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HomeMy WebLinkAboutPermit Building 1978-2-9 ~' ~__' '--"''1-,';' ,- ~rv;~S. T~ ~iie C~ ~~63- ~!~ 2. z -_..~---,._,' .....-._-,-- , ~." f:.- ' .t:r3s-m .r. '.: .". -~ lif. --, JOB LOCAT'ION l,a>:::...~'/lO (,;>\ rf-... /~, /!,{ A _,.~i--.f;.V;"'- L-.t/. /\___ _ ,-,.I i)-" ~- ,., 30378 ,SP-;~"&. _ .(4' c'''. ':h' , t'J{)/~: jbJ' Acreage or Lot Si70 7 /' Contractor's O,S, # IV /t' . _'1 ....... .,:,., LANE COUNTY PERMIT Partitioning # ,>//.4 ) Completed '''' ' . ~ . :,..-; . -::V,.r-~' , .s:cl... ,d~t!.,' -r d_ S bd' " "'"<J--<- ,~_ o..ryW ,-~ u IVISlon _.I~ ~ ( Lot "7'k7 Block ;..;> Phono 7</6 - 3701 Phono Pho,;'o (owner, etc,) when ready, .., A-I_ I APPLICANT'S NAME AND ADDRES" OWNER'S NAME AND ADDRESC:: CONTRACTOR'S NAME AND ADDRESC:: Mail permit to ( ) Applicant ( ) Owner ~dLlr1.S,{d~ V If (/ 1/ ) Contractor, ( '/Prefer to pick up, Call '''''''.0'';; IV! -- ~~, STRUCTURES NOWON THE PROPERTY" m it- '" THISPERMIT IS F~R ';;1~ait.:~=~-le c:'l." La/1 )OC.<,,/LZ,S7,'!{"" # BEDROOMc::A/-i p"LUMBING CONNE'CTION?/A ~~JATER SUPPLY ~CU SEWAGE'DISPOSAI /'---M~ 148'J-70s,1. # - THIS PROPERTY IS WITHIN ONE MILE OF THE CITY OF ~. PLUM~ING BY /V A,.." I hereby certify that the above stateme'nts are true and accurate. and that I have the following legal interest in the property: . ~iNner of record; contract purchaser; _ potential buyer; _ realtor or agent, I further certify that (if not the owner) I am authorized to acffor the owner of record. and that said owner is aware and,approves of this action, I hereby agree to CO~'1iPIY with all applicablelCodes relating to this permit, c---- ' / C] ((P/.8) , (u .,;t;; /?P1 'i~ "I [./- 7(/ Fee Paid $'. J 7, l.? <:) _I ,Signature r<' ~ ' ~L Y"f: Date 0'- ) NEW ADDRESS ( ) FACILITY PERMIT TO TRANSPORTATION DEPT / ) SPEciAL PMT~REA, MIN, ELEVATION: ii, II . . SANITATION ;1, Minimum Septic Tank Capacity (Gallons) Drainfield Required '.Lineal Feet Maxi mum Depth' , , Comments: tlo. "t...~- cl~. ~. c~,?d.,e"./" C ' _'- (J, ' // ,'c:/AA"'j ~(A~tPU. ,4APaJ.(,.. &G -"'1:J&~:tr- ~h~~' ./ BUlbDING' .6 Al'Type of Construction J t:C-C-c..~'lse Classification Comments: " ,,:,{7 . "'roup :3 Fire Zone - /J it;Afl.11/ ./''{ 1'\~" ?::iv'" ;:-. ..: ,- BY'-Ot: 6o--y:1 z -J:.:"'~]~ ~. . '" ~' C55,13 BLDG. PERMIT - WHITE; BUILDING - GREEN; PLUMBING - CANARY; SANITATION - GOLDENROD; OFF-ICE Eop.y - WHITE ~ " t", '1 "!,,/'-"~ I ~ ft~f"of /'" J:, ',;, "b:.';'",-Tf ,1",r,,,,,,t- ,": ,y;. , (V /.~ ~'f}(;> ~~ .(] w' ?[), I ~ ,,,,-~,, . . , ~lb:~..~';-i::!~.f.f'~;:;f~.~;>~~ ..' 'j .~I ~-'" Ot-V, """"""" G T";~~ ,"'~<:: j3;'c1 e D f 01 ' :'i>~i~ fi 0 of' 1 ^' e; 1 ~ . 'i ~( ',::i9i3' L B II' ",<;~;;~X;?' " - 11\!/ ~.,~'- I I :~:;i,'~{~~~~";13i~~~:~'~,~~:t.~"'" ~~-. ~..'FI,,': _ C";;' ,'.' ~;_' ~.~: ..... ',,:;:i;:. ','~.", -'.. _~;i..,.".",.,.:<~:);,.."~:,,,,:._~ !." - ~",. ": , .,,,,, ........- .~. ',' '.. .> . :.~ ..~ :5r L." _' PeFTf- .,L".)'lt':..Q' -,,~ ,. " .- '.' . :'"--;- .'~.z. ',' ,. PB 0 $' ;:.' "i..') ,;':. ~ ,~, ~. ''\ .. <., ,0 ' , . /~ '/-- , .~. ,f'-_ ~;, '''': l":' ,,-,~ '0 .;- '.-" " :,.' '3tf"FI l~ I "I ! " ,..i~: ~~ ,'(~'\. ',' ." . / . ''''''', ',,, '/ ! ";,,1,, ~! ".Je, -~~" ,-', I.~- 0....,/,;', ' J~,' Gi ',; ':\1 /~/(' ,: I ' ."";:"I:\j. ",-,. t " /;;(' i,:,'.i.'~,.,.'~' \s<', VI' '" . "',,",, " ',/,1. ~,"'~ Ii; C"" -' ,~-i>:"~" " " .". .. I', ,~ ;" " 1 , ~i-rftf; r'-l /, / 1/ ',. i' t/ / p"" '/ '" .; I ! i I i ! " I .I .". ".-.:. -i;> ,- I "," ~ it. ~, 1. ~. ~~, .' "-' ,I' ,I 'iP , ' / , ~~/. q,;, ' I \' ~ ry ',. .,"', ., ..---- , .j ",i j~ ~~~~~ :r'~~ ;' I '/ c ~, . "f:.'" L/X~ i i'.IX fif: ",;;- _,.,.c,' . '.,. ;'" ,,' ._; , ...> ..' :., ,;::',..,,' ;:", >.',s :,; .. '.:" , ,~ ". .~:" ......,~ '."~ ST~EJ,..' ._' '~~ ;S (/P,:o}?T5 ~;,;. '. -~~!~~~3~ ~>:' '~::~"'. ;- ~..-'~"- ,:~{.'~_.,~:~, :-., -'-,,' '-,.J , ..~}. ; ':....' . ~-;"" -',. ,,'; - .. ~ .;i~'J:",~''r;'+ ~" :'''''. ,,- :~,. " '" ,:" ':: :;f~"~,,, "' ',' "'\i.,. ':.., ..,,- .~ . . :' ,~l,~'" :'::~:: >>,'~:-, ., ~. , " ,,,', .-,-'-': ,$:" ~~~ ~~~~: "":))I ''''''~':': f~~ ~tll ~l l~ ~~td '''''-,.C ~ l""~:;! ''''~ '...'~, ~~ .,,,, ""~ ~t~ t5'~ ~~ fif.:."1 ~~ . tk~ ~'.4 ttJg ,t1~ ~ II I"," )~i ,;;;~ ;.;;t~" *~ ID~ l~~ 1,'G\j I",;;q I~~ ~->, - f~ .1 ,'.>,'< 'iI'" iit~ itli ""~ ~~'~.:!.: i! ~ ;~~ ~~ l~ 5' !tf0 ~~lJ [,',,< t"~-:'- Jli1 I'~" r~:~;tJ 1r;J~--': I . :~,;. .) ": " q - -I' -\ ,."- ,\ ':WJiii;: , ' Do \'" \ \'00 \'0 ... \ TRS, TI written Directions , vJ p So u T k Job Location :J-O (:; ~ Ii ~; -, , / r fJA NGe 3 '/ y/c ,f'",c- II ::z. ;)... /~/Tce/ JVu. 35'00 INFORMATION SHEET , (',De tf/lM'/IIo -/9- 0/ (X) Building Permit. ) Site Feasibility Study for Septic Tank, Number of sites Acreage or Lot Size Test.~~1 be rypdy., , l.: '. Partitioning # . ( ) Completed Subdivis~ ~ -, _ ~,l" ~ , ( ) Pendin\l, ~ APPLICANT'S NAME AND ADDRESS lY---4d<..t?J1 . .26(~:L Ho-rI~ 01: d~frU~ OWNER'SNAMEANDADDRESS,ifdifferentfromapplicant's(; ''; ~!';" /eT"- CONTRACTOR'S NAME AND ADDRESS Mail permit or results of site feasibility study to . ) Applicant ( ) Owner ( ) Contractor, I KI Prefer to pick up, Call 71/C-..3'7o/ (owner. etc,) when ready, 'STRUCTURES NOW ON THE PROPERTY 7?'/ ~ Al ~ ~ 6~ f'~f?~ Lot ~0, Block. -::::2, Phone 7~C-3'70/ Phone Phone Contractors 0, s, # PROPOSED USE (this permit) :l!: ~rnrm~ WA TER SUPPLY (existing or proposed well, etc, If public, name of system/ SEWAGE DISPOSAl (existing or proposed septic tank, etc,) S,I. 1= PLUMBING BY Address ) PROPERTY IS WITHIN ONE MILE OF CITY ( No ****.****************~*"**** **-Jl-'** -Jl--Jl-*-Jl-**-Jl--Jl-*-ll--Jl--Jl--Jl- OFFICE USE ONLY BE LOW THIS LINE *** **** ** * **.* ** **** ** **"* *** ** **"* *" ** '*"* * '* *........ ( ) New Address Necessary ) Facility Permit Necessary ZONF SETBACKS: Front Side Facing Street \ (FROM CENTERLINE OF ROAO) ) Special Permit Area, Minimum Elevation: Interior Side Yard Rear (FROM PROPERTY L1NESl 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 '\, ~ l::'"' ' \ ~ 0\.0 ~ 'cc. ~ ~ 00 ' -::r .,' ~ ". , " / '..-' " 9,5; / r i~ .~ : J, I.. 11/\ ) I I ~ 48 ' I f--I '1~ r J:RoN' -:T , A~ ~ :::r. 0 '" 0 ~ 'l "" 3'. - 'tlb , t- , tu f\l o.:J:l ~ ~ \ ~ II ".~ I -\ \J' "- "- )-- ~ /SaPTlc '-. l) . ~ "" ___ c. TANK , 1\'\ ~-, t ~S~ " " Iv >- ~ I ..", '- -'. - b _J:> ~-- ~~ --<.. \ h, ... 001 ),( ..; " ,,5'"1'" 11 (2. e. / - fI.li If 13' 0 K- [) tt/ II e- '