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Home My WebLink AboutPermit Building 1974-1-24 :::;.--' ,.."", ~ ;:7 AJA-/ '/..,i )..f a v- :______ ? I ;( ( . LANE ~_ _JNTY BUilDING 1m , , -~- " , ' ~, ., / --- 75:~ ?q ~ - ~ , f" OR MOB. ,.JHOME PROPERTY OWNER Lov. J<: C~t CONTRACTOR Same PROPERTY LOCATION - INCLUDE POST OFFICE 1~$6 Hovden Arldac Rnad PROPERTY LEGAL DESCRIPTION - METES BOUNDS Church Subdivision. Lot 3 TWP RANGE BUIL1)ING' PE.RMIT MH D " MAILING ADDRESS .II 1535 Carter La"" ;J,;~ Sorinnfl"ld n~""..n MAILING ADDRESS . USE PERMIT PERMIT NO 75-7L~ PHONE 7ll'''-'2I:i1..... PHONE SECTION 17 03 '4,~.3 TAX LOT NO #~03 CODE CENSUS TRACT APPl NAME & MAILING ADDRESS FOR MOBilE HOME PERMITS ONLY No of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT EXISTING STRUCTURES ON PROPERTY tdonQ LEGAL ACCESS TO PROPERTY Hovden Brld~e Road PROPERTY SIZE - FT WIDTH DEPTH AREA Connect to EXisting Sewage System D TYPE CONSTRUCTION SQ FT -# BDRMS New System D VALUATION Dwelllno - main Frcme n6~ nl2 (4) lG.HG UODer 1'1' rOt) 10 <:3) Garlloe (;14 )( ,ill <;76 (.)~ 1_17;1 Covsr"d Dorch SEWAGE DISPOSAL (/16 )t 6) PUBliC 0 BUILDING W A5TE DISPOSAL PLUMBING PLAN REVIEW PARK TRAnfR SEPTIC TANK dj OTHERD $ 101.50 30.00 il3.00 FEES n6 nl PLUMBING INSTALLED BY OWNER 0 OTHER NAME WATER SUPPLY ,)7~ -~ 29.2G:J PUBLIC ~ o OTHER MIN SEPTIC TANK CAPACITY , 17450 COUNTY BUilDING & SANITATION SPECIFICATIONS DRAIN FIELD REQUIRED"" tiN FT 320 TRENCH WlDTH FT 3 OR SQ FT 960 TOTAL WITH DI51 BOX GAL 1000 noof drains to the ~tract. TYPE OF STRUCTURE 5tJ OCCUPANCY I & J ZONE RA PUBLIC UTll EASEMENT BLOG SETBACKS FRONT 45 FT FROM eTR OF ROAD RIGHT OF WAY USE CLASSIFICATION REARNortil ancl Eost 7 Faet Pt.bllc U~illtics Eascm:::nt DATE 1-21;-71} slf John Shook SIDE INT SIDE EXT AUTHORIZED SIGNATURE - DATE J.e. [loss by C. Harbaugh BLOG PERMIT - WHITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENROD Construction to comply With uniform budding code and county regulations covenng plumbing and sewage disposal All butldlngs require a certificate of occupancy before bemg occupIed (See Statement on Reverse Side) (POST THIS PERMIT ON MAIN BLDG AT SITE) LANE COUNTY, BLDG & SAN DIV COURT HOUSE EUGENE, OREGON 97401 FO"'M == C55 13 . - ," , ~ I - .... Dote - , ,r---,\ , V ~:t: ~--- , 'J '. \, ~ I , "J' ..I \ - . Permit " ,.. No ) CURB CUT PERMIT IN THE BOARD OF COUNTY COMMISSIONERS OF LANE COUNTY WHEREAS, the attached application has been fully considered by the Board of County Com- mISSioners of Lane County, and It IS the~oplnloh_and'ICJdgment of the Board that the said application _, I <,/......~ should be granted. and that a perrfllt"'should be ISsued, now, therefore, It IS hereby ORDERED, that 0 permit be ond IS hereby ISsued to " ,'" ~ t.:._ II for placing, bUilding or constructing the following focllity ;, Jj -; TJ"'~' ( "'i! t~ ~ ~ . ~ o . " ..~ '"".".J o "v ~; I upon the right-of-way of County Road No ' l,;' , Mile Post , In strict conformity to the' exhIbits attached hereto, and sublect to 011 terms, conditions, ogreements, sllpulallons and prOVISions contolned In the application and permit, the Rules and Regulations Gov- erning Focil,t,es to be Permitted upon County Road Rights-of-Way, os set forth by the Lane Man- ual 50 190(2) any amendments thereto, and any other applicable regulations. law or-ordinance Special PrOVISions Driveway will be constructed In occordance With the attached driveway approach speclflca- lions (Drawing M98-50) 2 Permittee will be responSible for the Immediate removal of all mud. dirt ond debris from the roadway ond right of way caused by hIS 0 peratlon. leaVing the roodway and area In a neat, occeptable cond,llon ThIS permit IS revocable at any time, and will be strictly adhered to and no work other than that speclflcolly menlloned above IS hereby outhorlzed ThIS permit sholl be VOId unless the work herein contemplated shall have been completed be- forp - (...() " 19_ Expires ,19_ Inspected and Approved Approved by Board of County CommISSioners By Date By DIrector of PubliC Works WHITE - OFFICE FilE GREEN - RESIDENT ENGINEER PINK - PERMITTEE BLUE - ROAD SUPERVISOR ORANGE - BUILDING & SANITATION OEPT YEllOW - REAL EST ATE C98-79 # ~ Date Building Permit # APPLICATION FOR FACILITY PERMIT I, (Applicant's Name) hereby moke application under Rules and Regulations Governing Facilities to be Permitted Upan Caunty Rlghts-of-Woy, to construct the follawlng facility Upan the right-of-way af County Raad Na , at mile post on the I No I So I E I W I side of the rood, or (mark with X) as shown on the exhibits which are attached hereto, In strict conformity to the statements of the exact nature ond amaunt of work to be done, and to the description of the facilities contained In sOld exhibits The oppllcant will be the principle owner of the faCility os constructed, or other- wise primarily liable and responsible to members of the public for ItS proper mOlntenonce, repair, operation and use The applicant accepts 011 terms, conditions, agreements, stlpulohons ond pro- . . - VISions, In Rules and Regulations Governing Facd,hes to be Permitted Upon County Road Rlghts- of-Way, as set forth by the lane Manual 50 190(2), any amendments thereto, ond any other ap- pllcable regulation, law or ordinance To Permits Processing Noted Date Noted DIrector PrincIpal Engineer SubdiVIsion Engineer SIgnature Permit Engineer Address Weighmaster Zone No WHITE GREEN PINK -OFFICE FilE - RESIDENT ENGINEER - PERMITTEE BLUE - ROAD sUPV ORANGE - BLOG & SANIT YEllOW - REAL ESTATE Phone No c98-78 ~UILUIN~ ~ITt tVALUATION ;:J~ e 1.(' BUilding Permit ApplrcatlOn No. "76~ .?#~Ili Site Inspect Ion % j' T /7 R d S ~ // IAX-. lOT _2..c::>.:::3, CENSUS TRACT ~ ~~ APPl/CA~ (.-::-.,/ ().d;: N/\ME "W,lj7J- 2i')A,f'-L' AODRESS' . /' . ~ ( ) ( ) Pre-Permit InvestigatIon PHONE OATE /-.2/-74 / l/\NE COUNTY PlANN I NG DEPARTMENT Zoning Ordinance Compl ranee (Zone kA- ) SubdiVIsion Ordinance Compl lance NOT applicable () () ( ) ( ) ( ) ( ) NO YES NAME DATE o -' Required Access ( ) ( ) ( ) ( ) (~ (-r (-r- (-) -- ( ) -----vJ//5Z--- , . / -22--7 1- 2 4 BUIlding Site (Area, Width, Frontage, Setback) Other (see comments) 5 COMM ENTS BUilDING INSPECTION SECTION NOT NO YES NAME DATE applicable 0 6 Plans Subm I tted ( ) ( ) ~ 7 So I 1St ab I 1 I t Y (foot I ngs) ( ) ( ) 8 Flood Plain ( ) ( ) 9 Ot he r (see Comments) (X) ( ) ( ) t~;7'~<flL /~24~?t/ I - -- 7F COMMENTS' SANITATION SECTION 10',,- Sewag~~osal NOT NO yeS applicable . /' () -() VJ / -2'{~ 7'1 l~_lL DATE , . ::.." LANE C.uuNTY BUILDING 0 BUILDING PERMI! OR MOBIL~ HOME MH 0 MAILING ADDRESS USE PERMIT PERMIT NO . , .~ PROPERTY OWNER PHONE CONTRACTOR MAILING ADDRESS PHONE PROPERTY LOCATION -INCLUDE POST OFFICE PROPERTY LEGAL DESCRIPTION - METES BOUNDS TWP RANGE SECTION TAX LOT NO CODE CENSUS TRACT APPL NAME & MAILING ADDRESS FOR MOBILE HOME PERMITS ONLY No of Bedrooms EXISTING STRUCTURES ON PROPERTY \); ~~ ~-~ ~ ~ I , LEGAL ACCESS TO P:ROPERTY~ PROPERTY SIZE - FT , , , ~ WIDTH DEPTH AREA STRUCTURES TO BE BUILT THlS PERMIT Connect to EXisting Sewage System 0 TYPE CONSTRUCTION SQ FT ~ BDRMS New System 0 VALUATION " ... '" .... J....._\,'t:~~t).,.~ \..........,..t.'\.. ~1.:..", J:,": ~ ~'i:~Q'- ~\...\.~~ ~ \ ,... ~ \ *~~ ~ .::l~,t~~) ..\) \':.~\ ~ ~~), ~'t.\- ~ ... ~:\..~~"~ ~ ",t. .)'.. I, b-U *vb...\Y...'l- A"'\J\ ,t",,_,' PLUMBING INSTALLED BY - - , , , .. SEWAGE DISPOSAL ~ PUBLIC 0 BUILDING WASTE DISPOSAL PLUMBING PLAN REVIEW PARK TRAILER SEPTIC TANK 0 $ OTHERD FEES OWNER 0 OTHER NAME WATER SUPPLY PUBLIC 0 o OTHER TOTAL $-' WITH DIST BOX GAL MIN SEPTIC TANK CAPACITY 1 COUNTY BUILDING & SANIT A nON SPECIFICATIONS DRAIN FIELD REQUIRED LlN FT TRENCH WIDTH FT OR SQ FT TYPE OF STRUCTURE OCCUPANCY ZONE PUBLIC UTIL EASEMENT BLDG SETBACKS FT FROM CTR OF ROAD RIGHT OF WAY USE CLASSIFICATION FRONT SIDE INT SIDE eXT AUTHORIZED SIGNATURE - DATE REAR DATE BLDG PERMIT - WHITE OFFICE COpy - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENROD Construction to comply With uniform budding code and county regulations covering plumbing and sewage dIsposal All burldlngs require a certificate of occupancy before beIng occupied (See Statement on Reverse Side) (POST THIS PERMIT ON MAIN BLDG AT SITE) LANE COUNTY BLDG & SAN DIV COURT HOUSE EUGENE OREGON 97401 FORM == C55 13 -- ~ , . -... -'~ ., SITE INSPECTION A\'PROXtD / ,~I Dly:'PPROVED Cl d11;d( ;A-<--e-::,w <,/4 tJ REMARRS P /..n,u.,<~,;J. .L -7- 'ltl DATE INSPECTOR FOUNDATION INSPECTION ApPROVED ~SAPPROVED / / DATE)!:., -}? r~ 1"1NSPECTOR t( REMARKS...I2l< ~ ~~-tl.fJ.;'l/dL , . FRAMING INS;?N 4Yl ApPROVED 1L 01 SAPPROVED / / DATE 1/ ~ ? ,1 t( I NSPECTOR (~.- e( REMARKS 4u- fZ'ffl#'<< ;'-'J.~-11/ ~1~~~ ~ ~~. I~-i~~i,-<t ([JJ:e;;:'if{~#;'~ :j~~" ./fnR~ \,.;n'?-l....~ -'l:I:IiJl. ~__ :\-,l . o LATH OR SHEETROCK INSPECTION ~. ApPROVED ~/ 01 SAPPROVED ~ DATE r ,') " '7 'I, NSPECTOR(t;:j[.. A ( REMARKS FINAL INSPECTION ApPROVED ~ISAPPROVED REMARKS 41.:1 A-lAj~ 11U .),,{];, j"'-/7'1--11/ I NSPECTo(jJL ~/ / / DATE CERTIFICATE OF OCCUPANCY READY TO ISSUE / / NOT READY TO ISSUE / / DATE INSPECTOR REMARKS I ~~~ N.-W 7.j--Jf ~ 10:> ." 0 :: i-'- ~,,;:;rc;'-I - - . "-c 0 Cl..<D <) _ :r ~-3~:OO;;..3~:' I;~ g~:~> ";r~~"-~ 10 ~ ~ _ ~ <I.. ;. g :r.. ! _ ~.. ;;.:;;;~ S~~;5-~ ['1 ~ ;;;....:> "-"; '" ~ 0 ~ ~~ ~~gob' :i_",:~; -lT~D...;-lT..Z-;;n~; ~.. o;2~ g..::;gg- i~ ;;~~ ~~~~~~ :t; ;: ;; ~:';:'"a g. -< g ~ ".; ~; ~ :r. ~ g lT~~g ~;.:=~~ ~ ~g;. g....;;. g ~ ;:..~ 5~ ~~ CL. C1! c _ '" '! r:J II o g !:. ~ ~ ~ 2. 0 ... &.~..; ~ ':: .. r:: IT "" " ~ -U ~ -U - -U ,. -i ,. ~,~, 6J \) '" 16 ~~ ,- i \j o ~ r:> roo r r r r r n n ;0 ;0 m ~ 0 0 r r 0 0 -u -u Z Z 51~ () () - :) 1:)1:)D j1 jl j) TlT\T\' o ~1 (.n ;0 _ n ,. 0 ,. .:E: ~ r z . m , "'" , -< . --;." I~ f )j: n " I I" ~ ~ ~ I ;;; I o J '" -< :JI '" " '" -i . ~ n n '" . '" '" 3 . . ~ 3 3 ~ o:r 0- <II III ~ " " " " " , " " , , ~ , ~ ~ ~~~~1 ( TT --- '1t,r r (J' If it: tJ-- .-.,:=-~, Il'-J-J C- .~ _ o ~I VI '-J C) () .....-"+1 l,} ...........-' f. I~~ l'). t.>' ^ r~ ~ b... o v> 0 '- r () );> I ;0 0 0 C -l m );> CD n V> rl m :i z }>o ~ -I Z 0 ::! 3:: () 0 m z Z::u o :1.I I f'.. ~ 0 ~j ~ ," :) r' 1'v" I - - r-i 0; S- J >~:)) .....p.Xl:J :J1 [l1 ';J -:> ) J " 1..- >j 7, . ~~ ~ ~m~~~ /' flCO~(Af11 L- fflJl. - i:r_ 0- cJ;<- ~-Z::(flN ~~~~{ Z:::r-(/l-lN~ oljlrn~r> ^:;:Y'>:t1 "v' ~;>< 5;1~(/ll:1 ~rd1\,., ~~~~~ ~9LT1 ;: 8 y-.c~b(j ~-1~0n' ~~(J\(i1~ 0Y01(J1 i'r ~ ~ q ~i.lft S:J.-o _ if-- z;:c:;. !: -..l ,- [/. G' ~ a g ~ ~G --l ~ () ~ " (J1 N ~ :: , '-- );8c,,#: ~ , '\ 6' N :: 6' (> J7 ~ @ ;-{ .-J I 5' ~- N: l'\ 140(,,# - . 4531P @ 141* 4 ~ = (U 6 o - ,. I N r- t' N_ ~ 6' 6 .p.. o " N, () 2:- di r ;0 .201'lt - -, ~~ 6' " ... ~4so- ~ n o ~ -< ~ " x -< ~ ~ . 1\:..... ,'" ,S ,"'- ._~ ':J ~ ~ ~ ~ ~ ~~, ~ ~ \\ tt 2' ~ <d ~ ...71 ~ 00 . <oQ o CD ~ ~ "I' () '" ~ 'f <':; i':; ~ ' /- ~ ~ -r: \i,t ~ r o ;0 ,. o o ~ -u '" z () ~ " "') "" , .u. 41::"''''- . ~;J 5' 1- ,0. - , @; ~ ~ 0' loJ '" " ~,\ n o r o '" ,. o o " <' ... ..... I ',' -- LI\NE CO EI\\'/ HEI\LiH 'ON D\n\~ _,MAR 1 ~ \974 - DNF Te .,p 1_ pERM , . I." ~ , - I, - In . - , . 1; ~ ~ =. ~~ . * < . !! ~ 0.< ;; ;; "'-! < -;;'2!'-~:'~~~;! E;::;: 0 it:; " :3 ; " ; ~ : ; 1> : :r ~ g:: o..:r ~~Q~g-~~:r..!<::' fT ;; 0::3 c!!: Q ~ 7 ~ ;; ~ n ~ '" n: ~ ~ ;..e1 ~ ; Q ~ ~h' :;~IO: ;;; oa~g:::r~~~"~; o:t:;~ ~2;E~:: " .... ~.. ~ ... n C ~o:~ ~:g~e..:: ~:: ~ ~~<1l'<-:::D g :-.".; Q ~ ;r~ ~ D'"-o!!g ~~~r~ ~~g~ ~:r~~~ ~ : .. =- g: <D ~ ~ o :; -< ; ~ r:l ;0 i ~~ a ~ ;; ~ ; g. - . . . , . , ~ ~ " ~ " co " " --{ 1> --{ . 1> ~ n n z n n z I " 0 " " " 3 . . ~ 3 3 . . if ~ 0 ~ . . . " . . (~'" "- " " 0 0 "- ~ '" . if ~ , , II ...~ - Ii' r " " r r r r r r \ n n " "," \ '" '" 0 0 , r r 0 0 , ; z " " ~ z " " m , \J"'\ I o ~ V> '" n 1> , 1> ~ ~ r z . m o 6 ~ ~ ~ n I m ~\,r\. r- ~I " '" -< " ~ " ~ r n 1> I '" 0 0 c -< m 1> co n ~ m m '" 1> -< -< z I z 0 -< 0 " ~ 0 m Z Z '" 0 ~~ ~ :},) ~ I .'" f- ~, ~~ .D... (1"1 j I 0 IUl 'i\ -J " f"-Il\.) ~ ::\ J ';. ".. C :;: ~\ A/ , (}1 6' Sik- JjI //1 0 r: 11 () rn J> :r: ()) \ ()1 (}1 a'li- lfl -.J N " ()' \ .( " "\ , \, , > -,- , n o ~ ~ ~ " I ~ ~ ~ b ~ . tj . ~ tJ ~ ~ lla n t) ~ l'tJ ~ ~ ~ n o r o " 1> " " ~ " ~ z o ~ n " r o '" 1> " o .-- , Lf2NF CO D,,~H -,--Cf"-t ~ ~ MAR - 19 1974 - - DNF - TEMP PERM . -' ,~ - '\. ~ , LANE ~UNTY BUILDING D \.. BUILDING PERMIT OR MOL. _ HOME MH D MAILING ADDRESS. USE PERMIT PERMIT NO \ " PROPERTY OWNER r. ,~ ....~ -'" CONTRACTOR PHONE t'::( , .. 1'1 i \ ~ (~~ ' ~, MAILING ADDRESS PHONE , y, PROPERTY LOCATION -INCLUDE POST OFFICE 1 ~ -.. C) / ~, """ ~: 'S. \ r1(y':.1 PROPERTY LEGAL DESCRIPTION - METES BOUNDS ..; ,.7......~ u ~~"eJr~':;v~ ~ (. ':: 'j TWP RANGE SECTION TAX LOT NO CODE CENSUS TRACT e) QB ~~j APPL NAME & MAILING ADDRESS FOR MOBILE HOME PERMITS ONLY No of Bedrooms STRUCTURES TO BE BUrLY THIS PERMIT EXISTING STRUCTURES ON PROPERTY r>,;,:,) LEGAL ACCESS TO PROPERTY l'''tj(l..) )1n'Dr"'~..,~, "J PROPERTY SIZE - FT WIDTH DEPTH AREA Connect to EXisting Sewage System D TYPE CONSTRUCTION SQ FT :;; BDRMS New System D VALUATION .::, "Hie:' Q Jln rJ~\ ':..) )~0:j 'J5? ~ l ~~~ " . ~RliJ :-: ~ ,', C- " ' , ~fl~ it:} ~ \ \ \ " . , 11 'l' ~'~~i 'I.. _II "-_ , ~ " ... ~ ;,f,,- A (;"~i:; ;,cJ I ~~ " ... J KG II C)~ PUBLIC 0 BUILDING WASTE DISPOSAL PLUMBING PLAN REVIEW PARK TRAilER FEES ,~. ~ ttiv ~~ PLUMBING INSTAllED BY OWNER 0 OTHER NAME WATER SUPPLY ,- , ' SEWAGE DISPOSAL .. " SEPTIC TANK G OTHERD t ~v~. ....:} ;' ~.:J -,->>.C:J ~, ~t ____ .- PUBLIC B o OTHER k , MIN SEPTIC TANK CAPACITY t. 17').:";) COUNTY BUILDING & SANITATION SPECIFICATIONS DRAIN FIELD REQUIRED 'J'cJ 1 UN FT TRENCH WIDTH FT .... OR SQ FT .':::J TOTAL WITH DIST BOX GAL " ,...,~'"' U'",.J ~ / (l~()~ .~'1 -:"0 C[...; C)\i:f?c.Ja. , TYPE OF STRUCTURE r " ~ OCCUPANCY I f, .9 ZONE :''\ PUBLIC UTll EASEMENT BLDG SETBACKS FT FROM CTR OF ROAD RIGHT OF WAY FRONT ..) REAR '-lr::,:: 6-:~1 USE CLASSIFICATION '['01; I C'C:..G P,')ilc ;~eJil<:I:.::: eCUe:",l:; SIDE INT SIDE EXT AUTHORIZED SIGNATURE - DATE J. .. \~, :)1.. (;V ,). !~':~:)':.!I~~ r ',... CC.........." t;. _ .'~ .......~~.'" DATE lo~c;..j'I) {)117 BLDG PERMlT - WHITE OFFICE COPY - WH ITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENROD . r Construction to comply WIth uniform budding code and county regulations covering plumbing and sewage disposal All buildings require a certificate of occupancy before being occupied '- , (See Statement on Reverse Side) -a ! :> (POST THIS PERMIT ON MAIN BLDG AT SITE) LANE COUNTY, BLDG & SAN DIV, COURT HOUSE EUGENE OREGON 97401 FORM it C55 13 ~ ~ , 1 DATE{ -:lb- /4 INSPECTOR. :-/# ~r~;= ",( . / SLAB FLOOR PLUMBING GROUNDWORK ApPROVED ;---? DISAPPROVED ;---? DATE REMARKS GAS PIPING GROUNDWORK ApPROVED / I DISAPPROVED 17 DATE REMARKS ROUGH PLUMBI NG ApPROVED ~ DISAPPROVED .cJ INSPECTOR INSPECTOR REMARKS__Ll'z' .,..,IDLJ'" V e. vt. -r "" /...-' ..P V t/ / ?*Iv. .k .. --1-74'" <05-_ ~ ,,"'-=--..... ...- , "l-'2o-;>q ~../--- r // -, ROUGH GAS PIPING ApPROVED .cJ DISAPPROVED .cJ DATE REMARKS FINAL PLUMBING ApPROVED ~ REMARKS DATEt'/~ -)r OISAPPROVED .cJ FINAL GAS PIPING ApPROVED .cJ D1SAPPROVED / / DATE REMARKS CERTIFICATE OF OCCUPANCY READY TO ISSUE ;---? NOT READY TO ISSUE ;---? DATE REMARKS INSPECTOR I NSPECT'OR INSPECTOR -~;(I~ ?/ INSPECTOR . ~ ~ PROPOSED S 'URFACE SEWAGE DISPOSAL SYSTEM Installer: -Omplete top ~..rt of form to , . signature and submit: both copjes with application, PermJ.t N~ 75-7 'I . .. Installer's N~e I1roJys- Sror;r, No. Living Units 1 (Exhibit No.1) Iproperty Address -z:;,,/- ,S;.,.v/rJ?_ 1466 H:wQPn R""~ !'lo"rt I Bedrooms Baths I Basement /~ Water Supply 7'- rt i- Yes_ No~ I Community s~eel_ Concrete ~. Compartments / Gal. Capacity / ~ Ft. -Tile Disposal Field: ~~ r;, .......Diameter Depth b 2. --- Distribution Box: Yes ~_ Other Distribution - Type , Public ~r-List_ SeptJ.c Tank: Ft. from well InsJ.de D1mensJ.ons: " Length 1:6 Width Applicant Name JACK LOY MaJ.1J.ng IS15 Carter Lane #21 Feet from Well ----- FoundatJ.on /~ Lot LJ.ne Front /tJ Side/tI R..ar/ to Ft. betweenlF1lte~,~ f.uter DepthlEi:J.ter Depth lines / 0 Type/~ I mxe c? in. titgw h in. Address Snrlngfleld, Or~gon Length of Lines - Ft. l Trench I Total Sq.1 lJa2Jd1h/n14. 5. 6. Width#" ft,,6 r)--O Plot Plan (See instru~ti,ns.: v,o ____ _ _ __~ !A i' t} --- -- --,~pfaz.~.....d.utt/'( ~^ 1~.-h.1-- I_I "-" I j< J'- I r , Date -r - -- ---- ----- -.J ~g__ __ I J { I I _- -..._- i_~--_-~ \l_-~, -- - e!~~~.~~TT r-=:-= -, I ~~.- ~~-:- - tf,,-:~-_I;.~-;:,IJI' --~ll, ~T I I---~ - i--- _/H ---- --- ---- - ------ :~--t~v~~_~~-- ~1 i - l-~'7t~:- 5(.<tI'<O"-~j~~H~:-~O-' t - ,I~- I I I +---1 --1----: /' , !. ,o''''' 1!f -+- i l' ~r'!ih ~ O~I\;"-~ ~ --~I-~:~~/;:V;~------- ------- - --- --- I r --,--,. ;;-~---'""", -- - -?f ---~-- -------- .-- - -- j 1_1__ V _____'-~ m~ ,~I-"--._____?i:~~~:,' ~; __ _. _ __ ___ __ -I- ij.Jj~It^-.j.tLf&L_ :.c:~-- --- ---b~---~-- -- - - -.-_ ______ I I' \ ;e<'''~ ).'f \ Si<mature - /;kA ~n WI IS nl ' = {/ illl (- / UJ Conforms to DEQ Rules for SubsurfaJ~~~}..,~J9J~sposal to DEQ Rules for Subsurface Sewage Disposal Date: ~E ElgNTY JJ,EA2-JH UNII sanJ.t~~~:r-P) ----I /z/., <-I / ~r ~anitarJ.an Use Only: Approved. System Installation o DJ.sapproved: Does not Conform Remarks: State of Oregon Department of Environmental Quality InterJ.m Fonn #2 ,. lANE COUNTY BUilDING PERMIT OR MUBllE HOME USE ... PERMIT TYPE - Bl' 'NG)1 MOBilE HOME Dose RE ;>ROPER;j.Y.OWN~R MAILING ADDRESS :;;( P..r ()~ /s J..:L ~~f~ ~ ~ CONTRAC~~ t:J MAILING ADDRESS V~~rl , , PROPERTY LOCAtiON -INCLUDE POST OFFICE /~/-,~ ~~ .I~I___~ /CZ/_ PROPERTY LEGAL DESCRIPTION '/}" -/./ / ) LOT - BLOCK - SUBD1V (~--A ~/' 4/-(./, 7 7' ~N3 ~"+ TA~ # , APPLICANT NAME ~ OLL ~ AND MAILING ADDRESS FOR MOBilE HOME PERMIT ONLY Number of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT ~A_O./_;, U-r,! - /h -#./_// =.Jrl f/'/~/ jAfUl''''--I-€'./ ~--VU d .~ SEWAGE DISPOSAL APPLlCA nON PERMIT:#: 75-7../ ~ONE -:11.;23. A-v..//, . ,; /' v PHONE 7~b -35./'7 Xo--T-J METES & BOUNDS 0 YES ATTACHED 0 NO CODE CENSUS TRACT DESCRIBE EXISTING STRUCTURES ON PROPERTY IF ANY '--7?~ l~::L::TY-:&;'2~ R/ PROPERTY SlzY""':W-IDTH- - DEPTH C/ AREA Connect to EXisting TYPE CONSTRUCTION ~Q...-n1 -' ~ / F1 RECEIVED B / / / '<' c> _ ".{/ --[, I p~n1J.'l' 'j / .d2:--"'7S - V COUNTY BUilDING & SANITATION SPEciFICATIONS / F I DRAIN FIELD REQUIRED I UN FT '.3.1,1, 0 TRENCH WIDTH FT 3 OR SQUARE FEf/r I \ / V (...p-,;;./< b) , PUBLIC 0 BlDG WASTE DIS PlUMBING PLAN REVIEW PARK TRLR SEPTIC TANK "\z( ~ /t?/_,?t:f' .,?tJd-<> ~ 'I "'-<J FEES OTHER 0 WATER SUPPLY PUBLIC ~ OTHER PLUMBING FEES ..3 /3 F1XTURE~ ..;( 9' ~ CASH 0 SEWER CHECK [If CONNECTION FEE ... PUBLIC WATER CONNECTION FEE ~ (LAJ TOTAL / 7>/. SO c>? , O'-i) MIN SEPTIC TANK CAPACITY WITH DIS1 BOX GAL /OOD r\DTS TYPE OF STRUCTURE $/1/ OCCUPANCY /rJ:*.::r Sewage System 0 or New System Req D SQ FT # BEDROOMS VALUATION /:;'L~/..2..(4) /~3~0 . . , /~ /.Q/.D 9 /:J. - , ~..,.. oK.;:zd )5172. .5' '- /- ;Z 7(,; {j}. ! /O.9LJJ' 17:2:5' c;r 7 t. PLUMBING INSTALLED BY OWNER 0 OTHER 0 NAME PLANS FURNISHED YES"Kl NO 0 5f~ TURE OF APPLICANT c:29,<JhP ....FACllITy PERMIT f YES lS:. NO 0 DATE /~t:,/-;J+ /" [)"ATE 960 ZONE ~ REAR YARD PUBLIC UTlL EASEMENT IV ~.E.. ~~\RI;I-lf' SIDE 'NT S- SiDE-rx..- REAR ,'l-'U~ _ /) ~ ~ I' ~/~'-7J;\M'9-:. { - ?-?--'7'1' "LOG I.NSu:lf11;;; 11 (t!/t /- ~ I/~ 'IfDa" DirectIons 10 FInd Property _ BLOG SETBACKS - FT FROM eTR OF ROAD RIGHT OF WAY COpy 1 - OFFICE COPY 2 - JOURNAl COPY 3 - AUDIT Form it CSS-1Z ~.....~r~'i-" ,-., .f, --<.,---- ~- , ~-;r.;; ",-....,., USE ClASSIFICATION - ~J~~, ........ -~--~ - -