HomeMy WebLinkAboutPermit Building 1978-04-21E PERIVIIT #
TRS,',
Acreage or Lot Si 7tr
JOB LOCATION
Partition ing
LANE COUNTY PERMIT
( ) Completed Subdivision
Contractor's O.S. #
APPLICANT'S NAIVIE AND ADDRE
Lot =-- Bloc
SS Phone_-_-_--OWNER'S NAIVIE AND ADDR trss
PhonCONTRACTOR'S NAI\1IE AND ADDRESS
Mail permitto ( )Applicant ( )Owner ( ) Contractor. ( ) prefer to pick up. Cait (owner, etc.) yyhen ready
STRUCTURES NOW ON THE PROPERTY_-
-*- = 3 E D H oo I\,4s-- -# P L u tut B I N G cc r -- N E cr r o r\j s -__
WATER SUppLy SEWAGE D|SPOSAL S.t. #
THIS PROPERTY lS WITHIN ONE MILE OF THE CITY OF----
-.
pLUMtBiNG ByI hereby certify that the above statements are true and accurate, and
-contract
purchaser;
-- potential buyer;
--
realtor or agent.
record, and that said owner is aware and approves of this action. I hereby
Fee Paid $-
Phone_*___
HIS PERMIT IS FOR-
--
that I have the follouring legal interest in the property:
-owner
of record;I further certify that (if not the owner) I am authorized to act forthe owner ofagree to cornpry with ail appricabre ccdes rerating to this permit.
Signature Date .----...-----..------.-_--() NEW ADDRESS () FACILITY PERMIT TO TBANSPORTATION DEPT.-{ } SPECIAL PIVIT. AREA iVIIN. ELEVATION:
SANITATION
Minimum Septic Tank Capacity (Gallons)
Drainfield Required - Lineal Feet
L{aximum Depth
ype of Construction ___=Croua
BUILDING
-T
--_'--_ F ire ZonetUse Classificarion
Jomments
By
Comments
Date
PLANN ING REOU I HEIVIENTS SAT I
ZONE SETBACKS: FRONT
ts
SIDE FACING STREET
SFIED. By Date
Date
Date lssued
(F ROt\,1 ci L)INT. SIDE YARD REAB (F ROM P/L)LANE COUNTY DEPARTI\4ENT OF ENVIRONMENT AL IVIANAGEI\NENT, 125 EAST BTH AVE., EUG ENE, OREGON g74O1
POST THIS PERMIT ON MAIN BUILDING AT SITE8LDG. PERMIT -U./HITE; AUILDiNG - GREENT pLiJtviBlNG _ CANARyi SANtTATtON.- GOLDENROD; OFFrttE COpv_ .y1pj ;;5
c55-1 3
PHONE: 687 4394
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INFORMATION SHEET
5s-AN
( ) guilding Permit ( ) Site Feasibility Study for Septic Tank. N
Acreage or Lot Size (20 < llt Test holes will be ready
Partitioning#-- ( ) ComPleted Subdivision( ) Pending
APPLICANT'S NAME AND ADDRESS A A/!)*^
OWNER'S NAME AND ADDRESS,if different fro a licant's
CONTRACTOR'S NAME AND ADDRESS
y il permit or results of site feasibility study to ( ) Applicant B owner ( ) contr r. 57,
I Prefer to pick up. Call ( owner, etc. ) when ready
STRUCTURES NOW ON THE PROPER
PBOPOSED USE (this permit)tueltl& k*n<
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(existing or proposed well, etc. lf public, name of system)
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(existing or proposed septic tank, etc.) S.
Address
lnterior Side Yard Rear _
(FROfVI PROPERTY LINES)
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WATER SUPPLY
SEWAGE DISPOSA
PLUMBING BY
(>IPBOPERTY rS WTTHTN ONE MtLE OF CtTy
* + * * * * * * * * + ** * * + * ** * * * * * * ** r + + * * ** * ** ** * * * * Q FIC E ONLY BELOW T IS
,, ) New Address Necessary ( ) Facility Permit Necessarylortrr- sErBAcKs: Front *"r.:i1E^l?i,JgrtltTl,
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( I Special Permit Area. lVlinimum Elevation
Con
D"d-
rof s rtes
il At\
To: Planning/Building lnspector/Sanitarian/Surveyor.
This applicant appears to have a problem
Your assistance will be appreciated.
By Permit Processing Section
Response:
By
DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
Permit Processing Sect ion.l25 East 8th Avenue
687-4394c55-12
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PERIVIIT #
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Acreage or Lot Si
Comments
JOB LOCATION
Partitioning #
LANE COUNTY PERMIT
APPLICANT'S NAME AND ADDRESS
-
phone
Contractor's O.S. #Lot Block-
OWNER'S NAME AND ADDRE Phone-.
CONTRACTOR'S NAME AND ADDRESS- phone__ _
Uail permitto ( ) Applicant ( )Owner { )Contractor. ( ) Prefer ro pick up. Calt--- (owner, €tc.) when ready.
STRUCTURES NOW ON THE PROPERTY
IHIS PERM!T IS FOR = B E D R OO 1,4 S-=___+ P L U l\4 B I NG CO N N E CT I O Nj S_-.-
U/ATER SUPPLY- SEWAGE DISPOSAL s.i. #
THIS PROPERTY IS WITHIN ONE MILE OF THE CITY OF - PLUIVIBING BY
I hereby certify that the above statements are true and accurate, and that I have the following legal interest in the property: _owner oI record;
-contract
purchaser;
-
potential buyer; --::- realtor or agent. I lurther certity that (if not the owner) I am authorized to act lor the owner oirecord. and that said owner is aware and approves oI this action. I hereby agree to comply with all applicable C,odes relating to this permit.
Fee Paid S-Signature Date
()NEWADDBESS ( } FACILITY PERMIT TO TRANSPO RTAIION D EPT.-- | SPECIAL PMT, AREA, IuIN. ELEVATION:
-
-SANITATION
Minimum Septic Tank Capacity (Gallons)
Drainfield Required - Lineal Feet
l"4aximum Depth
BUILDING
i Type of Construction] .- Use Classifir:atiorr
Comments:
roup Fire 76n.
B Date B Date
PLANN ING REOUI REMENTS SATISFI E D.Bv Date Date lssued
ZONE SETBACKS: FRONT SIDE FACING STREET (FROIVI CiL) INT. SIDE YARD REAR (FROM P/L)
LANE COUNTY DEPARTMENT OF ENVIRONMENTAL INANAGEMENT, 125 EAST 8TH AVE., EUGENE, OREGON g14O1
POST THIS PERMIT ON MAIN BUILDING AT SITE
BLDG' pERMIT - SJHITE; BUILDING - GREEN: PLIJMBING CANARY; sANITATtoN -- coLDENRoD; oFFtcE cop.{ - v!rjirr
c55-1 3
PHONE: 687-4394
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', LAB t LOOR
PLUMBING GROUNO/ORK
APpPovro
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Dt slppnoveo I Nspr c toR
GAS PlPl NG GROUND^/OI?K
AppRovro
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ROUGIi PI.t]MB ING
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ROUGI] GA:, PIPING
AppRovt o
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D Dr.:apppovc , D Darr itr:;pt,.Top
r I NAI PI.TJMB ING
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F lr'lAL GAS PIPING
Af,pRovro / / DrsapnRovr, [-7 [)orr___--
llruanxs
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CI R I'I I' I CATI OF OCCUPANCY
Rtaoy r0 lssuE
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Acreage or Lot Size
Contractor's O.S. #
APPLICANT'S NAME AND ADDRE
JOB LOCATIO
Partitioning
LANE COUNTY PERMIT
( ) Completed Subdivision
Lot- Block-
SS Phone-
OWNER'S NAME AND ADDBESS-Phon
Phone-CONTRACTOR'S NAME AND ADDRE
Mail permitto ( )Applicant ( )Owner ( )Contractor. ( )Prefertopickup. Call-(owner, etc.) when readY.
STRUCTURES NOW ON THE PROPERTY
THIS PEBMIT IS FOR # BEDROOIV]L# PLUIV]BING CONNECTIONL-
WATEF SUppLy-- SEWAGE DISPOSAL-_- S.l. #
THlSPRoPERTYlSWlTHlNoNEMlLEoFTHEClTYoF.PLUtVlBlNGBY
I hereby certify that the above statements are true and accurate, and that I have the following legal interest in the property:
-owner
of record;
-contract
iurchaser;
-
potential buyer;
-
realtor or agent. I {urther certify that (if not the owner) | am authori2ed to act for the owner oi
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 $- Signature
l NEW ADDRESS () FACILITY PERMIT TO TRANSPORTATION DEPT ( ) SPECIAL PtVlT. AR EA. tvllN. E LEVATION:
-
Date
-
SAN ITATION BUILDING
Type of
Comments
It
Cb nstructionMinimum Septic Tank Capacity (Gallons)
Drainfield Required - Lineal Feet
Maximum Depth
Use Classification
roup
-Fire
Zone
Date
Comments
BBy:
PLANNING REOUIREMENTS SATISFIED. Bv Date Date lssued
ZON E SETBACKS: FRONT SIDE FACING STREET (FROM C/L)INT. SIDE YARD REAR (FROIVI P/L)
LANE COUNTY DEPARTMENT OF ENVIRONMENTAL TVIANAGEMENT, 125 EAST 8TH AVE., EUGENE, OREGON 97401
POST THIS PERMIT ON MAIN BUILDING AT SITE
C55-1 3 BLDG.pERMtT-wHtrE; ButLDtNG-GREEN; pLUMBTNG-GANARy; sANrrATtoN-coLDENRoD; oFFlcEcoPY-wHlrE
PHONE:687-4394
Date:
SITE INSPECTION
Appnovro D DrsrppnovE, D
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TOUNDATION INSPECTION
APPRovED D DrsapPRovEo
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FRAMI NG
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Reuanx s
I NSPECT I ON
!_a DrsappRovso D DArE I xspecron
LATH OR SHEETROCK I NSPTCT I ON
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FINAL INSPECTION
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Acreage or Lot Size
Contractor's O.S. #
APPLICANT'S NAME AND ADDRE
Mail permit to ( ) Applicant ( ) Owner () Contractor. ( ) Prefer to pick up. Call
ob{r,L
JOB LOCATION
LANE COUNTY PERMIT
Partitioning #-( ) Completed Subdivision
Lot- Blo ck
Phone-
OWNER'S NAME AND ADDRESS
CONTRACTOR'S NATVIE AND ADDRESS
Phon
Phone-
(owner, etc.) when ready
(}IrHIS PERTVIIT IS FOR
WATER SUPPLY
# BEDROOMS ,*"'# PLUIVIBING CONNECTIONS
r r,,1..[ . .
SEWAGE DISPOSAL S.I. #
THlSPRoPERTYlSWlTHlNoNEMlLEoFTHEClTYoF.PLUIVlBlNGBY
I hereby certify that the above statements are true and accurate, and that I h
-contract
purchaser;
-
potential buyer;
-
realtor or agent. I further
record, and thatrsqid owner is aware and approves of this action. I hereby agree to
Fee Paid $ Signature
ave the following legal interest in the property:
-owner
of record;
certify that (if not the owner) I am authorized to act for the owner of
gomply with all applicable Codes relating to this permit.
Date
( ) NEW ADDRESS { } FACILITY PEFMIT TO TRANSPORTATION DEPT.- ( ) SPECIAL PMT. AREA. lvllN. ELEVATION:
-
SANITATION BUILDING ARIA iType of Consf
7*4-t-JJ
lVlinimum Septic Tank Capacity (Gallons)
Drainfield Required - Lineal Feet
Maximum Depth
ructio
Use Classification
n Group
-F
ire Zone
(Comments
Comments
By Date By:Date
PLANN ING REOUI REMENTS SATISFI ED By:Date:Date lssued: '
ZONE SETBACKS: FRONT SIDE FACING STREET (FROIVI C/L) INT. SIDE YARD REAR (FROIVI P/L)
LANE COUNTY DEPARTMENT OF ENVIRONNIENTAL |\4ANAGEMENT, 125 EAST 8TH AVE., EUGENE, OREGON 97401 PHONE: 687-4394
POST THIS PERMIT ON MAIN BUILDING AT SITE
BLDG. PERMIT - wHITE; BUILDING - GREEN; PLUMBING - CANARY; SANITATION - cOLDENRoD; OFFICE COPY - WHITEc55-1 3
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STRUCTURES NOW ON THE PROPERTY
WATER SIJ?I'LY SYSTEM REVTEW lune ccunty
t'14 *
Pcrmlt #0t3 -7
The followlng information has bcen forwar<l:d to the permlt
processlng section. If there are any questions regarding
ih" lnfor*atlon below coritact Lane County .invirorment.al
Healthe 125 E. 8th Avenue, Eugcnc, OR 9740I 687-4051
D-^--arx l*-Naioe
dJress7rz td
Z ip Code
ffi comruNrrY wArER sUPPLY
A. KApproved
Conrnent. s :
No knowledge of indicated public or corurunity water supply systeo
Pending approval due to lrnprovanenrs belng made
Not apProved
[--l Provlslonal appfoval '
f . ffiwithin water dlstrict
I noa wiririn water <]istricr lndicated, check !.rlt,h Boundary Cmnlsston
WaEcr DistrlcE. cannoE extend services to this parcel at thls tlme
services wlthout, iroprovementsC. fl Systern not adequate for more
f] r*irting connection
[] rNorvrDUAL I.JATER suPPLY
A.Permit on file
E *o permit on flle; permit required before lnstallatton frm
Env iroru'nenr.a I lleal th
B. f] Spring or surface watcr supply needs varlance approval
C. E Existing water supply not connected
! r*rrEing connectlon to w8t€r supply
StrR
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En virorloenca I Health
l.*lG"","^ t^l fJ
,Rs ate 7-rs -71
rRs, rL 18 - 03 - 6 > Job Location -te 7rJl{u-r- ql,t 5#ll 8^{ f?tll?
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rritten Directiqr. Spl1( - so...pft^ ( st t"r o^ctr ( &.^ S*tt" ao{ S+ lat/t , $ |gy1l}c bu( !l'rv *llr4!$ WAtt
NFORMATION SH
( ) Site Feasibility Study for Septic Tank. Number of sites--e4/l
Phone 3v3^325F
Phone
Phone
ry
zuz- ttt09-;a:'{dr-
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ry( ) Building Permit
Acreage or Lot Size
Partitioning #- ( )Completed( ) Pending
APPLICANT'S NAME AND ADDRESS
OWNER'S NAME AND ADDRESS, if di
^lNTRACTOR'S NAME AND ADDREI
ril permit or results of site(X Prefer to pick up. Call
STRUCTURES NOW ON THE PROPE
PROPOSED USE (this permit)
WATER SUPPLY
fferent a
SS
feasibili s v ( ) Applicant ( ) Owner X) Contrr"tot
7-crG0 (owner, etc. ) when ready
60 x((0 Test holes will be
Subdivision
tla w
d adrl Lot 4 Bto"(
A'
Contractors O. S. #
ts"(AS Z
existing or proposed well, etc. lf public, name of system)
SEWAG E DISPOSAL (existing or proposed septic tank, etc.) S.l
PLUMBING BY
(}.() pnoprRTy ts wrrHrN oNE MrLE oF crry (
rl**r'*. OFFTCE USE ONLY BELOW THIS LtNE ****+*+*l.l+'
Address
l ) New Address Necessary
zoN
( ) Facility Permit Necessary
SETBACKS: Front Side Facing Street
(FROM CENTERLINE OF ROAD)
( ) Special Permit Area. Minimum Elevation
lnterior Side Yard
-
Rear
(FROM PROPERTY LINES)
E-
To: Planning/Building lnspector/Sanitarian/Surveyor
This applicant appears to have a problem
Your assistance will be appreciated.
By Permit Processing Section
Response
By
DEPARTMENT OF ENVI RONMENTAL MANAGEMENT
Permit Processing Section
125 East Bth Avenue
687-4394c55-12
D ivision
)
q
au
Address
Minlnun Elevati
q V7
LANE COUN- gEPARTMENT OF ENVTRONMENTAL MANAGEMENT
125 EAST 8TH AVENUE, EUGENE, OREGOI\ 401
PIANNING DIVISION CuTrcnt Zoni
P6rtltlonlng f_ fleendlng f--lConpleted
Parccl No._
Partltlohlnq Reoulred
Othcr t
HATEn POLLU?ION CONTROL I of Sltcr
UGv Slt. Inspcctlon(.!
6DS Con.tructlon [-1 uey f] nepalr
[unber of Bedroonrar
Corutcrc tr
AVERAGE PROCESSING
v\
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UI
CONSTRUCTION PERHITS AND INSPECTION
(S€o abov6 lor I of bedrooras,/l o! employeaa)
t] l{obit. Hotlo S
fl Pcrnanent
q Temporary
t] RenewaL
Sq. Ft, vaLuatlon
rEE
$
E
6)F'Total vlluati.on S
_- Plumbing fixtures at I
_ Sewerl{ater Conn. At 9
Each $--
Dach 3
{l St6t. Surcharg.
Planr Check Fc6
Change of Occupancy
l{lntmuro .tructura!, Belbacks !
FrorE centerl,inc o! atreet: Front
Exte r
Subtota I
TOTAL BUILDING PERHIT FEE
$
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ot,
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Frora lntorlor lot lines: s
Conn'I planr eheet to appllcant Curb cut to appllcant
near E\
--=rf-trtl (,),,
i] Paciltty Permit
tr ErrvrRoNr{ENTAL HE^Lrt -
tt\(C
PUBLIC IANDS
PUBLIC T.JORXS
Ca.h_ Checl I
AFFIDAVIT: If th1.
wi.ll be used for agrfor no otherthls applica
ca
to
FOR
'EErq
ELevat i on
-t7
Roc 'd TOTAI, S
permlt le for an agricultural buildlng, I hereby declare thlt thls bulldlngj.cultural purposes as allowed by zoning and/or the State Building Code, and
. I further certify that the statements and other information submitted on
true and accurate. and that I have the followlng legal intersBt in the
i conEract purch.aeri lesseei holder o-f an exclusive oPtlon
zeil-fo sct for a person wE6-hes the f6lflowing legal lnterest!
r or that the orfier of record is knowledgeable of thi8 ldne countyI
am no owner agree t comP w1 licable codee relatiag
Applicant'e signa
IS YOUR RECEIPT, AND DOES !'lOT GM YOU PERMISSION TO
c74-L70
AEOUT THE PROGRESS OP YOUR APPLICATION, CALL PERMIT CONTROL, 687-'357 (687-HELP)
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/coNrRACroR (ctRCLE 0NE)[ -]PREFER TO PICK UP. CAI,L
resldentlall type of famlng; cor@rcl6l or indutrlal; vacentl etc
2. DESCNIBE STRUCTURES NOT, ON THE PROPIiRI'Y NOTE ANY SI'RTIC'TURES TO B!] DEMOLISIIEI).
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3. IHHEDIATE PIANS FOR THIS PROPERTY (THIS ICATION) ARE
4, FUTURE PLANS
0IJNER (IF DIFFERENT
ADDRESS
t.l^IL PIIRHIT TO A.Pt'Lt
5. PLOT PLAN Sketch (a) all road
proposed sryage d1s(g) easements (h)
or lnductrlal, shou
TOTAL I.O1' SIZE OR ACRFTCE a
s (b) borndartee of property (c) exlstlng/proposed butldlngs (d) extettng/posal areas (e) extstlnS/proposed wetls (f) extstlng/propoJed drlverayedralnageways, strea*, creeks, any other perclnent re"tures. rf comerclatfreestandlng alBns, parklng areas. INDICATE DIMENSIONS.
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EI,ECTRICITY FI]RiISIIED BY
}iATURAL (;AS IlY
INC__. S1'RtiAM - _purr-r, Y-t-
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125 EAST BTH AVENUE, EUGENE, OREGON 97401
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FLOOD PLAiN MANAGTMENT
Departrnent of Public [,Jorks
I 25 East Bth Avenue
Eugene, Oregon
687-41 95
TO:
PERi'IIT PROCISSING
PLAI..IN I NG
PUBLIC WORKS
PERMIT NUMBER 3A IB-?6
PARTITION NUI.IBER
SUBDIVISION
OTHER
SITE ADDRESS
PERMIT VALUE IS A SUBSTANTIAL II4PROVEMENT.
SITE IN FLOOD HAZARD AREA YES L/ NO
YES NO
SITE LOCATION iS WITHIN A FLOOD HAZARD APPROXIMATE STUDY AREA, EXTRA
PRECAUTIONS MAY BE APPROPRIATE TO ASSURE THAT THE BUILDING SITE tdlLL
BE REASONABLY SAFE FROI.1 FLOODING.
SITE LOCATION IS WITHIN A FLOOD HAZARD DETAIL STUDY AREA.
. MTNTMUM FrRST FL00R ELEVATToN 0F 4zl-b99 (M.s.L. ) REQUTRtD.
. MINIMUI4 FOUNDATION ELEVATION OF (M.S.L. ) REQUIRED.
. MoBILE H0ME TIE DOWNS REQUiRED IF GRoUND ELEVATION THAT i"10BILE H0t4E
WiLL BE PLACED ON IS BELOW THE REQUIRED MINIMUI'I FIRST FLOOR ELEVATION.
4. SiTE LOCATED NITHIN A DESIGNATED FLOODI^JAY CHANNEL, BUILDING PROHIBITED
REC0MMENDATI0NS: M H'T\E- E>orrux\e-BE rr..ra.rr.rESr t F
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PERTVIIT #
TRS, T
Acreage or Lot Size
Contractor's O.S. #
By
JOB LOCATIO
LANE COUNTY PERMIT
Partitioning#-.-.--'- ( )Completed Subdivision
Lot Block-
APPLICANT'S NAIVIE AND ADDRES
OWNER'S NAME AND ADDRE
Mail permitto (')Applicant ( )Owner ( )Contractor. ( )Prefertopickup. Calt
CONTBACTOR'S NAME AND ADDRESS
Phone-.--
Phone- -Phone----
(owner, etc.) when ready
s.i. #
THIS PROPERTY IS WITHIN ONE MILE OF THE CITY OF- PLUN4BING BY
I hereby certify that the above statements are true and accurate, and that I have the fotlowing legal interest in the property:
-owner
of record;
-contract
purchaser;
-
potential buyer;
-
realtor or agent. I lurther certity that {il no1 the owner} I am authorized to act lor the owner oI
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 S-Signature Date
l NEW ADDRESS ( } FACILITY PERMIT TO TRANSPORIATION DEPT.-- 1 ) SPECIAL PIV]T, ABEA, IV]IN. ELEVATIONI
--sANrrATloN BU |LDING
Minimum Septic Tank Capacity (Gallons)
Drainf ield Required - Lineal Feet
l,4aximum Depth
Comments -
I Use Classification
F ire Zone
Comments
Date B Date
POST THIS PERMIT ON MAIN BUILDING AT SITE
BI DG. PERMIT - WHITE; BUILDING - GREEN; pLUMBtNG - CANARy; SANTTATTON -_ GOLDENROD: OFFICE COp./ __VvrlrrE
c55-13
PLANNING REOUIREIVIE NTS SATISFIED. B
ZON E:
Date lssued:Date:
SETBACKS: FRONT SIDE FACING STREET (FROt\,{ CiL) INT. SIDE YARD REAB (F ROM PIL)
LANE COUNTY DEPABTMENT OF ENVIRONMENTAL I\4ANAGEIVIENT, 125 EAST 8TH AVE., EUGENE, OREGON 97401 PHONE:687-4394
SITE INSPECTION
Appaov E o
Rrurnxs
/ / Drsrppnoveo fr Dare I Hspcclon
FOUNDATION INSPECIION
Ap pRov E o
Reuanx s
/ / DrsrppRovEor-7 Darr I Hspccron
FRAM I NG
Apenov r o
Rruanxs
I NSPECT I ON
Dr srppnoveo Dalr I Hsplcron
LATH OR SHIETROCK
Appnovro
Rrxanx s
, INSPECTION
Dtsappnoveo Drr r I nser cTon
FINAL INSPECTION
Ap pnov r o
ReMa nx s
d DrsappRoveo F-Datr l uspecron
CERTIFICATE OF OCCUPANCY
Reaov ro lssuE
RruaRx s
D Nor Rerov ro lssue D Darr__ lNsprcroR
r-t \
-,br 5: NEPTUNE AVENUE
PERMIT #
SPRINGFIELD OREGON 97 477
JOB LOCATIO
LANE COUNTY PERMIT
FILBERT GROVE 2nd ADD:
Partitioning #) Completed Subdivision
Lot 4 Blo 4
R.A. ALLEN 575 SOUTH A STREET SPRINGFIELD OREGON
EMERALD TRAILER SALES 575 SOUTH A STREET SPRINGFIELD
r ( X ) Contractor. ( ) Prefer to pick up. Call-(owner, etc.) when
NONE MOBIIE HOME HAS BEEN REMOVED FOR NEi^I ONE MH167-71
\\o-'. '18-03-02
T RS,.
60 x 100
Acreage or Lot Size
Contractor's O.S. *
APPLICANT'S NAME AND ADDRE
O\VNEF'S NAME AND ADDRESS
CONTFACTOR'S NAME AND AD
rv.ail permit to ( ) Applicant (
DRESS
)Owne
7 47 -40L8Phone-
Phone---
Phone--
ready.
STRUCTURES NOW ON THE PROPEBTY
TH IS PERM IT IS FOR PLACEMENT OF NEW SINGLE I{IDE MOBILE HOME
\^JATER SUPPLY EXISTING SEWAGE D ISPOSAL
TH IS PROPEHTY IS WITHIN ONE MILE OF THE CITY OF NA
I hereby certify that the above statements are true and accurate, and that I h
-contract
purchaser;
-
potentia I buyer;
-
realtor or agent. I f urther
record, and id is aware and approves of this action. I hereby agree to
+ B ED ROON43-= P LUI\48 I NG CO NNECT IONS
EXISTING S.l. #
PLUIVIB ING BY NA
ave the following legal interest in rhe oroperty: =-_owner of record;
certify that (if not the owner) I am authorized to act for the owtrer of
ply with all applicable Codes relatirrg to this permit
ijee Paid S a -- Signature AJJ'-a
( ) NEW ADDRESS ( ) FAC|L|TY PERIVItT TO TRANSPORTATION DEPT.- ()SPECIAL PIVIT. AREA. IVIIN. ELEVATION
s<
SANITATION
Minimum Septic Tank Capacity (Gallons)
Drainfield Required - Lineal Feet
Maximum Depth
BUILDING
Type of Construction
-GrouP
Use Classification
Comments:
ire Zone
Comments
+&NT\\q-HED luvEStlGrArtoL{
Coh <-
By:Date
PL EO EMENTS SATISFIED. B
LANE CO TY PAR
cs5-13
B Date: t\-t6'-l-l
(F ROM P,/Li
MENT OF ENVIRONMENTAL MAI\AGEMENT, 125 EAST 8TH AVE., EUGENE, OREGON 974O1
POST THIS PERNIIT ON MAIN BUILDING AT SITE
BLOG. PERMTT - wHtTE; BUtLO|NG - GREEN; PLUMBING - CANARY; SANITATION - GOLOENROD; OFFICE COPV - \r'HlTE
REARSETBACKS: FRONT SIDE FACING STREET (FROM C/L) INT. SIDE YA
PHONE:687-4394
Date lssued:
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REMARKS ALT o o*l
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