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Home My WebLink AboutPermit Building 1977-8-5 ,. "TRS TI ..J /, .' ~ \'c) 2' _'? '7'.::1' 3~ cJ() . J;r- ). /')', / ;J 1/ JOB LOCATION , -;. - ...... ,\ f7~8./-!/ -~ '<I.'-'J~ ..,,/ 11'1 l-cr-7-"~-l;;;S';P?/tf'~ ,~: PERMIT # /....... ,'/. J .j' 7 I .' LANE COUNTY PERMIT --~ Acreage or Lot Si7P :. <" ~ 'It /. ( , Contractor's O.S. # ' /-, I'Ll ",.- I ;- J / ,'-:", APPLICANT'S NAME AND ADDRF"C:";< ,'.,,}- r "r-"'}~"l ' ,./;',.~, " ',.I, ': OWNER'SNAMEANDADDR""" .....':' ',T:" j :', -,.,..} - ./.".1 /'" . ,. CONTRACTOR'S NAME AND ADDR"""..... /,', -"i.' /"'7',J;.:r,','>-: 'J?-"' .,.. Mail permit to (l..kAPPlicant ( ) Owner'" (..') Co~tractor:( r r Prefer to pick up. Call Partitioning # I Completed Subdivision I , Lot : - ~": ,1/' I :' ,1 . Block. 1,- .,' ,.~ t:....-:-/ '''') I I ! .':t -''t.r - .- Phone ./.' /. / f ) ~ Phonp :: Phone (owner, etc.1 when ready. , IHIS PERMIT IS FOR . . ".' f'" WATER SUPPLY__,:..> } . ;1 1 ....) . 1.-' I ; , ;/ o . ." , .- If -, , /L-:J f _ --'-, f-z! ' I /, tr: /" , f;:::-;/i ,/ # ~D-R-;OMC: '/ . ~. SEWAGE DISPOSAl " " . , / / . PLUMBING BY # PLUMB I NG CONNECTIONS-.... ) STRUCTURES NOW ON THE PROPERTY .,/ '(}/.l' .'- J,; " " rOt... /' .:t_, f' "HIS PROPERTY ISWITHIN ONE MILE OF THE CITY OF, S.1. # , I hereby certify that the above statements are true and accurate, and that I have the following legal interest in the property: _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,.fvvare and approves of this action. I hereby agree to comply with all applicable Codes relating to this permit. Fee Paid $ 2/ 9 C.( ..:J.;:;8L/) Signature " \. Dw ( ,) NEW ADDRESS ( ) FACILITY PERMIT TO TRANSPORTATION DEPT. ) SPECIAL PMT. AREA. MIN. ELEVATION: c SANITATION Minimum Septic Tank Capacity (Gallons) Drainfield Required, Lineal Feet Maximum Depth BUILDING 1':"". ,iType of Construction "i-r,roup , ,~ , llse Classification i'.( ~, .' + 1'.'7 Comments: Fire Zone . 1 Comments: ...,;,.:..,7 Ii' ,,~ /~ , t , rt. ,t' r .,' ( I , . . ('_-t./ . ,. ... .... ... i . \... ." -..;-' By: '. 51 /.' -",-,'" .', /~. ".. J-/f ;-/Date: ,..-' , . 77 By: <1=- PLANN ING REQUI REMENTS SATISFI ED. Bv: , r .. .. ..,t Date: "7. -;1,/.- > ".., Date Issued: y _ J I ,., ~: , ,-' . ,..1..SETBACKS: FRONT. '7,ft 'SIDE FA'CING STREET (F'ROM CLL) If-n'-SIDE YARD ,- 'REAR: I(FROM Pill LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE., EUGENE, OREGON 971011!a.''7"H.bNE: 687-4394 , Date: POST THIS PERMIT ON MAIN BUILDING AT SITE C55,13 BLDG. PERMIT - WHITE;.BUILDING - GREEN; PLUMBING - CANARY; SANITATION - GOLDENROD; OFFICE COPY - WHITE !} .- \ ~ ~ i I J I ~. I .,:ffi ~ ~. 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',;'~':'~~:~ ~>";' 11t;;i'~:~;:----'------ 1{'1!'- '0'. ,~,j'..,-"., l..;"i.,';~ ';':;;,I"J'';1S :sr~, ~Ff6 -, ' ;,fJh;'f.; ~-' ~~~nr~:' ,~~ ~' 0\ I 0 : \ - . I i 01 ~ \J i Q / c., i J t I J K" ....-.------ ,rT ! , ." , i , S I i i i. L J. 'I"~ c- ~ \ \"", :, .../ i ai _1 J .AIJ t." -, I , " i \ , I ....1 .1 ! i : ~ I ' ~ 1 '1;'. l ,'v.' i .' ~.~ ../\/; ~ Q\ , - . G -: 'II ",;-; ,'-1 I , ~i LJ - }; .. i fV ~~ 1 h I ~ 1/" ~,~ ~ \f -"Q--"' \ / --.. -- ----. ~/ F I ! , , I I , - -.----..,-.'-.. . i(,.. .. \ '1"'// . "0 ; "" \1_-,-_ _.. . '/1 " \ ( I I I I" ill' .il~ I I J i I I . I,.,.... ~--]~ :".... , ----' .jt'j '\..._~ I , , i ..>! i !j>:""" " ,/ j~-- \ r~"'- -<iC , \ \ ! i I I I i I J , / ~ "'" ! " !c) J' \ -~\ \, '; Jr I, \/ ......(.01/ ,"/\ / . , . /. }:~ 1-( ., 55f' (I} c),/:' } -/ , I ~' . ~)-J i! I "tiV i I ') ,,(tl (, 1/'-;:/ ., ' ~ "lie: , ;11','" .'. REFUND o F FEE THE LANE COUNTY DEPARTMENT Of' ENVIRONMENTAl. MGT. I HAVING REQUESTEO RUUNO Of' f'EE TO:- Of' NAME ADDRESS ApPLICATION f'OR BUILDING PERMIT DENIED, AND NO APPEAL Of' SUCH DENIAL HAVING BEEN MADE. ApPLICATION f'OR BUILDING PERMIT CANCELED. APPLICATION f'OR BUILDING PERMIT, OVERPAYMENT. ZONING PETITION. APPLICATION f'OR RESTAURANT LICENSE. ApPLICATION-f'OR CERTIf'ICATE Of' SANITATION. APPLICATION f'OR PRELIMINARY SITE INS~ECTION. FOR THE f'OLLOWING REASON: AND THE APPLICANT DESIRING THAT THE f'EE BE REf'UNDED, THE DlftECT-R ~f' FINANCE AND AUDITING IS REQUESTED TO REf'UND THE AMOUNT Of' $ , (UNDER ArPL,CATION NUMBER IN THE CASE Of' APPLICATION f'OR BUILDING PERMIT), WHICH IS THE f'EE CHARGED. DATE - ", " 55-029-12 TRS,TI ri" ~- y . .Iecti. Wr~tten DlI ons Job Location ~ /8ffbA~fLw,J !f:'i- 7 7 INFORMATION SHEET ) Building Permit ) Site Feasibility Study for Septic Tank. Number of sites Acreage or Lot Size Test holes will be ready Partitioning # ( ) Completed Subdivision / S r .4 ,Jh I;: t r(.,,_ of' ~.".... ( ) Pending h '\ APPLlCANT'SNAMEANDADDRESS r/,o"rI<'" C S/(NM,r /76Y 41?t!uy UIl, OWNER'S NAME AND ADDRESS, if different fyom applicant's c:~~_ 7A //..*, "f?VJ- Jf4UI." /L1 lNTRACTOR'S NAME AND ADDRESS //", v r> .\"r;,... "r ;;!"/Vr""" "" ~_ ( ."ail permit or results of site feasibility study to (x.) Applicant ( ) Owner ( ) to~t~actor. ( ) Prefer to pick up. Call (owner, etc.) when ready. STRUCTURES NOWONTHE PROPERTY /f..t'6 ~,L_ /../. ..._ (4'Yr~7.c Sri.....,....... PROPOSED USE (this permit) --:;;?"'d'" <>I- ~....r:;i>~.... /J1!'f''''''' '- (14" ,?1/L7 hL.A..~,- C'.w </ .p Lot ?~ Block S- Phonp? </;7 /9.ri Phonp , Phonp7 y~ /p.rJ-: Contractors o. S. #./ Co ~ €. <:> i ~r(YTn"i .3 WATER SUPPLY (existing or proposed well, etc. If public, name of system) SEWAGE DISPOSAl ~ /" 7: e.. .(existing or proposed septic tank, etc.) S.1. # PLUMBING BY Address ) PROPERTY IS WITHIN ONE MILE OF CITY ( :s v C. , ****....* *..** it"it* **********************it***** OFFICE USE ONLY BELOW THIS LINE *** .......... **... *...... **... **... ** ** ...**... *....,... *...*..**..... *...... ) New ~cessa~y/ ( ) Facility Permit Necessary ZONE, 1rJ f\[ SETBACKS: Front Side Facing Street (FROM CENTERLINE OF ROAOI ) Special Permit Area. Minimum Elevation: Interior Side Yard Rear (FROM PROPERTY LINES) To: Planning/Building Inspector/Sanitarian/Surveyor. This applicant appears to have a problem with Your assistance will be appreciated. By Permit Processing Section Responsp' C55.12 By DEPARTMENT OF ENVIRONMENTAL MANAGEMENT Permit Processing Section 125 East 8th Avenue. 687.4394 Division , ql ....... SUPPLEMENT NO. . BUILDING PERMIT OWNER address phone CONTRACTOR address phone PROPERTY ADDRESS (Building Valuation) Revi sed ( []addition []correction ) Prior ( [Jamt. due []refund Bldg. Waste Plumb. Plan R. 3%sur. TOTAL amt. pa i d: amt. due Signature of Applicant Date Fee Received By Date []cash []check LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT -' C74-119 If Lit 7 Y.J - ..., PERMIT # TRS. TI JOB LOCATION ( , LANE COUNTY PERMIT I I Acreage or Lot Sizo , Contractor's O.S. # Partitioning # ) Completed Subdivision Lot ~ Bloc~ APPLICANT'S NAME AND ADDR<=<:<: OWNER'S NAME AND ADDR<=<:<: CONTRACTOR'S NAME AND ADDRESS Mail permit to ( ) Applicant ( ) Owner ~ Phone Phono Phone (owner, etc.) when ready. ~ , ) Contractor. ) Prefer to pick up. Call ~TRUCTURES NOW ON THE PROPERTY I / ~ - , - '7 WATER SUPPLY '" " }. SEWAGE DISPOSAl ,/ # BEDROOM<; / ( , # PLUMBING CONNECTIONS- THIS PERMIT IS FOR " ( . / . S.1. # THIS PROPERTY IS WITHIN ONE MI LE OF THE CITY OF. PLUMB ING BY I hereby certify that the above statements are true and accurate, and that I have the following legal interest in the property: _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 this action. I hereby agree to comply with all applicable Codes relating to this permit. Fee Paid <I: ) NEW ADDRESS SANITATION Signature ) FACILITY PERMIT TO TRANSPORTATION DEPT. BUILDING Dato ) SPECIAL PMT. AREA. MIN. ELEVATION: ~ Minimum Septic Tank Capacity (Gallons) Drainfield Required. Lineal Feet Maximum Depth '", Type of Construction ~ - - - llse Classification Comments: Group .Fire Zone . Comments: I By: Date: PLANNING REQUIREMENTS SATISFIED. By: ZONE: ~ SETBACKS: FRONT By: ~ Date: Date: Date Issued: (FROM C/U INT. SIDE YARD REAR (F ROM P/L) ... SIDE FACING STREET 1 - LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE., EUGENE, OREGON 97401 PHONE: 687-4394 POST THIS PERMIT ON MAIN BUILDING AT SITE C55,'3 BLDG. PERMIT - WHITE; BUILDING - GREEN; PLUMBING - CANARY; SANITATION - GOLDENROD; OFFICE COPY - WHITE .... ~ SITE INSPECTION / ApPROVED ~ DISAPPROVED ~ DATE REMARKS FOUNDATION INSPECTION ApPROVED r-7f' DI SAPPROVED ~/ DATE REMARKS FRAMING INSPECTION ApPROVED l'"77~' SAPPROVED ~ DATE ~ '7 ~ 7'1 REMARK 5 LATH OR SHEETROCK INSPECTION ApPROVED / I DISAPPROVED 1--/ DATE h~ REMARKS , ~. ~ # INSPECTOR INSPECTOR INSPECTO~ , INSPECTOR FINAL INSPECTION ApPROVED m DISAPPROVED ~ DATE::! ~_i-!~ INSPECTOR ~ REMARKS CERTIFICATE OF OCCUPANCY READY TO ISSUE ~ NOT READY TO ISSUE ~ DATE REMARKS INSPECTOR , J .. .. SUPPLEMENT NO. OWNER CONTRACTOR PROPERTY ADDRESS address address (Building Valuation) ~ ~ C74-119 Revised( []addition [.]correct ion Bldg. Waste Plumb. Plan R. 3%sur. TOTAL . BUILDING PERMIT phone phone ) Prior ( ) []amt. due []refund amt. paid amt. due' Signature of Applicant Date Fee Received By Date []cash []check LANE COUNTY DEPARTMENT DF ENVIRONMENTAL MANAGEMENT