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lANE COUNTY DEPT ~NV MGT REC[lPT I 40380
\ APPLICANT KEPHARI, JACK ADDR 1690 SOUIH A. SPFLD
TI.I 1703230001:'02 sunDIV
NEW ~lDG TYPE GAR USF R NO BDRMS 00
CODI:. Ar-'PL NO I\CT 1 ON DE SCRIF'TJON
HI' GARAGE
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NO STORIES NO DLDG~ 001
COST VALUATION FEE DAYS
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NO. 1- I XTUf,:ES
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MECHANICf'lL FEE
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PL AN CHEr-I< FEE
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FLOOD PLAIN MANAGEMENT
Department of Environmental Management
125 East 8th Avenue
Eugene, Oregon
687-4357
TO
V' PERMIT PROCESSING
PLANNING
4t:?5 -80
PERMIT NUMBER
PARTITION NUMBER
PUBLIC WORKS
SUBDIVISION
OTHER
APPLICANT'S NAME ,J A-C k Ir h" P f.J AI'?,
SITE ADDRESS Z. 742- #AI? 1/ E c:; 'T A II f'
PEID1IT VALUE IS SUBSTANTIAL IMPROVEMENT
YES J./ NO
SITE IN FLOOD HAZARD AREA
YES V NO
SITE LOCATION IS WITHIN A FLOOD HAZARD APPROXIMATE STUDY AREA, EXTRA
PRECAUTIONS MAY BE APPROPRIATE TO ASSURE THAT THE BUILDING SITE WILL
BE REASONABLY SAFE FROM FLOODING MOBILE HOME TIE DOWNS REQUIRED
I~SITE LOCATION IS WITHIN A FLOOD HAZARD DETAIL STUDY AREA
- ,
1 MINIMUM FIRST FLOOR ELEVATION OF 44 Z 4 9 (M S L ) REQUIRED
2 MINU1UM FOUNDATION ELEVATION OF M 7, L~'11 (M S L ) REQUIRED
3 MOBILE HOME TIE DOWNS REQUIRED IF GROUND ELEVATION THAT MOBILE
HOME WILL BE PLACED ON IS BELOW THE REQUIRED MINIMUM FIRST
FLOOR ELEVATION
SITE LOCATED WITHIN A DESIGNATED FLOOD WAY CHANNEL, BUILDING
PROHIBITED
RECOMMENDATIONS
DATE 2. -2./ - DO
C74-189 J L-
}r'p',Je
BY
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OEPARTIIENT OF ENVIRONI~ENTAL 11ANAGE~IENT
, 1_ A.'_ ~ PSB, 125 EAST 8TH AVENUE
~~I EUGENE, OREGON 97401
Job Address l.'IlJ. z, Y~J- Cjty;S1"~"'lII;'/d
'row~tMp. R~nj}e. :Se4tH'n. Tak~o~ - O!.- ~ 0 0 I 1..0..... 1/<1-0 ""V
SlIb((1vlSioll . ' . _ .. tot .lllock
AppllcatlOn for ~.~o. a..~ ....."'ff,.~ T.-IL
Structures now on the property .,..", l1')li c:...-..
::~:::tU$~I~f ~7::{L ~ l~:~'t.:p:?:-~e~hl
- . tillehti prlntl
If thlS appl1catlon 15 for an agrlcultural bUlldlng ,t wll' be used for purposes allowed by the State BUlldlng Code and
Lane ~nty Code Chapter 10 (zonlng) and for no other purpose I have the followlng legal lnterest 10 the property
~ owner of recor contrar:fJt purch ser, lessee, holder of an exclu51ve optlon to purchase,
duly author d to a~for the ner, 0 lS knowledgeable of thlS appl1catlon ....." l
Slgnature/Addres ~ 16c;{J r;outL"/}" )A#Mttl!/ (fJJ-. (ZlP).,,,<l//1
Telephonel ?~L-c.tV'l'7 or Ii e ~- "2.0-f:lo
When permjt lS r dy n tlfy ICI AlP lcant IJl? Owner CI Contractor 2Y ~ mall Cf phone
Owner .JJ~.:.. "~6t ~ I- . , (Z1P) 1IJv'l'j Phone ~t/, ~V'4;
Contractor A "'/vi..-'" UI f d.-IN!' (ZlP) q~'!:!.1 P~one ~~L -q:tI"Z- _
Contractor's OSR#' 1'7/ ~ - P];;mbln9 by ftNIAII c.. he; p. - ~ """, ~
DO NOT WRITe BELOW THIS LINE .
t of stort~~ # of emp 1 oyees t of lInlts
/I of ~dl'l)OlllS SOS: I-I EXlstlng,
SItes t ho 1 es ready ,0';oposed,
f'ee Sq" f't: or 'VA,ft
(;~dJl llescriot1on # of S1U>. ,Cos.t
~L//. C:AJ'V~-pdf~ ~/~ ~~ :<tiJ.d"J
7If~]Zf:;!<<~-~~ . //~;A2f ~(.~.~ :'
~WJ.!j~f1J
1\.. i line? ~ ft~mbel'~:
CI lml..tr,al ^
O^l'Ilh1Je
. hereby certlfy that thlS lnformatlon 15 true and accurate
If Commerclal
ReSldentlal
BP #
SI # .'.:2K-/~ 7
,
>
~,
Valuatlon
Fee
O'M" f
~~e\'t / ~1!-~ "
RecelVed by 'I'~---b_
Water Supply ~~
,
Proposed EXlstlng
Year Installed
Total ValuatlOn $ $
P11lfl!bh9' flllture~ at $ each $
sewer/wa~er'cpnn. at $ each $
Subtotal $
4% State surcharge $
Plans check fee $
Change of Occupancy $
TOTAL $
- -
Part d12//7;:2X -7?'rcel # l ParceySlZe -7'~:t;
, It, ;de . lnt r 5 . rear /
-
PERMIT PROCESSING Zone~~
Mlnlmum:zetb s It, froa#' I L/-6/
/ ~~
Commen -1101 jA/Z . /.'..:;
To be typed on permlt - ~# A-?1
/7;~//;Dff';"//2:? P1/'"7~.
- By /~~)' Date~
.F5JJ Group~ Flre Zone :~
permlt ~~ f1;7M,tdcx::trtf,..,
~P.
CP&I Type
To be typed on
By ~~ Date -z,-fR-XV
For plans lnformatlOn a1 (area '"Spector) . J tlMR ~hone , -... ~.l ~ 7
v61r~lOns to slte ~~ ~ S>'), h /C/..#'..-<6 C'A^Z?-4~ d/?/ t?
r:/L4 ~ ~-93 A-..rfY~~?l-u7i;l) ~ /'./Aj{ -. - -
/-1 stfl plans to CP&I _ set(s) Date' "Hold SllP - D~(e Date to
~ /: WPC _ set(s) Requlred to PCC Completed PCC
rL1' CP&I
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CI Address
C/ FaCll,ty Permlt
/~/ Envlronmental Health
FOR INFORr~TION about progress of your appllcatlon call
C74-171
Perm,t Control Center
6B7-HELP (687-4357)
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Job Address 2. '1 C/ j...
Townshlp, Range, See/lon. Tax
,
(J DEPARH,ENT OF E,JVIRO~11E"TAL t1ANAGEr~EIF
V PSG, I ZS EAST 8TH AVENUE
/:?cv-tA4iv EUGEIJE, OREGON 97401 ,
f':./a I:..I-{J/j;.. Clty '5tJVw.,j/;"/ ~
Lot ." D~ ~'i 0" /1.0.... f /'Y-o"1' V
AppllcatlOn 1:
",.
Asslgned Numbers~
SubdlVlSlon R ~ Lot
Appllcatlon for ~e a.,.,A .~_I/lh&. ~Ii
Structures now on the property JI"'IIII't'IA C-- ,
Proposed use of property {Y(ReSldentla,/ C/ Commerclal
Affldmt I, ,/fl.~J/ l'fltl)~Oe?F
(please pnnt)
If thlS appllcatlon 15 for an agrlcultural bUlldlng It wll1 be used for purposes allowed by the State BUlldlng Code and
Lane County Code Chapter 10 (zomng) and for no other purpose I have the followlng legal lnterest In the property
lI/owner of record.. contract purchaser, lessee, holder of an excluslve optlon to purchase.
- duly authorlzec{ to ac;?for the owner, wh"o 1S knowledgeable of thlS appl1catlOn ~/il.' /1 AI, ?
slgnature/Addressp;' Jh..,~f..oJ....r 16q{) t(;()",II.''A'' SIJt.tcJ'fflfl7: vJ^a..~'(ZlD) '1?1./-1{
I" I Telephone I '7<tL-aJC/.?."1 or ' Oa't': &- '1.(,1-0:10
When pernllt 1S ready not1fy ;;("1 Appl1cant /1/.fOwne~ /~I Contractor ~ (~/malk /~/ phone,,/ d I.d'
Owner ,J"".._b ILG'.flI:..-ro.8-J:- ,-' (ZlD) 't'it/'1I Pho~e '1J'"O'""1l'y"2..f-.,
Contracto~ - Vo/.J"tJ!!:vi.. 1" XUI ( ri...t:<e (ZlD) '1:J.'1!'1f'Y Phone '1';(" -~'q &.p'
Contractor's OSR' -r 1171(~ Plu;;'blng by rtH~ G.. tic;" P/~"t. ~@
,
Block
L~I Industnal
CI PubllC
_, hereby certlfy that th1S lnformat1on lS true and accurate
f of stones
~ of bedrooms
51 test holes ready
00 NOT WRITE BELOW
# of employees
. If CommerClal
ReSldent1al
o
IHIS LINE
# of Unl ts
SOS I-I EXlstln9, BP #
-c. ./
1_/~Proposed, SI #
/ls -/~ 7
Fee
Code
DeSCrlpt10n
Sq Ft or
ell of Sltes
Unlt
Co<:t
Valuatlon
CI Cash,~
- /
L/......Check #
Recel ved by
/ ~R" /-
'/P~
~kc~
Total Valuatlon $
, Plumblng flxtures at $
Sewer/water conn at $
each
each
Fee
$ A>
$ ~.c.
$
$
$
$
$
$
$
$
$
$
. .., ---- ./ /./ L
\. ~.-?.L..-./ /" c...A /....'-.. /yy- ff~,/7~...' ~/C,/ ~-'/i!Pl:1.. ~;;1t rc'
//S-~ IS .6, ~
/1
lJ7/~7-./.z~ ~ ;~A'Z-r:Ztk-~
""'I_~_H' -- x- ~
Subtotal
Water Supply
Proposed
Year Ins ta 11 ed
EXlstlng ~
4%,State surcharge
Plans check fee
Change of Occupancy
TOTAL
PERI~IT PROCESSING Zone d..--;r---
t~lnlmum setbacks 't, front"t:? I
, t! .' ,
Comments--6~ ,/~ .,..~ ~ ~ J' ~ . /#..1 ,-.~
To be typed on per;;;,t - ~~k 0"~~#L:/L7/~#~.8 /' CJ
, , By / ~dfi!::(/
~/
Part #
dJl/);25) - ;t;icel #
'L, slde
/
Parcel Slze
79'//
, lnt
rear
Date
- / /
c;7I/t7Y
I
WATER POLLUTION CONTROL
InstallatlOn speclflcatlons 1000
7/-1 '_ 3(') II To be ty"ped on p.;'rml t
ir C[md1i;J ~f/ilA)'
. ;. IAl-IuJte i(;ttPAA /YIA;./d 10M f-
Mfa Q<; sh(JJj . ---.)
,/ J."lePhon~..iLV?.:~.:?q,(ao - By kzh/..fv. '111 IJIIOr!Mtl/J/r!Oate(')Cfft1CUir.J,. N%f)
Ovectlons to slte t7k. /.h, ~__ >> ~ /<;( A?O L~( ~/'>'~
r:/U ~f ?'<p~ ?---.tfY4~... /</a<t) ~ ~T .
/~/ SIFOO Plans to CP&I ~ set(s) Date Hold Sl1p Date Date to
~ V I-,IPC set(s) Requlred to pee.. Completed pee
- /
IILCP&I
-=- --
C I ,WPC
C/ Plannlng
~-I Publ1C hror~s
- /' -
C/l,Elevatlon CI n/a
CI Address
~~/ Fac 11lt'. Perml t
/~I Envlronmental Health
a.1
05 flJ.
PA~O)~ /I~1AOP/h:1t44.,-r
al tank,
ft of dra1nfleld, max
FOR INFOPI~TION about progress of your appllcatlon call
, '
Permlt Control Center
687-HELP (687-4357)
bne county
, ,
-:J-jr;
;
HOLD
SLIP
APPLICATION #
LOCATION
....:!..,.a '
NAME
ADDRESS
,
,
I jf{,
-,
.c~ '''''/
, " /
zip CODE
I
The Lane County Water Pollutlon Control D1V1Slon cannot proceed wlth
processlng your appllcatlon because
1 D Incomplete appllcatlon (Hems deflclent)
r::J Address and/or dlrectlons to appllcatlon slte
c::J Proposed number of bedrooms In dwelllng,
t::]Approvable plot,plan (see~at,taGhment) ,
jj/11lSe -~!A 1.;1 - I.. ;; /[/ - .s. '
D Notlflcatlon of1ija~e testiholes wlll be ready ~
'0
(,7
Verlflcatlon of eXlstlng system requlred (memorandum
explalnlng thlS procedure attached)
2, 0
3 D
Two test holes (2'X4'X5' deep) requlred for expanslon
or repalr of eXlstlng sewage dlsposal system In the
area of the proposed dralnflelds
4, 0 Ojl:her
'D~d, 3~ '
/t,I}V,ldl ,
l v V \U,UI'
~ ~QIl>~ \\~l~~
-pP ~} h~; oJ ~ If) ~,~( ~ ~ '
-Z1 (0.(\# (jJ-~ (jV'- p~ ~~w
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1~~IJt,Jh\
.vt,.,..r,I,J V"
I?D/ B/ f
>>n.iJJ OA
ClMC( c/u
4' {)t401"',
-~,
I I J II
J ./1 Mol IlJllilohMd
SIGNATURE
75 t:eb /9 jD
DATE
't -X: 30 !YI -Ih /()X r.!J MI J
OFFICE HOURS vns:Ja!.f ~-v .f. ' CUo,P.,HQNEv".Mvt I~QP ~~1 ' a.,;
,dfvl c~l/aClutt: )11)';' () 1/111 S-h?,lt1;1 ;"'1/,,/ r1 /' ~}/'"..l /1..'" jl Gr.J,l):,;-';/, ~J1A". /'1 ~,y.J.
-;cJ;;a~ ,'/", If. If the necessary...correG-tlons1.g,r:e no~ma~l.th'lrl~0'/'YJ/r~ijays, .ttie/,
, me t'(.~app'flcat.'onfl~kl'l /oe'.<denl e&~ '.U~'€J'.' ..J /-- . MEc)_v. ~ ,'tJr!J'C1./1-ftIt&z'r"t'
V MJ-r31tJJo W#U VI 1'/lOclMhdd OOS f}.la~c.1..- I"'lffD
WATER POLLUTION CONTROL DIVISION I ENVIRONMENTAL MANAGEMENT DEPAR8TMENOTl
125 EAST 8th AVENUE I PUBLIC SERVICE BUILDING / EUGENE, OREGON 97401 6 7-4 6