HomeMy WebLinkAboutPermit Building 1978-3-15
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LANE COUNTYPERMIT________~U A. ~
Acreage or Lot S17~ f? () /I I (). (-; Partitioning # #/q- ( ) Completed SUbdtv~3;.V-z( rf-<A f ~~
Contractor's 0 S # Lot A, "1 Blm:k----. ~ _ '
APPLICANT'S NAME AND ADDRES"',j,/Ct.:-7L IG ~C:-I-u~,./L -t: r16t./ 9\h,1~ LJ, _ Phonp~7'.f5'S-
OWNER'S NAME AND ADDRESc::~_....("jC -kil'J-~...-" Phon~ 7</"'1"b ;>-;:;>
CONTRACTOR'S NAME AND ADD'RES'" OV/?_71 /"1. ~'-,rt-~ -r--, Phon~
Mail permit to ( ) Applicant ( ) Owner ( ) Contractor (L).Prefer to pick up Call "14"/-IL.f.5 "') (owner, etc) when ready
STRUCTURES NOW ON THE PROPERTY /)11-1 ~dl ~
THIS PERMIT IS FOR .~lJ7kf A .......-Jv...."'... ....Y'A(~.? f /i/_~L
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) WATER SUPPL Y ~,()'-;{..-o.c '
THIS PROPERTY IS WITHIN ONE MILE OF THE CITY OF
SEWAGE DISPOSAL
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, # BEDROOM'" #PLUMBING CONNECTION~
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PLUMBING BY
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I hereby certify that the above statements are true and accurate, and that I have the following legal Interest m thr oroperty _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 th,s action I hereby agree to comply with all applicable Codes relating to this permit
Fee Pa;d" 5,~--;:; Slgnature>;K' <;J~~. Date _<1- /3-7/5
) NEW ADDRESS ( ) FACILITY PERMIT TO TRANSPORTATION DEPT ( ) SPECIAL PMT AREA MIN ELEVATION
SANITATION
Minimum Septic Tank Capacity (Gallons)
Dralnfleld ReqUired. Lmeal Feet
MaXimum Depth
BUILDING
_"5/L/ Type of Construction Group
ar /'~I'se Classification
~;mments ,./J:' - k ~
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~tre Zone
Comments
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By(2(~ ,k Q~ate '3-/5"'-/8'
PLANNING REQUIREMENTS SATISFIED By~~ v Date d-/V-/K" Date Issued 3-J5-7K
ZONE f~/h H' SETBACKS FRON!.. -- SIDE F~ING STREET -'(FR~ CIL) INT SIDE YARD-REAR-\.(FROM P/L~
~A~OUNTY DEPARTMENT OF ENVIRONMp~::ATLH:Ap::~~~~~T~~~: EB:~::~:G:~ ~,~~GENE, OREGON 97401 PHON~ 687-4394
-.....:::::: BLDG PERMiT - WHITE BUILDING -GREEN PLUMBING - CANARY SANITATION - GOLDENROD OFFICE COPY - WHITE \..........
By
Date ~I
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" 'T-R~,it" / [?-O,3 - (j-;z.;;
*ntt~ DJIectwns OVt-u
( ./1 Building Permit ( ) Site Feasibility Study for Septic Tank Number of sites
Acreage or Lot S,ZP 5? 0 >< / 0 u C---Test ~ be rea~ ' '-/ n ;/ / -::c:.
PartitIOning # ~ : ~~n~;~~te ,_-S-~~dl.VI~:O~~\~ ~ -j Illlun~ Lot 31 Block d-
APPLlCANT'SNAMEANDADDRESS ~t,N// c -.J"Fv'hLll 17("'cf f-I,.u-fJO{ ld-r.::>nfT:J. Phonp;/,V.7/-PJ'[
OWNER'S NAME AND ADDRESS, If different fr9m appllcant'< '7,q e,L /y 0 fON .. J Phonp ,'7 V? C:.J-? 2_
CONTRACTOR'S NAME AND ADDRESS ,L.t4"r/<, C' S/vA/lI- ~r Torll /)/uS~J Phonp
Mail permit or results of site feasibility study to ( ) Applicant ( ) Owner (x 1 Contractor
(11 Prefer to pick up Call (owner, etc ) when ready Contractors O. s. #./ b ~,{. <-'
STRUCTURES NOW ON THE PROPERTY hn~/L ~ y.- ....J", '" Ie
-y(:;ry; Job Location 2 6 2 z...-
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INFORMATION SHEET
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PROPOSED USE (this permit).
WA TER SUPPL Y ~n'tJf:' 0 }("L
,SEWAGE DISPOSA' S IJ $..
N.4
C/JUP/r
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t:::.;x,l'S ( ~/'..1'" b
;)c) elL.
H 'Rf.::.rlr("V"'mS
Waku- uS1-
(existing or proposed well, etc If public, name of system)
,(existing or proposed septic tank, etc 1 S I #
PLUMBING BY
Address
) PROPERTY IS WITHIN ONE MILE OF CITY I _)
***********iHH-*****************************OFFfCE USE ONLY BELOW THIS LINE ******************************'*******"1-*,****
( ) New Address Necessary ) Facility Permit Necessary
70NF SETBACKS Front Side FaCing Street
(FROM CENTERLINE OF ROAD)
) SpeCial Permit Area
Minimum Elevation
'Intertor Side Yard Rear,
(FROM PROPERTY LINES)
To Plannl ng/Bulldlng Inspector/San Itartan/Surveyor
ThiS applicant appears to have a problem with
Your assistance will be appreciated
By
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Permit Processing Section
Response
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By
DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
Permit Processing Section
125 East 8th Avenue
687 -4394
r)tVISlon
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JOB LOCATION
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.' LANE COUNTY PERMIT <:, ::A .' '/ / I.
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Acreage or Lot SI7aD /0 ~-' Partitioning # t , () Completed SubdivIsion -, "" ~
Contractor's 0 S # d~' k. ~, r'-/ Iy( T , ;..J:Lot -- I Bloc~ -'
/'10 To 'r (-1-.',/;7 -1 L / I'?-(/ fa, " if"" < . _
APPLICANT'S NAME AND ADDIREc;C; ("-.-' (...,... -..) I ,<- C ~ .
OWNER'S NAME AND ADDRESi'>.,tj- (' Ie.- '-J', '}..t.,/'.'/
CONTRACTOR'S NAME AND ADDR~"" '7')'c<" U -:. 7, L~l T /)" //"J .r:rrc--
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Mail permit to ( ) Applicant ( ) Owner ( ) Contractor (-'r~refer to pick up Call
STRUCTURES NOW ON THE PROPERTY _I) I if. c" ,.,. A (/?L' /2-
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THISPERMITISFOR:",' ,'^, J 1-.t/J _;(/J-_'u., _n-'C. # BEDROOM"
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WATER SUPPLY~-~"c..o IJ ~- SEWAGE DISPOSAL ~ r-
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PLUMBING By'.........
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Phone'-- J. L'I " .... ,,,./ -.....
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Phona
Phona
(owner, etc ) when ready
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"PLUMBING CONNECTION~
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THIS PROPERTY IS WITHIN ONE MI LE OF THE CITY OF
I hereby certify that the above statements are true and accurate, and that I have the following legal Interest In thp oroperty _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 th.s action I hereby agree to cOl1)ply >iVlth all applicable Codes relating to thiS permit
t::: ) ;) . ).IC' I ~ -:?~ 1.2,/1 :ir
Fee Paid ~ ~ ~ ,- L...... _ S,gnature'" 1.,..') ................ DatE' ... J. ....." I ()
) NEW ADDRESS ( ) FACILITY PERMIT TO TRANSPORTATION DEPT ,() SPECIAL PMT AREA MIN ELEVATION
SANITATION
MInimum Septic Tank Capacity (Gallons)
Dralnfleld ReqUired. Lmeal Feet
MaXimum Depth
BUILDING
~ "5 N Type of Construction Group
t1/~"'".of :'0" ;' US7.!Classlflcatlo~
Comments .4J-f-..-c-dZ ~
3
F Ire Zone
Comments
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By DMe
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PLANNING I3EQUIR~MENTS SATISFIED BV7'(.p'rvt./v "
~ONE :K:./1/lJ If SETBACKS FRONT -- SIDE FACING STREET
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By (d~--" / 11:;; Q.;;Gate 361.;2'-.:jrl!
Date <::::-/ I '1 '/ <l ' Date Issued ~~.' - ."
(FROM CIL) INT SIDE YARD REAR (FROM PIL)
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LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE, EUGENE, OREGON 97401
PHONE 6874394
C5513
POST THIS PERMIT ON MAIN BUll.DING AT SITE
SLOG PERMIT -WHITE BUILDING - GREEN PLUMBING - CANARY SANITATION - GOLDENROD OFFICE COPY - WHITE
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SITE INSPECTION /
ApPROVED ~ DISAPPROVED
Cl
DATE.3 - /0 -7%
INSPECTO~Y- ,/
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REMARKS
FOUNDATION INSPECTION
ApPROVED L-/
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REMARKS
DISAPPROVED ~/
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DATE
INSPECTOR
,
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FRAMING INSPECTION
ApPROVED (/:'1~APPROVED / /
DATE t/- j-7~ INSPECTORQA/_
/
REMARKS
LATH OR SHEETROCK INSPECTION
ApPROVED ~/ DISAPPROVED ~/ DATE
INSPECTOR
REMARKS
u~
/7 DATE fI- 5- '71 INSPECTOR ~,~
ApPROVED
REMARKS
CERTIFICATE OF OCCUPANCY
READY TO ISSUE / / NOT READY TO ISSUE / / DATE
INSPECTOR
REMARKS
.
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