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HomeMy WebLinkAboutPermit Building 1981-1-23 , ' ~ CONSTRU( ION/PLACEMENT ,vpERM~IT"":__ " ~,. ., L,: '. FOR OFFICE USE ONLY ~ ,"" ,,,..::, -It " .1'Jl. ,W' C .... DIRECTIONS' TO SITE , , " " ~, .,: :. < ,. .:7 , ..'. CO~TRACTOR'S OSR # ., I.'. '-,-. -, , q " ." ~..;'.. 'I' . ,- " ""-. . ;, ' ',' - i, :;"" ...:::: ,~,.I)' -'it'.. _ .~ " " .." 'I. ,I " r !lAVE CAREFULLY EXAMINED,THE COMPLETED APPLIC?\-TION FOR P~RMIT. and do.here>by certify thJt ,<>11 informatioii hereOn i.s' true and correct end I f).lI't.her certi.fy that ~any, and <1.1-1.- work ~erforrl\e_9 ,shall be, ~qne ,in ,accordance wit~ _l:!Je Or.:~inancc5 of Lare County .~[]d . the _LaWs?f the ,~~[l ~e. c:-L 9T.ellon ~'erL~i lli Ilq to the work described herein, and' that NO OCCUPANCY, will be,made of any. structure without the perrni!;sion of the "Building DLvisl.on. ,I further certl(y I that. regist;~ti'~'n ~it.h ~ the Builder i 5 ,soarer is - in"! i:~\llfbice "and ~ffect as~r~q\]ircd by ORB 701. 055, .'that i'fex'emp,t;\h"e ,basbs',for exemp;ti..,on 'is noted hereon', and that only' subcoritractors and' employees who are iri, compliance .with ORS, 701. 055 will be used 6n this -project:. ~'I HJINE READ AND CIIECY..ED THIS , APPLICATION THOROUGHLY"' '. . ..,..,:, 1 ,,' .." ~. . . I ~'..,', , .. -",;,' ., . ", ',;,. < ".:,".,~ r' ,'", ','>-/7_ A/J- ~",. ';, ',;, "" ~r "-~~ /?" $C I( "lOt!, 0) U( .y:;r:-<.I-l,..:', "A~2r.);:Z:7i~~tr'T~91!'J\lbcontr~ctor ., NAME ."~~l,e.ase p"iint,) ..:..~ .,,'. '" ':,; ,SIGNATURE <J_,' ~ C,-........~~~DA'tE,:....:;.-:_~1 .O.Agent I, . O,PLANNING/ZONING: ,;,zo~e If-I ."'Min~}l'um~.set.!?a~k"s,: eL, fFO!1~'" '~.~0 eL, -'side '. -. .. ~ interior Parcel #. . ,<-, p;orcel size/7tJY~ J' ., , -.> .,.- I . '~~'ear' \. '\ ~l-'artition, # Comments: .iJ. .. ',\. ~DPr;AIN:: 1~:Inflciod hiizard qrea? ...' ~ ' '. " , .0 RU.JU\L ' ADDRESSING: ;~G~;\'" COO~lNATE , . , ., I ErSANI1wi'roN: "'5,: L /,': :.,-' -'" O.NO, _ Dat~, ;P:zr/cf! ~ Ye~~~ :~f.~e~~~e~tte:Date' ." I":'Zb.~ 81 E , '~', .... '. ~ t . N .> . Date: I~Q~:;7 7: ;;3ris~~il~'~~~n 'Re.~O~d - _, 1", -> ~ '." ':~" .. ~ !.~ P B: P. ,issued? I2Sl.Yesl 0 ~o~' . . . '.~ Installation ., Gallon Line';l F~et -\". Maximum Depth Specifications:. Tank ". 'of'Drain-field, 'l'.-;'~ '. .' of Trenches" - " ,Co,,""~-;J;lJJrQ(f!r:I Ct/r1:Jrud/fIVV" Yrl1}jUibr.Lf.4-ff/''',~Oj!oIl;f' IPC111 f"'?,:"rliAA1 ,(', p(;// ,~ag .a'" ~#1 '~hh' ~ fY-9z,,'tI,Q>b "'-" "''"f'"'''' ~rt:e:,/re,y{tl{nf.!d\r6MOyitut4I!dfB~_,,~ r1.;(}jrfoki ';:('J~: Date~!~~1~,/:..' ~ LANS EXAMINATION':~ .-'.. _ -'. ,I"" 'Use, r~'...: ~ ,I:, \ ' , ico,,""ent~.',SE:E";AJ.O~TES,.<Qv pt..ArI~,e'~~ A.i2.t>lil(1.~ u)SPlFGTttJAl'S , ' .,~ ~ ."' ,." ,'~ _. _ ' '.,', . ~, _':. " .. 't A-1Jl/ He IfT}(i(;., ~.!)u, PME:tJT' Foi2.V"il-E' P:~'t&. .,W~ ,R.E'&u-teF' ~_A (fj/ 14,~J4.71- ~i=IZHtl7., ~''{}.5>Date. j_:':~.;.7:0f1 " 0 ~, . CONSTRUCTION'AUTHORIZEO"BY, THIS PERMIT " 1" r' ,-- ,.~' . "~po ~i:Pt~.~9~." . . " lV., " sq.. FL Fixed' Feel unirf. Cost. ~,:,,'.~ , ,.' ~1()o'~p~ain-F~~ :Subsurface"Fees '. .... ~ ~ ,.-: . ;:.';r:- .... ,:""'f_",'. :' ,$: ':, $ $ /,,0 ,r7t") . $ $ , $ $ '$ ,', Building Fee . -" SewerlStorp1 Drain/Wate~ , Plumbing Mechanical Plal}s Check Fee State S.urcharge F~xtures : ,'. , , ;;'" " , , c;;::' ',' Date: ~' . ~ .-~,.,' 0 , (per ORS'456.805(l)} _~. '. TOTALT:~.. ,.. $ ',;E~~:;:~~. .D Ca~h 'Y2JA'/ ,..~ DATE ~OTAL VALUATION, $' PERMIT 'APPROVED BY BUILDI~~ OFFle C74 -,194 . SEE REVERSE EUGENE, 'OREGON ( , 97401, LANE COUNTY DEPARTMENT OF ENVIRON~NTAL MANAGEMENT I 125 EAST EIGHTH.AVENUE, -. :~ ~ -- .'-;CC'. -J .'t' ',. . " 'C ..:0;-,.. .-...~. ~_ : i..". ; l,'.,.;, '{...;I'" " '... 1" ' ,.'... J" I. '':'-i- -' ~, ~'. '.- '.-..,; .... ---,.;" '.. . l' ' ", ,''\., ",_i",', ':"':" 1 !i" '.} . ~ Y1 t "...~. _... _ '" ~,,:..:, ., \. '-..... ..,.... .~,., ...10.....:; ..'~. " . "',.:',:...~~.;~.->. i, .SETBACKS A,ND;,OTHER C.o~DITIONS 'OF APPROVAL MUST BE STRICTLY OBSERVED" VIOLATlON,CAN,RESULT- IN, REVOCATION OF THIS PERMIT;, -;..; ',,' '~ CITA~ION"UNO~R.PROV\S.I.QNSOF'LANEC9UNTY'S INFRACTION ORDINANCE, AND/OR OTHER REMEDIES ALLO~IED BY, .LAW: ';~ ,'.-,''';-' <' .~. ' . " . . " , ' ,..."., " , , " '. ":"': . WHEN READY',FOR'INSPECTio'N CALC ,687-4065; , A MINIMUM OF AT .LEAST,:24 HOUR AOVANCE,NOTIGE FOR INSPECTION REQUEST MUST 8E 'GIVEN. . Have,j~he fol:l o~'ing':i nfo_.tmatJi_oJ1..r~a_dy;~~,~er.~~t~. number,," 'job- ?ddre~s~::r~YP~;'l?f '; nspec~5.qd ;..w~~.~~ir _w~i]! ~.~_ r..e<tdy:, ~;,'; ,'"'l t\...' .', your name.\and, phonenumber.and:~:any speclaL-chrections to site'. \ .... _. '.-" ~'.'; -; .i.... "'.' -' . ,f! ~. . ~.~ . .:. ," -~;: ~r ~.'" ~ ;. '" ~_" ' \'''i, ..."... " '1'-'''''" I ,.' .\ BUI)..DINGDIYlSION: '-~:' ",,~-. .,'" __~_.""'~_'''':~:':'''';h . \". l.':' ,::,( "':-.... -;." ..,;"r;j~"_ , ,'_ 1 'REOUIRED IIlSPECTIONS, ,~, '", ,'f ' ..' , ,', , '. .J- 1')~' FOUN[iAT~ON .INSPEct~I6N'-:: I_~~O .be ma~e-a'fte-~'~tr~nC:hes ~are ex"ca'~ci~e'd ~h~_. fo,rms:e~e~ted an'd":wh~n.:?,l,~, ma~e!i a,ls :fcir: ~_he: .fqunqati_on ~:' ,l ,are del ~vered on. th~ 'Job... ,Where, concl:'ete from a centra 1 mlxlng' pl ant (commonly. termed' "transl t ,mlXed!I;) 1 s, to be, used, to" . ' ' , '. l' ' ... '-'-f ",' " , ..... ..' . \,.. -~... ',"- -'..... '-' , ...... ,"'" , ~-- - -, '. ' .' matenas need,notbeonthe-job.-. ..::. . ..._':.~._,.;..~:~,'...w~,:.' :~1_-_"_:._~l.....-....~~.;,:'-I.r-:> '~" ~...-':.".,"...lt."J . ". ,";-. ....'._ -_, - .,b r ',' '--, - ,~' ,'", F-":.! -:: - ,.... '!.":'':J_;'<7~:~ ".;::~.- .. 2) CONCRETE SLAB OR UNDER-FLOOR INSPECTION: To be made after all in-slabor,under-floor..builoing service equipment; ': ~,' c~nduit, pipi ng.,accessories and oth-e_r .ancil ,1 ary equ,i p~entjtenis are in p,lace .but _Defor'e. __any 'concrete j s:':poure'd~, \_. ..":.':. _: or f,loor.~heathing_ i~sti!-l1~d,'including, the subfloor.. 'J' . " . .--:. '.~,\ ~._", .,,"'t. - '-, : ,-,': ,. , ", " -' " ' ~)... , --3) FRAMING &'INSULATION'INSPECTIONS:-To be made"after: the roof, 'all',framing;~ire blocking and bracing,'arein'p1'ace and ""---~ , 'a 11 pipe,S ;".:fi replaces "anq chimneys an'd 'vents~~'are c~mRrete and ..all rOljgh' el ectri ca 1 'and pl u'i-hb.ing- are approved. ~ All ". .. Iwa.l)."':in.s_uHt.i,on anl;i. vapor ~baj:;:;er. '~re' .i rLP'l~'c~.:.. . ~ ~ :. .... '. J ......:t ....~, . '.,:. , .-:: !.~ 7' .:~~. .',-' -' . _ .- .:Y ~:..:. , _, ~ ~ " ..,' 'f "t')' , .'" ,J . ,,', ,'\~:. ' ' '. '. - ,; .... " 4) ,;LATH.-,AND/OR -GYPSUM BOARO INSPECTION:, To ,be;'madeaftero an -lath,ing' and gypsum board-,interio, and exterior, is in place . ~cbt:l.t ~efo.re'.any 'plasteri n9" is-appl ied ~or~before:-gypsum' boar:d ~joint's;"an'd fasteners...a're,.taped and.fini shed. ' ..;'..._J,.... :..,~. .:...~'- ~ . -," '.' " ,.' -, :. ~ . . . . '. - . ',i '-l.-.' 't ,,~r, FI~AL INSPECTION: ~~? ,~~,m~d". ,~.fte~.!~e bujlding is rOEJPlete g~d ~:for~,.?~c.~ea~8'.'l T: '_',', .', APPROVAL:,REQUIRED, No'wor,k',shall be done on any part of,the building:,o", structure beyond the point indicated in each success,ive' inspection.wttliouL"first Obtaining the approval of thebui.lding official.. Such'_approval shall be g,iven 'only .. after an. inspection sheil 1- have been made of each successive,sfep' in, the construction as,'ind'icated liy each of ' the inspections required. ._, , . . '. ." i ....,'" . ^ . "'< .:. ..,,~...~. .',', r ._.'....._,...,..................;....... ,__,_ ,..;...,_,....,_ .~,_J_,:_ ._."""'_..... ._..~~. .'.,'__,.~.~_ ._ NQTE.: ~ 11 building perrnit~' require i nspections'-. for' ,the wor,k autho"ri zed., such as~'but not 1 imi ted.to: ,. ., ':: ., ":' .';' . . ~,"'" ' '.' :. , ',,,, .. ',...,' -- .. .. J ,^ ',J'" ! 1,.'.- '1. __+...,. j1-' .' " :ri.;' . BLOCK WALL.:, T.o~be.made.,'after,reinfo.rc'ing is in -pl'ace,.~ut~,befOre'any,grout'is"pour:ed: This-inspection is. re.qui r~d 'for._ .~~ch'ppnd;' beam.'pou[, Jh~r:e, wi ll+b~: ,,:0' ~ppr'6'~~J. ~'nt,il ,~h~, p,l uJnbing an~, ele'~tri ~al~ i...n-spectjons havebe~n,'!1)a,~eand,~-ppr~ye.d,.",.. '..+...".. :r.... .~-" ~!....;.,~ ," ,.' - '-~ '. ..>~".I _.,;',' l'l.'. B. WOOD STOVE:.-.To be made after comple~io!l of masonry (if aODlical:1.1e) and_when installa~_ion_ is.c.omD,..ete...,..'..;~..:~ .~,' In'sta 11 atim; sha~ll .be.'i n accordance with-an ,approvei:J tiatioF}a lly "recagni z.ed testlng ag-encyaf\d the manu- '-'W- factur~r~? ').n~ta11ation; instr:uctions. ,.,\ .' ". . " ". '.,. . \,/\.'1 "'S_.~....J ,. .'j_ ::;:"1.,._ ': ~ . .._..,.. tt", .';\ "',', 'c. ,r~OBILE 'HOME:: An.')nspection is re,quired after ,t~e mobil'e home, is con"necte~ to .an"',approved_."s<ewe'r-or septic j' ~:.. e.. sy.~tem for:,. .s.e,tba~.k.lJ.~qui,reme!lt~,,' b.locki ng,,- ~ooti ng conn~c~1.on! t\~d9wns, skirting" ~and,. 'pl.umbi rig.. _ ". ._.;. connections. . .. ",::" -".'. f-"" '-: . <^,....... . .tl) 'Footings' and ,'pi~r~:,to comply with St~te foundatfon, requi ~~ents \~or. mobil Ii homes -i:;;~as:'r~CO~~~nded ',-' . , \ ,by the manufacture~-. " P, .', ,~'_ ''':...'''..> .', " -., (2)-' Mobile home minimum:finish floor elevatron.snaJl"b~"certified',when required by ~ .floodplain: "'."" . mana,gement" letter. c,, ,', ' " ..__ ~.~ ' . . ',' . " ;,I. (3-) Mobi-l e"home ti edowris. when-.requi red, and ski,rti ng .shall' he ,i nstalled. and,. ready_ for '.i nspectf6fi ' '';' : ': '.~ i::~~~,~th.fn~t le~sY 30_~days af.ter occ~pancy. " Tiedowns ~~d ski rting shall be ',insta 11ed per .encl.osure. i i: ~J .~D. : s~wi~MM1~G:~POO'L: ~,~el o~ '~::;~~~~'~h~~.7.s~~:1'::'is .1-n~;~'~1a.c.~~~;'d b'e(Ore c~nc~r~'~~i~'s' ;our~d. ,'.,-Ab~V~ :'g~:de~w-;::'~.:~'~~j~ \\ ~;:'(" - , . ". iSinstal.1~d. '._ "', ." ~..." .' ...~.. :..' i'!,--'~f:~_'~~':'-;:-''''':.' - .<\-.': .~-~:~ '~"'~~-~'_'t': . _ . ,... , , " APPROVEO PLANS MUST'BE ON THE J08' SITE AT ALL'TlMES DURING 'WORKlNG-'HOURS"THIS,PERMIT WILL 'EXPIRE I,-fIORK DOES, NOT,BEGIN, 'WITHIN 180 OAYS' OR- IF, WORK 'IS 'SUSPENDED OR AB'ANDONED," FOR 'MORE\THANI80: DAYS, "SUSPENSION OR REVOCATlON,MAY OCCUR, IF.'THIS ': PERf1IT WAS ISSUED ON njE'BAsIS"OF INCOf1PLETE OR"ERRONEOUS-INFORMATION:, "','; ,"I,' ' ','::',_:"' ..~,.;, " .' - ".: '., ..'. ~. ~ ;; .'...", .! ',,' ;_., r _. , " ~_ ' _' :.-~ .. ~ '", ,,':. _ . 'ANYONE ,PROCEEDING PAST ;THE POINT OF REQUIRED.INSPECTIONS HILL DO SO AT 'HIS' OWN "RISK .~- '''' -<1:.... 00;-. . -. ._". , ,SUBSURFACE AND ALTERNATIVE' SEWAGEDISPOSA(SYSTEMS' " ':', ':;...-_.._'.'...'.<;'-. -- .~...,_:_.~,'_';.'...;:'~...'. .........~~."-:..,_. "..'. -:--_'~_""~...-j...~,.....,.. -_~':-"~' -'.,J...... _._: + .. ;;t...-.~' :.~ P~.rm\t~ .s,hall- l:ie.~eJ:f.~c;Ji.v~. fqr:..Q.Q~ .Yi-~ !:rQ.'!1'.Jh~:~~te ot. i,~~o:Q.s.f .~~~ L.~..~:"'....:":. ... ':,...': .~_. .~~...'. _': -_~,~ ':.....~. _ ,._~::.,:'.__ ' Upo~. ,!;:ompl,eJing~~th_~ .c?nst'r~ct.~on+.fgr '~~i ch 'a...p~.f111i~.b~~~ ~ee_n:. f~~:u~~~li.'!.h.~..~~rnij.~_~oi der' Sh~~~~'~~o_t~,~~:~t~~ " .:-. _-~';:Rl~.:...~;.. , Depar.tment by submlttlng the )nstallatlon record form. -The -Oepar.tmentsliall lnspec~the con~tructlOn: to~ _' '--:.- - determi ne if it campl_i es :wi th':'the 'ru.1 es:icontai ned J..i n,~this,. drvi s.;.on .'~' -If.: the-.cons-tr.ucticih '_does compJY~~li.th. r ;-...t :~.~such rules, the.Dep_artmen-t' s'hal1' fssue~a, certifiC"a~te' of satisfaEtor.y"ccmiRfetion.t'o"the_ permit holder. - If,~the"".. .i..~,;\ ': \ . ' :cons_tr'tict10n 'does, n'ut i:o!'l'pJi..w~ th -.sl!ch'- rul~s", ~th~e 'p~parb,n~n.t s.h~1 L_n'9!i.fy,~~~~'~perm,1 t, hol der :an,d' s~all. requi re ".;.' ~. satl s,fa:~ory'..col]Jpl ELti?n~ b,efore, i ~~,~i ng,..~h~ .c:ert)f,ic~_~e.. :{~1.1ur~-,to me~t. the requi,~e,mfn~sf?~c._sa.t.l ~fac~or~ '".; i'~ :...~, '.. -, compl etl on-..w,l,th'l n~.a reas~lnab l,e . t lme. _cons.tl tutes;"a '_ Vl 01 a t~.on of OR~. 4?~ ..6D5'~ ~;;,454, !4.5~~~d' thl s ,rul ~'. :,:' + ': '. _~~;. : _ _ _ sit1acks_~..,:S'ubs.'ur'fac-e' Sewaae _DisDosal, .,.,,/:,~~,:-;:'J -.::i-'" . r'. .~ " 'L :" \,.:.-, ),:.-,~:~ ,.,.-'~ ~',' +1. \. i" .'. \, -. _ " -:' ~. -.... '. r' -~.''f'.--.~'" ,.. .". -;'~'.:.'....~-'~n~"'""""'''SeDtic Tank' -p.Drainfield "'"'" '--.,_.,."...,.- _ ,..,.';,,,~' .':*"-rt Frbm:: ''Interior'property-ii~es .. ;/: .',,:.. 10"~ ~:'. .lO~:+'" ..' Edge'of road right-of-way,' 10" 10' --.." . Bu,ilding _foundation:" ". .'.:~:pl.;.',~r( ":' 51 '.... :":~;' 101 . Wells, other'water~~our.ces:-.., :~ 501 .,!'. .100' ., ...... ' ~ 1 ~. " ,;; .. 't,.-. . ' ~. ~', ~ . ,; ;.~1 ,.l . "" .. -!~ ' ,: ,r " ; ", '. .," , 'l ~ , t ;}~ .' .;.,~ , , ~' , OJ.. ;~~ I ',,~(2) , ' ... ,.t'.~;:, '~.'~:: .-:,';:......t, - ...~ "~ ~. -, + '~"!'. ,r :.,..:' -...._;+..;:. :.. ~"::"J . ~~P" '"I.::,:.'i ".i.,'- ..' .~l -..- ,- ,,",'~ --'-'-.- --"...". ...--.., "'"-'! , , . )'. ~: t'.-,... " , ,"'.;.' " , - ,,' --. ': ....--: .. ." ..-- - '..",. ~,..' " t., 'C " , . ,~ , - ~ ., " ;>~:-: '" , " ' '" ;..- .... '..' t ;', i.~:~' ~..:- "?":-- _. '_ ~ '<, ,.. . ~ ': -t'. ~.- -'.~~~- '. '-, - ,~. -., . '-- .'. ,,'" ,..-. .,<t' 'C ;:'-'-". .../,- '-... ..:"-' , . :-_.v';l~' .. . ~. F- - ....r~. '-. ~\, .... ,II , , ~.'; , . .r"':. .-.......... ~, { ir;o: \,' ~ ., ~ .~~: ...t .. 'r-:' .,. ,i"J..' .'i'Z't\ ~- , ~~'l/V'~~ '0'.., ,", , ,,' ",a'Registeted.,Professional ',. . . ,. ".. . , ""-.,. ". ,. -,' . ~in; the State orM'egon,~diJ' hereby -,' , , . . ,'. .' ',,'certl(Y:''::t'o i_ane"County, that the following e'levat;"on represents ,a survey', " . . ,maq~by me.or:,~nder,:my s,uper'visio,n.~.'" ' · ' , ',~ ':'" ~",,' ' ;:i lj "Tb';,:fo~rida~i'on,\;levat;on',(inciulin<baSe~e?t';si~,b)f '~+ ' ", , ";(r~SL)'"", ' ~, :'OThe,~rou~d eleva,tion.tha'tstructu~~w,i,1l9e.,p:aced9n= '<0' "(~'SL): i ',:/0 '~he f,i r,s't. ri,oor,el evat,iOn ',=<, ',j :'," ' (MSL)" "~. ,,' :', ,0 .' Th'e e!ev,a~i on,of-"theto~ o'fflood~roof~ng :~ ': ';,' ':"'.!(~~'l'I':'" < ,~',;:. ~, ~~, 11 D-- Othe..:~t . " ::~ ~:r ,...' , .'~. ."'>- '. . -"L"," '...~:.".:.' '~( Reference 'Bencry ,Mark No.'" '." " ~!. " , '. '".,. ;~';,f ~' '. , ','" ",' .',. , " ,""'7" ":~'''' '"~, ...., , . :", .;' .r "\' ,- , . ~' " ..,\. " ',I . ;1:, ''':" co, "..,- .~ ,~'~~ \,~',~:"_(:r...:,. ~___ ',. ~ ~ ".~ ~.., ~ . ~ '.~' '-'~'._" "': ". '; "" ", " , ,,',,'F[OODPLAIN ~lAtJA'GEr>1tpto., ,', ;-',' " Depa rtmenfof Envi rorimenta l'Management/l2,5 East ,Bth' 'Pwc{"'- ~ugene ,.' Oregon:;' ,', ' '6B7~4357 " ,',-, , '" , 11z~.L.e.t~ "'. . :~y ,ad}. ;.{, , " .,. .',' , ,\ -" I... _ " :" Date ' ': ;. . '.:;. . ' .:' ',..", " , . ~'"".. .':: D: 'CEfUrt"rCATION ,OF ELEVATION ',' , , I, ''''; '" "0 . ) i~, ..r. j"- " " , Locat,ion: " .:" '.1: ~. , '. ..... , ,-' ~ ., "' \. ..., '" >>::1 ~ . f" ---I "'V "'_';' , .-'::"-'~. ~ignature . ' Date': , . ': '~'" SEAt ,r, " , , . ,J: _ i.~ " .1, ~ > '. .~ '" '. lilRQ (9YRty" " , : "" , ", " Ori gi na 1 ;t~:::'F~<:~ ,1fHj'I~E:tL:--:~ t') ~'~<-,'!:~q~," - '.. ' . ,;- "", ~"., .' .' .: ..,. -.. , ":,lst copy wi:th',appli'cation/inspection 2nd copy 'fo 'app Ii cant" ' , ' '3rd'co1Jy ;~o :Floodpla-in ManagC2ment - ~ . ~' , ~'."I , .> j\I .c , ," .,..'.. , ' .,..'.. "..;. " , , ',' Job Location (Address) 2fal5' \-\--,.;, r\ ," '" Pernd t II \-\ :-\ - '-\''\ ~ For S \ <c' .~ <", ,;----, , Permit Permit II \lrS, '\, 'I '\ For '--~''--'- ,,-I, \ ' ,"" "~Permit Permi t /I }'j0- 'X I For tJff'>/ ,-'> Permit , r TRS, TL , ') '. ,~:J.~'~./. . - \"--'--' POot Plan Subdivision Lot 7', , / I ' , - Block APPROVED DATE , :/.Y. !r2fklXI BY A&f.tJ \) ',() 'p./ [r€ t)-{~",....-!--.... ;/;2,11 /11/ -Ii e/.CY, V tu4.- ch, ,he. e..,<-4~,yt, ~;r..L .t.....~-t , .J~k.-~ .UtI ~~ /~,~,/-~' , Vicinity Map - N _C74-150 L ----_ t '" \) , , + .:: \ ; i , I ! , " ~ ! t I t \': I f\:; '\,', I, \ 1 ' \ ,r, \ 1 " I , i , (, C\ I t , , j', \" , ",\.J , 'II' ...J !~ \ , ~' ,~\ ....'-- ----- ~., /---,-- ''''f'' , , I ' i ' ! I, I _' ! I ....' o "11 II _u". ( I ", '.'...." " \:.jl~',;) 9,j.1l\~ , '0(; l)ft-' ~ I , -"-'I --li f' ~! 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COST VALUATION FEE DiiYS COUNTY DEPT ENV MGT RECEIPT I ADDR 2615 HAYDEN BRIDGE I "11 " NO. r:nN"I::f'I'()I:i<:: : ... _ 1'( _..., . ,1_ r\E:CHAN ICAL FEE-- ST,:,TE SUI:iCH,\l'iGE PI..AN CHECK FEE I, 60,,00. 1 ~'>" 00 Er.,CH --., ,... .(y/;, 50~{' I ,'. ! ' SDS PCK ':~ 4 SI. ' nTH ISS 4 TOTAL FEEJfJl" -60 . 00 CK 2 COMPLETION DATE 01,2<;>81