HomeMy WebLinkAboutPermit Septic Tank 1978-3-15
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. . LANE COUNTY PERMIT () 1 .il
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Acreage or Lot Si7D D) veto Partitioning # "( ) Completed Subdivision';? W Il.-t:-. (/./ ./),,(.,ff/t G6L"'-- ,
Contractor's O.S, # __ Lot / U Block a- ,...-, --/;>> ~
;PPLlCANT'S NA~E AND ADDRES" 7JU::, tJ.hl/1.An..~ <srlJ'rLul.I &. /3c/(Yt?tl,2/}a-,~~1h'0~:~~-:" 3072-::~
, OWNER'S NAME AND ADDRES~ 'II Phon;' 'l
CONTRACTOR'S NAME-AND ADDRF"~ " Phon'-!;
. : _... Mail permit to (l....)...Applicant ( ) Owner ( ) c~actor,j ) Prefer to pick up. Call (owner, etc,) when read~;: ; '::1,
. c; STRUCTURES NOW ON THE PROPERTY . ---- "~"
:. THISPERMITISFOrr5F.o IS153~ '3A/t-- S-g~n,~Sr/atfSf)\ #BE6'R~OM~5 #PLUMBINGC()NNECTIONJD::~
WATER SUPPLY WdiJam.R.ih.J-bJ1!t)U. eo. ' SEWAGE DISPOSAL S.I. # 74- ~c2.1
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THIS PROPERTY IS WITHIN ONE MILE OF THE CITY OF
. PLUMBING B'(
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.: ;!' hereby certify that the ab?ve statements are true and accurate, and that I have the following legal interest in the property: _owner of record;
I' (: contract purchaser; _ potential buyer; _ r,ealtor or agent. I further certify that (if not the owner) I am authorized to act for the owner of
., ~~.cor,:;nd that said owner is aware'and approves.of,this'jlction, I hereby agree to comply wit~ all applicable COd~~I.~~in1 to this permit. _"'. _ ~ .,
FeePaiH,.~:U;<r. t..I8 ( ~~ /~9.J .' Signaturp --,....1:u~~ ~ . /~/ ,DatD J.. ./ 7?J>
!0 NEW AODRESS ( ) FA'CTLlTY PERMIT TO TRANSPORTATION DEPT( / (k-)-S.PEC'iAL PMT,.AREA. .,MIN'jLEVATION:
. , SAN IT ATION.. . ..,. . BU I LDING I A;;:- . -.. :::'_".c:,,; ~ _.,~.". ... ~
" . /000 Minimum Septi~ Ta~k~Capacity (Gallons) . 5Njype ~no't~tr~:'~~i6ri? "J ;;"/~W'jp:~~MiJirMEA
/So. Drainfield Required ..Lineal.Feet. ".~ lJ<-JELLJN{., .. Ilse Classification ...
.3.> ,... ,Ma/ximum Dfepth +","",/<. d" ot d- c ,,;... .f'I.~( J "i Comments: F1NI:~II{;D. Fi..tJi:>,G '8-Cv'. TO 8$ Ai':~r -1<!G,izs4
Comments:. r"'H...1 ~ .f> e{'. .c. ..... ~$.s. CAP III/ .c"uf!;?- AT IlVit::.~54"'L77cN I.
O'e.r. 1'10+ f'14......s.+~'t 100 +'~...+ ft.- 0-1/ ~,.."I.L O~ Ox..!; WA<( ~ D/'!:JG .t:eW!: I~ 12'3.-:93
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By:./iJ~ :J o-<-~ ,I'I.-R, Date: r\ 7.-12-,'?/7~ By: ~ ~. Date: 3-IS-Tk
PLANNIN~..REQtJIREMENTS SATISFIED. By: ~ Date:~-c?7-7-A: Date Issued:,3-/5-7f!.
ZONE: '-Ie-fl. SETBACKS: FRONTu,r ~.\lP..EJ.;ACING.STREET .- (FROM CILI . INT. SIDE YARD <;/ REAR 7 r (FROM PILI
'. LAN E COUNTY DEPAinMENT OF ENV'I RO~~'EN~tl:(NAGEMENT, 125 EAST 8TH AVE" EUG ENE, OREGON 97401 PH~:t17-4394'
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, .POST THIS !,ERNIIT ON MAIN BUILDING AT SITE
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C55.13. .
BLDG, PERMIT:':' WHITE; BUILDING -GREEN; Pl.\.-FMB1'NG -,CANARYj SANITATION":' GOLDENRO,D; OFF'ICE COPY - WHITE
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Date mm-(lh I;:;+h '. l07B
Permit No.
4h'l- '78
CURB CUT
:'PERMIT
IN THE BOARD OF COUNTY COMMISSIONERS OF LANE COUNTY
WHEREAS, the attached applicafion has been fully considered by the Board of County Com-
missioners of lane County, and it is the opinion a nd judgment of the 80ard that the said application
should be granted, and t.hat a permit should be issued, now, therefore, it is hereby.
. ORDERED, that a permit be and is hereby issued fo 1'YLt>. if.LrnC'.l'n .Iru)'<:..'?11--
-'Yn OJl'1f ~ CO., i 346 c..ua.n-Llcdar GJ J SPF D. for placing, building
or constructing the following facility: '
,~IO)',~LfYK i',c{ Mm>>nL\a~s:od?~toS? (107\ (he
, upon ~"ght'of-way of County Road No. . Mile. Post .,
in strict conformity to the exhibits attached, hereto, and subject to all terms, conditions, agreeme!:1ts,
stipulations and provisions contained in the appl ication and permit, the Rules and. Regulations Gov'
erning Facilities to be Permitted upon County Road Rights-of-Way, as set forth by the lane Man-
ual 50.190(2)" any am~ndments thereto, .and any other applicable regulations, law or ordinance.
Special Provisions:
1. Driveway will be constructed in accordance with the attached driveway approach specifica-
tions (DrawingM98-50).
2. Permittee will be responsible for the immediate removal of all mud, dirt and debris from the
roadway and right of way caused by his operation, leaving the roadway'and area in a neat,
acceptable condition.
3. Sidewalks will be constructed in accordance with the attached sidewalk
specifications and drawing M9S-49. The Standard Curb Type shall be.
constructed unless otherwise specified.
This permit is revocable at any time, and will be strictly adhered to and no work other than
thaf specifically mentioned above '.is hereby authorized.
This perm if shall be void unless the work herein contemplated shall have been completed be-
fore "tYlrUT.h.
V
Inspected and
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Approved
,1920.
Expires
19_..
Date
Approved by Board: of County Commissioners
By
(1L ~~o~!::r~orkS
By
WHITE - OFFICE FILE
YELLOW - REAL ESTATE
PINK - PERMITTEE
ORANGE -.BUILDING & SANITATION DEPT.
C74-129
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TRS T.I . /~~ 2 ~oS"
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Written Directions Col'L
37(;-7?
Job Location
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01',' \/<L off Jd.5 b a;"
INFORMATION SHEET '
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) Building Permit
) Site Feasibility Study for Septic Tank. Number of sites
Acreage or Lot Sizp 10.000
Partitioning #
0'
Test holes will be ready
Subdivision l'1f. 1117. '-17" 17
17<; fO'flZ.~
-3 t:d Add Lot
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Block 2.
) Completed
( ) Pending
APPLICANT'S NAME AND ADDRE"" B'-t.-ICfL F'x /3t1-R C/lZ.at-WatfiLl- h-rhfE-
OWNER'S NAME AND ADDRESS, if different from applicant's
CONTRACTOR'S NAME AND ADDRES~
Mail permit or results of site feasibility study to (x.) Applicant ( ) Owner ( ) Contractor.
( ) Prefer to pick up. Call (owner, etc.) when ready.
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STRUCTURES NOW ON THE PROPERTY
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PROPOSED USE (this permit) DWIZ-/I,'nd I Jf 78 0'
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WATER SUPPLY L<I.'II.cv177<Z77'e. W'wla-r eel,
Gal-da/rz:
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:It P,p;1 rrY"nlC 3
SEWAGE DISPOSAl
PLUMBING BY 'W,d/w/~ ?/UI-n};,'l701
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) PROPERTY IS WITHIN ONE MILE OF CITY (
(existing or proposed well, etc. If public, name of systeml
(existing or proposed septic tank, etc.) S.1. # 7~ -382..
I'C. r,y f"l-tZA
Address
*******************************************OFFICE USE ONLY BELOW THIS LINE ************.*****_***************ll-*********<l-
( ) New Address Necessary
ZONF
) Facility Permit Necessary
SETBACKS: Front Side Facing Street
(FROM CENTERLINE OF ROADI
) Special Permit Area. Minimum Elevation:
Interior Side Yard Rear 7 { /Jt0 6-
(FROM PROPERTY LINES)
To: Planning/Building InspectorlSanitarian/Surveyor.
This applicant appears to have a problem with
Your assistance will be appreciated.
By
Permit Processing Section
ResponS".
C55.12
By
DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
Permit Processing Section
125 East 8th Avenue
687-4394
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'. T, ItlS,lS A PRElIMIIIA.R.Y,. oREPORt. ....'1.II.,I,~i .9. E.SAWi-.'IIIS.URE T11E ISSU^IIC,E OF A FUTURE OU.ILO.'.N..G PER!1iT,
'fLANSOR :XPENDITURES'1AO~t 1 N); '1 11 I CE, uPq~ ,THIS REPORT ARE ~T ~OUR OWN RI~~. ,.-.;, , .. ....1(' i
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;i':f';~~bdiV~~~O -/dm:~;, :Z~lf': ;hf-'-'~""". B~k!2. (b-; /1.)8~f J(H./Djot If; IO:'}Block # 2.~. '::.':, .
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1,!;r;R'-~..Ir.a;( F")y: !I~: .: I. No. of Sites /,5 $ ~./S.Ch) "'IS:--.'
~ ;,:ri~r4-J? CI<U>';-IN;;G;~,. L;:L~.~: :.No. of Acres,:;; 4-- $ .;, :';. .
>"Hail ing.Address I ,;; ,l'l : ,I ," ".,
'!"J:P.':;'bA';-;qf...,!..$.!/' : . Total $ :-525.0;'.: " ;:! f.
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',:'tof, Pr,op.erty::..!la-s,'d.n.I?T,O' . '.'. In Property: Other (Specify): .;
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,!f(open,y S,!/e.'. Lega'~c~e,~s R()ad 1~ame Exis~lng Structures 9" Propert~ '..
i ':s Property Within One,,/1i,le of City! Proposed Water Supply
~~s --: ~hat .City: ~ ~~~:~; ~ e;~~rlct:
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When Will Test Holes Be Ready?
MARK TEST HOLES WITH OUR FLAGS
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Location of Test Holes,on Property:
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MAKE CHECK:.PAYABLE TO:,) HEALTH MiD
MA I L TO: LA/JE COUNTY BU I LD I NG AND
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CS5-55.
SANITATION
SANIT~TION DIVISION, 135 E. 6. th Ave., Eugene, Oregon 97~OI .':
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Test holes will be ready
) Completed Subdivision 3 td Add. 1'1t. VIZ.(-ft/!)!-r ~<;-I-"",I<?_.s
( ) Pending J"!IJ, I!czt:l:7o/7
APPLICANT'S NAME AND ADDRESS --rhV~.,!fI-rl",,"1- t':n",h",I-u/ 13Jf8 /':.1<L"".w""fa_1- L",170-
'JWNER'S NAME AND ADDRESS, if different from applicar\t's I
CONTRACTOR'S NAME AND ADDRESS
Mail permit or results of site feasibility study to .( I() Applicant ( ) Owner (
(- ) Prefer to pick up. Call (owner, etc.) when ready.
TRS, Tl
19,-? -0,"
Written Directions (;", fa.
\'/""i./
I
("If} Building Permit
Acreage or Lot Si70 IO,nt)I'J
Partitioning #
01
C;(,7-76 ,
.,
Job Location
off D.' X ,'0-0/-,' va, 0 -fF ;Jr:l5 b a.r Rd
INFORMATION SHEET'
,
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) Site Feasibility Study for Septic Tank. Number of sites
Lot 10
Block 2.
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,<;bh''''''!:n././ OhZd~'"
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Phone 7-'16-7,072
Phone
Phone
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) Contractor'-
Contractors O. S. # IN I 2...
STRUCTURES NOW ON THE PROPERTY NO!-rrL
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V-.IO'lel- 1:""
PROPOSED USE (this permit)
WA TER SUPPLY W.' /ful"l7Iz-!fcz.'
Gure(e/t;;
1
!J8B t::J1
J! ~r";rms 3
(existing or propo~ed well, etc. If public, name of system)
SEWAGE DISPO~AI prtJ!i/)."\Pt?(existing or proposed septic tank, etc.) S.1. # 7~-38Z.
PLUMBING BY \.I"",//u /<; -10 r,.yf'-lhZ5 Address
I
) PROPERTY IS WITHIN ONE MILE OF CITY (
Il-** **** ************************************ OFFICE USE ON L Y BE LOW THIS LI.N E *** ****** ***.* ** *,***** ****** ** ** * **** -I(- ** -'\ "" * ""
( ) New ~ess ~ ""sary ( ) Facility Permit Necessary
ZONF ~ /. ---- SETBACKS: Front . Side Facing Street
(FROM CENTERLINE OF ROADl
) 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 wi II be appreciated.
Responsp.
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C55.12
By
Permit Processing Section
.,
By
DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
Permit Processing Section
125 East 8th Avenue
687-4394
nivision
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