HomeMy WebLinkAboutPermit Building 1974-03-12 (2)IANE COUN1 BUITDING i'ERMIi
BUILDING E MH E
OR MOBILE HC. . USE PERMIT
PERMIT NO.
PROPERTY OWNER MAILING ADDRESS PHONE
CONTRACTOR MAITING ADDRESS PHONE
PROPERTY LOCATION _ INCTUDE POST OFFICE
PROPERTY tEGAt DESCRIPTION - METES, BOUNDS
RANG E SECTION TAX LOT NO CODE CENSUS TRACT
2l-2A(
APPL.EXISTING STRUCTURES ON PROPERTY
NAME
&
MAII.ING
ADDRESS
TEGAT ACCESS TO PROPERTY
PROPERTY SIZE_FT.
WIDTH DEPTH AREA
FOR MOBILE HOME PERMITS ONLY
No. of Bedrooms Connect to Existi Sewoge System [] New
TYPE CONSTRUCTION sq. FT BDRMS VALUATION
m
STRUCTURES TO BE BUILT THIS PERMIT
SEWAGE DISPOSAI
PUBUC n SEPTTC TANK n oTHERn
PTUMBING INSTAI.LED BY
OWNER I_I OTHER: NAME
$TEES WATER SUPPTY
PUBUC tr N OTHER
BUILDING
WASTE DISPOSAI-
PTUMBING
PLAN REVIEW
PARK TRAILER
TOTAT
COUNTY BUILDING & SANITATION SPECIFICATIONS
MIN. SEPTIC TANK CAPACITY
WITH DIST. BOX: GAL.
DRAIN FIETD REQUIRED
tIN. FT TRENCH WIDTH FT OR SQ. FT
'l stlng SDS when hooking up. lf SDS chould foll at any time, I
rppl icd for irmedlatcly
TYPE OF STRUCTURE OCCUPANCY ZONE PUBTIC UTI[. EASEMENT
BLDG. SETBACKS FT. FROM CTR
FRONT SIDE INT.
OF ROAD RIGHT OF WAY
SIDE EXT.
USE CTASSIFICATION
REAR
AUTHORIZED SIGNATURE - DATE
lJ" Grey J-12
DATE
J.E ss by C. Harbauqh
BI.DG. PERMIT _ WHITE
OFFICE COPY _ WHITE
COUNTY TAX _ PINK
PLUMBING - CANARY
BUILDING _ GREEN. {NITATION _ GOTDENROD
Coll 687-4065 to schedule oll required inspections. All construc-
tion sholl comply with Uniform Building Code, D.E.Q. stqndords
IMPORTANT: for subsurfoce sewoge disposol ond counly regulotions covering
plumbing. All buildings require o certificote of occuponcy before
being occupied.
(See Detoils on Reverse Side)
(posT THrs PERMIT ON MAIN BLDG. AT SITE)
LANE COUNW, DEPT. OF ENVIRONMENTAT MANAGEMENI
COURTHOUSE ANNEX, I35 EAST 6Th, EUGENE, OREGON 9740I
IANE COUNTY
PERMIT TYPE.. BUILDING
BUITDING PERMIT OR MOBITE HOME USE
MAII.ING ADDRESS
HCATTON
MIT o-PROPERTY OWNER
e g"os ,
ION - INCTUDE POST OFFICE
ql"lo ,,,.,2,!{--&2-< Fata- E/MAII.ING ADDRESS
PHONE
PHONE
PROPERTY TEGAL DESCRIPTION
I.OI_BIOCK_SUBDIV-
/?-o3-zc - A'/- afroo
METES&BOUNDSDYES
ATTACHED D NOTWPRANGESEC.
APPTICANT
NAME
AND
MAITING
ADDRESS
FOR MOBILE
Number of Bedrooms
o
c)
,RU a/lJe , O V
CENSUS TRACTq-o
DESCRIBE EXISTING STRUCTURES ON PROPERTY IT ANY
TEGAL ACCESS IO PROPERTY_ROAD NAME OR#
PROPERTY
TAx roT #CODE
_5-
o
/ DEPTH /// AREA
enmrr oruDr'
Connecl to Existing Sewoge System l-l or New System R.q.V
STRUCTU RES TO BE BUII.T THIS PERI,(IT TYPE CONSTRUCTION se. FT. # BEDRooMS vAt uATtoN
SDs [e ,nL
SEWAGE DISPOSAT
PUBUC I SEPTTC TANK i_l oTHER fl owNER n OTHER [I NAME
PTUMBING INSTAIIED BY
TEES WATER SUPPI.Y
PUBUC tl
PTANS FURNISHED FACIIITY PEiIMITBtDG.
WASTE DIS.
PIAN REVIEW
PARK TRtR.
,/<06--OTH ER YES E NO
, Pt UMBING P[UMBING FEES
-_ - FIXTURES
CASH D SEWER
CHECK D CONNECTION FEE
PUBLIC WATER
CONNECTION FEE
SIGNA
rEE
PERMIT
DAIE
DATE
,lol-?
TOTAT
COUNTY BUITDING &ITATION SPECIFICATIONS
DRAIN FIEI"D REQUIREDMIN. SEPTIC TANK CAPACTTY
WITH DIST. BOX: GAI.TIN. FT TRENCH WIDTH TT OR SQUARE FEET 3bc.
TYPE OF STRUCTURE
BTDG. SETBACKS _ FT. TROM CTR. OF ROAD RIGHT OF
SIDE INT
rections to Find Properly
PANCY ZONE REAR YARD PUBLIC UTIt, EASEMENT
stD REAR
NNING
EXT
DOIE BLDG. INSP
USE CTASSIFICATION
Dote
)PY I _ OFFICE
PY 2 - JOURNAI.,Y 3 _ AUDIT
15-
\h ra\
*r*h +{s
& er6\
\l rL: t 0 tru 'g'.r e , eo*t
,51 >n& iUr S o|.\r*'S .',\
B^t
rr+yrS-\ - \ - .s t, - ff$-t\
erlq
wll
t""L;t
=) rA oB
O \.tr1$UIJA
w\*E*\trt
\\of1 .,t\.., ^ \,*t* ^rl)-E e 't )ot
3o7z-77
TRS, T 11-03-zL -a{ I T,L, floa Job Location 1-tS GntagflP"m RD
r{ritten oirecEions Af Nf-Lo,^t RD q {J.rnE:fnR/,,-TU(P hnertt oN G,luaF/|fm PPaPsary / s
--+1l,Building Permit
Acreage or Lot size I Oc' X (oC;
Partitioning #- ( )Completed( ) Pendi "1 , p4APPLICANT'S NAME AND ADDRESS
OWNER'S NAME AND ADDRESS, if different
0N Kts&r BEtuQg (*,urt'iligRMAn?#rIF_T
( ) Site Feasibility Study for Septic Tank. Number of sites_
Test holes will be ready C
-33\A,&€
I 7-7
Subdivision Lot _ Bloc v
Phone
Phone
Phone
7 qd-q qqz
CONTRACTOR'S NAME AND ADDRESS
from applicant'ssAths
lilpermit or results of site feasi bility study to (.' )'b - LIqULrX) Prefer to pick up. Call -7rl Applicant ( )Owner ( )Contractor
(owner, etc. ) when ready.Contractors O. S. #
STRUCTURES NOW ON THE PROPEB
PROPOSED USE (this permit)
WATER SUPPLY
US
existing or proposed well, etc. lf public. name of system)
Address
sewncr otsposar E Yt SlI (existing or proposed septic tank, etc.) s.l
PLUMBING B
() PROPERTY IS WITHIN ONE MILE OF CITY (
* * * * + * + * * * * ** * * + * ** + * + * * * * + * * * + * *** ** * * * * + * Q f FICE USE ONLY BELOW THIS LINE *****+***ir** *****+*+****** *******r* * rr ++ ++
) New Address Necessary ( ) Facility Permit Necessary ( ) Special Permit Area. Minimum Elevation
Front
-
Side Facing Street lnterior Side Yard
-
Rear
{FROM CENTEHLINE OF ROAD) (FROM PROPERTY LINES)
N F SETBACKS
To: Planning/Building lnspector/Sanitarian/Surveyor.
This applicant appears to have a problem with
Your assistance will be appreciated.
By Permit Processing Section
Response
By
DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
Permit Processing Section
125 East 8th Avenue
687-4394c55-12
D ivision
PEPO rf? S ep-rt c * *0,.,o.,'. L
+
J
)
!'EFF'
B
Bi
IrAR
_, rId1
'\l\
{'l l
:4d\
i-.
t
ffi
a
+
s
q'
H
g
b
C
\
a
mwlt Bk
44onogea;er?t
+'U['$$\AiIIt\I
E- 'a/'oi)fy
srsS.*o&cbd-r %*%|%l-l*
b
\$
}l'!,r(:
\-
N
#
\
f,, I \i_6z
?3 ${}.tr9
8A il&I
Drtd Hnr€h l-
(sng
I?ATB oF oR[coH, cotrty of Ls., ll. Iuuoy qr.i tb.06! rd
norlr L. ttulta, w trorlr L. Chrlrtl&..a
.,rd lfult { ttr rcqnrq rrtua !o D. -}a&__ roharuT rc! rart dod. lrfqr u:u0
ttGo*rc .23-
I
I
I
!
i
i
For YlujtriurvlD
r,3I, L tttl,l!3, u ril{t L gll8ltltu
Itarte rc&-?id tB 3 Hr fratl6, hla, { rd clty rr
?nar & rtllcirll
fd nffira ta r FaB Aa fndi ed rJ po7ay, ag rrm, fo*ca, ra r,F...r.r, b tGlcjlmtrgat r pottt lrbEilt 3l!1.,t.a6t ch. lrtl,ll.l Xrt lri.C ot tbattracr llomLe-lro*arvtlrol rrgr tlreto th 8..t
)
rtSh: ot xglI,e Cstlr
tulrEl !o . rEtt.at t llcltr tltls ruGr Hry ra t rrr.ter-.
'L
ts' r'srdcdhd- b tr *t t is' . rb ,nqej'cr{ d@c-raa l sr. I Et Lg..
Bry.r. !h,E*.rf#*a*4<rra..,r>r.ltut,
l>II 1*r;8 E838
}i}
I
eaIu
3
at
I
,
,
te
T
€
IoI
aaI
t
H
tB
{
o
ad
o
I
ot
3
ta
o
I
6
7
t.
j
II
T
!o
,.1
ta
?
!
o
j!
o
Id
J.t
(,\-.Et\?\t\SJ
a!Ir
orH)
i?
E
ctlt&
,41t:
,
6A
A
I 6t
EI ?
o
,H1 0
ffr*E FFr
iIAR
An iziron;rren/Ol
os
1 I tst4
&u.ug.*..
fit
I I
otes.
tl,
-t]'l
.O tsaH!
$Ecds
LANE COUNTY BUITDING PERMIT OR MOBITE HOME USE PERMIT
MH E PERMTT NO.BUILDING
PROPERTY OWNER MAILING ADDRESS PHONE
CONTRACTOR MAITING ADDRESS PHONE
PROPERTY I.OCATION _ INCTUDE POST OFFICE
PROPERTY tEGAt DESCRIPTION - METES, BOUNDS
RANG E SECTION TAX LOT NO CODE CENSUS TRACT
EXISTING STRUCTURES ON PROPERTY
tEGAt ACCESS TO PROPERTY
PROPERTY SIZE-FT.
WIDTH DEPTH AREA
FOR MOBILE HOME PERMITS ONLY
No. of Bedrooms Connect to Existing Sewoge System I New System I
srRUcruRES To BE BU|LT THIS pERMtr rypE coNsrRucrtoN se. FT. # BDRMS VALUATIoN
SEWAGE DISPOSAL
PUBHC tr SEPTTC TANK tl OTHERN
PTUMBING INSTALI.ED BY
OWNER D OTHERT NAME
FEES WATER SUPPIY
PUBUC tr n oTHER
BUITDING
WASTE DISPOSAT
PI"UMBING
PLAN REVIEW
PARK TRAITER
s
TOTAT
COUNTY BUILDING & SANITATION SPECIFICATIONS
MIN. SEPTIC TANK CAPACITY
WITH DIST. BOX: GAL.
DRAIN FIETD REQUIRED
tIN. FT TRENCH WIDTH FT.OR SQ, FT.
TYPE OF STRUCTURE OCCUPANCY ZONE PUBTIC UTIL. EASEMENT
BLDG. SETBACKS
FRONT
FT. FROM CTR. OF ROAD RIGHT OF WAY
SIDE INT. SIDE EXT.
USE CTASSIFICATION
REAR
AUTHORIZED SIGNATURE _ DATE DATE
BLDG. PERMIT _ WHITE
OFFICE COPY _ WHITE
COUNTY TAX _ PINK
PTUMBING _ CANARY
BUILDING _ GREEN
SANITATION _ GOLDENROD
Cdll 687-4065 to schedule oll required inspections. All construc-
tion sholl comply with Uniform Building Code, D.E.Q. stondords
IMPORTANT: for subsurfoce sewoge disposol qnd county regulqlions covering
plumbing. All buildings require o certificole of occuponcy before
being occupied.
(See Detoils on Reverse Side)
(posT THIS PERMIT ON MAIN BLDG. AT SlrE)
LANE COUNTY, DEPT. OF ENVIRONMENTAI. M,ANAGEMENI
COURTHOUSE ANNEX, I35 EAST 6Th, EUGENE, OREGON 9740I
ronv # C55-13
APPt.
NAME
&
MAITING
ADDRESS
SLAB FLOOR
PLUMBING GROUNDdORK
Ap eRov e o
Rruanx s
D Drsrppnovro D Darr I Ns pr cron
GAS PIPING GROUND/ORK
Ap pRov e o
Reulnx s
D r sappnovro DarE I rusprcron
ROUGH PLUMBING
Appnov r o
Reulnx s
D r sappRovro Dar e I Nspecron
ROUGH GAS PIPING
Appnovro D DrsappRovro D
Re Menx s
Dar e I rusprcton
F I NAL PLUMB I NG
AppRoveo K Dtsappnoveo
ReurRxs
Irspe c
FINAL GAS PIPING
AppRoveo D DrsappRovr" D
Rr uanx s
Darr I lrs pe croR
CERTIFICATE OF OCCUPANCY
Rraov ro lssue
Reuanrs
Nor Reaov ro lssuE
D D
D ,^rrW
D Dore-lnsee cron-
LANE COUNTY
BUTLDTNG fl
BUITDING PERMIT OR MOBITE HOME USE PERMIT
MH tr. PERMTT No.
PROPERTY OWNER MAITING ADDRESS PHONE
CONTRACTOR MAITING ADDRESS PHONE
PROPERTY TOCATION _ INCTUDE POST OFFICE
PROPERTY TEGAT DESCRIPTION _ METES, BOUNDS
RANG E SECTION TAX LOT NO CODE CENSUS TRACT
EXISTING STRUCTURES ON PROPERTYAPPt.
NAME
&
MAILING
ADDRESS
LEGAT ACCESS TO PROPERTY
PROPERTY SIZE_FI.
WIDTH DEPTH AREA
FOR MOBILE HOME PERMITS ONLY
No. of Bedrooms Connect to Existing Sewoge System ! New System !
STRUCTURES TO BE BUILT THIS PERMIT TYPE CONSTRUCTION se. FT. # BDRMS VALUATIoN
SEWAGE DISPOSAI.
PUBLIC tr SEPTIC TANK tr OTHERN
PTUMBING INSTALTED BY
OWNER E OTHER: NAME
BUITDING
WASTE DISPOSAT
PTUMBING
PtAN REVIEW
PARK TRAIIER
TOTAL
FEES WATER SUPPIY
PUBLTC n tr oTHER
$'
COUNTY BUILDING & SANITATION SPECIFICATIONS
MIN. SEPTIC TANK CAPACITY
WITH DIST. BOX: GA[.
DRAIN FIETD REQUIRED
IIN. FT TRENCH WIDTH FT OR SQ. FT.
TYPE OF STRUCTURE OCCUPANCY ZONE PUBTIC UTIt. EASEfiENT
BIDG. SETBACKS FT. FROM CTR. OF ROAD RIGHT OF WAY
FRONT SIDE INT. SIDE EXT.
USE CI.ASSIFICATION
REAR
AUTHORIZED SIGNATURE _ DATE DATE
-l
BI,DG. PERMIT - WH ITE
OFFICE COPY _ WHITE
COUNTY TAX _ PINK
PTUMBING _ CANARY
BUITDING _ GREEN
SAN ITATION _ GOI.DENROD
Ccll 687-4065 to schedule oll required inspections. All construc-
tion sholl comply with Uniform Building Code, D.E.Q. slondords
IMPORTANT: for subsurfoce sewoge disposol ond counly regulolions covering
plumbing. All buildings require o certificote of occuponcy before
being occupied.
(See Qetoils.,on Reverse Side) I
(posr THIS PERMIT ON MAIN BLDG. AT SITE)
IANE COUNTY, DEPT. OF ENVIRONMENTAT MANAGEMENT
COURTHOUSE ANNEX, I35 EAST 6Th, EUGENE, OREGON 9740I
ronu t 655- 13
-
-rr-I
Darr
SITE INSPECTION
AppnovEo
Reuanx s
DI SAPPROVED I ruspecron
FOUNDATION INSPECTION
Appnoveo
Rrua Rx s
Dr sappRoveo Drre I ruspecron
FRAMING INSPECTION
APPROV E D
Re unnx s
DrsappRoveo Dar r I NS PE croR
LATH OR SHEETROCK
Ap pRov r o
ReuaRr s
I NSPECT I ON
DrsAPPRovEo V Date I Nsprcron
FINAL INSPECTION
Ap pRov e o
Rruanx s
D r sappnoveo Dar r I NSPEcToR
t/r
r'
CERTIFICATE OF OCCUPANCY
ReaoY To lssuE
RruaRx s
D Nor REAoY ro lssur D Dore_I ruspEclon
Y"7/-h {td- Ma.*z fo---vl H az-r(
:,.ffiE
BU ILD ING S ITE EVALUAT ION rJln-!_s ?P.d /I, ;US TRACT
rax rcr5?ooll S /c,4.
P{ Buitdins permit Apptication No.lAH #-7y
( ) Site lnspection
( ) Pre-Permit lnvest igat ion
APPL I CANT:
Nr\llE R=olo
ADDRES S
PHONE
DATE
L/iNE COUNTY PLANNING DEPARTHENT NOT NO YES
6i'l icable -
NAJ,'1E DiiTE
2
Zon i ng Ord i nance Comp I i ance
subd i v i s ion o.o, "jill'm)..
-(T--( ) ( )vr () ()
er () ()
(+ () ()
() () ()
3. Requ i red Access
t+. 8u i ld ing S ite (Rrea, uridth,
Frontage, Setback)
5. 0ther (see comments)
COI{}4ENTS:
BUILDING INSPECTION SECTION
6. Plans Submitted
7. Soil Stability (footings)
8. Flood Pl a in
9. Other (see Conments)
NOT NO
EEF'I icable -(I ()
YES NA},I E DATE
)
()(
()
()
()
(
)((
CO},IHENTS:
NAhE DATE
,- Z * , .-,--r,n
()
-07-
TRS, T JOB LOCATIO
Partition i ng
LANE COUNTY PERMIT
Acreage or Lot Size
Contractor's O.S. #
- ) Completed Subdivision
Lot- Blo ck
APPLICANT,S NAIV]E AND ADDBESS PhONE-
OWNER'S NAME AND ADDRESS-Phon P
Phone-CONTRACTOR'S NAME AND ADDRESS
Mail permitto ( )Applicant ( )Owner ( )Contractor. ( )Prefertopickup. Call-(owner, etc.) when ready.
STEUCTUBES NOW ON THE PBOPERTY
THIS PERMIT IS FOR # BEDROOML# PLUI\4BING CONNECTIONS-
\AJATER SUPPLY SEWAGE DISPOSAL S.I. #
THlSPRoPERTYlSWlTHlNoNEl\4lLEoFTHEclTYoF'PLUIV1BlNGBY
I hereby certify that the above statements are true and accurate, and that I have the following legal interest in the propertyr ]--!owner of record;
-contract
purchaser;
-
potential buyer;
-
realtor or agent. I {urther certify that (if not the owner) I am authorized to act for the owner oI
record, and thaisaid owner ispwire and approves o{ this action. I hereby agree to comply with all applicable Codes relating to this permit.
Fee Paid $-Signature Date
()NEWADDRESS () FACILITY PERIV] IT TO TRANSPORTATION DEPT.- () SPECIALPIV]T.AREA, MIN.ELEVATION:-
-
SANITATION BU ILD ING
Minimum Septic Tank Capacity (Gallons)
Drainfield Required - Lineal Feet Use Classification
Maximum Depth Comments:
Comments
B B Date
Date lssued
"1
PLANN ING REOUI RETVIENTS SATISFIED. B Date
LANE COUNTY DEPARTMENT OF ENVIRONMENTAL IVIANAGEMENT, 125 EAST 8TH AVE., EUGENE, OREGON 974O1
POST THIS PERMIT ON MAIN BUILDING AT SITE
C55-1 3 BLoG.pERMtr-WHtrE; BUtLotNG-GREEN; pLUMBTNG-GANARy; sANtrATtoN-coLDENRoD; oFFlcEcoPY-wHlrE
PHONE: 687-4394
(
( lr/\
Date:
ZON E:SETBACKS: FRONT SIDE FACING STREET (FROTVI C/L) INT. SIDE YARD REAR (FROM P/L)
^-l1ln
-t
o1(D
o)(oo
o
rodq
oo
o).)do
q
o'"
+
T'!r
o
z{
CNz
m
z
rJ
g
ofl
m
o€Z
mnaz
m
zo
Uon
maU'
ooz-la
o
-lo
io6z
m
Zo
o0f,
m
=!o-
=)
toi
U
=o
o)
=
c{
=o
^C)
o
='+a
OJo+of
t-(D+(D
do
o'-C
o
=
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
a{
=o:
(D+
!',
€
=of
(D
o)o-
a
-l:D
Co
-.{Cu
m
CNzo€oz
-l-m
T'IoTmu{
I
I
I
I
I
I
I
-a
-o
ma
+
a
'TtoI
=-lm1
aC!!r
I
I
i
al -l(Dl rgl=-
Fl, S ioo*< A34s g
.+O)a
-a+lDd+td-\< {
qg6 a?H; E
d-r.D fl. I o: r-ol H z315 ogE - ZciY* m
d- 4.1 =o)=lo -= mEg-d oAi. 'rr
<(Da-J3--t iol4 mll E o
-tL.' o -l
?de I:;q
I'o)l
d'H 6
Iaif o Ign e I
Io)dl(o:I :' IaLol(Dadl(Ddl
6P=l
8831
-alAasl! =J I€'<., I.€ +o" Iae - I
^, =: !. =+='r
.. q; ftO (-:E-eg
=o == -&l = AdE a @
6-dl(Dt
o-al:rI I
I
o)-oli'E '" i6 +d I*5a I9-(Dl
:1 N i IJ (D.< |6 g" I-.+, I601 I'lol I'Jol I
-.dtt- *o IoE l-l I'. d<o IJ: Ito
I'O+lla I(81qel
'Tt
(D
(D
r!d
@
I
m
=
ooI
m
U)
U)
'Tt
ar
=
!
ma
=-t-lo
-{D
zaTon
-l
-loZ
0
m!J
L
;Tm
a
r
'a
J
n
m
P
=mrm
+
oZ
(-o
tr,ro
C)
-{
o
!o)-3,
3.o
=.(o
zm
oo(-z
'oma
=
=
It
N9.(o
:f
3
C
6
I
F
d(D
;o
3Eto-
?g
o-
=.o
o
=roi
!fo
=
am
=o
m
E
aT'oa
-
+
@
mono.o
=a
l,'+
!rC
@
z
6)
C)ozz
mo
-lozo
I
I
G'
!5o:l
(D
T
=o
e
I
+
rl
tt)
z
=-J
oz
(
U
3lo
f
2
@
<C]<
Uo)f
< +J
c(D=
orr(D (Dn
E! =+c='
(Di
Q- OJ
,f
7S!oJOJ(Dio)X
o'Tl
='3<
d^o
o)_
o
=I
I
o)d
(D
IG'lct-lr-Ir:l-l2
-1 O
!o
o
oo
lot
co+
o'
=
I
I
I
I
I
la-oc
I
I
I
I
I.TI
='(D
No
(D
0(D
od
9.aoo)
n.o:
oo
3
3
(D
=d
?.
@
o
o)
do
-or
zZ
=o
:D
m
C
fl
m
=mZ-{U)
U)
-{
CN'Tt
m
P
@
0
A)
(D
o
o)
;
c
(Do
o3>
d=*
oo
Cz
-l
U
m_u
6!Dr-lB<'mBz
l-{5o-r -n
I12is$f,
oO9z
Ex
=4\=A+:
lIl
9r iE['\L > tJ,E= m:{ =60 m
tZz',J
Q3?z iliz <lr
IE g
>: cn.
zl -1i9 3iz;
?I Pl{ m
E-r mHm czAa2-Y 61qbr,iHiio2zr(OixIOn-
!
:EoZ
IT
o,
@!
.ir(,
@5
Nozr
am-t@
o7I
'Ttaoz-l
I0m
'Tl
azo
a-{a
mm-t
-Tt
ao
o
tr
=JIo
m
n0
:D
m
1
'Ttno
=-.lc
a
I ffi
IANE COUNT" ,UILDING PERMIT OR MOBILE
BUTLDTNG [] MH. []
HOi UsE PERMIT
PERMIT NO.
/'rc c zq
t4oo-7tr
PROPERTY OWNER MAILING ADDRESS PHONE
Pinqcl ton Brothert
MAILING ADDRESS
PROPERTY TOCATION _ INCLUDE POST OFFICE
PROPERTY TEGAL DESCRIPTION _ METES, BOUNDS
l7
RANG E SECTION TAX LOT NO
,1,
CODE CENSUS TRACT
t7 o3
EXISTING STRUCTURES ON PROPERTY
ll
APPT.
NAME
&
MAITING
ADDRESS
TEGAT ACCESS TO PROPERTY
80 t{orth Gnnd t#3
Eugrnc, Orogon
PROPERTY SIZE _ FT.
WIDTH DEPTH AREA 3915 sq. ft,
FOR MOBILE HOME PERMITS ONLY
No. of Bedrooms
STRUCTURES TO BE BUILT THIS PERMIT
Connect to Existi
TYPE CONSTR N
New
se. FT BDRMS VALUATION
I 000
Seutgc Dlsposrl System Rcpal r
SEWAGE DISPOSAI.PTUMBING INSTATTED BY
PUBTIC
BUITDING
WASTE DISPOSAL
PI.UMBING
PI"AN REVIEW
PARK TRAILER
SEPTIC TANK
FEES
OWNER
WATER
OTHER: NAME
$_l5.o PUBLTC n n oTHER
l% curchrrgo
COUNTY BUILDING & SANITATION IFICAIIONS
MIN. SEPTIC TANK CAPACITY DRAIN FIELD REQUIRED
uN. FT TRTNCH wrorH rt. 1WITH DIST. BOXr
TYPE OF STRUCTURE OCCUPANCY ZONE PUBLIC UTIt. EASEMENT
BI,DG. SETBACKS FT. FROM CTR. OF ROAD RIGHT OF WAY
FRONT SIDE INT. SIDE EXT.
USE CTASSIFICATION
REAR
AUTHORIZED SIGNATURE _ DATE DATE
7126174 tusls J"E. Borr by J. Shook
BLDG, PERMIT _ WHITE
OFFICE COPY - WHITE
COUNTY TAX - PINK
PIUMBING _ CANARY
BUILDING _ GREEN
SAN ITATION _ GOI.DENROD
Coll 687-4065 to schedule oll required inspections. All construc-
tion sholl comply with Uniform Building Code, D.E.e. stondqrds
IMPORTANT: for subsurfoce sewoge disposol ond counry regulorions covering
plumbing. All buildings require o certificote of occuponcy before
being occupied.
(See Detoils on Reverse Side)
(POST THrS pERMtT ON MA|N BLDG. AT SrTE)
LANE COUNIY, DEPT. OF ENVIRONMENTAT MANAGEMENT
COURTHOUSE ANNEX, I35 EAST 6Ih, EUGENE, OREGON 9740Ironu * 655- 13
I
CONTRACTOR PHONE
I
BU I LD I NG S ITE EVALUAT ION
Building Permit Appl ication No.
Site lnspection
Pre-Permit lnvest igat ion
rJZ a_03 s_A,!,L
CENSUS TRACT
TAx LoT 57 oo
()
()
(
'o-APPL I CANT:
NA}4E
ADDRES S
4
PHONE
DATE
LANE COUNTY PLANNING DEPART}IENT NOT NO YES NA}tE DATE
r ance
2. Subdivision 0rdinance Compl iance ()
Zoning Ordinance Compl
(zone
3. Requ i red Access
4. Bu i ld ing S ite (Area,
aool icable-"Tr()
(r (
()
()
)
()
()
(
(
(
5
Front
0ther (see comment
l, idt h,
e, Setback)ag
s))
CO},I}lENTS:
BUILDING INSPECTION SECTION
5. Plans Submitted
7. Soil Stabil ity (footings)
8. Flood Pl a in
9. 0ther (see Conments)
NOT NO YES
+ptrselLe -()()
NA}4E
()
)
()
)
((
()
(
(
)
)
COHHENTS:
SAN!TATION SECTION
Sewage Disposal
Usable Area
Water Supply
0ther (see Comments)
aool icable---rr()
)
)
)
NOT NO YES TE
t0.
il.
t2.
t3.
()
()
()
)
)
)
)
COT4}IENTS:
ry$;
Your Building Permit / Site lnspection:
}<L Can be approved.( ) Cannot be approved at this time as indicated on item N0. above.
QuestionsandfurtherinformationonitemsIthroughsc@-
COUNTY PLANNING DEPART}IENT. Questions and further information on items 6
through l3 contact the Lane Count Buildi and Sanitation Divis ion.
()
()
u/ill be held in this of ce until you can resolve the prob ems n cated.
ls being returned.
( ) Your building permit appl ication fee is being returned under separate cover.
I,ANE COT]NTY PIANNING DIVISION
135 Sixth Avenue East, Eugene, Oregon 9740L
Phone (503) 687-4186
I,ANE COUNTY ENVIRONMENTAL MANAGB{EM
135 Sixth Avenue East, Eugene, Oregon 97401
Phone (503) 687-4065
c55-28
)
DATE
-
. IANE COUNI ." jUIIDING PERMIT oR MOBttE HO! . usE PERMTTBUILDING fI MHI PERMIT NO.PROPERTY OWNERilotor Saa
MAITING ADDRESS PHONE
CONTRACTOR
Plascl ton tretitffi MAILING ADDRESS PHONE
PROPERTY TOCATION _ INCTUDE POST OFFICE
PROPERTY TEGAI DESCRIPTION _METES, BOUNDS
I ,-{13-rt-l* l -O{
,J
RANG E SECTION TAX LOT NO CODE CENSUS TRACT
2?I).I m0
EXISTING STRUCTURES ON PROPERTYflteturd PlnEllto*rAPPI..
NAME
&
MAITING
ADDRESS
0 llorth krrd *pr #3
I.EGAT ACCESS TO PROPERTY
fugrxrr. Srcgon
PROPERTY
*,rr, I SIZE _ FT,
DEPTH AREA
FOR MOBILE HOME PERMITS ONLY
No. of Bedrooms
STRUCTURES TO BE BUILT THIS PERMIT
Connecl to Existin Sew
TYPE CONSTRUCTION
System ! New
BDR MS VALUATIONse. FT
3*qn llrnomt Syrtrc Rprlr
SEWAGE DISPOSAT
PUBLTC tr SEPTTC TANK n oTHERfl
PLUMBING INSTATLED BY
OWNER fI OTHER: NAME
BUITDING
WASTE DISPOSAT
PI-UMBING
PTAN REVIEW
PARK TRAILER
| .- :1"{lr }l'. .r
TOTAT
$FEES WATER SUPPTY
PUBLTC fl N OTHER
COUNTY BUILDING & SANITATION SPECIFICATIONS
MIN. SEPTIC TANK CAPACITY
WITH DIST. BOX: GAT.
DRAIN FIEI,D REQUIRED
.N. FT | !$ TRENCH *,rr, ,r. 2 OR SQ. FT,
TYPE OF STRUCTURE OCCUPANCY ZONE PUBI.IC UTIT. EASEMENT
8I-DG. SETBACKS
FRONT
FT. FROM CTR. OF ROAD RIGHT OF WAY
SIDE INT. SIDE EXT.
USE CLASSIFICATION
REAR
AUTHORIZED SIGNATURE _ DATE*ls J.E. ]*r tt J. $blt DATE
BLDG. PERMIT _ WHITE
OFFICE COPY _ WHITE
COUNTY TAX - PINK
PLUMBING _ CANARY
BUILDING - GREEN
SANITATION _ GOLDENROD
Coll 687-4065 to schedule oll required inspections. All construc-
tion sholl comply with Uniform Building Code, D.E.Q. stondords
IMPORTANT: for subsurfoce sewoge disposol ond county regulolions covering
plumbing. All buildings require o certificote of occuponcy before
being occupied.
(See Detoils on Reverse Side)
(POST THIS PERMTT ON MA|N BrDG. AT S|TE)
IANE COUNTY, DEPT. OF ENVIRONMENTAT MANAGEMENT
COURTHOUSE ANNEX" I35 EAST 6th, EUGENE, OREGON 9740I
FoRM =C55-13
I
I ruspecton
SITE INSPECTION
D I SAPPROVEDAp pRov r o
RruaRr s
Dar e
FOUNDATION I NSPECTION
APPROVED
Rrua nx s
Dr sappnoveo Drr e I ruspecron
FRAMING INSPECTION
AppRove o Lf Dtsrppnove o D
Re Nlnr s
DarE I xspecron
LATH OR SHIETROCK
Ap enov r o
Rrunnxs
I NSPECT I ON
Dr sappnove o f--7 Dare I NsPEcroR
rINAL INSPECTION
Ap pRov e o
Rruanx s
DTSAPPRovED Dar r I NseEcroR
CERTITICATE OF OCCUPANCY
Reeov ro lssuE
RruaRx s
D Nor Rraov ro lssue D Dare _I ruspEcron
a
t
P' 1OSED SEI./AGE DISPOSAL SYSTE}1 REC
INSTALLER: Complete top pa rt form to si gnat u r submit bo*ies with app I i cat ion.-
PERH NO 60 -')
\S2
v n Un ts
t c
Ft. f rorn wel I Steel
Yes
ater'upP.
Publ i c he L ist
Concrete Compartments Gal.Capac i ty
lns
Len
mens ons: Ft e sPosa e
h Width Diameter De th Distribution Box es Notstruon-
NAI-{E
rorn
}IA I L ING Foundat I on
A S Lot L nee<_J Fr Side
F TFor Sanitarian Use Only: Date:ln accordance with 1973 Oregon Laws Chapter 835, Section Zl4 this certificate is isas evldence of satisfactory completion of a subsurface seurage disposal system at th
I ocat i on.
4 Approved: System lnstal letion conforms to current standards/D Disapproved: Does not conform to current standards
Remarks:
r
Feet
trEI I
r
O',eril
s
e above
,{g
}Jid LY
Sq.'?otal
Ft.
t e
I nes
etween
d tn
er ePt
ove Ti lenstrusee
6CTSC#
$qotic-
NK
ooo
0l
P
nr
b
NOUI
NVl
Cl6u
\
$
AINnOC
bL6L., 7,
&t3
/6
'It/1il01/'l
lp
+
)
N
e
0at
e A
{
A)
o
\t lo
!
c55-11 tar
COUNTY
QUAL ITY
an s
STATE OF OREGON DEPART}.IENT OF ENV I
9na ure
tr
\ RS,T
LANE COUNTY PERMIT
Acreage or Lot Si Partition ing ) Completed Subdivision
Contractor's O.S. #Lot- Blo ek
APPLICANT'S NAME AND ADDRE Phone-
OWNER'S NAME AND ADDRE ss Phon p
CONTBACTOR'S NAME AND ADDR FSS Phone-
Mail permitto ( )Applicant ( )Owner ( )Contractor. ( )Prefertopickup. Call-(owner, etc.) when ready
STBUCTURES NOW ON THE PROPERTY
THlsPEFMlTlSFoR#BEDRooML#PLUMBlNGcoNNEcTloNL
\^JATER SUPPLY SEWAGE DISPOSAL s.l. #
THlSPRoPERTYlSWlTHlNoNEtVllLEoFTHEClTYoF.PLUlVlBlNGBY
I hereby certify that the above statements are true and accurate, and that I have the tollowing legal interest in the property:
-owner
o{ record;
-contract
purchaser;
-
potential buyer;
-
realtor or agent. I further certify that (il not the owner) I am authorized to act for the owner of
record, and that said owner is aware and approves of this action. I hereby agree to comply with all applicable Codes relating to this permit.
Fee Paid $
JOB LOCATIO
Signature
()NEWADDRESS ( } FACILITY PERM IT TO TRANSPORTATION D EPT.- () SPECIA L PMT. AR EA. I\4IN. ELEVATION:
-
Date
SANITATION
Minimum Septic Tank Capacity (Gallons)
Drainfield Required - Lineal Feet
Maximum Depth
Date
BUILDING
Type of Construction
IJ se Classification
Comments
roup Fire Zone
Comments
By:By Date
PLANNING REOUIREMENTS SATISFIED. B Date Date lssued:
ZONE SETBACKS: FRONT SIDE FACING STREET (FROIVI C/L) INT. SIDE YARD REAR (FROIVI P/L)
LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, '125 EAST 8TH AVE., EUGENE, OREGON 97401 PHONE: 687-4394
POST THIS PERVIIT ON MAIN BUILDING AT SITE
BLDG. PERMIT-WHITE; BUILDING -GREEN; PLUMBING -CANARY; SANITATION-GOLDENROD; OFFICECOPY-WHITEc55-13
I
!'t .tr:t.
):'
I,
,\'.?
t
'e. t l.';
..t
,\,:,i ..
.lt /- t.:...H1:
,.'idry'
EI
o
rf.s ,'rj
I
";
b:
s.I
Z
AJ
rcsf)
l1
I
I
:
t
:\
i)
c)tQ'A*
o
?-,
?tlr{g.
oc
+,,o
6)
{Jo
1)
,)
,,
r)
n4,l
i,
ct
t^)ao
i,
0,
L:
,1
-t
h-dct'!o
lb0".{O
OLtopqroht+J!.c)JOrc)
),;1 G)c'i5
!).ttr
'd r-{
.) b0,:tr
l, '-{,:E
ND
I}{?M?N\O ./1gl
, ^1, .'
,!, ti.'.
,1' 8
:','u":+
F
tr-N
fr
I
\a
a)ttl
t ri
6.\
*
o.,{I
T
orL)
\"\,
,:)
a
\N'c
6J.5
.?
I
I
$.la
D
3u
s
?,LE
bL
o^rJt
acf)c
3i
a)
I
{'
I
I
s'.\\
F
d4
drd.lj-.
t)
,.x
tr"
j{
3
I
I
rn,
'GJ
:1
01qa Yla
.',.'.
l, t
l*r1..
, ,?t',. .,..4J1
,1
:
: '':!''.?l
I
,:, 'i'1
rl
l, r.
'i t,
| ', l1
1Y]"'1',.. I I
).
i, i r.'. t''
.1,,
:ri .:
rl
2 't'
,
rl
:l
l-
I
I
I
!. i
;.. r .-
.+ .'-'___-
I
,
---l
I
I
I
I
\
a_
ul
sld
t
! r.'