Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
Permit Building 1975-5-18
Wi;j ~ I.e. ;. r .' /17# d0'1-'7S' " LANE COUNTY BUILDING Q;X BUILDING PERMIT OR MOBILE HOME USE PERMIT MH 0 PERMIT NO, MAILING ADDRESS 2248 SHADY LANE: SPRINGrlELD OREGON MAILING ADDRESS MH ::>~l..7" PHONE .... .,. PROPERTY OWNER EUG[tlE HI~<<'LE:1l CONTRACTOR ' ., PHONE SAME PROPERTY LOCATION - INCLUDE POST OFFICE 2ND STREET SOUTH TO HARBOR DRIVE -'!51I!i'- HARBOR ORlVE:-: (? PROPERTY LEGAL DESCRIPTION - METES, BOUNDS FILBERT GROVE: LOT 2 TWP RANGE BLOCK ~ SECTION TAX LOT NO. c:;'iODE :1-.3.:2 :# /~ EXISTING STRUCTURES ON PROPERTY CARPORT' UTILITY CENSUS TRACT 35-400 18 3 APPl. NAME \11 NKLE:R SHEO & SAME: LEGAL ACCESS TO PROPERTY HARBOR DR. PROPERTY SIZE - FT. MAILING ADDRESS, FOR MOBILE HOME PERMITS ONLY No. of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT WIDTH DEPTH AREA Connect to. Existing Sewage System D TYPE CONSTRUCTION SQ. FT. += 8DRMS New System 0 VALUATION PERMIT TO PARK MOBILE HOME LANE COUNTY SPECIAL PERMIT AREA: SEWAGE DISPOSAL PLUMBING INSTALLED BY PUBLIC 0 BUILDING WASTE DISPOSAL PLUMBING PLAN REVIEW PARK TRAilER l%SURCHARGE SEPTIC TANK 0 OTHERD . FEES OWNER 0 OTHER: NAME WATER SUPPLY PUBLIC 0 o OTHER ~.oo TOTAL $ ,0.00 - _04 ,4,011, COUNTY BUILDING & SANITATION SPECIFICATIONS DRAIN FiElD REQUIRED MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GAl. EXISTS . lIN. FT TRENCH WIDTH FT. OR SQ. FT. PLACE MOBILE HOME AS PER PLOT PLAN: TYPE OF STRUCTURE OCCUPANCY ZONE PUBLIC UTIl. EASEMENT -MH I BLDG. SETBACKS __ FT. FROM CTR. OF ROAD RIGHT OF WAY USE CLASSIFICATION FRONT 4')' SIDE INT. '51 SIDE.EXT. AUTHORIZED SIGNATURE - DATE REAR 10' PUE DATE /S/ J. E. B095 BY C. HARBAUGH ':-SNJ/75 'r DLM BLDG. PERMIT - WHITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUilDING - GREEN SANITATION - GOLDENROD ....... IMPORTANT: Call 687-4065 to schedule all required inspections. All construc- tion shall comply with Uniform Building Code, D.E.Q, standards for subsurface sewage disposal' and county regulations covering plumbing. All buildings require a certificate of occupancy before being occupied. (See' Details on Reverse Side) ~ CO"M" C55 - IJ (POST THIS PERMIT ON MAIN BLDG. AT SITE) LANE COUNTY, DEPT. OF ENVIRONMENTAL MANAGEMENT CO~RTHOUSE ANNEX, 135 EAST 6th, EUGENE, OREGON 97401 '. AA" .20.1/'75 . IV/IV .V" PLOT PLAN . <, LANE COUNTY ENVIRONMENTAL MANAGEMENT Name aad Address of Owner Telephone: .The building being,constructed under this permit will be used for Date this property was p~rchased Do' you now, .or did you ever own property adjacent to this tax lot? If so, please list those tax lot numbers or draw those properties on the plot plan below, Indicate on your drawing the location of all homes (including mobile homes) now on the property, as well as the location of the new buildin~. o ~. ..~. .. . .'. u , u .. ~~.=:.::.::~~ ,::;/(,J./'d:;u ,f;),;;:--" .0- 1::> 'I.", r:::~' , n ~j ~ ~ : IU r ~ 1= =: u= ~ ~:~ ~~~',~ == :, = = n= ~ ~ ~ ~ = ~1'= ,= =: ~.. ,. - - - - --- '. _L",,,,;;:;;;,.. I ....-. -, -,-,'.. ,. -4Y'j.f' 9(1,'" ,u::: :. . n, _n_ d,,- - - ., __ _._ .... . __ .. .\ - .. ... ,_ - ___._ .u." _. . _ _ _ _._ _ _ - __ - - - - ____ ____ _.1_, UIIF:;Oltlr11Y' ..,.-,., --,.- :NVIR J[ I]Iff~' -AL ~I~ M~,~::" n.~, .... =. ;~. ?='? '~9:~~ ~...~: ;'..' '. _ ._.._ __ _~. ... ,_ .U _ _., __. '.' _~ ~. ._ .. ._ .._, _ _., ._. u._ _ ~ _ __. "'n ~. "' _ _, .", --- .- , ....., . ~. ._ _ i_. , . ---------------- n__._'_" _ _ _.__ , m u ,/-"," " k,. 1/ C;: . :- - I ' {. " " -.. - u _ m_ u , I . ~.: .' //~ ;;~ .~! = I .. .. , ...r....,.. .f.;... ,- ~':l ..~ ..1. .. .... '=1=-:-:: ':"[-Cl. ." , ',./ - f--- - -- - -, I- . - , " . I';; ..r? ,7 --~~~.::~:...::_:..=:..=:..:_:.::~.::~~/~~{:[=- .. .. - , - .', ~- , t'..: , ",.'-' .r..' . . ,'.. ...:......:....------. . - ~ :,.-.- i , ~i~___ __~==~=_ c~_________ ,',li" ~~'f" 1 j H~ li~ ,J.<z.t'/ ,... . r ri I. - It 11. ~ ~ tt ~ -" ~ ~ / - - - - . B ,': ~ ~ ~ ~ ~ ~ :, D :; /' ' ." - ~ -::,: '; ~ ~ ~ : -= .. y .,--If, -,. , ", _ . ,..'........ \ /---t~"'-'" -. ,... .. - ~ J~ "f Y J "~: -1 j; -: .. :-~ _.n - ", - I - -,- - - (-- ";;' 7-- - ~ ~ ~ - ~ -- -- f:". .... .. \;..... /t.4--;7- - ..-.. - ----~~.:~--~~~~--- ----- .::, ':. uXi.;';; .':''':,. ",' :,'-/~I..7.5.. ..-iT'.l.~/L;I< .)1 .,..?"-:. .. I,. ,.~' .",,,,, .' '....c... ' . ~~~ .. , \C:\A/; l~q;7' a '1'- :,:J, J' -Z ;- - --,-,..,-y-...,~I-.,...-',..,..,'.,' ",C ,n. u,I,", -,--," .',n U.'. , Applicant (if different from owner): ~' ---,-------:~, - - - - - - -1":"- - -_ .:.~:.r;LUr'1! I:. .r:. <5;:;~~i::.. ". .-' "/1:7 +'r; .,. ,., u. ... U' E.. ( . -1- - - - - - - - - - - - _. -- nilE ~,)\lf 11 Y . i{ I\i I~ QJ ~ p if N ri L. .U< I~ T, ... "...~ , r ' ... " ...... , , -I; '. i " ~: . ~, ~> .. ~ i.:. _~-~--~[~m~~--~.- -1-1-- Name ,of Address Telephone Map Tax Lot Permit II Applicant's Interest: Buy.er D Seller 0 Agent D M74-99 \ .",' '. . ,; . d 7 .. rsr-~ -::. =: ,-,'" , , ~ \ \ \ 'I. \ ,,\i Cl -~~ ~, ,--' \ ~-'-'-- 11.," - -::-~_----r;--G ->..---- ~ ) r r -~ \ J I ,~ l ,;, ~"-. "'" \ -. ~ . ',,', ".~.._".. I em , T II U::n:3JQMO:> 3'8;>'(r~~",,'.~,~:~ ' , ' , n . ~ ;.<>T 03U2ll :r!~Ai!3~ "<.,Jt~~ jl1~ <jch)\.'Gu :16: ilSrrA n'1-':J:.1l!S,,",' . ~..,;,.; \ -':1;;~:' ".rr;~J!~ ..dmun linnoq Qnibliu8 -L...:. -"-' , , .' ~;:",,"""'.mul>1 '\1.':,. . .n6t!~,. J .~nq2. (\ r (.08'f.O ~cL . ~_ :, -:-'::. " '~~;Jl 10J ,."'ob!'. y!'oqo,~,-". ".. "',,,bho pnd.oM" '11f.\; '0 '011 0 "V :In..;'.,08 _.rit08, ~'moo,b.a ~'Iinu ~ni,iJ ,,,.dm~" iDioT _" ";~l:!j m'l'y, ytinuin;"o:> '-m",y, .I~~bivi'bnf" 'm.I'x' ',ildu9 :~d ~Iqqu, "loW .I?,'\.; iln.mt,gqmo, 10 ,0,11 "loil.toM ,t.~9 ' lI.w r.-,o,l'"nol,iO :.nol ,ilq.2 ,_ p.:; , - rijbi~ .bi,nl ,t,I,'t'l ,.',' ril~n.1 '~i,nlb 'bl~Q 'J "I "\'~Yli,oqo~ biUPil'IOI~GT' ' f~~; n1q, IUpl .1' _19hmol. f:';:'::~ ,.ritO 0011, ~ ":O~xod\:"ijudillliO :bl;il io,oq,ib .liT ' .If" .tt ~. -J-'u.. .~. .:-t.:..b. '~nil lbos r1tQn~J. ~~ ,t!" ,~,,\ ~le;,.llofoT .fl "c: . rb~!ni~o nttiW ',t! ',.'.\ ,,",'L.': , 'Qolool OlOUp' 1010 r- .1t. ~~:. . 6nil n9,w1~d.95no1li(]' '"r1tO r;:-...J.: 19~DIC) : IO!\9fom. ,~t,1ii l~~ 9q'(T .z9tbni "-\ 'llif 1!)YO loil:ittom ,',tlii ,lo rhq-:.q .... , ._~.,' <.t-:O.I~Jl,jIO YJRl~TR~~HAJ'IO~1 oniUllB \~ " '~'-~~"'~~~ "~""":..:'~":91UIO."~i~_ _~~~ _~ ';,\' \ --i\ :\C\&-,.Ioi' -':.... ~ . .. .. " ',. " . . , " "':', , .. : ;" '----~-i.Y-u10 I-1AIR ,W1A2 90,3W. R09 , "',.:',' ';, 0 b;o~qq~~i;la""O 'pi b.vo,q,qo 91o.h..ril ,i bno ,'(li'Ohohito, "noi'(;~;;, .. Jt~"li~~biliw' ~I!n"~qqo m.l,x2 ' ',~- , , ,,,h,,';'.R -.t.;-;;.:., ..,it,l,... ' , ~y..~~ ..:~ r~ . ~:'~"\~,~~_~ '. . --- ~:~~~~ :,' lI" ".:" ';'0;;"1"':" ;:;,t ~-,;;: ~':f;,:.~""e;;:'}:'f"..\;,,}t0?~ Oq . '. -,," -, ~"'lo'~' '",r. '," ..,'{~~.;y-.1i\"iYot"'-l<"~~s(r'-h~c"j,J '" --~~.~~., .':. ~~,',;",";:;J.~,: ,-',,"-< '. ;.j,.'.r.~ ';. --;~, ,,))~:v..,,_.u.'i.!...~,: ~ .~ ~, :~-~~:'~;i~v-t~". ,~,('-';~'j.i\: .,:....~. ,""'~~,(,.. ~r"/ "'":' :",~'- ...... \.';'-'!'t''Rl.r;~':;;lw::~~~}:...t:'.t:#;;~rr!'-'.o:H;..7 ......... - '..t:..Z:t.:... .._" w:<J-; '~..."*i"i',~ . _ . " ,.' - , : . ~ ' O()-'ao~ , "'lmDn l'utllDflnl ;-:., "~\i?,,:;l j15dfi] ['>::'019. ..~ d~' . /'>1: "'I I . a d H to - :r" .-.1- I::3V 1 10 "i5. ~*;~ ~:.. -- 'r~' ~'_., .... r~7'~'::,":' ;,11 ~'::7' -,.,' , ".J '" "'. .:-- ','~' :~~:nt !)'~no1liO ----~'7"II.W 1i"D,H ,0;;: .bi2 n' ,Ino;~ :onil,loJ ~ ---':noifDb~~o.1 IDj,~!Dm~ ~!)tlit '.to rttG~Q. " . :10.1' " " ',to.I" ." C\ [] 'D'~ ,1001 . .Iit 'ril~.n.d ~ ..l,rI~i, ~\ { .'1 ',:, ./., ,.,,' ' . '.' ~ ."::\ r . - . '.-" ~ .. . .;...<, " -. 'I ~ '~. " 'r, '- 'I 'I~ _._- ... <~. :;~,;5/i~ ~~..;' ~ ~ " 1,~fl/'i"'''';I,'' ',., ~~\..r~ s:n~ " r " , . -t,'''}''" .~ .~~,:'~ :. \+ ., f;~:~:~ ~; <:0..... < :' . . . : " " L. '. . ~ I I {Ii '.91 , , J '~'. ~ ,', '- " '1., J.. " '. , ,,~".\ ;'JI , "- '. ' ." . -~.-.,.. .. . GJ"': ":,,,'7:--- rJ ""'. .... ~.~ ..~' -t.:':-;. J.. ",.'".. -1,<....1"./.:,., , .. ",....,.-;(. '~. ' '( ',' ", , , '. "':.';; :.~ ., .' ~. " , ,.' .('- ,,' .- ~:). , "" '-"'1' ..... ',.' ~~ " '" ., '. ,/'. ,~ . ~: ' , T~lMUAqJ.O HTJAlH y~~ l~,J ',' ..~~...::t....!-...t'~...(~~~-C'. ."RAT,.." . ~'" ;.. '.",';:' \ .~~, \-," '"... , , -'l-.r / '.' .;.:.... 'J' ." " .' ~ ,; '0 .~-' 0,',-:>;'" ~;" ~,ll1l ~.;"',._- -,' ,.....-i c ,!tHr, . ! 0 o;:~,{lft;;.)~,f';\ :.\,jl ~ 0 .. 1 ;~ C .,. ,.- ~."., ~.~;J.t;.s.:!:f~..:.~'.~$',;I~-'lt,;""- '- 'rr ~":'"'~'b;;"~~,-(!,.~~.~ J -c, ""p . ~." ._. J.. -....,:'1' _ ______.......... ./_.... o .Jl '''''"'it. '-, 'I Uk . '''' ,I' ,I ','. I ": (ui~if)u-dl~i ~,ltH~n)l( .... c J,: .. f. ! '~'f ~.. . ~ ! '~.. '" 1\ \: \" ~ ~ '. .' , . \'~':\..:;.r ,';00 p;" ._1 .' f~>~ .l r., ",1 ,1; 0) t, ..' t :. k,. I''';'' L:~\; I' "." 7- ;~~~ >, r. I.....; ;;':;W ',' "'I" . ~ (':-,,,.0 , I;};~,;~ 'j, H".,., I.L . ,I : :"'t,':,:,',~ .1... !oj ," ~"-t:; i~,,:.l :'_ j,::'" . . j':'3. ~.. F,,;;' , _'L':;:\:' ~, ." . .;',.';;,;: t~. .. . ~ ~~':.. ':j',~;,;H , - . '~ '1':,.'<1 ,I, .,' /::.;::?-' (~::;: -: ~ ~~;../ .r...-;Io' ,,' . p~~7: ~' '~~.. " . '". .- ~" .:..~.... ------:;-'" .......... . . ,err BU U./;lING: SITE EVALUATION () BUILDING PERMIT APPLICATION NO..44# ,;:lc:.v- 7.r () SITE INSPECTION PLANNING DIVISION Not Appl i cab Ie 1. Zoning Ordinance Compliance: Zone~/MII{) 2. Subd i vis i on 0 rd i nance Compli ance / ( ) 3. Requ i red Access ( ) 4. Building Site (Area, Width, Frontage) () 5. Other (see comments) ( ) COMMENTS: T tC:Z: R C)SS 02- SUBOIVISION: LOT: TAX LOT- APPLI CANT DATE BLOCK: Wi V\tl-e~ No Y"s T) T J 6. ( ) (P- () ( ) ( ) (I~ ) ( ) ( ) CK'D BY: Setbacks from ell of road: Front Y ~ Side Exterior Setbacks from interior Side Rear 1 ines: '?'" /C /'vLT PLANNING DIVISION ACTION PENDING: YESl ) NOl ) APPLICATION# BUILDING INSPECTION DIVISION Not Appl icable ( ) ( ) ( ) ( ) 7. Plans Submitted 8. Soil Stability (footings) 9. Flood Plain 10. Other (see comments) COMMENTS: ,. WATER POLUTION CONTROL Not AppfiQable ~y) t(~ 11. Meets Department of Quality Standards. 12. Other (see comments) Environmental COMMENTS: 3f)S lEA":" j, r)~ ,( ) () , ( )( ) ~. ,f ./ ( ) ( ) CK'D BY: V I'h~~-Ud.--?.j'16.?t (DATE No Yes T)Tl' ( ) ( ) CK'D By~7W~ OATE TO APPLI CANT: Yo~r Building / Site Inspection: ~ Can be approved. _ , ( ) Cannot be approved at this time as indicated on item NO. above. Questions and further information on items I through 6 contact the LANE- , COUNTY PLANNING DIVISION. Questions and further information on items 7 through 12 contact the LANE COUNTY BUILDING ANO SANITATION DIVISION. ( ) Will be held in this office until you can resolve the problems indicated. ( ) Is being returned. ( ) Your building .permit appl ica!_[~.'lJe~s beincL~~t\l.m.!l.d-'!.nde. seoa.ate c'1"e., DEPARTMENT OF ENVIRONMENTAL ~NAut~tNI 135 Sixth Avenue East Eugene Oregon 97401 PHONE: 687-4065 LANE COUNTY PLANNING DIVISION PHONE: 687-4186 /-/10"16 \J Sr? c55-28 i I , SITE INSPECTION ApPROVED Cl Ol5APPROVEO / / DATE REMARKS FOUNDATION ~INSPECTION ApPROVED 1----/ DISAPPROVED / / DATE REMARKS FRAMING INSPECTION ApPROVED /~ DISAPPROVED / 1 DATE REMARKS LATH OR SHEETROCK INSPECTION ApPROVED 1----1 DISAPPROVED ~ DATE REMARKS , FINAL INSPECTION ApPROVED ~ DISAPPROVE~ / / DATE REMARK 5 CERTIFICATE OF OCCUPANCY READY TO ISSUE ;---? NOT READY TO ISSUE ~ DATE REMARKS . INSPECTOR INSPECTOR INSPECTOR rNSPECTOR INSPECTOR INSPECTOR . /'11-/, 26'1-7S If/~dr /611'1 11f~/).~/f., ~ . . " . . , 'I !' .' USE PERMIT PERMIT NO. f ~ -1 " .,'... '.;-: PHONE '..' , .. . LANE COUNTY BUILDING [J]:U BUILDING PERMIT OR MH 0 MAILING ADDRESS ;';..J!i, : tli(';'; LMiJ MAILING ADDRESS I \..,./ MOBILE HOME , PROPERTY OWNER i: UO:.;. r U n~tu..~~n CONTRACTOR Jpr;I0011C:l.O C:::,-C.~ PHONE [,,.:~.j: PROPERTY lOCATION -INCLUDE POST q~F,ICE~ r'~~J ~?ni:l~7 f:~~\ln VQ nA\~~C:~ t;~HVC PROPERTY LEGAL DESCRIPTION - METES, BOUNDS C lU;"::, G,.~;lL :.1;;1 2 C~OCtt i TWP RANGE SECTION 1}tit.~ {_~t:(:'-:o.~~ ;~t\i';: ~ TAX LOT NO. CODE CENSUS TRACT ,:... t-'n.'. ,',':r~~\)V' "I '" 3 " r: & r:l~~ EXISTING STRUCTURES ON PROPERTY r.c,{;PO;IV liY e" !"'I ,;.;;:D LEGAL ACCESS TO PROPERTY !iAr.C9..l (l:l. PROPERTY SIZE - FT. APPL. NAME :;'C~I.::rCt MAILING ADDRESS FOR MOBILE HOME PERMITS. ONLY No. of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT Pc ::J~ 1 \"0 flA~":::' ~:C~JU..r: t~C;':!:: WIDTH DEPTH AREA Connect to Existing Sewage System 0 TYPE CONSTRUCTION SQ. FT_ :t: BDRM5 New System 0 VALUATION i_: ,:et::;':V' 1\.' DtiL ~~'lr.;nT frU':A: SEWAGE DISPOSAL fEES PLUMBING INSTALLED BY OWNER 0 OTHER: NAME WATER SUPPLY PUBLIC D BUILDING WASTE DISPOSAL PLUMBING PLAN REVIEW PARK TRAILER SEPTIC TANK D $ OTHERD PUBLIC 0 o OTHER l}.G:"l TOTAL $ '~G..~" .vt1 '.l;.fl1~ COUNTY BUILDING & SANITATION SPECIFICATIONS DRAIN FIElD REQUIRED 'f.".- :;~ i ;~i MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GAl. ~'1C!\1J lIN. FT TRENCH WIDTH FT, OR SQ. FT, :','.f'.\:.:; ~,~~u n.c ,~~.;!: A.D PttQ ClLO'l7 ~bt\:a TYPE OF STRUCTURE [,'J BlDG. SETBACKS __ FT. 1'~)-1 fRONT. OCCUPANCY o ZONE PUBLIC UTll. EASEMENT fROM CTR. OF ROAD RIGHT Of WAY SIDE INT. ~). SIDE EXT. AUTHORIZED SIGNATURE - DATE USE CLASSIFICATION REAR IQ'PUJ: DATE .- ' hI J. c. r 1(;'1') D'i' CO (l/ltlllAUC:l ..ofvO l<;;:l :.J I J,I "\ ~. ,/,-..W BLDG, PERMIT - WH ITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUIlDING - GREEN SAN IT A TION - GOLDENROD IMPORTANT: Call 687-4065 to schedule all required inspections, All construe. tion shall comply with Uniform Building Code, D.E.Q. standards for subsurface sewage disposal ~:md county regulations covering plumbing, All buildings require a certificate of occupancy before being occupied. - \ (See Details on Reverse Side) \ \ \ FORM =C.55-13 (POST THIS PERMIT ON MAIN BLDG. AT SITE) LANE COUNTY, DEPT. OF ENVIRONMENTAL MANAGEMENT COURTHOUSE ANNEX, 135 EAST 6th, EUGENE, OREGON 97401 SLAB FLOOR . PLUMBING:GROUNoWORK , ApPROVED / -; DISAPPROVED ~ DATE 'REMARKS GAS PIPING GROUNDWORK ApPROVED /. /, 01 SAPPROVEO ~ DATE REMARKS .' ROUGH PLUMB I NG ' ApPROVED / . / DISAPPROVED ~ DATE REMARKS '-. ROUGH GAS PI PI NG'. ApPROVED ~'DISAPPROVED ~ DATE .,';. REMARKS FINAL PLUMB lNG' . INSPECTOR INSPECTOR INSPECTOR INSPECTOR ApPROVED IX / DI SAPPROVED / / DATEfl.- J ,;/-,;:; I NSPECTO, ~/-;../ r-yci ' REMARKS FINAL GAS PIPING ApPROVED ~ DISAPPROVED /. / DATE REMARKS CERTIFICATE OF OCCUPANCY ,READY TO ISSUE' / - I. NOT ~EAOY TO .ISSUE / . / DATE REMARKS INSPECTOR. INSPECTOR ~. . ,~ , '.." . /7} H c51b'f--:7S PERMiT!" BEEN APPROVED \:; , . NOTE; NO PERMI~'WILL BE ISSUED UNTIL THIS 'APPLICATION HAS , .,' ~ CONSTRUCTION 0 ,:.'. MOBILE HOME "~ -. , PLAN REVIEW ~-. .qIANGE"OF.?CCV~A!!CJ '.~ ,~~~ A )MbA/t?r\: I.J'-"T~~' '7". r~nh~~>,( '17';'7 ?- -- 4 -Name . ~ Address ". /J City (". . Zip. Phone I In.~~R ff)l}J l-to ~~Lj~dd:~act;r ~lity~.' ~iP' APPLICATION FOR: J.-' Phone O,S:REG, II Twp. / {f Tax Lo t -. 'Code- Census Trac3.yL!W Section eX. 'Subd~'vi~ion J.-f ;,~o,{ ". ~ " Block. 3 ... Property Acreage Width_Depth ACCESS T,O PROPERTY' (Road ame)~I::I-o/i,'~ . LJII ' ". < .'. " EXistingStruct~res on Property: i. () Jri /J L'lM ~~(.ct/Lf -hi ~ ~ . prop~~i:Y"Locati'on ~ Address/Pirec:~ons:'. ~/7~~. ~1ZL) ~ -.HOA t5-u1----lJ?.. . . ' /5- '-/'-1 ','~r?J"l/ .~. . . :3 ";,. /: / Below fa r Of f ic e Use OnI vxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx:xxxxxx.xxxXXXXXXxv"""~~~r"'~ . ,Sq. Ft. " #Bedrooms. . , ./uation -- l'IfJ:flAi') I77~N. . ~ ~ '~fi"''''':''';' ".,.,. ..~ .~~\!;I~A/ .'. 4H1lI1\n~ tUU~nrg;PiFt:AOW,~i{' , ~.nJ' It ..of Fixtur'es' Public , SEWAGE DISPOSAL: ~$ite'Jnspection # WATER, S;WPLY': .We~l .:-__< Existing Sewage Disposal System -'Spring' Oth~r COIlullunity CJ c=J, ~ame Public Sys FEES: PLUMBING: lnst",d.led, by Owner:, 904;r , ' , . Name Bldg. < . Wa'ste ,Dis"p." . " .- Plumbing"' ': ,_ Plan Revie~ ~1!JMBING FEES: . .' Sewage Conne~t;Lon '!L Wa ter . ":~o~nection ~ ,'f.' . , ',~ n. ~ ~;I'>'r"CAs~r -:.2/1'/-----/ -j .' . _'J "7.' [J'7 ~. CHECK . '. -' ',' \ Septic Tank Capacity $kl<570' ,', Dra' PLr~ ~.~f,. A~~a . .. "FACILITY .PERMIT Mobile H6me. 1% Surcharge, " , TOTAL Min. d Required - Lineal Feet O~l/P,} ~r:' Ma:~iinum D'epth Type of cons'tru~tion~~roup: I Fire Zone: Use Classification Bldg Setbacks' Front /~ from Senter ot Road Right'of Way': Side Int. ~ Side'Exterior Rear ;..- C/ ft,l5' . Zone IR?1/I'V1/r / ~ PIi~~ ~7Z. C55 ~, 2 , DATE: -7) 7;/?r , , . 'LANE COuNTY .DEPARTMENT .OF ,SANITATION: DATE: . fC~t?L/;::/r~fJ6- MkNA6EMENT (, , ,. . .. ' . .' ENVIRONMENTAL