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HomeMy WebLinkAboutPermit Septic Tank 1974-7-24 ~O~,~NSptJlA~~tn i'., " 'LANE COUNTY ", 'r) ,.',. BUILDING 'f)I, ! PROPERTY OWNER BUILDING PERMIT OR MH 0 MAILING ADDRESS ~~ht~~n AnnA A CONTRACTOR Rt_ q Box Illi4 MAILING ADDRESS \.In. 1 "At' ')n.rClnIlA .~t R_ R"x e\76 PROPERT"Y LOCATION =- INCLUDE POST OFFICE ~ROPERTY LEGAL DESCRIPTION - METES, BOUNDS J;; lhnt"+ r.rl"'lu" ~tfo:1 ~,..tt I cn_ R.-1 TWP - RANGE SECTI?N TAX LOT NO. 'IA APPl. NAME .,~,11 n. " & MAILING ADDRESS ,FOR MOBilE, HOME PERMITS ONLY . No. ~""of Bedrooms .STRUCTURES TO BE BUILT THIS PERMIT ';~~F~;-: n.c,..-....~...l ., 'j" -4="";'.. 0' hn.rf.,..';nm hnUc.'A <<::"c"'cm , ~- SEWAGE DISPOSAL \, \ \ / , '\W,S / ?~.')~. \J PUBLIC n BUILDING 1 W'ASTE DISPOSA"l PLUMBING PLAN REVIEW P.ARK TRAilER SEPTIC TANK OTHERn r;], , MOBILEQME USE PERMIT PERMIT NO, PI easant Hill C,?OE CENSUS TRACT EXISTING STRUCTURES ON 2-EDIS\A PROPERTY none _ LEGAL ACCESS TO PROPERTY ~~I-\."'rt>,qr Drlv~ PROPERTY SIZE - FT. WlliTll DEP.TH / PLUMBING INSTALLED BY" OWNER n OTHER: NAME WATER SUPPLY' PUBLIC 0 o OTHER " , TOTAL' $ r::~ ~t\ COUNTY BUilDING & SANITATION SPECIFICATIONS DRAIN FiElD REQUIRED MIN. 'SEPTIC TANK CAPACITY wrTH DIST. BOX: GAL. ann UN, FT lliO TRENCH WIDTH FT:_2 OR SQ. FT. /(}..QS-7J 1295-74 PHONE I, , 747~7717 PHONE , ,/ /,,; / / New System 0 VALUATION I. 't.. I ./~... 300 -: M~ cGMulrG" rnn"....tln"~ tn be ,made untl'l water svstem Is approved, See. attached ~ltteet'~ I TYPE OF STRUCTURE OCCUPANCY. BLDG. SETBACKS __ FT. FROM CTR. OF. ROAD RIGHT OF WAY FRONT SIDE INT. SIDE EXT. . AUTHORIZED SIGNATURE -DATE REAR J. Shl:":'~ !l.lDG. p,ERMlT - WHITE "f OFFICE COPY::"" WHITE ~~ COUNTY TAX - PINK PLUMBING - CANARY BUILDING -_GREEN SANITATION - GOLDENROD ,'-'( I", .,. eJ ,PUBLIC UTIC. EASEMENT ZONE RA-MII USE CLASSIFICATION DAT~ 7-24-74 bD Call 687-4065 to schedule all required inspections. All construc- tion shall comply. with Uniform Building Code, D.E.Q. stand,ards IMPORTANT: for subsurface sewage disposal. and county regulations covedng plumbing. All buildings require a certificate of occupancy before being occupied, (See Details on Reverse Side) ~ ~ Y"M '=C55, 13 ( (POST THIS PERMIT ON MAIN BLDG, AT SITE) LANE COUNTY, DEPT. OF ENVIRONMENTAL MANAGEMENT ,.--COURTHOUSE-ANNEX, 135 EAST 6th, EUGENE, OREGON 97401 '-"'-ti;",,~'- . ' ( LA~~ ~O~~Y I ' BUILDI~G !ru: l'''';''''''':'f'''':':''!''-' :-:. .f7 . -i~, - \. .~~.....-\..J. .... It , "",' .~;.,.. ,l/ I :'f"', . l' '<I !'\..~W;;' ~ 1.- ..,) <t: ',' " ~_(~RO:ERTY~.Ow'NER i.~. " ~,( Rnhln'lon, Anne IL ! I. CONTRACTOR I J "'~It.r Sl)rAaI!~ , j PROPERTY LOCATION -= INCLUDE . 4. BUILDING PERMIT MH 0 MAILING ADDRESS Rt. q Box 8;4 MAILING ADDRESS OR MOBILEQME USE PERMIT PERMIT NO, 12915-74 PHONE . Plusent HilI 747-7117 .r' II PHONE "h: Rt. 8. lox 576 POSFOFFICE TAX LOT NO. CODE CENSUS TRACT 111 APPl. NAME J & MAILING Oil 2+11 2-ElnSlA EXISTING STRUCTURES ON 'PROPERTY none LEGAL ACCESS TO PROPERTY " I. __ "(,..' HIIrbor DrIve PROPERTY SIZE - FT. j t ADDRESS FOR MOBilE HOME PERMITS ONLY I LNo. of Bedrooms t S~RUCTURES TO BE BUILT THIS,PERMIT ~, "an..'" ril~;"'C"1 S""t.", fer S'bl!drrcm houae 'I r wI6TFt DEPTH 141 AREA Ii/Lao PUBLIC 0 D- otHER New Syste", G ,!" . VALUATION I i 1. I il I,' , ,:it ,,,; "~:'~'" -.. ",':1, 'i: "~..' '-.:Ii ,; 1" '''''::'" i.:t_~ i(~, 'i-' ;~j ";t:, Connect to Existing Sewage System D TYPE CONSTR.UCTION SQ. FT. ~ BDRMS . I' i I t I '!,S.,EW ~GE, .' DISPOSAL. ~PUBlIC-(D-" 1,'1i' o' ,BU.,ILD.,INq(;~-"' _-~'. I 1~"-':f'-'."'4' ". f~t~!~:'":DIS;?~~;L"i_~: PLUMBI~,. .t..", " ~\<!!:, PlAN REV:I~y!:" l fe' , (: ,ARK TRAI~t~'; . , ,'.:" I TOTAL ,. , ~rU2t'1 COUNTY BUllDING':'&: ""'- \~""- '-'" '- \-", - ',,, . '\0... '-.. S;A!NIT"'T IQ.N..SPECI FICA TlONS (\ ./ I ,..4. (\ I.'i,' -''''):'J '" J' ii' .. Of' I I,' 'V '1 " ' "~, I,!,~,:', ;", _A"...Y-1.:"",...f~;~' ',,1/V<'jt~~ :, .r 'Or' __ ::)j~\~' .:.:V~ c .~''t't 1 :';":~'~ gf~~,l ., :~ :'~:":~.t:Jdr.' ~:a~~ "'~<;'-;';;"lk.'t"'.j ," '.'~ ..0_',..,., $; o fT ~":,;,.iJ!.>;;,<,,+ ~ RSQ , '...'f~< .~:;i4:~ ;:' .'.""l )-,J.,' ''I'' . ,if' ',~e.f;-iJ' ~~ ,~ PUBLIC um, EASE~ENTtt:ii:~'fi' '.7iF."':' ,~,;,,' : 'i'"\,, ;, 'l1'{, 7..1"-1-; ',bliDArE ,'. Y;",1'.j " _~:") -,~,-,-'~~' ~- ;~:J:"' Call 687-40.65 to schedule all, required insp~ct!ol}~_.;,":_:AII.c"onstruc-;' J tion sholl comply with Uniform Building Code, P,E:Q,' standar~sl " for subsurface sewage disposal and; ',county 'regi.Jl.ati~n,~cpve.rin,g_:,,:,i1 plumbing. All buildings- require a certificate of'-Occ.!JP~ncy...bef~r.;4'!' being occupied. ',J \' (See Details on Reverse Side) PLUMBING INSTALLED BY " FEES OWNER n OTHER: .NAME WATER SUPPLY SEPTIC TANK; "[KIlt OTHERD " . \;, .r M~.~., S~.~J!t'::~~N-~_i.S'AP1,91},(_ .:~'" ,,';hfH D1'~i;~(6X ;', ~GAi~,:; " ,tlb(f: ' '1 t ':~.l> ,~'~1'~;~;;~> :'~'. '_'{, .' _ , ,it H~'~:i~i2;~<~~U~' :'fT' ',' i~~ ':;~:!:I~t: '~:~v :J'lr-Y.p( qF, STRU0.JURE' -~r':, 1_ :_,>. \:~:~j";;~f~~" , rB_~~G:, SETBA;qi<:s-;:., FT. FROM' CT~. OF ROAD RI9HT OF WAY I {-FRONT"" SlOE INT., . ,SIDE EXT; ( ~. AUTHORIZED. SIGNATURE - DATE L)J,.I~k- I.\'~. ~,,;~ -:" .~. ,.; ,i _IBLDG...PERMIT'_'- WHITE 'r .fg~{J~~):r!~.=;~~~M ;, j'PWMBIN'(;,::,:'CANARY ~ tji:'1BU I"CD I NG':~.<G',fEEN ~~;,' "1SAt'! i'rATl9 N ';'GqLpENROD rf!) " I ~ t'~ '1' :~,i.'t .'"~OR~; ;:-'C55-13' ~-;..?;~" ~.l';-;'~."'\,';." ,'.,~ ,'".,' :!:~> ",;~~;>- ..:,-~ {.' DRAIN FltCb:-REQUIRED UN, 'T 150 TRENCH WIDTH FT. 2- to b. lllade IoInHI~ti.r llyU. III al'ProvllJll. , " -(.</ S..att:.$h,d .h~,;~, OCCUPANqy ,~ " <, ZONE RA..;MH USE CLASSIFICATION REAR IMPORTANT: , ,,' (Posy THIS PERMIT Ol\i MAIN. BLDG. AT SITE) 'LANE COUNTY, DEPT. OF ENVI~ONMENTAL MANAGEMENT ,COURTHOUSE ANNEX, 13SEA'ST 6th; EUGENE, "OREGON 97401 ....;J , , 'I >......"'-'0:.. ~,...' . -''''''I''''-~ '.. '" ;;.-\ is! TE INSPECT! ON ApPROVED CJ DISAPPROVED CJ DATE INSPECTOR REMARI<S FOUNDATION INSPECTION ApPROVED / ! DISAPPROVED / / DATE INSPECTOR REMARKS FRAMING INSPECTION ApPROVED / / DISAPPROVED 17 DATE INSPECTOR REMARK S LATH OR SHEETROCK INSPECTION ApPROVED I I DISAPPROVED ~ DATE INSPECTOR REMARKS .' j _....-, .I /ii / I ~ ,.-.- FINAL INSPECTION ApPROVED CJ DISAPPROVE'O CJ" DATE INSPECTOR REMARKS CERTIF!CATE OF OCCUPANCY READY TO ISSUE 17 NOT READY TO ISSUE 17 DATE INSPECTOR REMARKS " " . . , (., .. " js elf- 1 'e,- --='-I/,- -z.. 'L IL 3/00 T~~O~ s:2-1I/ TAX LOT . CENSUS TRi}CT ,:;'/kI"T Grove- ~11t4d i.-50 APPLICANT: 0 I ' 'S_ 3 NAME ' ~h'/I<'I'I'IA ~~..., ADDRESS r 'iJ ' -;7 t; L '. '. BUILO.lNG SITE EVALUATION \'u . () Bu i I ding Pe rm i t App I i cat i on No. () Site Inspection () Pre-Permit Investigation PHONE DATE 7-/2-'1/ ~ ~ I. COUNTY PLANNING OEPARTMENT NOT NO YES NAME DATE appl icable /1/K52--,' 7-/7 -7cJ Zon i ng Ordinance Compliance ( ) ( ) ( ) (Zone ~-H N- ( ) ( ( I Subdivision Ordinance Compl iance ) Required Access ( ) ( ) ( Bu i I ding Site (Area, Width, ( ) ( ) ( ) Frontage, Setback) Ot he r (see eomments) ( ) ( ) ) LANE 2, 3, 4, 5, COMMENTS: SAN ITATlON SECTION NOT NO YES ~k ~.~ 7h~1/J i-j aDDl i eab I e 10, Sewage o ispos a 1 ( ) ( ) (,) II. Us ab'l e Area ( ) ( ) ( ) 12, Water Supply ( ) ( ) (\ ) 13. Ot he r (see Comments) ( ) ( ) ( ) COMMENTS: TO APP LI CANT: ( ) ( ) ( ) Building Permit / Site Inspeetion: 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. Questions and further information on items 6 through 13 contact the Lane County Buildinq 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 returned under separate cover, ~ /}y /tir \'-~ LANE COUNTY PLANNING DIVISION 135 Sixth Avenue East, Eugene, Oregon 97401 Phone (503) 687-4186 LANE COUNTY ENVIRONMENTAL MANAGEMENT 135 Sixth Avenue East, Eugene, Oregon 97401 Phone (503) 687-4065 C55-28 . INSTALLER:,' camP I ete , " pROPC; j top. part, of f~rm SEWAGE .0 i SPOSAL~Y~TEMRECOR9' ~ r , to sj gnature,and~ s,ubmi t bottl',i:;opies, wi t';j~p I i1C9t.i ~:-" ,." .. ;: . ,PERMIT NO. cYJ'(~ , , I~STALLER'S NAME , R.c'Etfe~le~ EJ(ca,,~t;"j : 'No. Livi,ng Units Bedrooms 1 .~' Septic Tank: Ft. ~ rom wid I ',PROPERTY ADDRI::~~', J1.~s.- '" '; 0" ,,'" HAR~OR, DR I VE ',,',., , Baths' :'.Basement" ,Water S~pply" 1'/". ,Yes No)( ,Public)( Other-List" "1 .' - -.,'. Stee,l E)', . ::~'- ..-- ".. ':.. . " ;con~,r~te,IXI'NO. compar~met,ts " Gal: /~:t;;i ty " Tile Disposal Field,:' Depth D:i"stri but,ion "Box: 'Yes II c;No pther,D i str,ibut i on-Type Insi,de LenQth OWNER NAME, D}mens,i ons: 'Ft., , ' , ,W i dth ' 0 i'ameter ' . ,- ..). AN:NE ROB l'NsoN " MAILING," [h" ,Q RnY ij,,4' ::,'ADDRESS . t~ . ,Feet f....oin" , , . WEll' Foundation,"'d, Lot Une' ," , ,. ,Front', 'J.f"'" "Side !7/'.' ." 'Rear Illrt" ,I F!. B,!'twe,en:; ,lFiller, II IFi ller' Dep,th, ,lFiller, B,elow Lines ',/0, 'TVDetJ~ Above,'Tile.J'in.ITilel, in. , , ~ " . ,.. .- Pl~^<::^~T kll.11 _",()R~r.:.tl"l'-~'-':-i'-"-: "..,J__ ,'~~?~\~.Li~~S-~,~. 6. 1~~~i~~J1:~~~~o~q. 'lot Ph,n (see 'instructionsl: ':~"", . ..' , " , '0.. ..... - ;". '. . -'. ~~ ~ ." ., ;..\oBrLEHoN\E . , , . - '-. '.-.'. : .~ ~.", "-~h. -~, '~ jo.., , ' "'I.. ~ - ~- o ... V.' " , Q <:: ,,., . t.,..;',_::: :~~_:_' ~; . ..- ~~ ,: " " :~.:-_' .'. -'" .. , \>" CAl1~RT, , , - , .- .~ ~., + ~, " :(. . .'~. ~, ~ '. <..,;.}: , )i...' ~ ';:' . ".' ~~ . ;~'. '" , " .',- ,.- " '.' f ! ',." ..-'i , " .;y"';-' .~ -. .r , '. ,- ..- -.';;' , " ,;H-AREO'R, DRIVe ,/", ~'Date '7 -,..., -7...., . ' Si~ature 1?~~P-~ " , _ "',' , ", "CERTIFICAT,E.OFSA.TISFACTORY,COMPLET,ION' ,".\' ,','.'.,,' '1/3'/hif ,For San.tanan Use Only: , ' ", '" .' ,"'" "Date://.II/'/:' '>,Inaccordance with 1973 Oregon Laws ,Chapter ~35. ,Secfjon 214..this,'certHi,cate ,is lssued . as evi dence', o~ s~ti sfactory' compl,e:ti on of a: subsurface se!,age .di sposa 1 system at the above location. '., ' '''',': i" .'. , ,.E;LIJ.\ppro~ed: System Inst,~1l1a.t,i.on' co"riforms to' current standard~,"" ' .:1t:::r Disapproved: Does not:' conform .to :curr.ent ,standards' ,,' : . Remarks: . ". ' , ":, > " ',,' , ; . I. ".' '. ' ',' --:- . \\;\'~(\~Q;,' . " :~ tarian'sSignature, , ' ANE COUNTY" pF ENV I R M~NTAL QU!lLlTY . ., , (:55'-11 ;, , ..... ~.....: ' . i__~ STATE 'OF OREGON DEPARTMENT ~ ~-,.::;:;--..............-. .-.;' . . 'J;" ,-,,' ~ .' ". lANE cOUN 'u.~UILDING' PERMIT OR'MOBILE H(., .,~, USE, APPLICATION PERMIT TYPE ~ BUILDING 0 MOBilE HOME'G OSC REG, # PERMIT :it! 2..{) S-- 71/ PROPERTY OWNER . MAILING, ADDRESS ',,- - PHONE ,/ Ro9>\\~~~-i-~"\\\) F B~.> . 'R+ q-Bbx 9,SLJ ,;P/ eo.SA'4tU: U 747-771; CONTRACTOR . :-- I -, MAILING ADDRESS ", . . PHONE' fR-\-,~ 80><. 57~ " L/ 7C17-%07 ,r '. PROPERTY LEG,AlDESCRlPTiON ',.,..- . '\ D~ r: nO' 1= .e'::L' A.")) LOT - BLOCK::- SUBD/V; ,- -..,t _ f"")t::.:t<?"j-\:51 t{; v 1= c...J' V'lr....-J J TWP 'RANGE" . SEe. TAX; LOT # /'6 C>3 :2 f-.) I -A"\N.F- ~,' NAME R.:(') ',?, '1 N So t-,.) ,) 'Lf- ,~~ R".,L ,~METES & BOUNDS ~ 11 ) '^ .~ ATTACHED' . CENSUS TRACT 7.-' FD JS)~ ~ . '.DESCRIBE EXIST!NG, STRUCTURES ON PROPERTY IF ANY O"VES o NO CODE APPLICANT ;:5DS ,','~~-- O~, " 9- " \Th\>= / , LEGAL ACCESS TO PROPERTY - ROAD NAME OR # ".:.PROPEtt ~fJFoe\<. \Jf,.p)~).E- I . "'. ~. "(;,01 / I Lj q Conn'e:t :0 .ExistingSew'age 'syst~/~ TYPE CONSTRUCTION ",' 'jcj, FT" KP.A' ./?T,!i:.'7A~ / AREA AND MAILING ADDRESS. ' FOR MOBILE HOME PERMIT ONLY Number of. Bedrooms, STRUCTURES TO, ,BE BUILT, THIS 'PERMIT " ~" . or New System Req,:)(] # BEDR09M,? VALLiATlO~ '--'~'. , - SEWA'GE' DISPOSAL BLDG, PLUMBING INSTALLED BY OTHER 0 / OWNER D. OTHER' 0 NAME WATER SUPPLY, ' / ' . - P.LANS FURNISHED FAqLlTY PERMIT ~EES ' PUBLlC,','fii' 'OTHER " _ YEs.K NO 0 YES D NO~ PLUMB;MG FEES .' '.j".' ~G~NATU~E 0, F' APPL~CA~J /7 \, ',' ::;( - DAT~ ,_FIXTURES, ,~ ~<L/.!3)f:';-//L<.A~ 7-/2-7(,1 C~HO' .,' X FEE.RECEIVED~ '~E SEWER .. l\ /) /J ' "'-7: eHECK\ONNECTION FEE '. \ ~ .Y ~ ~ '7 '- / ~ .. /y , . 'PUBLIC WATER I' .{\,ll PERMIT # " . .c;-f)" C1J ONNECTlON FEE I V ~ ' 'COUN<l:,Y BUllDI G & SANITATION SPECIFICATIONS :"~H S:::\~xNKG:~P~CITY .900." ' ~~'N ,;~),UI~::ENCH WIDTH 'T '>:z OR SQUARE. FEET 300 ,.' SEPTIC TANK 1':11( / ~-:rO - O"l PUBLIC 0 'WASTE'DIS" ' PLUMBING PLAN 'REVIEW PARK TRLR, TOTAL Nr; -:~"'fr,,;,'rp,':, I~ D/Y;)I'('ju~r_I. c~n~'p rf /o:'s . , ~J ' ....-/./p. &c:>, 10' h-e J7?ar/e.., 'cdfaJ, ~/ S-:,6,ee;/_ t(hd(~1 ,coo..Je,r' 5;q~je~ .v TYPE- OF 'STRUCTURE . ,OCCUpANCY ZONE M~:ki+- REAR_,YARD P~BLlC UTlL. EASEMEt';JT BLOG: SETBACKS - FT. FROM erR. OF ROAD RIG':lT OF_- WAY .F~ONT ._!J(J, ~S'IDr:. ".~-,. ::.1{": :~~-. -EM ~:~"~:f-<\~''h .,' n _"7~"OO USE CLASSIFICATION INSP, Date , ~ -~ COPY 1 - OFFICE COPY 2 -JOURNAL' , COPY 3- AUDIT ,', Form # C55- tZ