ - Acce~s to Property (Road Name):\--<',.~.I:...,.. \-0 '_\ Exis;ing Structures on Property:---\--\.", ,c,., =- Acreago Width <Q..cA I , C\ .... ~() v e._CI '{? '-'>- r:'-....-: .c...ro _:l"\.o. Depth ..Directions to Property' Addres;,_~ ,,;,n.' '"\'(.~ ~. ~ -\ -, I ~, '<'-<:.\. ' '''-.: (\ ~ I , \,.., (ST.e~CTURE (# BEDROOMS) __"vr.c-.""O ~ - \- 'r-. I \~~'C ( , "V"'...r....o I.... ,-\Sp~p~ ~ ,I. \-1. '?\ ~ ~:. \ (oe) s....:c,o .J VALUATION i ';-\-... ;::::)t',l..\\'~ 1 1---.r,C; s) :::J, GO r SEWAGE DISPOSAL: , PUBLIC (J SEPTIC TANK [] OTHER ( """' p """'C' BUlmlNG .,.........)( ,,--- PLUMBINC:; 3% SURCHARGF MOBILE HOMF WASTE DISPOSAl PLAN REVIEW I :-~~ P,W \ ' CONSTRUCTION PERMITS & INSPECTIONS AND WATER POLLUTION CONTROL SPECIFICATIONS MIN,:SEPTIC TANK CAPACITY: GALS. MIN. DRAIN)jIELi:? L1N. FT. (,.{iJJ\ /'J/J';,.,.J- S1 /\~I~J v,...t_'/JPrl~___;:,.. ~ b,,, (' , tJ ' (I PLUMBING INSTALLED BY: OWNER (] OTHER (] NAMF \.4_ T' -.;;t...r-..,c:.. .,~ , ---..... ?"I\. WATER SUPPL Y: PROPOSED ( ] EXISTING (] [ ] PUBLIC ( ] COMMUNITY, NAME: ( ] PRIVATE WELL ( L OTHER, SPECIFY' TOT.AL (\\),~~ \i l,.." TYP,E OF CONSTRUCTION I ~AJ, GROUP 0- (/ MAX~ TRENCH DEPTH INCHES ' ...i,'-/-t.,," In",n J1.-v,',-I.'.-... ..J,,_:,.-l,ol-/ , , . ' . - (/. /1 -- ,,'t', STAY 100' FROM ALL WELLS USECLASSIF. ./j"-",J .~_~ ./ ~ FIRE ZONF SET/BACKS, FT. FROM CTR, OF r/W,s..o" ~...''''\..>....) """ FRONT I,\c:..', ' SIDE EXT. ' \ . .. , .t::;::)' J! '....., ~ a..., ~"" ' ";L.,.. ,C:;S,' \ ' , ".., -~ ..... , _. ''''- ,l '\~ . '--'r~_P~-~ ,0""\"\-,,,\\.0. FT, FROM PROP, LINE: SIDE INT. ,c:::..' REAR ~J zo~h. I . ., AUTHORIZED SIGNATURES: r-:\'""', '. \ '. \. Isl \. ...........___..... ....:...,~ \"'. -- . BLDG. PERMIT - WHITE OFFlCE COPY - WHITE COUNTY TAX - PINK PLUMBING - CANARY . BUILDING - GREEN SANIT A liON - GOlDEt:JAOD ~-> I" ISSUANCE DATE: .l} 11\ IQ.\I-Il. M~.r.J..Jlql./IIINht. OA~...-..A k j&-dl ~ , '. ' II' ,- Q '"J" R. ii- 9- Lt'71'''' Call 687-4065 to schedule all required construction inspections. Call 687-4061 to s?hedUle~lI:reqUired septic system inspections. All construction shall comply with the State Buidling Code, D.E.Q. standards. for subsurface sewage disposal and the Stale Plumbing Code. All buildings require a certificate of.. occupancy before being occupied. , . {See Details on Reverse Side} :~J. l rl. t' IMPORTANT: (POST THIS PERMIT ON MAIN BLDG. AT SITE) C55.13 LANE COUNTY, DEPT. OF ENVIRONMENTAL MANAGEMENT COURTHOUSE ANNEX. 135 EAST 6th. EUGENE, OREGON 97401