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Home My WebLink AboutPermit Backflow Test 1976-01-02n Owner LANE COUNTY PERMIT FOR: CONSTRUCTION [ ] IVIOBILE HOIVIE [ ] PLAN REVIEW t ] CHANGE OF OCCUPANCY t ] NAIVIE ADD R ESS ZIP CODEC ITY PHONE n Contractor NAN4E ADD R ESS CITY ZIP CODE PHONE O.S, Reg. + Tw Range- Section Lot- Block u, tor* /6 00o ,oo" AcreageSubdivision Existing Structures on Property Census Tract Access to Property (Road Name)r : : Width Depth Directions to Property Address STRUCTUR E (# BEDROOIVIS)SO. FT VALUATION SEWAGE DISPOSAL PLUIVIBING INSTALLED BY: OWNER[] OTHER[] NAIVIPUBLIC [ ] SEPTICTANK t] OTHERT]tr PLUIVIB ING BUILDING 3% SURCHARGE TVIOBILE HOIVIE WASTE DISPOSAL PLAN REVIEW TOTAL WATER SUPPLY: PROPOSED t ] EXISTING t] PUB LIC COIVIVIUNITY . NAIVIE PR IVATE WELL OTHER SPECIFY CONSTRUCTION PERMITS & INSPECTIONS AND WATER POLLUTION CONTROL SPECIFICATIONS IVIIN. SEPTIC TANK CAPACITY GALS IVIIN. DRAINFIELD LIN. FT IVIAX. TRENCH DEPTH I NCHES T STAY 1OO' FROIVIALL WELLS TYPE OF CONSTRUCTION G ROUP FIRE ZON USE CLASSI FE SETBACKS FT. FROI\1 CTR. OF r/W FRONT SIDE EXT FT. FROIVI PROP. LINE: SIDE INT. - REAR ZONE AUTHORIZED SIGNATURES ts/ BLDG, PEFMIT - WHITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GFEEN SANITATION - GOLDENFTOD IMPORTANT Call 687-4065 to schedule all required construction inspections. Call 687-4061 to schedule all required seplic system inspections. All construction shall comply with the State Buidling Code, D.E.Q. standards for subsurface sewage disposal and the State Plumbing Code. All buildings require a certificate of occupancy before being occupied. (See Details on Fleverse Side) POST THIS PERMIT ON MAIN BLDG. AT SITE LANE COUNTY, DEPT. OF ENVIBONI'/ENTAL ft,4ANAGEIt/ENT COUBTHOUSE ANNEX, 135 EAST 6th, EUGENE, OBEGON 97401 c55 -l 3 PERI\4 IT NO. L ISSUANCE DATE: r.l fil 4L --LANE COUNTY PERMIT FOR:PERI\4 IT NO. CONSTRUCTION [ ] t\,lOBILE HOIVIE [ ] PLAN REVIEW [ ] CHANGE OF OCCUPANCY [ ] n Owner t$rrd L Slnclalr, Rt. ?, Box 35In [ugrae 97401 NAME ADD R ESS C ITY ZIP CODE PHONE D Contractor Self NAME O.S. Reg. + Subd ivision Access to Property (Road Name) ADD R ESS CITY ZIP CODE Census Tract PHON E Twp- Range-, - Section- ---.Tax Lot--,. Code Lot - Block 0lxon Strrct Acreage Width Depth lloneExisting Structures on Property: Directions to Property - Address:Corner of {oburg lloed rnd Dlxon Sitmrt, Cebury STRUCTURE (# BEDROOIVIS)SO. FT VALUATION Barmr l0 SEWAGE DISPOSAL: PUBLIC [ ] SEPTICTANK [ ] OTHER [ ] PLUIVIBING INSTALLED BY: OWNER [ ] OTHER [ ] NAIVIE- BUILDING ---PLUTVIB ING 3% SURCHARGE IVIOBILE HOIVIE- WASTE DISPOSAL PLAN REVIEW TOTAL - WATER SUPPLY: PROPOSED t ] EXISTING I] PUB LIC COVIT\4UNITY NAIVIE t I t t PRIVATE WELL OTHER .SPECIFY CONSTRUCTION PERMITS & INSPECTIONS AND WATER POLLUTION CONTBOL IFICATIONS I\4IN. SEPTIC TANK CAPACITY: GALS.- IVIIN. DRAINFIELD-_LIN. FT IVIAX. TRENCH DEPT I NCH ES ST F A WELLS TYPE OF CONSTRUCTION on cppt1o ans Eu3 GROUP RE ZONE- USE CLASSIFFI SETBACKS FT. FROIVI CTR. OF r/W: FRONT SID E EXT. FT. FROIVI PROP. LINE: SIDE INT. _--- REAR ZONE AUTHORIZED SIGNATURES Fttrrrsk 8110176 ISSUANCE DATE: lsl BLDG. PERMIT - WHITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENFIOD Call 687-4065 to schedule all required construclion inspections. Call 687-4061 rMpoRrANr, ffii::,"Ji'i,T"'1T,f3r""X1;ii#1"i:'ill:Li:il 8itrJI"U'3"T: TlTlil1."3n" occuPancy before being mcuPied. (See Details on Beverse Side) to schedule all required Code, D.E.Q. standards require a certilicate of POST THIS PERMIT ON MAIN BLDG. AT SITE LANE COUNTY. DEPT. OF ENVIBONMENTAL MANAGEMENT COUBTHOUSE ANNEX. 135 EAST 6th, EUGENE, OREGON 97401 t,\,,\J }L SLAB FLOOR PLUMBING GROUND/ORK Ap enov e o Reurnx s .4 DI SAPPROVED I Nspecron GAS PIPING GROUND/ORK Apenov r o RettlRx s D DrsappnovEo D Dare I ruseecron ROUGH PLUMBING AppRoveo R/ D rsappnove o - 3-zz->> Remanxs ll-t-? b , Or,rD updsr F4 Z,Lia,,Lllar; u* Dat e I Nspecron ROUGH GAS PIPING Ap pnov e o RruaRx s Dt sapPRovEo Dar r I rusprcton FINAL PLUMBING Ap pRov e o RruaRxs D r SAPPRovED Darr I rspectoR FINAL GAS PIPING AppRoveo D DrsapeRoveo D Re uaex s Drre I us pe ctoR CERTIFICATE OF OCCUPANCY Reaov ro lssue REuanr s Nor Rerov ro lssue Dare I Hsprcron D oorr T-/h26 D A It I e-'* f , jaaiaitiir-- I t:VEL alRAl)ii'{r, :it,cL 6xr{ () -ltrla CAP.. rbR! \ 0\r , j"l '. ) ,I .r'"il 1i l,irl ir . outf, U) ,I,T JPATIO l. rver- i;,Rl.l-rrJl Qd -ci' .j(-ALE l;l i t11 \0 v -E .! .s, Hg rf, o t oL .{";.i ( "-J ' ! BUILEIING S ITE EVALUAT tON t1r t1^ -R__eAs 7z- rAx toral[ooo SUBDIVT JN: LOT: I ?t SLOCK: /4 )\A/CK W BUtLptNG PERHtT APPLIcATIoN No. ( ) srrE tNsPEcrroN PLANNING DIVISION l. Zoning Ordinance Cornpl iance: 2. Subdivision 0rdinance Compl iar 3. Required Access 4. Building Site (Area, width, F 5. 0ther (see conments) Setbacks frorn interior I ines: Side 5'Rear z:^'vu€- t7--7b Not Aool i cabl e:22'q() rontage) ( )() APPL I CANT DATE No Yesna 6.()a()a()(4 () () CKID Setbacks Front $ide-Bcte#cr cOr{r{ENTs: FuANITNET a V I s tEN-IeTIo[ BUILOING INS t0N Dlvlsl0N Plans Submitted Soi I Stabi I ity (footings) Flood Plain 0ther (see conments) COHMENTS: n0{TEFrmr Ioi# Not 7 8 9 0 Aool i cabl e-'-Tr ( r)(u (\ Yesqt () () () Nor)() () ()CK' D BY WATER POLUTION CONTROL ll. l{eets Department of Environmental Qual ity Standards. 12. Other (see comments) Not Aool icable No Yes -(T r) Tf () ()()CKID BY DATE COI4HENTS: TO APPLICANT: Your ? Building / Site lnsPection: rF{-e an be approved.above. \\ ,t ()c annot be aPProved at t his time as indicated on item N0. the LANE- i tems 7 S ION. Que stlons and further i nformation on items I through 5 contact PLAN DIVISION Qu estions and further information on t rough 2 contact the LANE C BUILDI AND SAN ATION D lrill be held in this office unt you can reso e probvetK ls being returned. c55-28 () () Your bui ldin ems nd i cat ed. rmit a li i on fee sbe 135 Sixth Avenue East Eugene Oregon pHoNE z 68l-4055 LANE COUNTY PLANNING DIVISION PHONE: t 97401 587-4r 85 I O. n Owner PERIV]IT NO CONSTRUCTION [ ] IVIOBILE HOIVIE [ ] PLAN REVIEW [ ] CHANGE OF OCCUPANCY [ ] NAME ADD R ESS CITY ztP cooE PHONE n Contractor NAME ADD R ESS CITY ZIP CODE Census Tract PHONE O.S. Reg. + Twp- Range- Section-Tax Lot-* Code Subd ivision 0 iRd Lot B lock Acreage Access to Property (Road Name) Width Depth Existing structures on Property: Directions to Property - Address STRUCTURE (# BEDROOIUS)SO. FT VALUATION SEWAGE DISPOSAL: PUBLIC [ ] SEPTICTANK [ ] OTHER [ ] PLUIVIBING INSTALLED BY OWNER[] OTHER[] NATVI F BUILD ING PLUTVIB ING 3% SURCHARGE IVIOBILE HOIVIE WASTE DISPOSAL PLAN REVIEW TOTAL WATER SUPPLY: PROPOSED I ] EXISTING t ] PUB LIC COVINlUN ITY NAtvlE PRIVATE WELL OTHER-SPECIFY CONSTRUCTION PERMITS & INSPECTIONS AND WAT ER POLLUT ION CONTROL SPECIFICATIONS IVIIN. SEPTIC TANK CAPACITY GALS IVIIN. DRAINFIELD . LIN. FT MAX. TRENCH P I NCH ES STAY 1OO' FROM ALL W ELLS TYPE OF CONSTRUCTION- GROUP FIRE ZONE USE CLASSIF. SETBACKS - FT. FROM CTR. OF rM FBONT SIDE EXT FT. FROM PROP. LINE: SIDE INT. REAR - ZONE AUTHORIZED SIGNATURES lsl ISSUANCE DATE BLDG. PERMIT - WHITE OFFICE COPY - WHITE COUNTY TAX _ PINK PLUMBING _ CANARY BUILDING - GREEN SANITATION _ GOLDENROD IMPORTANT POST THIS PERMIT ON MAIN BLDG. AT SITE Cail 6g7-4065 to schedule all required construction inspections. Call 687-4061 to schedule all required ""piii .vit"- in.lucito"s. Atl construction shall compli wilh the State Buidling Code, D E.O. standards ioisuodurtace sdwage disposat and the State etumOing Code. All buildings require a certilicate of occupancy before being occuPied. (See Details on Reverse Side) c55 -l 3 LANE COUNTY. DEPT. OF ENVIHONMENTAL MANAGEMENT COUBTHOUSE ANNEX, 135 EAST 6th, EUGENE, OBEGON 97401 ,/ LANE COUNTY PERMIT FOR: SITE INSPECTION App Rov E o ReueRx s Drsappnoveo Dare I ruspectoR FOUNDATION I AppRoveo Reua nx s toN Dr sappRoveo Drr ,H!-7(tr\.(:,il. EC I FRAMING INSPECTION App Rov r o RruaRx s .rn Darr A' ,7"llrsprc 4,,\LtsAPPROVEO L.."--- LATH OR SHEETROCK INSPECTION Ap pRov e o ReuaRxs n DTsAPPRovE o [-a Dare "-p " fa ,'t' - I nspecron FINAL INSPECTION Ap pRov e o Rrua nx s % D APPROVED 9*4,3 74*,",,, .2'/A , 7 Datr o -14,,x, CERTIFICATE OF OCCUPANCY Reaov ro I ssuE RruaRx s D Nor Rraov ro lssue D Dorr_ / 7 /r,,,/bda I Nspecron - D I ) ?ULrt aU Witt ?Uc uP WLv'n *ffi fTrG NOTE: NO PERMIT I^i- , BE ISSUED UNTIL THIS APPLIC,AI- ., IIAS BEEN APPROVED APPLICATION FOR: CONSTRUCTION PLAN REVIEW*3 OWNER CONTRACTOR REG. # Name Address Address Tax Lot City Code Census I t6 Phone -13{6- th_Depth_ zLp o. s. )Twp..Section Subdivis ) o..rs ro pRopERry <rc.a ra'e> fiJltrJ 4w. ) n*trting Structures on Property: /\ Property Location - Address/Directlons: for Of lce Use SEWAGE SLte Inspectlon WATER SUPPLY: Well Bldg. Plumblng 3Z Surcharge waste DLsP. Plan Review MoblLe Hone TOTAL rto. oo PLUMBING: Installed by Owner PLWBING FEES CASH CHECI{ b.lb Sewage Connectlon PI,ANS FURNISHED YES Signatur e of Applicant .Fee Received By Water Connection FACILITY PERMIT Date FtSq {,1 oExiK-No$'k ;*q".!'; ,",i#J i'll*sal svstem Public Sprlng Other ComtunitY or New System Requlred f-l Name of Conununity or Public Systen NameqJ+ of Fixturest, 2_o NO Maxlmum Dep iLMln. Septlc Tank CaPacl Dralnfield Requir ed - Lineal Peet Fire Zone Use Classifl-caEiontype of Construc Bldg Setbacks pa6111 $,' - from Center of Road Side Int. 6' Right of Way: c5s-r2 LANE COI]NTY DEPART}'IENT OF ENVIRON}'IENTAL 6'p 2o.," AGf CRA) DATE:DATE: MOBILE HO}G r--_l Nr# + +l .)D aI