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Permit Building 1977-6-1
TRS, TI Job Location Go5".[j--~';'}'LAJt) BLJi<. V I ' / ;J-S;S"i} >>~ <' td (j Rt'7.$L.J " -. INFORMATION SHEET (vi Building Pe!mit ( ) Site Feasibility Study for Septic Tank. Number of sites ',~ Would lik,e to meet on site. Call (owner, etc.) Acreage or Lot Size 5; LA(" Test holes will be ready. Partitioning # ( ) Completed Subdivision !:'//},,,,,,.r 4",,,,,,,_ Lot .31 ( ) Pendi~ '\" APPLICANT'S NAME AND ADDRESS '7) 10--1 q (( f) fI7 cG' I/IV'!:.e_:,(. ..:2D<,<I -L")J~.vn UA\I ) "'pel rt\'j-t.e Ir>{ ()Phone7.,Lb-bO</t:, OWNER'S NAME AND ADDRESS, if differe~om applicajJ,W I Phone CONTRACTOR'S NAME ANDADDRES~ -'~,eODN 'tp. ']e.e<:. /I.;!" /1/ ..,-')(-u- ~~P' .0(1'.1",., lot Phone 717- .:JD71j Ma}permitor results of site feasibility study to ~ Applicant f ) Owner ( ) Contractor. ' V / Prefer to pick up. Call 7 'II, - (-,0 tf-" (owner, etc.) when ready. . STRUCTURESNOWONTHEPROPERTfY!.HC';??E C(' ;::?,-r,,, S,.tn.P,-,,ap -~"'}-1''''~ .' '> J PROPOSED USE (this permit) fA) () II' V 5' J-, n, n (),M ~ ~.. ,<J-.-... ~--, "- Q. "X:I-~ .. \.,,(~ ) WATER SUPPLY , t (exISting or proposed well, etc. If pUbl~ame of system) Yh kf jOS--7cj / t/rj:) /'7S BlockJ .~AJJ... SEWAGE DISP9SAL (existing or proposed septic tank, etc.) S.1. # PLUMBING BY Address _ ) PROPERTY IS WITHIN ONE MILE OF CITY ( ******************************************* OFFICE USE ONLY BELOW THIS LINE ******************************************* ( ) New Address Necessary ONF ) Facility Permit Ne'cessary SETBACKS: Front Side Facing Street (FROM CENTERLINE OF ROAD) . ) Special Permit Area. Minimum Elevation: Interior 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: C55.12 By DEPARTMENT OF ENVI RONMENT AL MANAGEMENT Permit Processing Section 125 East 8th A venue 687-4394 nivision , J ,{ . 7, - J I. -.. ...') . .). .'-- 4l- ['1 0 () JOB LOCATION .;) {J ~L/ \ ,_' ,f} / PERMIT # /)SS 771 \'Jnlcl' ndr l-l/CUA, ... '="; A ' tI ~' , ~/ I} ;/ J/) V.. TRS, TI , " ~ -- -" / t I.... J. .J .J r .' , Acreage or Lot Siz~ Partitioning # ) Completed Subdivision ,___/./ ' "t<. I ' "'::-:; , /. ,...-.:..... Contractor's O,S. # I - I ,;...../ / f ,'/, Lot ;"'~ I Blocf-' V, . . / . APPLICANT'S NAME AND ADDRESS'; ':> (' / fL, Ii /i j('" ~ /' I {;, /. ( J ;.,::) ,,(.~,r;-, ,:_--- Phon~7<1k'" 1,:[ '// OWNER'S NAME AND ADDRESS '" /, / ~..' _.-' . / Phon~..-"A -"~-'et CONTRACTOR'S NAME AND ADDRESsJ7',;...(..1",' n le,~ :,'JI";,,,' //~) ('/ ,'// '::>.-1"" ,"~;'/"'.'- ",:;-1 Phon~ /'I /<-Y' / / Mail permit to ( ) Applicant ( ) Owner" L ) Contractor.) I...tPrefer to pick up. Call ;'(:~" .,~ '--/ t-" (owner, etc,) when ready, STRUCTURESNOWONTHEP,ROPERTY ///, II \ ,', l ./ .;),..!,-r, <-__ /'(,.'1 V "'::t::-- :';f(-/~ I ;( " / ,;HIS PERMIT IS FOR .:.-'-:-; 7~-(~1' ,;f 0:- [ri" ( l' /.> .~ I LANE COUNTY PERMIT --- # BEDROOMs '-.' /. ,".. ~."< /" . . ./ -,", .. # PLUMBING CONNECTION5-- .' "J WATER SUPPLY SEWAGE DISPOSAl S.1. # r THIS PROPERTY IS WITHIN ONE MILE OF THE CITY OF ,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 owner is aware and approves of this action, I hereby agree to comply with all applicable Cod~s relating to this permit, -7 " j' 1) .,1 /) ;-., "'ii. 'r,! ,,- P,o' Fee Paid $ 'c/ f3f, Signature-::::. 6rl. ~?;.d/ '..' /'~...:jul 1')r1.?atp _) - jJ-- " / ) NEW ADDRESS ( ) FACILITY PERMIT TO TRANSPORTATION DEPT ( I'SPECIAL PMT, AREA, Ni'lN. ELEVATION: " Minimum Septic Tank Capacity (Gallons) Drainfield Required - Lineal Feet Maximum Depth BUILDING .-Sf J Type of Construction ")-' Group _ ..... ,'" d...... ......,r ""f-~"t lse Classification .~.~- ". -. - / Comments: j Fire Zone SANITATION ~omments: " , , , .. I,' ..,..".,."....r,.". Date: / _,' / -/ ._" By: "'_~'_. l ',".~V:;i'.~ I__~ ,-~ _ r'~ c - ' r Date:.S-/ (~' - "'77 Date Issued: b - 1 ~ II (FROM C/L) INT, SIDE YARDS' REAR 7/ (FROM Pill .. By: _/ Date: "-~--: ,..: ...~. -; ;> PLANNING REQUIREMENTS SATISFIED, By:CJ fL{.e ,ZONE:.,;:!;/ (nU SETBACKS: FRONT.'-:-;r,/'SIDE FACING STREET ;LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE., EUGENE OREGON 97401 \"\', ' , . POST THIS PERMIT ON MAIN BUILDING AT SITE PHONE: 687-4394 C55-13 BLDG. PERMIT - WHITE; BUILDING - GREEN; PLUMBING - CANARY, SANITATION - GOLDENROD; OFFICE COPY - WHITE: ~., ~ "'-"t'~'f~"~""",""r~.\'),. - ,...",~ '~".' .,~..' ..., . ",' 11?,~1/i~fil~'f~'!':~~1~(iol~~~<., "",...: ,(;:,. 'l:1::C' iti'-:~~I ;'~i~:tr\ \,~'::;1<l;:'li'-'N:~'~",;~1f"f":-"""1';1J~~I\.tW;~~~"',i'.fJ"'"~. 7'l~'f.i1'~l.i'/:tr.1f1rn:!.~;.'7:.~'J;~g.~';I~-,":~. .,,;.-~~~;(_';l'~i''!;"'Xi'7''JI''~t1'i:~:;~" j,:,' 'd~.!l,W~i:;::::~...t\~tLl:~'"'' :~:'.,: '.. ~;.\"l'";. : i.~j.:..': ~~';11'~'I.:.:I~~ ::,~~~-~'tf~:!~2t:~dli:J if- '.i:..l.'lj"3'-'~< ~;f~~.f~'i'_~_~:ht: 'tl<:'::!r:t:.f~';~j~H,;}..i..:.: :t.\, .~_,. rt~,.rd~~: Vt.~':~'.}l!~_j:.' 1 '....', :~'.~ :.- '.:; . 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't..' ~,I" tIClY-::,' :~-. ,'-- '" -, ~o.,t,_}~_,I:;"'-,/-'!.,....':,i,, ..(7IYr. ,v,rl. ;l""'~-'~;'';' ". ,.,~, ,,;-,-., ;"-'~,-;:Cl,h ','~1rf,\.-{rif'r.~ !i -" r'-. "'j . , J<ro." ,(/) 'b :,~%V. TRS, TI .. 11 I/!I, 'L PERMI.T, # ~S 77 "J:lllA. Q.rcd.' ~ "/~ rf-J (7 .II v c"t.J.... d.. /,' Acreage or Lot Siz~ Partitioning # ( ) Completed SU~vision ,<::...;/d i.vt1-.4tf7/~ Contractor's O.S. # j D () I 'J-/ .;)0 / 17 / p- Lot ;::j I Bloc~ (., APPLICANT'S NAME AND ADDRESS D-e.lY1/lJl Jr'76.!J.jbu~ ~~ _ Phon~7~-60Yb' OWNER'SNAMEANDADDREc:c',,_' _A ,'n- - . j/ '., --'11':./ r . 1/ Phon~-'/- ....""7U CONTRACTOR'SNAMEANDADDRESS~&f'..6?7f 4(fLAO //:35.! /LY~X-':,.,,_~.(;It''''-&r Phon~ /'7' /-o-v 1 Mail permit to ( ) Applicant ( ) Owner ( ) Contractor. ( L.)tprefer to pick up. Call 7'1'6- (.-;,0,'7 f::;:.' (owner, etc_) when ready_ STRUCTURES NOW ON THE PJOPERTY . /7/1 -AI -' (lO/)_:Z>aI'll-, .d 1-CV1. C1. "l.e.-~cfJ. (HIS PERMIT IS FOR -~~ C{JJ-e) - w--M 'f.- ~;1-:J/)o # BEDROOMS~# PLUMBING CONNECTION5- U .. '0 SEWAG E D I SPOSA l------f /V.......-'7..1:::. , \ i ;J 0 ~t.1 1'R .~- J I. "J. 'J---' JOB LOCATION , i -! " LANE COUNTY PERMIT i , , ,. ,. '. f' ,., ~.. : , WATER SUPPLY S_1. # {- THIS PROPERTY IS WITHIN ONE MI LE OF THE CITY OF _ PLUMBING BY SANITATIO,Ng J i?A/~ Minimum Septic Tank Capacity (Gallons) Drainfield Required - Lineal Feet Maximum Depth ~omments: ~ ~ ~ S' a.-P'd j~ r .~L SJ)S 'lif"'''~:V; 13.._ (r---~ ~ . I, ,0 _h .4-a<'1 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 owner is aware and approves of this action. I hereby agree to comply ~ith all applicable Codes relating to this permit_ Fee Paid $ /.d}- / SignawceC--iJr-1cr.h,,! jJ Pt~kFjDate ...5-=-JR-~ 77 ( ) NEW ADDRESS ( ) FACILITY PERMITTO TRANSPORTATION DEPT.-- - ( )q-ECIAL PMT. AREA. JI!lIN. ELEVATION: BUILWNG ':..-&),( ) Type of Construction r../ ....... d '-'*.- f~ ~Use Classification C;:rr;;~;;;;ts: I Group J Fire Zone ~ vi -- .5-"27-77 . ,. PHONE: 687-4394 POST THIS PERMIT ON MAIN BUILDING AT SITE C55-13 BLDG. PERMIT - WHITE; BUILDING - GREEN; PLUMBING - CANARY; SANITATION - GOLDENROD; OFFICE COPY - WHITE .1. _' J SITE I NSPEcTI ON ApPROVED ~DISAPPROVED Cl DATEj,~'Z'?-11 INSPECTDR ~~, REMARKS , " FOUNDATION INSPECTION Ap~ROVED LJL; DISAPPROVED 1--/ DATE REMARKS Jf~ dJ- 6JK --? - J - '1 71 NSPECTDR ~ rf?-. 6- Z "5-7.--;7 SJrd. . 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