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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 ;--r-5 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 /4 ^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 crr-0r7-0? PORT 15 NOT COMPLETE WITHOUT THE SIGNATURES OF THE BUILDING INSPECTOR AND SANITARIAN. ll--^ a 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