HomeMy WebLinkAboutPermit Building 1977-1-20
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JOB LOCATION
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PERMIT #
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LANE COUNTY PERMIT
Partitioning #/J.5.{!C/ 7(~ L...)"Completed
Subdivision
Lo'
Block
Acreage or Lot Si70
Contractor's O.S. #
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APPLICANT'S NAME AND ADDRESC: I
OWNER'S NAME AND ADDRESS
CONTRACTOR'S NAME AND ADDRI=C:C:
Mail permit to ( I),Applicant ( ) Owner
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(owner, etc.) when ready.
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STRUCTURES NOW ON THE PROPERTY
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rHIS PERMIT IS FOR
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# BEDROOMS
# PLUMBING CONNECTION~
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WATER SUPPLY
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SEWAGE DISPOSA'
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THIS PROPERTY IS WITHIN ONE MI LE 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: _owne~ 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 i.s aware and approves of this action. I hereby agree to comply with all applicable Codes relating to this permit.
Fee Paid 'i: ,;};( J ,:/. . $~Ol t,t Signature Dat~ /- ~'h'" -77
( ) NEW ADDRESS ( ) FACILITY PERMIT TO TRANSPORTATION DEPT. ) SPECIAL PMT. AREA. MIN. ELEVATION:
'-,
Minimum Septic Tank Capacity (Gallons)
Drainfield Required. Lineal Feet
Maximum Depth
BUILDING
Type of Construction
Use Classification
r:roup
Fire Zone
SANITATION
Comments:
";omments:
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PLANNING REQUIREMENTS SATISFIED. Bv: jt/*,z,/f;.-./~..,;r ..3'4>/77 Date: '/-6)n- 7' 7 Date Issued: _..~. >'.' \ \ ,. o,,' \
ZONE: t:,-1- tv, +--i SETBACKS: FRONT"J~d;iSIDE' ACtNG STREET (FROM CIL) INT. SIDE YARD5' REAR ';', (.FROM P/L)
'~NE/tbGN~ 6E~A~~NTo~(.E:~(I~'o1J~<ENVj:{5~Ai<j~6tM~~-(1{251l\ST 81~~I'iC~UctENE.-6~lGON 97~'Ol' r-" P~O;~E: 687-4394
'~~.P ~ ~ POST THIS PERMIT ON MAIN BUILDING AT SITE .
C55-1ti U ~.. --,,- BLDG. PERMIT - WHITE; BUILDING - GREEN; PLUMBING - CANARY; SANITATION - GOLDENROD; OFFICE COpy - WHITE
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LANE COUNTY:PERMIT FOR:
PERMIT NO. Pil 1,i>;:,:
'0 Contractor
NAME
SWim
NAME
ilA
[Xl,] PLAN REVIEW [J CHANGE OF OCCUPANCY [ ]
575 ~!jJ~rl ~ Street $pI"11I!,"1"'17<1 nrc.j~ll
ADDRESS CITY ZIP CODE PHONE.
CONSTf)UCTION. [] MOBILE HOME
I.;Pilrul:1 Trmilcy Sfll~!l
o Owner'
ADDRESS
CITY
ZIP CODE
PHONE
O.S. Reg. #
'Twr HJ
Subd ivision
Range
flA
C1
Section
02
Tax Lo'
;,)1
Code
"',,1 "_ffl
lJt -# ~'...
Census Trac'
Z5a~{Fl .
Lo'
Block
Slluth 2nd Streot
Acreage
Width
Access to Property (Road Name)'
Depth
,
Existing Structures on\Property'
Directions to Property' Address:
tlano
145<:l H!l~llr Ortvo
:>pnnllTHllO ~JrotiUI1 ":)1'>11
'STRUCT,URE ,(# BEDROOMS) ...41 u
":'I'cn t 'CO IfQl'U: I :!t1J. e .,:JiOOl
SQ. FT.
f!3 Oedroocs
VALUATION
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hJn~l" W !lIli1;1.I1 e ;'U\~Ul.l UlilIjJUtitll :::'Y5r.l!IJ
SEWAGE DISPOSAL;" <~ =:'\', ".\
PUBLIC [] SEPTIC TANK l] OTHER [ ]
BUILDING
PLUMBING
3% SURCHARGE
MOBILE HOMF
WASTE DISPOSAl
PLAN REVIEW
715-111
PLUMBING I,NSTALLED BY;
OWNER l] OTHER l ] NAMF
WATER SUPPLY; PROPOSED [ ]
EXISTING [J
l ] PUBLIC
l ] COMMUNITY, NAME:
l ] PRIVATE WELL
[ ] OTHER, SPECIFY'
IJ.OlJ
.Il!
10.00
23.0ll
TOTAL
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'.:: CONSTRUCTION PERMITS & INSPECTIONS AND WATER POLLUTION CONTROL SPECIFICATIONS
MIN. SEPTIC TANK CAPACITY" ',' ,i'-
GALS, ~OO _ MIN. DRJ,l.INFIELEl ., 150 L1N. FT.
I':~,s':!rve ."'" areI'!. Tor mp.a,,,,,,,,,,..!: or ::iewa!;~
I HElS a.'w ,;CD' I C' :!ft!"oG 1':1 tn \lTill n...ell d
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GROUP
MAX. TRENCH DEPTH
~iSPCl!illl :l,ystom Stay
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"Pi' INCHES
1'3 t'CGt fll'lYl l)1"C~C!rty
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STAY 100' FROM ALL WELLS
USE CLASSIF.
TYPE OF CONs;rRUCTION
FIRE ZONF
SETBACKS. FT..,F,ROM CTR. OF r/W:
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FRONT. --. SIDE .EXT
,. l':OIH I:~ nvr.n I;~S~ W? ,nr.p.'tec..
2. :lMarva a \'K.PC21 ekl<; V'"<.1l\ll
AUTHORIZED SIGNATURES:
/s/ J. E. !!o:;g bJl Fullor
FT. FROM P~OP. LINE:
SIDE INT. REAR
no cl()';~1' thu:l '1l0' H'cm C'i"r'HHll"'/
9ar.::,1 fll il3fng r.aloasad -
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10\1 I~t~r
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rr",y/slInf enrlan-
ISSUANCE DATE:
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BLDG. PERMIT ~ WHITE
OFFICE COPY - WHITE
COUNTY TAX - PINK.
PLUMBING - CANARY
BUILDING - GREEN
SANITATION - GOLDENROD
IMPORTANT:
Call 687-4065 10 schedule all required construction inspections. Call 687-4061 to schedule all required
septic system inspections. All construction shall comply with the Stale Buidling Code, D.E.O. standards
lor subsurface sewage disposal and the State Plumbing Code. All buildings require a certificate of.
occupancy before being occupied. .
(See Details on Reverse Side)
(POST THIS PERMIT ON MAIN BLDG. AT SITE)
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C55.13
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LANE COUNTY. DEPT. OF ENVIRONMENTAL MANAGEMENT
C,oURTHOUSE ANNEX, 135 EAST 6th, EUGENE, OREGON 97401
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SITE I NSPECT I ON
ApPROVED Cl DISAPPROVED Cl DATE
INSPECTOR
RrMARKS
FOUNDATION INSPECTION
ApPROVED 1----1 DISAPPROVED 1----1 DATE
INSPECTOR
REMARKS
FRAMING INSPECTION
ApPROVED I; DISAPPROVED r-7 DATE
INSPECTOR
REMARKS
LATH OR SHEETROCK INSPECTION
ApPROVED 1----1 01 SAPPROVEO 1----/ DATE
INSPECTOR
REMARKS
FINAL INSPECTION
ApPROVED Cl DISAPPROVED Cl DATE
INSPECTOR
REMARKS
r/
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t..,i - /. _ 7 "7
CERTIFICATE OF OCCUPANCY
READY TO ISSUE r-7 NOT READY TO ISSUE Cl DATE
INSPECTOR
REMARKS
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JOB LOCATION
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LANE COUNTY PERMIT
Acreage or Lot 5.70 Partitioning #~ 5cfl/- 7(~t),Completed SubdivISion
Contractor's 0 S # f'~ / . Lot
APPLICANT'S NAME AND ADDRESS (7 . f' '- 4'U/; fa n }..--;)c:j{?) _ ..;';;//I/-"..t/..u) 121
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OWNER'S NAME AND ADDRESC:: A.. 'I
CONTRACTOR'S NAME AND ADDRESS f7//JfL.l~& 1./1-"/>-r-
Mail permit to ( ) Applicant ( ) Owner ( ) Contractor Cl...)'Prefer to pick up Call
~ STRUCTURESNOWONTHEPROPERTY (J ()u1 tI';J/.I/i/
~:THISPERMITISFOR J?7f.J rf./J7./P.L
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THIS PROPERTY IS WITHIN ONE MILE OF THE CITY OF
Blocl< ~
;..iph") Phone
, (/ Phone
d
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-'JCfG.jh~d:.(owner, etc) when ready
~t/h- 0635""
WATER SUPPLY
SEWAGE DISPOSAl
~B"EDROOMS_# PLUMBING CONNECTION~
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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 (,f 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 Codes relating to this permit
Fee Paid $ .c:: /;:,. ~ I') . Signature 7L U~ - .::tv... ..),..'".,J,.. Datp
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) NEW ADDRESS ( ) FACILITY PERMIT TO TRANSPORTATION DEPT ) SPECIAL PMT AREA MIN ELEVATION /~-u--e.&~
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BUILDING--- ;?;- t:h>I ~- ~
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Type of Constj;uctlon Group Fire Zone
Use ClaSSification
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SANITATI~
, )<;l"':''/' M,nimum Septic Tank Capacity (Gallons)
,/ }/O . Dralnfleld ReqUired, Lineal Feet
/" ..
MaXimum Depth
Comments ,~ Yh'A'~ ~J...z.. IOr~
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By -"..// --d.............. 00..tA. Date rh~7--..77 Bn..4~--Y L~ st~Date L.. 2-0/- 77
PLANNING REQUIRE-MENTS SATISFIED By ~A.L~ v' Date (,.',.]2 /7- Date Issued~w..1A" 'A/77
ZONE t-'./I 171/-1- SETBACKS FRONT.t::;7,1 SIDE FACING STREET (FROM C/L) INT SIDE YARD c; REAR"', .I\.(FROM"P(.U
Comments
LANE COm'i-- - __~
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PERM!
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LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE, EUGENE OREGON 97401
/0 ' "1 '3 '
(S-( if P t>' POST THIS PERMIT ON MAIN BUILDING AT SITE
C5513 SLOG PERMIT -WHITE BUILDING - GREEN PLUMBING - CANARY SANITATION - GOLDENROD OFFICE COPY - WHITE
() K pl"~ /lJJr
PHONE 687-4394
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SLAB FLOOR
PLUMBING GROUNDWORK
ApPROVED / / OISA,PPROVEO .Cl DATE
REMARKS
GAS PIPING GROUNDWORK
ApPROVED .Cl DISAPPROVED .Cl DATE
REMARKS
ROUGH PLUMBING
ApPROVED .Cl 01 SAPPROVED .Cl DATE
REMARKS
ROUGH GAS PI PI NG
ApPROVED .Cl DISAPPROVED .Cl DATE
REMARKS
INSPECTOR
,
INSPECTOR
INSPECTOR
INSPECTOR
FINAL PLUMB I NG
ApPROVEO ~ DISAPPROVEO .Cl DATE ;r~~;f~~INSPECTOR
REMARKS
FINAL GAS PIPING
ApPROVED .Cl 0 I SAPPRQVED /7 DATE
REMARKS
CERTIFICATE OF OCCUPANCY
READY TO ISSUE .Cl NOT READY TO ISSUE .Cl DATE
REMARKS
INSPECTOR
INSPECTOR
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Job Location ~~ 1)--,-" ~~ <<it
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INFORMATION SHEET
"
) Building Permit ( ) Site FeaSibility Study for Septic Tank Number of Sites
( ) Would like to meet on Site Call (owner, etc)
Acreage Or Lot SIZP . - Test holes will be ready
Partitioning # Wl < 4 L/-1( '::(Completed SubdiVISion -Y:~f' _-P-. _ !.-, --.ll.. Lot
( ) Pending --1 < ~ -1 0 -4 '"
APPLICANT'S NAME AND ADDRESS Q Q..----r -,.~k . C<,o-:::t~. ~ ~-trJ' ra...fJ
OWNER'S NAME AND ADDRESS, If different from--;;pplica;:;-t's '<7----f!'-"~~,iJ "f'.rZJ ~,,-"~~
CONTRACTOR'S NAME AND ADDRES~ - - ~ - ---'7 v
Mail permit or results of site feasibility study to ( ) Applicant ( ) Owner r ) Contractor
( ) Prefer to pick up Call . (owner, etc ) when ready
10(( 17
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Bloc\.-
Phone ?~-~Js~
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Phono s: ~ "---
Phono
PROPOSED USE (this permit)
WATER SUPPLY ~
SEWAGE DISPOSAl ~/L~....f
II
04
f11/ff //{; y:3 (7
-!exlStlng or proposed well, etc If public, name of system)
( 0 ~/ 7 C
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_(exISting or proposed septic tank, etc) S I '"
PLUMBING BY
Address
) PROPERTY IS WITHIN ONE MILE OF CITY (
) Special Permit Area
Minimum Elevation
***** ********** ********** ***** ** *** ** ***** * OFF I CE USE ON L Y BE LOW TH IS LI N E *****.. ******* ** * ***** ** ** **' ** ** ** **** ** ****
( ) New Address Necessary
ZONI=
) Facility Permit Ne'cessary
SETBACKS Front _ Side FaCing Street
(FROM CENTERLINE OF ROAD!
Interior Side Yard Rear
(FROM PROPERTY LINES)
To Plannlng/Buildlng InspectorlSanltarlanlSurveyor
ThIS applicant appears to have a problem with
Your aSSistance will be appreciated
By
, Permit ProcesSing Section
Response
C5512
By
DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
Permit ProcesSing Section
125 East 8th Avenue
687-4394
D,vISion
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Acreage or Lot Sizo
Contractor's O.S. #
LANE COUNTY PERMIT
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Partitioning # Ifl":; ,-/</' It, ~).'tompleted
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Subdivision
Lot
APPLICANT'S NAME AND ADDRESS (2
OWNER'S NAME AND ADDRI=C:C:
CONTRACTOR'S NAME AND ADDRESS
Mail permit to ( ) Applicant ( ) Owner
'1/ .t1.h 1 1,,;,4,
Phono
Phonp
_ Phonp
)1'- /. \ (owner etc.) when ready.
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Block
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) Contractor. (L--),'Prefer to pick up.
Call
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STRUCTURES NOW ON THE PROPERTY
THIS PERMIT IS FOR /''')') c/.::J t'1-~ //
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THIS PROPERTY IS WITHIN ONE MI LE OF THE CITY OF
WATER SUPPLY
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d"#"BED ROOMS_# PLUMBING CONNECTION~
SEWAGE DISPOSA' /UH' / I::":?' )(; S.1. #
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. 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 Codes relating to this permit.
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Fee Paid ct. L..... - __ _ 'i- T . Signature }~.. -., . Datp
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';, ( ) NEW ADDRESS (
) FACILITY PERMIT TO TRANSPORTATION DEPT,
) SPECIAL PMT. AREA. MIN. ELEVATION:
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SAN IT ATION
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BUILDING
Type of Construction
Use Classification
r:roup
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Fire Zon'e
I
Minimum Septic Tank Capacity (Gallonsl
Drainfield Required, Lineal Feet
Maximum Depth
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Comments: L
.AN~_COUN"""- --_
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Comments:
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PERMIT. AREA
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By:._ Date: ~:..-..;;),.- "-;--:;i' By:
PLANNING REQUIREMENTS SATISFIED. By: ,'J T-
ZONE:,;.../,.4/nJ SETBACKS: FRONT "~,,")I SIDE F~CING STREET
.... .. ."L.~.:A_ I'" '. .... _ ,.-...: I .. ~ . 4 , ~ i . )
..., '!-... ~ I,...... '... -J r _.. ',. ~ $if.
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Date: {.. .J' j I Date Issuec:J:--'", \.u- ';AI"
(FROM CIL) INT. SIDE YARD ;;' REAR"'". -( (FROM'P/Ll
'-, ...
,LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE., EUGENE, OREGON 97401
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, <'':;:-' , I ..... POST THIS PERMIT ON MAIN BUILDING AT SITE
C55-13 BLDG. PERMIT - WHITE; BUILDING - GREEN; PLUMBING - CANARY; SANITATION - GOLDENROD; OFFICE COPY - WHITE
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PHONE: 687-4394
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LANE COUNTY PERMIT
Acreage or Lot SI70 Partitioning #j..lh Sqt./-7(~~),ComPleted SubdivIsion
Contractor's 0 S # f/aA,,('.d I Lot
APPLICANT'S NAME AND ADDRESC: (7 .(1 '- 4J/i Ian )./1)40 _ J/;//)/U;'A'L) I2r
~
OWNER'S NAME AND ADDRESS . - "\
CONTRACTOR'S NAME AND ADDRESS fi / /J /Ljy 1/1./....-,-r--
Mall permit to ( ) Applicant ( ) Owner ( ) Contractor !l...l-Prefer-to pick up Call
j:STRUCTURES NOW ON THE PROPERTY 0_ (Ju1 tr9-.T./ /11
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\.., THIS PERMIT IS FOR m'AI- rf-h7./ ..I-f.f2_~
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THIS PROPERTY IS WITHIN ONE MILE OF THE CITY"OF
Phone
~"__ Phono
--:/~ffc--)0:? \(owner, etc) when ready
Bloc~ A
d'--~h-r C~hono ~{/h- C1(,~S
/V
WATER SUPPLY
SEWAGE DISPOSAl
~BEDROOMS_# PLUMBING CONNECTION~
mil / ?-.P-7c:' S I #
. "
, 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 (,f 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 Codes relating to thIS permit
Fee Paid $ L:::" /....," ~ I') Slgnatu re 71" iVl~ .::e.. ~:...j""v,-j), ~ Da<p
( ) NEW ADD"RESS ( ) FACILITY PERMIT TO TRANSPORTATION DEPT - () S~ECIAL'PMT AREA MIN ELEVATION 4-,n,,'7.f
SANITATION BUILDING f en, 7!ic7~
~ MInimum Septic Tank Capacity (Gallons) Type of Construction r:roup .Flre Zone
C///O<r--.r Dralnfleld Required, Lineal Feet II,e ClaSSification
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("""'- MaXimum Depth Comments V
\.....)com~~nts ~ "YJ-~....~ IOf~~ LANE'COUNv\' "._~,__
,,-,it f1~-V4V t {;.U) ~0-i!..- ~~ /1tc~' /~. ~- :L PERMIT AREA.
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By ~ ~~L-- {.ija. eM. Date 6...-;.2'h.77 By ( ~.~ /..h:.- c;r,."fDate L _ 2-q- 77
PLANNI/lLG REQUIREMENTS SATISFIED By ~R f.:l: 1/ Date c,-.--/ 2. - /j- Date Issueg~u.U.R ?1/-/7
ZONE f/./l In /...I-- ~TBACKS FRONT Q, I SIDE FACING STREET (FROM CIL) [NT SIDE YARD <: RE"AW', /((FROM P;'U
,LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE, EUGENE, OREGON 97401 PHONE 6874394
(1-( Gf. P -)0 .;; 7:5 POST THIS PERMIT ON MAIN BUILDING AT SITE
C5513 SLOG PERMIT - WHITE BUILDING - GREEN PLUMBING - CANARY SANITATION - GOLDENROD, OFFICE COPY - WHITE
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SITE INSPECTION
ApPROVED Cl
DISAPPROVED Cl DATE
INSPECTOR
REMARKS
FOUNDATION INSPECTION
APPROVED.c:J DI SAPPROVEO L-I PATE
INSPECTOR
REMARKS
FRAMING INSPECTION
ApPROVED /i DISAPPROVED / I DATE
INSPECTOR
.
REMARKS
LATH OR SHEETROCK INSPECTION
APPROVED.c:J 015APPROVED .c:J DATE
INSPECTOR
REMARKS
FINAL INSPECTION
ApPROVEO ~ISAPPROVED
/ /
0,,-:7-7-1- n""",,,~/
REMARK 5
CERTIFICATE OF OCCUPANCY
READY TO ISSUE Cl NOT READY TO ISSUE Cl DATE
INSPECTOR
REMARK 5