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HomeMy WebLinkAboutPermit Building 1974-8-20 r} I e ('CVt.~';;' ','" " p~ . r~ ,,' . ,",' , .".{& ... '''." ,( ...' .... +"" . ), ~,,' I PROPERTY OWNER " Me CARTHY. l.j\ eHA.El D. ~ ~'~. "'0'1"',..-. .l\ ,..- LANE CC ITY BUILDING ,0 BUILDING PERMIT OR MOBILE HOME USE PERMIT MH 0 PERMIT NO, MAIL-lNG ADDRESS 46l:l3 UNION TERRACE SPRINGFIELD 1493- 74 /(/tf.3 - Y ORE, , PHONE' 4583 ("to'" , " CONTRACTOR SAME:' .J MAILING ADDRESS PHONE PROPERlY LOCATION - INCLUDe POST OFFICE DRIVE OUT SOUTH 2ND STREET SPRINGFIELD TURN RIGHT AT PARK PROPERl;, -l6~Al' DESCRIPTION _ MET~^_BOUNDS ;; I 't' tR ~m7;;" ~-; -,::::: ; s a;; ~: :i-:I':" . "I,.OT"9' 'EllOCK~3r r!lBERT GROVE SUBDIVISION STAY ON PAVED ROAD =:1S:. "'1..._. ~~...~~:n DRIVE ALONG I "or ho './1"'0'" ;.. c:. \nl!. T1'8 RANGE 03 SECTION 02 TAX LOT NO. CODE CENSUS TRACT APPl.. NAME MICH.AEl D. Mc CARTHY EXISTING STRUCTURES ON PROPERTY , NoN!! MAILING ADDRESS FOR MOBILE HOME No. of ~edrooms SPR IlIGF IElD, PERMITS ONLY OREGON /.i LEGAL ACCESS TO' PROPER.TY Julio HARBO~, UR I VE PROPERTY SIZE - FT. & 4683 UNION TERRACE WIDTH DEPTH AREA STRUCTURES-TO-BE,BUILT THIS PERMIT , -. ~- Connect_ to Existing . _ ._'-::YPE,fONSTRUCTION. / FOR 'FUTURE 3 '..BEDROOM'" Sewage System 0 SQ. FT. ::; BDRMS MOElI L E HOME New System 0 VALUATION INSTAll SEWAGE 'D,ISPOSAl. 'SYSTEI4 ONLY I " . .f , SEW AGE DISPOSAL PUBLIC 0"< BUILDING. WASTE D'ISPOSAL ~LU~B,I~G\ PLAN REYIEW PARK TRAILER . . ; qTHE~D '" ., ~..l" ./".;;''' FEES PLUMBING INSTALLED BY OWNER 0 OTHER: NAME WATER SUPPLY" " SEPTIC'TANK 0 PUBLIC 0 o OTHER ~ TOTAL . -- -,.. ;V....r..., MIN, SEPTIC TANK CAP~ WITH DIST. BOX: GAL COUNTY BUILDING & SANITATION SPECIFICATIONS. DRAIt-:-l FIELD REQ~I~ 21 . lIN, FT TRENCH WIDTH FT. OR SQ. FT. 300 " '>!-. No PART OF DRAetlF I ElD TO BE CLOSER THAN 100 FEET TO: RIVER BANK TYPE OF STRUCTURE , OCCUPANCY ZONE PUBLIC UTll. EASEMENT BLDG. SETBACKS__ FRONT 50 /S/ J; FT. FROM CTR. OF ROAD RIGHT OF WAY SIDE INT, 5 SIDE EXT. AUTHORIZED SIGNATURE - DATE E. BOS5 : BY C HAllBAUGlH, REAR 5 USE. ClASSIF!CATION J. CRUICKSHANK/SANITARIAN . 8/20nli . ,I. D~l BLDG. ,PERMIT - WHITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING:"- GREEN ' ~ANITATION - GOLDENROD Call 6B7-4065 to 'schedule all required inspections. All construc- tion shall comply with Uniform Building Code, D.E.Q. standards IMPORTANT: for subsurface sewage disposal and county regulations covering I plumbing. All buildings require a certificate of occupancy before being occupied. I (See Details' on Reverse Side) FORM'::: .c ~5 - 13 (POST ,THIS PERMIT ON MAIN BLDG. AT SITE) LANE COUNTY, DEPT. OF ENVIRONMENTAL MANAGEMENT COURTHOUSE ANNE~, 135 EAST 6th, EUGENE, OREGON 97-401 .... . c."~ .~ . ....." ..... *"' /VcTf.: C;1''f ~~~ ~1v{ \ \~"'~li" r ...,.' \ ROSEI--'TJ""" :t .,.,,- --.iJ!~,- .cul,../ ." < .~o~7J... .,.- -- 1'1 ----/ l' .. p~~ ,"c,,<,! _'_' ~r If'" ?..__I.VUu't- -. \- Uh:jvlcl 1. / ' .......... <t;:~ J7 ~.<" Jtfo FT l';o_ A..,~'. Ifd,,, 2... r "'.ff' P7 ~ -- , I . , , I , (v I , '\ I 1\P ( i5'c>- ~ .:.......,. ,q"'t'.<.( "'" un., , ~) . .~J; p ~ J-;r ,.1 a '--___,-= Hpp (tc.__1: 11.~"..- ( 0....... .....~H, 'I"" Uo..... tc.... ..~c Sp"d. ~4~ 1iJp _ 0,.",(._ Se" _ TZ _ S<t'(),:,;~:.", . .LoT...!t.L 6/1~L /j t1~e 4ft!: 1 l. T .J .. Il,d" E ,., E · 1 (,J,,' I A lot Tff. . 1l,.,<.. Fl...; ; ,:J f) ....., n II ,.... r-, '''} I , t..", i J, I . 1 l ...... '--~ '--.:.. 1..J L. ~ _) _J 3'J _ flvet v ..F iJiLf LANE COUNTY r:Ni~O[\!Iv;::~m.L fA GMT. )VQ3-JY sc.4IC; I ';'&J. : S'o ICcc.-T -;~ ~ ,~., ~H No. /Ljq2-7j/ :5f'<da~ T. I bed 6roue cr '19- elf ) /l R Q~s 02 TAX LOT CENSUS TRACT . BUILDING 51TE EVALUATION () Building Permit Appl ication () Site Inspect ion () Pre-Permit Investigation APP LI CANT: " I NAME VYlII ('t? vi-n u ADDRESS , J PHONE DATE ~ -5'-7(/ LANE COUNTY PLANNING DEPARTMENT NOT NO YES 0001 icable NAME DATE BUILDING INSPECTION SECTION 6. Plans Submitted NOT NO YES aDD~ ) able (~ ~ ) () () ) () () ( ) () () NAME DATE 7. Soil Stabil ity (footings) 8. Flood Plain ~- V' == fJ~/6 /1i( 9. Other (see Comments) COMMENTS: SANITATION SECTION NOT NO 0001 icab 1 e 10. Sewage Oisposal ( ) ( ) 11. Usable Area ( ) ( ) 12. Water Supply ( ) ( ) 13. o the r (see 'Comments) ( ) ( ) COMMENTS: YES NAME DATE 0' w ~1r~N. 2;}117-/ H- ' ( ) TO APPLICANT: nJl.;Vlr Your ././.1 (X) .q/ltrJ /() ( ) ( ) ( ) Building Permit / Site Inspection: Can be app roved. Cannot be approved at this time as indicated on item NO. above. Questions and further information on items I through 5 contact the Lane- COUNTY PLANNING DEPARTMENT. Quest ions and further informat ion on items 6 through 13 contact the Lane County Buildinq and Sanitation Division. , Wil I be held in this offiee until you can resolve the problems indicated. Is being returned. Your building permit appl ication fee is being returned under separate cover. LANE COUNTY PLANNING DIVISION 135 Sixth Avenue East, Eugene, Oregon 97401 Phone (503) 6B7-4186 LANE COUNTY ENVIRONMENTAL MANAGEMENT 135 Sixth Avenue East, Eugene, Oregon 97401 Phone (503). 687-4065 C55-28 '< .. " I ~ , . . ! :493-1:' .....1 LANE CvdNTY BUILDING 0 BUILDING PERMIT OR MOBILE HOME USE PERMIT MH 0 PERMIT NO, M~_I~ING ADDRESS 4003 UNION TeRRACe SPIlIM'irIElO , Oftc, PHr~i!1l3 ~ .PROPERTY OWNER Me CARTHY. MICHAel C. CONTRACTOR I!iA~t . MAILING ADDRESS PHONE PROPERTY LOCATION - INCLUDE POST OFFICE 'ORlvr OUT SOVTH!ND ST~tCT 5PRINGfltLD TURh RIGHT AT ~Aft~ STAY ON PAVEO _OAt - ..... - .~._- , PROPERTY LEGAL DESCRIPTION _ METES. BOUNDS n I ...." w..... '"' ,,,. y "'.. ~ oJ -... "..,.... i LOT Q9 BLOCK u2 rl~BrllT GReVE S~IVISIO" $ !::. ~::~: 7::':'! !o.:~ 0111 VI: AI.OltO ,..._ h~ ;....... _, H__' '~ ::'( TWeP i 1 RANGE 03 SECTION 02 TAX LOT NO. CODE CENSUS TRACT APPl. NAME & MAILING ADDRESS FOR MOBILE HOME ; . No. of Bedrooms ~1t CIlAltL D. Me C""THY EXISTING STRUCTURES ON PROPERTY ~ONW _683 IJru ION TIRRACE: LEGAL ACCESS TO PROPERTY HAIl.Oft o.IVE St'1l IH<I,., 11.0, PERMITS ONLY Oft EG iilH PROPERTY SIZE - fT. WIDTH DEPTH AREA STRUCTURES TO BE BUILT THIS PERMIT Connect to Existing Sewage System D TYPE CONSTRUCTION SQ. FT. ::; BDRMS New System VALUATION , D1 ,'{ , , 'IOSTALL SltIMG!: 01&'011"1. &YlIITEM ON!.., rOIl PI/TIJI'll: 3 IItllllOOM Melli LE HO"lt ", " f:!. , ' , "1 ; ".: ;,1;" ~ ~ .I " i i 1, j~; . . I:' ); I 't t J.... P ~! I '1' SEWAGE DISPOSAL I. PUBLIC ole SEPTIC TANK 0 <I r .' ,BUILDING ~ tASTE DISPOSAL , rrLUMBING PLAN REVIEW , , . 1_ ,~ARK TRAILER "1 i TOTAL I ~ 1> ! MIN, SEPTIC TANK CAPA~ . \- WITH DIST. BOX: GAL. 1 I , , ..- ...- ~.~v FEES PLUMBING INSTALLED BY OWNER 0 OTHER: NAME WATER SUPPLY " OTHERD PUBLIC 0 o OTHER {,:x ..J ., ~';:~ .i.\.. ....- , "'~....- , .Ili....~ . COUNTY BUILDING & SANITATION SPECIFICATIONS DRAIN' FIElD REQ~I~ ? L1N. FT TRENCH WIDTH FT. ':t._~ -~ '-':::!~~' ';.:':"~l 'Y~-~~'J-,.; . . , ." '" """"1. ':'"_i-,:.-,;o;Y..t;: . >l..<.~: OR SQ. FT. ..... p"..r ... D~AltWI~1.11 TCllIE <:..O$11t 'r/iAtI 100 raIT TO "Ivt~ ~Nl\ , , , , ! I I 'j f'TYPE OF' STRUCTURE . . ._~. , j . .,~;~ !' j ....< OCCUPANCY ZONE PUBLIC UTIL. EASEMENT 1<, .i' I : BLDG. SETBACKS __ FT. FROM CTR. OF ROAD RIGHT OF WAY : I : FRONT ~ SIDE INT. , SIDE EXT. II AUTHORIZED SIGNATURE - DATE , J. E. 00&, IY C HAUAOOM REAR 5 USE CLASSIFICATION ! ; J. CRUICK$HANK!$AHltARIA_ iiI_PATE fi1/..." r" ie,! ."'1 ~ r BLDG. PERMIT - WH ITE I OFFICE COPY - WHITE \COUNTY TAX - PINK .:1 ,PLUMBING - CANARY IBUllDlNG ~ GREEN ,SANITATION - GOLDENROD , IMPORTANT: Call 687-4065 ta schedule all required inspectians. AII,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. .-s (See Details on Reverse Side) I,' '1., j J I ."L tORM == CSS-13 t't :.4 .;' ~:-.''''''_'.: ___~_.. .,1_ (POST THIS PERMIT ON MAIN BLDG. AT SITE) LANE COUNTY, DEPT. OF ENVIRONMENTAL MANAGEMENT COURTHOUSE ANNEX. 135 EAST 6th, EUGENE, OREGON 97.401 -'-".'''' :~~...""' ,~,.:-:-"'- .". -"" ~.., ''-- ... -'--' , .':~i,;-."--~-l~':~';~ _~_ _~., ;-~~. r SITE INSPECTION ApPROVED ~ RE~ARK 5 .....,. DISAPPROVED ~ DATE FOUNDATION INSPECTION ApPROVED 1--/ OlSAPPROVED / - / DATE REMARKS FRAMING INSPECTION ApPROVED l / OISAPPROVED / / DATE REMARKS LATH OR SHEETROCK INSPECTION ApPROVED L-/ REMARKS FINAL INSPECTION DISAPPROVED ;----y DATE (Jf ApPROVED ~ DtS~PPROVEO ~ DATE .REMARKS CERTIFICATE OF OCCUPANCY READY TO ISSUE ~ NOT READY TO ISSUE ~ DATE REMARKS ~ . INSPECTOR INSPECTOR INSPECTOR INSPECTOR INSPECTOR INSPECTOR c Cq' . ,. " ".P~OPO~ SE~AGE' DISPOSAL SYSTEM 'RECORD" a '. ~. ~, .1 NSTALLE!l:i;, Compl ete, top ear:'; o!'form tos'i gnature and submi t:~oJh jc,:of",es ,w;a,app) i eat ion. " ~ ' " llf./...-L-., r::J/.fA-:DY , ".', ',' ,0".', PERMIT NO. 1493-74 INSTALLER ,S NAME.. '. '. " "'0' ,P~OPERT-Y AOL)RE~~ ,', "':..., ',: : JC ' t._..... . HARBOR DR I VE , No. l'i ving Uni ts. Bedrooms' .Baths Basement , Water, SUPPly, ". ' " . Yes ',No "Publi,c;/~Other~.list Septic 'Tank: ' , , ~L Ft.. from well, :Si~el,o ,co~c,;~te ti6, No. c~partl1lent::/.9,:),"capacitY Insi!le ~imensions: Ft.. . Tile,O,isposal',f:leld: 'I./' fen9'th . 'Width . Di'ameter "Depth "Distributlon Box: ::Yes 'rNo . ~ OWNER' ',', 0, OJher OistributionTType! . NAME' ,".. MI CH.AEL' D. Mc CARTHY.' , 4683 UN ION :TERRACE, '. /()f't:?t!l Feet from - WEll 'Fou~dation Lot li ne " ' 'Front , S i"de, Rear I F:~,~ Betwe~n 'IFinerdFiller ~epth~ IF~ller B:low It! neS /<J Tv De/.;2. !Above T !Ie~ I nJr11 e~ ! n. " "'A ," .. ",",', -~ '~"'. ",;, ".:>1" ~., -\~ >'~ ';'e;..t.::\'Yii" ~.,. . ",.,.\ ~~ ..~-. ~',: ~. .-'..;, ",-. . . SiJ<1!'atur,e; t1.v./~,.r-5.~ ,. CERHFICATEOFSATlSFACTORYCOMPLETlON ,',.' ~.,O .;, , ' " " "For Sanitarian Use Only: . Oate ~/i')' 74 In'acc:;ordance with 1973 Orego'n L'aws Chapt'eP'835. Section'214thj'~ eertificate is i~su; ~-/" :,!s evidence 'of.~sati~fact,?ry. 'c6n\pleti'qn of a, subsudace' sewaged';'~posal sys,tem at .the ,ab,ove ' , location-' . -.~ - : ."". ;- . '. .' .'. ..<_.......: ~A~pr.O~~d:; System I~s~~,llllii:on confor"]s t~ currentstand~rds '0. '. ",>: , C:J Olsapproved: ODes' ,not.- conform to':current .standards " <, Remarks:" ,,' .. " HAll'ING' ': AllORES S ' . . - -~ . SPRI N~F:I ELD ,,iOREGON Leng!:h'of 'L i nes,~F.t. ' ,.,l,Trench....I.Tota I Sq. '70S 2.7~.,' 4. 5. 6. Width~ .Ft'.?&'6/', 'lot 'Plan [see instructions}: " " ' l:: t; " A.."",,' " .', <;:)..' ..;". :':'/;~. ,.. t.-:> " ..." -,-' ---.-' ., .,..... ,-- >.-t,"" ;".'i',.,_. ' .I..,.~\ ..: . '1~ :'~ li\ '.,. . " , ,.I.~~, 'i~W' , ,~ ..~ ~ )" ~ )::. ....... ~ '~ ~ I ,~ - :::s ~. . ,;.- '- 'l"- i ,'. '" ~\ .~., .~< ,> ~>-~" " .:-i ' , '''t' , - '" ,", ." '. , Oate, ,q _ ~-;-. 7# "-. C55~1l -'" S"rA'iE OF' :O~E ON OEPARTMENT OF' -.':., . ...... " - ~ .- ". T .~ ~ \', ~. ,> '. 0 '- ~ . ~. , " " " .". ;~ 'Ittt~\j~Jr' .. w,V '60 9 \9j~, ' ' ",Sf-II:'" .11- '.""" -', , ' ',' OU~-r{ .. , . "tl\t4t..~,c; \. i,"".,>!,1.... ',- -- .' . ~- "1~;\00t\"~I'"~,''' . - \;,\'..~' " ,", -J -l;.- , .:.... , .~:Sanltarian's Signatur,e "", - . . " 'LANE CO~NTY ENV I RONMENTAL QUALfTY. :! ' .' " r '. ,i-:c\~5(;L '.. , . ' , , . '. >~. ~ COONIY' ~" '~(, PEPIDTif'j 413 -7tf ' ~I\ v!..J>' ,.,..,...,.,<,: . I " 'Building, I" " . ',: ,:' --~ DEP~ OF ENVIROl'MENTAL , '.',. "~' Mobtle Horne ' ,;' v ,; ;, APPLICAi'ImJ: FOR BUI1ll~ PERMIT OR MOBIIEHCME USE "., ' , ", .' NOIE.:,' ,~o;pepnit/will be issued tmtilthis aPl?lication has beeJl approved. PLEASE PRINr . . 'f\' ".' ,'" J;, ,fI,.fI~('fl;(fJ- '. 0 ,PROPERlY IiYcArIONJ.;JiJ./v.--i_/o-u:%- "'Y1-r~ ,) ,.u: ,(,~k-- ((,c,ti.. TAT (,f).YI\, ~ 7"" f..;' 2"11~ S1~::(J\A. ~.o,;:'~-i.d((oAlJ, . ~ ;../~ R(~ Uv../i I g( ~t-t-- /~ 'eM t1..t5t....-(}.cd~.;;JJe.:/ (/l1l\Jt:t.-::" J1ley7, ;V Ii'~'i:.t-,.L<>:f''f!.... t-J:a.sr ~v 0/' ~ 'illP. /fiWGE cJ...3 ' SEC. 'O:i.,' '!TAX LOT if 't.' lcooE. CENSUS TRACT ~ LOT NO. .9'7:' 'BLOCK "\...5.,.sUBIirvrsION "\"-:9-~ .~, xid.' ~7fIf~ ACCESS TO ~~lY Pu~/,Y?Yfifzr~, ~1Y SItE ~~/~r.?jOR ACRElCE ' 'DESCRIBE' EXISTIN:; STRUc:rtiRES ON 'mE PROPERTY ~ - , 'AP~~/:'k~} D )u(f~,'=<(0K:) ~~JPfd~ 7f((;,,{(.r~3 WlHN\CIDR. , ';,' . ,':' (~Lrn::;' , '. '.' .,.,,' , NAME' " " " , ,,'.:. , . ADDRESS '. " " , " ,'.. . ,', mONE , ,- ..' -. BELCW .FOR OFFICE USE. ONL'L:' :.:..1. :.:. :.:.:. :.:.:.:... "1':':"':' ..:.:.:~'<*'/.-:c:'.,..;.; ,;:. ,'ct,.,; :";,';';';" ..:... :.1.1. :.:.:.:. :.:.:.:..... M..IC'k'k'k ~tructures'tobe built/Mobile ~ " . ,sq; ft. ',,itbedroarns . valuation '. . ~7 o:/I,U:-.as Lhr ' c.....i!:/,u.. '-?.J;t/./A./!~"..7- .fi?fld//jj""}-c'/7V ~ 7'/ ." . ,,',. : f' " ,/j '. ' . (. ~. "" " \~ .....'... i ....' , "I' I.,' Existing sewage disp~sal syst~'O Of new ,system ~qri;-::ed ~' 'PP~.X ' , ,we~IO:S&~gO"Ot~ .' '-,," "'\ ;y ~~~~ Dis: .~nJ) l). Feespi~mg,~t~~led by CMn~r ,L ~ Nane: " " " Plumbing , , """ . , Plumb#Jg Fees . ' sewer~:~tion ,~ater connection Plan Review t . ' if of' fixtures inspecFioI). fee ' inspection fee ' Trailer ' , l%.surcharge '.. '~~:~k Sigmture o)hl~~;W~tr~~-?f TOTAL &6. D' 0 " fee rece.ive~ bY!dj<f dCit;e !f. -o:~-j9.--r' Min.' Septic,tank,capacity . Drainfield required", , I. . ".,'. .-' ", , with dist. box: Gallons ' '100., Lmeal:Feet' j.6?:J ' Trencp~p.th,.2.: or Sq.ft: 300 110 ,tarl:, afck4,irFreicl tv, k. do~/ ~~n, /oo.fCzi"to hWr ba-i!:., Sewage Disposal:;' Site Inspection if Water Supply: '. Public, fgc. District ,Name . :1, . .. i' Type ot Structure. :.' ,Occupancy ~'ire, Zone Use Classitic,ation .'.- . , , . ~ , Blgd. setbacks~te. tram center ot, road right .bt way. . .: Fro!'\t',~ 0" . Side Ine.~' Side Ex.terioY""'~' Planning ,~~ f ./#/Y' '; Rear ~ Zone _~.,.4 /vt-#' / date -:,,/0/ -11..( ,- ...9~~-;~&v~~.?jsJ>i.. (;55-12 . -"..',.;' .-, .' .).. ", " " . ;;. .-' / .-, If t~' ~ ~ '__,'_'_ ~.. '7111-/ /3{'--7Y j ~~ ~ TRS. TI I ct- () _J - ~ 3.. Job Locati5r1~;:Lo~e=/~{;w.~'S-, f)/W'^-L ( l \ P rf-.t( , (Jils;:: Written Directions~ 1 ~I vf: Spf-d.. S7,4.L/ ClV\. ~ PC1AJ~ /L(J~. &A--..Q....- a..tk""1 c..l~M'-0<- ~ ~$~ ~ I )'oT INFORMATION SHEET .e:,-.::.~"" .1 ~""'~ ~o'7G:> tt-.-d 2.0 f'-( t:lax"-u-. ,~ ( ) Building Permit, /tQI' CooL 7N~'" Acreage or Lot Size Test holes will be ready, Partitioning # ( ) Completed Subdivision:0/ ~ 0/1 "rv-q"A- (~c:z,1 4dJ) , () Pend~~!j., -rl- /' It APPLlCANT'SNAMEANDADDRES~m/~t1/l-F-( f). />>ccr"vt...-Ut-V/. 3033 b.47~~)q...., IS J OWNER'S NAME AND ADDRESS. if differen,t from appli~ant's " _S-a.~ ' 'CONTRACTOR'S NAME AND ADDRESS ,,\J)JLL.v, a (......(1.( #A'-.L,:/~ dO-W-V:L- ~ ~ ~ Ll.-JO Mail permit or results of site feasibility study t'o' (, ) Applicant ( ) Own'er () Contractor. ( ) Prefer to pick up. Call (owner. etc.) when ready. STRUCTURES NOW ON THE PROR-ERLY AJo st;C.1../ 'z<.VU/a./ PROPOSED USE (this permit), it;;i;~;~~{~j~--,,--~c.L~"~ JI l.---. - ,. ~A TER SUPpLY (i'(~)v\,:"/VL~ Ju (t:J...t.J..--.A:' tf'/t...vv~' tJ0h4 ('0) (existing or proposed well, etc. If public. name of system'- SEWAGE DISPOSA' ./' ..1<"/~I;'-~.l / L{ 43 - ,7 C{ (existing or proposed septic tank, etc,) S,I. 4= ~LUMBING BY S,p/t-~1/l1.t..-/,'~:I ,;l' h1...e ~;I ~ ,.1/ ~<Z.--- Address ;:::C/ ct.. a.,--I #~A ~ d; ctr.e... ) Site Feasibility Study for Septic Tank. Number of sites Lot </q , Block S/J rt:/ ()~ Phone7zG -/7tYJ' Phone Pho~e?2G -og:sl Contractors O. S. # ~ II RPr1r<Y"'JS. ( ,) PROPERTY IS WITHIN ONE MILE OF CITY ( '*.. * ** ** **** ** 1'"* **** **** ** *** ** *:'"*** ** *** **.. OF FleE USE ON L Y BELOW THIS Ll N E ...."*.. ** * * * * **.* ** * ****"*"** -lH!- * * ** * ~ * * ** * *... *"* -'1"...... ( I NeJ:)dHr-rJ!.,c;!:,ssrl _ () Facility Permit Necessary ZONE?;/, _f r f ~SFJBACKS:' Front Side Facing Street (FROM CENTERLINE OF ROAD) I 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' '. By DEPARTMENT OF ENVIRONMENTAL MANAGEMENT Permit Processing Section 125 East 8th Avenue 687 -4394 Division C55,12 '------ ~, !~t: CO, I / f- 5"- / / ~r 2- 32-- c:rcJ - , ! I JH:o ;f;/l d ! I t I 0 ),5 I '50 '15 160 1').5 , ISO (1101175 ,rqqFl I i I - S' f1 5;f, ( blt.A P~.ft~ 'f,/ .l.."'_ '4- ~~{r I! I ! 1 ~; r rJ , .t: Stf..(JTic; hEld ~s. , lofT \ ' '" \., lJO'<\ r -ISFr- ~: I ~ l' 0, /6~( ~. !.. " , 1 ~I GI . , , '-':' ' ~/)/lv d DI(V~ , . - , , 1 - - - , , I ,I 1 I I I .1. {Ilk K '= 5' f?~ T' I ! I I , - - ,j,3. g I'f lJo~{.t. A.""t; J. CEd'Iilts 3</f( - Ow( - ~J'1t.- . of iJA~ /( 36 f1 &...K St r hlkt(, tf?q~ ~,;frr )4tc/;/JtJ 0. JJfNlaA11.y "30:1 3 G~7~",-,~ #- t3 S(2Il-Wuf ~>d ~I cJ" [7 cf-'1 , 72(,,- (71)[('