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HomeMy WebLinkAboutPermit Building 1975-3-27 r;' . /1~' ,/11"-<' f- , '.t- .__n..:_. r_-:~_~. ,.,K_C-"""'_'J"' '~::"',_;!" ,,;'(>., '-.-"i '-"'-.., ';,' . ,0:.' (., PROPERTY O::t',tJER McBEE, WILLIAM CONTRACTOR OSHRliOUT CON ST. . r'\' . LANE ~OUN1,----,3UILDING PERMIT OR MOBILE BUILDING, ;itj:. MH 0 MAILING ADDRESS 2OSO LOMOfICl, SPR INGF I ELD, OREClO N MAILING -ADDRESS LOWELL . OREGO'''' H~) USE PERMIT PERMIT NO. 04o-?'':J , 640-75 . . .: , ~ . j,. -:1' ,,," ~",.. .~~':-:- ~,. OREGON PHONE 746-8523 PHONE 687-0251 ~~~&t~-~~, R.& 97477 PROPERTY LOCATION - INCLUDE POST OFFICE NORTH END OF 21sT STREET, SPRINGFIELD, PROPERTy'lEGAl DESCRIPTION - METES, BOUND,S Q,l.OO .... 17 03 SECTION 24 TAX LOT NO 400 CODE CENSUS TRACT TWP RANGE '9-0' 2O-ED -ISO. APPl. NAME & MAILING EXISTING STRUCTURES ON PRQPER1'{ NONE LEGAL ACCESS TO pROPERTY COUNTY RD. 681 PROPERTY SIZE - FT. ADDRESS " WIDTH DEPTH AREA FOR MOBILE HOME PERMITS ONLY No. of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT .' Connect to Existing Sewage System D TYPE CONSTRUCTION SQ. FT. ;;; BDRMS New System D VALUATION [lWEI_L ING 2 STORY 2448 (!J 21.80 720 @ 2. 80 5''1166. 40 2016.00 553lj2.4O CARPORT l~l\.IF r()II"'ITV'C:PFrl~1 5EE SUPPLEMENT KEEP DWELilNG ON HIGH GROUND IN.AREA SEWAGE DISPOSAL PF~MIT ARFA $ OTHERD 199.00 2'5.00 1t9.00 lIHOWN ,ON Y PLOT PLAN BY TRANSPORTATION PLUM.BI'::'G -iNSTALLED BY -OWNER D OTHER, NAME WATER SUPPLY DEPT. PUBLIC D BUILDING WASTE DISPO~AL PLUMBING PLAN REVIEW PARK TRAILER SEPTIC TANK ~'( FEES PUBLIC- D D OTHER \ , TOTAL I 1 2.1t~ 27'5.1ltl 'COIJN'f'YBUILDING & 'SANITATlON SPECIFICATIONS DRAIN FIELD REQUIRED UN. FT . 185 TRENCH WIDTH fT. 24" OR SQ. FT. MIN: SEPTIC TANK CAPACITY -' WITH DIST. BOX, GAl. 1000 INSTALL EQUAL DESTRUBUTllJON SYSTEM ,IN AREA' SHOWN ON PLOT 'PLAN. TYPE OF STRUCTURE , , , OCCUPANCY ZONE PUBLIC UTIl. EASEMENT 5N BLDG. SETBACKS __ FT. FROM CTR. OF ROAD RIGHT flF WAY FRONT 10' SIDE INT. 1 'j' SIDEEXT. AUTHORIZED SIGNATURE..:,... DATE / s/ J. E. 80ss 6Y Oi.lARL IE HARBAUGH , I' AND J AGT USE CLASSIFICATION REAR 20' BLDG. PERMIT - WHITE OFFICE COpy - WHITE COUNTY TAX- PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENROD IMPORTANT: DATE JOHN SaDOK 3-27-75 LDM Call 687.4065 t6 s~hedule all required inspections. All construe. tian shall comply with Uniform Building Code, D.E.Q. standards for subsurface sewage disposal ancf'''-county regulations covering plumbing. All buildings require a certificate of occupancy before being occupied. '(See Details on Reverse Side) " .r" (POST THIS PERMIT ON MAINBLDG; AT SITE)' LAN~ ~OUNTY, DEPT. OF ~NVIRONMENTAL MANAGEMENf COURTHOUSE ANNEX, 135 EAST 6fh, EUGENE, ~RE90N 97.401 FORM := C55 - 13 ~... ".-'..'~ .... ,". "".:~ ".-,.. . '.. 'i ., ., . "" ?".'~. .'- -t-,..' "b4"- ~...., .,," .---' ,r-' .,.. ,j LANE COUNTY,-"UILDING . ~ f BUILDING [":j. MH D MAILING ADDRESS 'n: ..~.~ ; I ~:-~. c. f'1~iJe..!:-,:?j:_~:~t.., PER.MIT, OR I . \- (\ . . MOBILE HOI'..-"USE PERMIT PERMIT NO. ~,--- ..-' ~. ,;: -".j'. --. -." (4<;;;.' PROPERTY OWfHR .~- ;..;'t ~U",:.,. h"!t~ O~t'J):'2 ~;,?,..":.'l PHONE "L~~ '.<~i I H " PHONE G1.~"", ~ .,- ell I ,~. .' .', .[ ", CONTRACTOR MAILING ADDRESS , .... . ~ ,) ~- , "':!~::"!17: ':.f~':.r~~::';: b C;-'i~01:~' PROPERTY LOCATION - INCLUDE POST OFFICE C~i~~ .:Y ~:'l~H' j,.....;i~~?W:- .:r;;,"';. ':2VH'.~~():: ~ti;::-o r.,;p r IDt.) r\Cl.IA. 0....... '" " .J Ir " ~ IV \: I.' 'j' 1'-\..._\ PROPERTY LEGAL DESCRIPTION - METES, BOUNDS TWP ~.'<, SECTION ~- f:'tJ TAX LOT NO ~IOC) CODE t~J',..r;J CENSUS TRA,CT .po. : :1,'1' 'If ;C~ RANGE APPl. NAME EXISTING STRUCTURES ON PROPERTY ..:... ,,' ...j- ..~.... .& " lEGAL ACCESS TO PROPERTY Ce'.:': " " R!l. htl MAILING' ADDRESS .' , \ \ ~,~" -'-.:. ", ." PROPERTY SIZ~ - FT. \ WIDTH . -1 '- DEPTH ,I, .; '.. Connect~ to 'Existing lSewage System D TYPE CONSTRUCTION SQ, FT. jz BDRMS j:-l ;l8 ~t ~:--I .J~~'} AREA FOR MOBILE. HOME, PERMITS ONLY No. of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT :! : l f~' '.00'- New System D VALUATION ~~?', ~~,~;; i:."} " co l p>'RMIT ~ I~_ANE LUUi'UI .... ~_..\ ' 4 \, .: , -/J&1,~~Ii.4/~ A.A).~/ ..th., . 1 ~ :,' . "'~'~~!i.'U ~ ~".~ '~""l:."'''' .. " r' '" ' <."'.,f".~."Q(fll:",;'+,,,,,,~~,,, -->.". ,'"'"i"tll"\\ ,..';l.\~ "'\Iii.'/. :i.~' '":i:",...~" "3'\1>l:'l.i.~,.., ~' .SEWAGETDISPOSAL PLUMBING INSTALLED BY ......., ". ft:EJ i, ': ',. ~;; ~ ___J';j:::...~')~ . J)~;'~ '-'.'k~ , , ~ ~~~~~ z. PUBI.:IC" 0 BUILDING WASTE DISPOSAL PLUMBING PLAN REVIEW PARK TRAILER SEPTIC TANK D,'i . OTHERD :1 _, FEES OWNER D OTHER: NAME WATER SUPPLY~ PUBLIC D o OTHER , " '. \ TOTAL ,,' .:." ~-' . I ~".q> f'.l't'l ." '. <. . r. "",' ,"" "'( .'~ " ~~" ~':-'\'~.:,,<>~ WITH DIST. BOX: GAL. MIN. SEPTIC TANK CAPACITY ~ ~-^~--iJ COi:JNTY BUILDING & SANITATION SPECIFICATIONS DRAIN FIELD REQUIRED L1N, FT ~.65 TRENCH WIDTH FT, i:.ll OR SQ. FT. ,:.. ....;~t,;~. ~~!'~ll ~~,'t't,,!,:, :...~/;::'r,:: jl ~;f.A ~-..'"~~~-::.: :..J; "~\,' -:"...:l:. ~ \e" TYPE OF STRUCTURE OCCUPANCY ZONE PUBLIC UTll. EASEMENT '.f ,> " ~. , :.. ~ '..,' ,'", BLDG, SETBACKS __ FT, FROM CTR. OF ROAD RIGHT OF WAY -,''I USE CLASSIFICATION FRONT ,.' SIDE INT, !;) ~ SIDE EXT, AUTHORIZED SIGNATURE - DATE 0'r, <h~(. ';,);: :;11"-(' .'::..j REAR , ./ ~~. L. :~;v~.. tc-~-~-~J : :t~{;r ;', DATE ~"..)j'J :i ,-~ BLDG, PERMiT - WHITE OFFICE COpy - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENROD ..... -, '~-_\ . ,~.\ f;:: ,.......'. Call 687-4065 to schedule all reguired inspections. All ..construc- tion shall comply with Uniform Building Code, D,E.Q. standards for\subs'urface sew'age disposal ana 'county regulations covering plumbing. All huildings reguire a certificate of occupancy before being \ occupied. (See Detail~ :on '.Re~!=!rse Side) IMPORTANT: '" FOR~ = C55-13 (POST THIS PERMIT ON MAIN BLDG. AT SITE) LANE COUNTY, DEPT, OF ENVIRONMENTAL MANAGEMENT COURTHOUSE ANNEX, 135 EAST 6th, EUGENE, OREGON 97401 --- , ~ --~ ....... ,.' .-.....;~~... j' .( , .. ,,-,:'!.. ...r" , SITE I NSPECT I ON x "~. \ ,/ ApPROVED L:::7 DISAPPROVED;---Y DATE INSPECTOR REMARKS FOUNDATION INSPECTION . -" ApPROVED / r/i DISAPPROVED / / DATE~"20~~ INSPEC 'REMARKSd!2k '0p.A".2-47k~4~&ilJIIJ. (!:-,,'(~t.-!/~~1;M-V;f' 'f"'iJ~ -116: ~.~tf.~"t'f.;;$12 '7,1 P'.dL-. / I tI/rCOj.' : . iAC/J/J '5'kI,7;1.rS~.' o K .~ ! 'A.Jl .4-l2!H I tt'fJ.b: 6' ~ /'-/. 'f() "l?I--=-, _ _ ~~~" , iJ:!..t( I"'!.. I P .J _', .J FRAMI NG INSPECTION ::::::ED ~A;;PPROVED '6/,~~O~;'l," '1~;:;:' ~"".7.ft7 . ..f~ Ijb. ,-' .....rl:k.ddA/~?,-;7JE-.:'/.-"; 0,,1{; /XI. -::S;$Ar/l,".JG. IS - -S' d':(::::Z:J:>U, /;>~;'& .=A;D ""'''''"s ,lJ"i's: ~/E'"no.e..t::> ~V EVtfl/A',Ft;.. fl/F'/7~~ ~ , LATH OR SHEE-T~'INSPECTION _ ApPROVED L.,L".J DISAPPRDVED ~ 9ATE 7~l-J-::7f' INSPECT REMARK sA/ .;I;iu~-r/14~.i1R /--f/&:ZEfFJi:M{fUfCt!I4.- , /J.f I'Lnlf.d1...f'J ~) J'(' 7-10 ~, 'j'.::;. I' ~ ~ '" /2""f:'1" pA" h:P1 If) k .- '7"'- Jl.,,' v ?)' .'1 .-~/,!';/.d '//L --t:._, ( C.J. . '1,1 ~Jl e. /, FINAL INSPECTION ~~~ ","om rT(,,,..,=,".o I . I 0,,,0;.j-76' ,.."u[.~ REMARKS~qAAJp.{#~ #t f~ r__t-Y~7J ' i CERTI F ICAT( OF OCCUPANCY READY TO ISSUE j" / NOT READY TO ISSUE I / DATE INSPECTOR REMARKS (;:/!/-7.~,' $((i:;, <<Ju'--' ,,} // '/) ,////.,' llL/ ..-1.l/-C:.A::.~l.-'l,/'Q I _J.-- ~/ .,....,.' ~'7 r I r--7 ^ / .. v, .0,).{t,4,t/ ,,,-I I; 1 . 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"C'li,; . ~\\".l' :',:;:" ". . .. i"t~ ~': ~,1~,j{ :~', 1.''' :: l' :~~~"';'I' ~ "~'i.~~~?L~'~I.:~.l~~:;:l:,~~,;~;~::.:u..'~ ~~S~.. :"'~'';_P_''''''_ ...._':. ~ .~..;",.'"". '~'~"'.'~ ':J!'..\ ", . '{~!:':'" ;.,;,:;~;',r'!;~\;:"':~~k.~(t~:;~~Y8:~~i:~r ,-PROJECT 'I~t. ,,<~,__l...,.I> ",..'~ . ... . I'V '. <S;PFl...O~':';'':; ~'~:t~(P;l b ';,"+{K l. p:: . By,l. ._. ~:>t~~:"::~t~.:{:' Sh~; . No ,1 I'. ''''';;~' ~1"""";,;'1.i;'I";.(. -....,. t.,',;;....~;r.,...;I,,\. r:-. :-~,'~~. ":'\>0;; ;.t"'-~'-~,.;,~-,,,,;:".;rsr''''-''''''''--<l'r:t ;:u.-h ":,""'W.>" -~..-'", ',.- ,;, ,; ': SUPPLEM~.. r TO BUILDING PERMIT NO, j:: u .-. ~ p """',. - , ." .~ l"'~:' irJ ... J Lane County, Oregon , ..~, . '" -' . .- ~ T , "O~NER ~ /8 oe-~~" . ./ CONTRACTOR PROPERTY ADDRE~~/~~~~ IJ -j v '\~-ADDITION: '" - .; e-,3 0 O~ tZd2~. ::Jl'lh, V CT , - /}J d. tn--' ~~ . CHANGE RESULTS IN: 'D REFUND OF FEE, OR D ADDITIONAL FEE: <l: ::1::J.oo BUILDING SEPTIC TANK SANITARY CONNECTIONS ~. 00 f'-utl'16-,;JY 70 t, 'C.> 0 TOTAL iI:'~ - u' [d/ DATE FEE PAIO.:<--..,,<'"--:->.... .7:jol,;:)~ Cash Check LANE COUNTY DEPT. OF HEALTH & SANITATION Supplement N~ 5 By g..,...-1k-..... (/ .1888 ....<.-;-;.,.-~'~ .7,') . '. "" ,'- .' ~ . C) CO (' , /'r?/J MAILING ADDRES~ 0('0 5ZJc),n,-~. ,<<:!L:.~(~>( -." r MAILING ADDRES~ /~r ,/ , ...,--- D CORRECTION: _ It 6.J.'1.oq ';5-3 f:..~!L.P.- '/ b ,,/06 ''10 :;. ~ ~ ~41J . f). J/. 0 0 /99.0 () '7JJ~C2..00 " )( , , I '-.../....}--z_~?7??)'( -.Oat"'..:? /.-7.~ /75 '-' -' / , , , .1:..... ". - ~ 1<.' I.';' , i r.. .' . JG" 'lZl~ :Mc."'SU'ZJ -r-~''''_i~ . .~.._....._~",,,,,-,<.,~ .' -- ~- ., " '. " i '. 13. " " , I.'. , .f , f' I I , , I ! '. i l I ."Df .... ". ~.' kf ".. 'S-d>frz :..t. [J h~'/~ f. : ;p.,:5c1-k/(-e..1. Jf-cc.P~d I /-A-N e' C,d 1JJ.J.f-f~ ," '.::; : :-;: rr:. .~ ". .....t. '.. ';;", ~. . ,-. . 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'-"._..,. u_ _ ( HAYDeN '<: a.1~,OI~ ~-~~~n: t t' . .'~~ k'.:.-..O*'-1Bi BF(,IPbe F<oAD '::m.J~) ,. ",,"~~ PI l ) J r,"" ), . ~." . I :I 7C-!r (/-V'BUILDING PERMIT APPLICATION ND.=-~71s.. .. ~H"' , . App I i cab I e Zoning Ordinance Compliance: Zone~~ (). Subdivision Ordinance Compliance ( ) Requ i red Access ( ) Building Site (Area, Width, Frontage) () Other (see comments) ( ) BUJLDIN~ SITE EVALUATION '. I( ) 'SITE INSPECTION PLANNING DIVISION 1. 2. , 3. 4. 5. COMMENTS: T 11..03 S "'24- TAX LOT 4cc.:> SUBDIVISION: LOT: BLOCK: APPLI CANT P'J. - /;11 ,,, DATE ~~~ CK'D Byr-!k %I~.,~ Setbacks from ell of road: Front ~' S+de-&x-t-er+or- . Setbacks from interior lines: Side lot Rear ~I No ~e () 6. ( ) ( ( ) ( ( ) ( ( ) () PLANNING DIVISION ACTION PENDING: YESl } NOl } APPLICATION# ,BUILDING INSPECTION DIVISION Not Applicable No Yes 7. Plans Submitted () 1) OQ 8. So il Stab il i ty (foot i ngs) (y) . ( ) ( ) 9. Flood Plain () () (>C.) 18 --2'/ ~ .I ,., 10. Other (see comme'nts), 12, () () (~) ~K'D BY:r..;;;//P~{'3'Z.'" S COMMENj"S: /(U'..{. LM"~ MJ,..;)f;A'f 1. ~ _....- ()A.,IA.. IlATE ...!AfAUlw ,'fYk- -PI~ V o4..&.A. (I u' - , ,/... I . . WATER POLUTION CONTROL Not App 1 icab Ie ( ) ( ) II. Meets Department of Environmental Quality Standards. 12. Other (see comments) COMMENTS: I No Y JS () <p ( ) ~\> CK'D BY~~jJt.SU~, / VDATE r I TO APPLI CANT: . ~ /Ie5 Your Bui.1ding / Site Inspection: .4AP;\ '~) Can be approved. Y1-(, ( ) Cannot be approved at th i s time as i nd i cated on i tern NO:" above. A]' Questions and further information on items 1 through 6 contact the LANE- COUNTY PLANNING DIVISION. Questions and further information on items 7 through 12. contact the LANE COUNTY BUILDING AND SANITATION DIVISION. ( ) Will be held in this office until you can resolve the problems indicated. ( ~ Is being returned. ( ) Your building permit appl ication fee is being .~~t.u.l:.n.~d under separate cover, OEPARTMENT OF tNVIRONMENTAL AANA~~MtNI 135 Sixth Avenue East Eugene Oregon 97401 PHONE: 687-4065 LANE COUNTY PLANNING DIVISION PHONE: 687-4186 C55-28 ,.. .- .~ ~dILDING PERMIT OR MOBILE HOM, JSE PERMIT MH D PERMIT NO. . MAILING ADDRESS mS!) lcf~~D,:J)PllWOl"llII,.C1, O~eCl)~ MAILING ADDRESS LOI;;EL\ . Oat\OOI1 . J"-. ( 971.\77 ..r -II , 6/ro..75 PHONE 746..8~3 PHONE Ge' . .Q231 . c. ) LANE COUNTY BUILDING ~( P~OPE~TY OWN,ER .........__ . ~ \ ~1I, tf'L\O~ '" " CONTR~CTOR OSVCR~euv 'OrlOT. \ '. '':--- ""'\ ..."'" '\'~ PROPERTY LOCATION - INCLUDE POST OFFICE .' NgnV~ ~NO C1 2107 BTR&~T. $PRI~Crl~~D. OOlIa~ PROPERTY LEGAL DESCRIPTION - METES. BOUNDS TWP RANGE ~7 03 SECTION 24 TAX LOT NO. 1:00 \ ',. CODE "19-01 CENSUS TRACT 2(}.,no -150 APPl. EXISTING STRUCTYR~S ON PROPERTY . do:.!!!: LEGAL ACCESS TO PROPERTY Coutny RD. Gal NAME- & . MAILING PROPERTY SIZE - FT. ADDRESS FOR MOBILE HOME PERMITS ONLY No. of Bedroqms WIDTH DEPTH AREA ~I,.LI"G 2 OTO~Y , .'., " Connect to Existing Sewage System 0 New System 0 TYPE CONSTRUCTION SQ. FT. # BDRMS VALUATION 2llll8' (t) 21.6.0 533'SG. ~ . STRUCTURES TO~~BE BUILT THIS PERMIT , , 'CI\gPORV ']mO e.80 :!016.oo 553"a. 'lO [fANe COUNTY SPECIAL PERMIT~AReA ::H!lt OU?PLltt:1ltClV ~e:e:P C~LUIUG ~ ~laH aROU~O IN ARltA OHO~ O~ PLOT PLACl OT TRAClSPORTATIGU DltPT. SEWAGE DISPOSAL PLUMBING INSTALLED BY PUBLIC 0 BUILDING WASTE DISPOSAL PLUMBING PLAN REVIEW PARK TRAilER SEPTIC TANK 1'J't $ OTHER[l l~.tiU 25.(!t)' qg.OO FEES OWNER n OTHER: NAME -- --- WATER SUPPLY PUBLIC 0 o OTHER TOTAL $ 1 2.I!O 215.ild <COI:JNl'Y BUILDING & SANITATION SPECIFICATIONS DRAIN FiElD REQUIRED UN. FT . '185 TRENCH WIDTH FT. 24" .\ OR SQ. FT. . c MIN. SEPTIC TANK CAPACITY. WITH 0151. BOX: GAl. '1000 InOTALL eQ~L OEBTnuOUYCON STOVE~ IN AR~ S~O~J ON PLOY PLAn. I TYPE OF STRUCTURE 5~J OCCUPANCY M:O J ZONE ItGT USE ClASSIFICATION PUBLIC UTIL. EASEMENT BLDG. SETBACKSu FT. FROM eTR. OF ROAD RIGHT Of WAY FRONT 50 . /0/ J. E. SIDE INT. 15' SIDE EXT. AUTHORIZED SIGNATURE - DATE EloSl:! Elv C!oARL I~ HAQOA\lCII REAR 80' JO:l1l SOCllllt DATE 3--27- 7 j LOO BLDG. PERMIT - WHITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENROD Call 687.4065 to schedule all ,equired inspections. All construe, tion shall comply with Uniform Building Code, D.E.Q. standards IMPORTANT: for subsurface sewage disposal and county regulations covering plumbing. All buildings require a certificate of occupancy before being occupied. (See Details on Reverse Side) FORM =- CSS-13 (POST. ,THIS PERMIT qN MAIN BLDG. AT SITE) LANE COUNTY, DEPT. OF ENVIRONMENTAL MANAGEMENT COURTHOUSE ANNEX, .i'35.EAST 6th, EUGENE, OREGON 97401 ~ . .., . ':~. . -I. . ..' .'~... . ,_"''''.'',!._ ....:.......,..., '_o,b;i'__'.A-.'''''.'--'' . . _,,~,",.1._ .~. .. ~.' ..,..........." , \ ., , , ., , .i:~ ~ FLOOR pLUMBING GROUNDWORK ApPROVED fY7 DISAPPROVED Cl DAT[,~.z:o.""XC t( 11_//"0' .+' //,,.,;- a /c INSPECTO~~ ?/ o REMARKS GAS PIPING GROUNDWORK ApPROVED D DI,SAPPROVED / / DATE REMARK S INSPECTOR ROUGH PLUMBING 'U,,"c/l7 (,"",,~ - ~ ApPROVED ~ DISAPPROVED Cl REMARKS . ........ ROUGH GAS PIPING ApPROVED Cl DISAPPROVED ~ DATE INsp:ECTOR REMARK 5 'r I NAL PLUMB I NG '. 'DA~~0Jl71J~NSPECT R-~ . ' 6RZ/ ApPRDVED t-r,! REMARKS DISAPPROVED Cl : FINAL GAS PIPING ApPROVED Cl DISAPPROVED / .j OAT.E INSPECTOR REMARKS CERT', FICA TE O~ OCCUPANCY READt~~O IS~;'UE / ,/ NOT READY TO ISSUE / "/ "DATE INSPECTOR REMARKS ". ~ ., " " " '.. JPOS EO INSTALLER: Complete top part of form ~ Nsi"'l~R' S NAME, -d .rZ//Z..o /)?" , No; L'ivil'g Unfts. Bwooms I .. ,fY:? Septj c' Tank: Ft. from well > SEWAGE DISPOSAL SYSTEM RE~vrtD to signature and submit both PROPERTY ADDRESS .~., '- ." ... '" copie.with applic~tion. . . PERMIT .NO. .. bllO-75 ! JS. Baths I COUNTY Ro. .Basement Yes No ~" 681 Water S~ly' Pub Ii c.lt) Other-Li st ," Steel C~n,crete 00 No. Compartments /' Ga I. Capaci ty , .I .,.rile Disposal Field: '.y .- Depthij..( 'Distribution Box: Yes') No , Other Distribution-Type . .' . ledr:!J ." D Inside g)~sions: F~ lenqth /,.J Wjdth..t/. ,\ Diamet~r OWNER ' , NAME. WILLIAM McBEE Feet fr~~ . I D WE 11 ~ . Foundat j on '. Lot Line . Front' . Side' 10 'Rear 'Ift. Be,tween.' IFf}3Je1V IFiller Depth:.. 'IFi1le9 Below, Lines./I} . r~.....,J Above Ti Ie 'Z/in./Ti Ie bin. I ',.-" -. .- . MAILING 209Q,LoMONO ADDRESS SPRINGFIELO:'OREGON ~'t9,9t'n.of .Lines-Ft.. t.T~enc.Q,1 Total' Sf!. }~t 2{fa~' (~~~ i~;tr~tti~~~~~ 'Ft~.~ 7f -1< I I I \ I l\". I. I I I' I J~o~- . :-r . i I I '\' I ~~'I: I I I I :RlEt E'~ V ED, ffJ ,....-..,.,-... .-j .-' '9-5 MAY'J,u,1 I ., . . bA~E: CqUNTY' . ;~'!!fl@i~ME~TAb MGMT. , ./ ,(11 It! - / ",,' (), , t;' "g' ,', . Date ~ / ".11 - 1 1\ ' . S i 9nature (t:.I tV /P'Lh~' . . . , CERTIFICATE OF SATISFACTOIfY COMPL ION . d= '/6' C.....! For San'itarian .Use Only: . ...' ate:& 'b1'7({"'! In accordance with 1973 Oregon Laws Chapter. 835, Section '214.this certificat is issu d as evidence of satisfactory .completion of a subsurface'sewage disposal system at th~.above 10ca,~A~pro~ed:. 'SyHein .Iris'tallatio~ 'con'forms to current standards . . . Disapproved: Does not confor')' .to current standards Remarks: C55..1l . -1\ J~n~' Signature,. ~ IE COUNTY STATE OF OREGON DEPARTMENT, OF ENV I RONMENTAL QUAL ITY' . . NOTE: NO , l\TIi' ;'iiT'l\T~Y <:'D~r.'T IJ.T Pli''RMlT j.:qU ' PEi6\fl-!ilIl 3'E1!sSUE&lulfih."Titts"'kWCiCATIl lAS -BEEN ,PERMIT IF APPROVED c C/o -70 .APPL~CATION FOR: CDNSTRUCTIoN ~ ,MOBILE HoME ~ -- . t::><::r. oWNER J.) ,,/ /'t!~', , .m 75~ ~./ ~osv ~ ""' ----pt -. Name Address c::::=J CONTRACTDRt1J..-l~A~.-b7""'''''''';- ~~4T -.Name.., Address PLAN REVIEW CJ Y CJ , ~7<Y 77 / Zip tCJ.,..e/ Zip 7 $70 -J(r;B City ~ Phone City t{,S7 - ~,.;JS/ Phone O.S, REG, II g) / ro Twp, / '7 Range /J ,::j' .Sectio'n d1 Y" Tax Lot -5/t? c> cOde/7-o -/ Census' Tract..:2e -Ef) '-/J() Subdivision Lot ..- Block Prope~ty Acreage '9.,.....) Wid th---..:..Depth ACCESS'TD PRoPERTY (Roa~Name)~.J ./ '.f?~ t{,R/ Existing Structures on P~operty: ~." Property Location - Address/Directions: 97,~ ~ ~ ;!;) I ,~ ~ ppT ~/e:-jJ.. p,: =;-V-~' -'1<;I]I-"t~~'~..,.,.,\~.. ~,\ .f,(..I ,r--.'J.'J-., I'. ,*!.QG>,,~4'(,)\{!\.V1A ~""iY\GC01' \4-V .{ . .. ,~Y'()'" . 'iJ ,/ Below for Office Use OnlvXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX '. . . . Sq,FLGJ:2/,8"O / IIBre rooms . Valuation . ~-,:)~ .' . rflF/V~.;L w ' 3)' '~~)Cf,t/1) tff:-.o.-.A.-,,~ . ~ _' 11 . '7J.,., ~'.'j' / A . ,,t;,, J r.. .nO 11&1.1.'; d.JJ;.If.l:MI,f tY1J.' !:..fIt!:J-/lwbU-d ~.bU.t1I_~J'ft....wt, J../&/", --, f) - ... { . - - (f . ,-" . J.-- -. - L7 ~/,j /J N-.. ..p+</'<~3lJ.;J., 'I _ .~~~A~.A'Y"_M._lf~...i Y~~I~.. ~~~G~n~~;~~~~: 117'/- 'ts-y . ;xisting Sewage Disposal Syste~ 6--- :1~t(j~equire~ WATER SUPPLY: . . Public, CJ/ . ' - ~ Well .x-.... Spring other - Conununity / Name of Conunu~ity or Public Syste~ 'Other ~ ~ame ? FEES: PLUMBING: J 99.00 Installed by Owner Bldg, ,. Waste Disp. ~~n'l"l PLUMBING FE~: Plumbing --"/-.9". c7 0 .. /..)~ II of \ Plan Review Mobile Home 1% Surcharge .;;,.<If?' C=:] CASH,.... TOTAL )'l 7 s-: t.j fiT ~ Sewage Connection ,::;JL- Water Connection .:J, PLANS FURNISHED , . FACILITY PERMIT v Require4 - Lineal Feet .....;~ 1 ~ YES . ~. NOrc=J YES m ND / si'gna_tuie of ApPl~cari~:j ,_. - ,'t71! 1~. Fee Received BYq.,~ Date;:3 - .20-/1,--" tI / X'~- s.l""""., a~ Maximum Depth '~~~L4 .~ ;J>-f/.L Min. Sept"ic Tarik Capacity /tJO 0 Drafnfield ~ .', I k.r.;;t....1:=. ,,-" Type of Construction ~~)LI .. Group .j4f:::T Fire Zone Use Classification BIdg Setbacks - from Center of Road Front ,-=::;0' Side Int. ,...::;,' " Right of~ Way: '. Side-6l1i:O:'____...:-__- .-:>" ./ Rear ~ . Zone AA.T ~ING: ......1... .. DATE: .' -- ,;rb!u;.CK. . . I' ,.... C55-12 LANE ~I...JZIT TIoN: DATE: A./... _BU~~IN~: A.Q'~.Ci;f.~~:...""" f.:C;~~~~ ;:j'-J1/_J,7;- . 'Y'r31J"~ ~Qt~~~~J;,~:) COUNTY .DEPARTMENT OF ENVIRONMENtAL MANAGEJ.1EtT . ,j" .' --,' L r,-_ f'_J- v-,1- oiJ. I ~ ..} r 15'- 7/ .J) '(:lrfl j'j:.::{;t ~..;lst. ~_:1~. Surname Twp. 03 Rnnge ,:, Section /100 Lt" ;J 9-0' Tax Lot Code Census Tract Receipt No. Date 7<:"'-75 I own;"".1l.,:: Owners Consent Yes 11:, No REQUEST FOR SITE FEASIBILITY STUDY THIS IS A PRELIMINARY REPORT WHICH DOES NOT INSURE THE ISSUANCE OF A FUTURE BUILDING PERMIT, ANY PLANS OR EXPENDITURES MADE IN RELIANCE UPON THIS REPORT ARE AT YOUR OWN RISK: Name and Address GTefl Oen~ r:'1S":. ~~. 1 $ 7:. O!~ No. Sites $ No. Acres TOTAL $ -I'd ":0 (~~5 i'lor~h I Strc_i. S'.JrlrlJflc"d, ~rc, ".7'.'77 Telephone No. 7~6-j47J Property Size ~g(J1 ~ i~OI Existing Structures 'Applicants Interest in hI.! i li~i" Legal Access - Road Property I Proposed Use of Property ON,. 1 f In(1 Proposed Water Supply Public X District Sprinq Name ISpeCi~) Permit Area Yes ;, No Is Property Wi.thi,n One lMj.i Ie What City? ~f'r.rl;;:I" l Other Specify I Urbanizing Yes X No of a City? Yes X No Area Well Property Location: (Directions) End O' ~brlh 21s~ s~r"':'>, ,,1t ~f YnL'nd" Street APPROVED "t,' 1\1". NOT APPROVED T~:s sIt" .1Ht:: 5:: ~" "t;lld' rJs'or SCW'IjO ~ls~Jns'l s)'!t_:T1 BEFORE CONSTRUCTION IS STARTED bring this form to the Department of Environmental Management and make appl ication for a bui lding permit. If the property is a por- tion only of a tax lot, a metes and bounds description of the parcel must be fur- nished. Exact specifications for the sewage disposal system will appear on the building permit. Two sets of building plans and a plot plan will be required, LANE COUNTY DEPT, OF ENVIRONMENTAL MANAGEMENT 135 EAST SIXTH AVENUE, EUGENE, OREGON 97401 , ' t ~ I . ;-1, "L.'-/: Authorized Signature C55-32 Date