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HomeMy WebLinkAboutADMIN 7/3/2008 1:11:06 PM Permit Building 15687 ! NO PERMI1 LL BE ISSUED UNTIL THIS APPLIG. PERMIT IF :2(; 07-7:) _ON HAS BEEN APPROVED CONSTRUCTION ~ME APPLICATION FOR \ c:J PLAN REV:(1W c:J CIUU,GC OF OCCUPANCY c:J c:J OWNER /l,.,U./ /l--;{;,het:<. / Name '~TOR /7//'A.IM ; IVUh-t Name .t;I6'O tl OS ReG II Address Cl.ty Zl.p Phone IA/tOo,,'/ .l/2cj'-<..~7.s $m;y~ S:/Ree?-'Y .5 fl1ZlA/<I..(; d/ 7 ~~I / /Zip Phone II l'wp ~nge D3 Sectwn I / sUb~~rT~ot 31<:, Block ~ l ACCESS TO PROPERTY (Road Name) ,.Jh.. .tr ~ Oil" jJ~./ V-<..-. EXl.stlng Structures on Property ~t7~~ . ~ Property Locat.=;7:' Address/DHections ~/.A./ N~ ;;';>1_?~ lO ?'o1 3.5 (:2&C9.:z~,i/C<:kJ~tJ/Z..~J.~.o Tax Lot Code Census Trac t Property Acreage Width______Depth r;// T ~If'_~ ~ ////J'eA "'" _^ / / / Below fo r Of f J.C e Us e OnlyXXXXXXXXXXXXxxxxxxxxxxX}J{XxxxxxxxxXXXXXXXXXXXXYvv~'VYVV~cxxxxxxxxxxxXXJrJQ(}QC\xxxxxxx:xxx:xxXXXXXXXXX1.. 2 I _~s Ft IIBedrooms Valuation <;, moO ~ J nap...r- ,TT <+ ..:J .J::;n -"?!t'",u' ' ~Vt;#U. ..e0 tj1/t?O/ , Bldg Was te Disp Plumbing Plan Revl.ew .:?r:J -- PLUMBING Installed bnJOwn r to=J Other PLUMBING FE !- ------- 10ft Fl {tures '/ ' New System Requl.red c:J SEWAGE DISPOSAL ,") , J L'1 7L.. Site Inspection II ""'.....,. ':"'JL..-~Existl.ng Sewage Dl.sposal System WATER SUPPLY./' Public C=:J Well ~ Spring Other Commun~ty C=:J Community or PubllC System FEES Name Sewage Connectlon Water Connection Mobile Home PlANS FURNISHED FACILITY PERMIT 1% Surcharge .~k C] 3)) . CJ,b... ~ c:J YES c:J~O" c:J YES c:J NO Signature of APPlican~~~~/7~~ ~~ Fee Received By pn natel_ q_? ?---r~ L)lJ -~t--... "-U~..::.J TOTAL Mln Septic Tank Capacity Required - Lineal Feet MaXl.ffiUm Depth ql / (.}-' , - ' , Type of Constructlon / ,,,ql ~J Ii"./ 'I / Fl.re Zone Use ClasSlficatl.on Bldg Setbacks - ell .. ' Front from Center of Road Right of Way Side Int ~ Slde Exter~ / IVI S' Zone III - M Ij PUe.- in.I"J ('..,Pw/f/" () -I /97- SANITATJ'fN~tI"'> DATE /ilBUILDING J f) /)/JDATE ~ / Vt.:tiM 'l-N-1r I!r~ kJ..>d:.{'AltI/{/),r)/1!J... /.. "},"; LANE COUNTY DEPARTMENT OF ENVIRONMENTAL ~;~G;E~T V! ~ '.- Rear IPA(;~~'3 )u,;h( V'" , , C55 II DATE