HomeMy WebLinkAboutPermit Field Test & Inspection Report 1969-03-06I.'ILL CALL WHEN HOLES ARE READY.
Recetpr No. 45150 TWP. ,- R
TAX LC'T NO
ANGE ^, SEC'--lffic0'
crroNs, LANDMARKs, HousE oR Box No., rr axv): 6o Coborg iloadline eil the wgy - turn left when it deadcnds thon turn rlght on
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REQUEST FOR SITE
Mntutxo Aooness
I NSPECTI0N DarE
BY llran ouden^ A TEl . No.
-JJrr'.'jief€-
Owxen or PnopERrv gpel At lon
trugcne, 0regisn
Srze or Pnor. 274 ; $5 LEeal Access
CoNsexr or Owxen?Y.rls.ls pnopEnrY coNTlcuous'To ANy ctry LlMt
ExrstrHc Srnucrunes ox-ffi P ERTY
s0uRcE 0F WATER SUPPLY: PuaL rc *_ spRrHe ldrlu: Dnrlue o_DnrvEN_Due
DESCRIPTION OF SITE (orne
and turn east on Belt
Deodmanr Fcrry Rosd.
PROPOSED UsE 0F SITE (E.G.r NUMBER oF DUELLTNGs, coMMERcIAL oR TNDUSTRTAL usE, suBDrvrsroN):
I Site - hrelllng
s
rtY
Rd.
jM'*"oNrzrNG AnEa'
fl Sercrar Prnurr Anee.
No. or SrtEs
No. or Acnrs
TOTAL-
FEE:
KC./kc
RESULTS OF I NVEST I GAT I ON :
r 2- I 8-68
I 2- I 8-58
z;,t f
d{r-#nL-
^&
Cancel.
Refun d.
Appl ication canceled, not interested in this property at this tjme
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^1
?1 fu,r *'t 4*U*--*1
"ry*b
7 a-rrtr'11,"to
TH ts ts A pREL rM rNARy REpoRT wH rcr"r DoES Nor rNsuRE TrE rssuANcE oF A FUTURE Bu tLD ING
PERMIT. ANY PLANS OR EXPENDITURES MADE IN RELIANCE UPoN THIS REPoRT ARE AT YoUR owN nlsx!
BEFORE CONSTRUCTION lS STARTED entNG Trtts FoRM ro rHE Butr-orNG AND SnurrarroN DrvrsroN ANDMAKE APPLIcATIoN FoR A EulLDlNG PERMlr. lr rne pRopERTy ts A poRTroN oNLy oF A TAx LoT, AMETES AND BOUNDS DESCRIPTION OF THE PARCEL MUST BE FURNISHED. EXICT SPEC]FICATIONS TOR THESEWAGE DlSPosAL sYsrEM !{lLL APPEAR oN THE BUILDING PERMtr. Two srrs oF THE BUtLDtNG pLANs
AND PLOT PLAN WILL tsE REQUIRED.
,..\LANE
{"w ut-*4rt r0
U
BU I NG,.AND SAN ITATION DIV IS ION :
NG I r.rs ECTOR SalrttnRtar.t Drre
TH IS
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PORT 15 NOT COMPLETE WITHOUT THE SIGNATURES OF THE BUILDING INSPECTOR AND SANITARIAN.
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WILL CALL T.'HEN HOLES ARE READY.
Recr rer No. qltll&Tt{P.t, RANGE0T SEC.ts
TAX LOT N0. &ror CODE
o
REQUEST TOR SITE I NSPECTI0N Dare llrrah 1 la6q
BY lt t.", qprt _ IMa t l t no AooREss 126 lto"rh 6rh Tru. No. 716-E92!
Sprlagf hld. Oregnn 97477
Owuen or Pnopentv *oue StzE or PRop. Rq ,rh Lrcal AccEss?
CorqseNr or OwNen?5 PROPERTY CONTIGUOUS TO ANY CITY LIMIT
Ex r st t Nc SrnucruREs oH PnopeRty
s0uRcE 0F \,/ATER SUPPLY: PueLrc _r__ spnrNs wElu: Dnrulro_Dnrvrru_1 Due
0ahrey
DESCRIPTI0N 0f SITE (Drnrcrror.rs, LANDMARKS, HousE oR Box No., rr aNv) :
Road onto Dcadnanrl Forry on rlght rldc - onc vacant lot.
Rlght on 8mo fsrn
PR0POSED USE 0F SITE (E.G., NUMBER or D\./ELLrNcs, coMMERCTAL oR INDUSTRtAL usE, suBDtvrsroN):
I Eldg Slte
&
N
UnelNrzlNG Ansa.
Specral Prnurr ARee.
FEE:
No.
No.
or SrrEs Ior AcRrs
TOTAL-
$_r,gg_
$ q.o0BOlkc
RESULTS OF 1 NVTST I GAT I ON :
H,.
Ruq,x u 3, tu-c
au ( n" ,?,*/L
/<- ,4It-^tO ( /
'';hd/
- /f
rt^-k *
7*p (a T
'i ofl*4 d"-5u4 6\fui'4
e >k "-{
vi- u
THr.s ts A pRELTMINARy RtpoRT wHrcH DoEs Nor INSURE THE lssuANcE oF A FUTURE BUtLDING
prRMrr. Attv pt-ANS oR ExpENDrruREs MADE rN RELTANcE upoN THrs REpoRT ARE AT youR oI.JN ntsxl
BEF0RE CONSTRUCTION lS SIARTED aRtNc rHts FoRM ro rHE Butt-orNG AND SarurrarroN DrvrsroN ANDMAKE APPLIcATIoN FoR A tsutLDrNG PERMtr. lr rnr pRopERTy ts A poRTtoN oNLy oF A TAx Lor, AMETES A'ND BOUNDS DESCRIPTION OF ThIE PARCEL MUST BE FURNISHED. EXACT SPECIFICATIONS FOR THE
SEWAGE DISPOSAL SYSTEM rr/lLL APPEAR ON THE BUILDING PERMIT. TWO SrrS OF THE BUtLDINc pLANS
AND PLOT PLAN WILL BE REQUIRED.
E COUNTY BUILDING AND SANITATION DIV IS ION :
-(6Burtorne lNspecroR ANITARIAN TE
THIS REPORT IS NOT COMPLETE WITHOUT THE SIGNATURES OF THE BUILDING INSPECTOR AND SANITARIAN.
crt-097-O7