HomeMy WebLinkAboutPermit Septic Tank 1985-08-20aro t<>(e-
FOR OFFICE USE ONLY
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17 03
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2443 61 00
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IO},I ADDR.ESS
21 95 0tto ',-I:'Y ZIPS
S 'ingf i e1 d 97 477
Septic tank inspection - for loan review
]:SCF.IPTION OF PROPOSED I,iOF,K . :]E SP!]CI'IC
tsEDi.OOi,IS
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0tto 9,, Springf i eld 97477
!;i::!R.'S ll-.\,18 AIJD ADDRESS
0rien Aldrich.219s
TELEPHCNE NUI,IBER
747 7901
.nf6lT8e'ftttAllE AND osR 5 I" Georqe Carrinqtqq, 2196 Cosmoledo St., Eugene 97402
licant - CarringtonA
ffi\1 ,rry Lane Cou
-frnrc
nty Authorization for'
Re
;J:i.]i-USED USI] OF PROPERTY
[] ,iesrdential n rnaustrial
Ct,rrraercial PubI ic
North on I 9 from Mo Junction to end of Street turn right on Yolanda to
Corral Dr.turn ri ht to Otto
Proposed
Exi s r-i n
TELEPHONE IIL,}:BER
688 2033
I HAVE CAREFULLY EKA.I'IINED THE COMPLETED APPLICATIOI] !'OR PEru'fIT, ar,J L1o hcrcLy,l,.:lf:,rhrt all rnforaation hereon is true and correct, and that I
have the fotlowing Legal interest in the properly,Io*n". of record; ncorrtraljL prrrchaser;[!authorrzed agent with evj.dence of authority attached.I flrther certify that any and all work perfcmed sha1l be done in accorLlf,Iri. \.'jt[ tl]e O.drQancee of Lane Couty and the Laws of the State of Oregonpertaininq lo the work described herein, and that No occUPANCY wil.l be iade oi ri-'srrilcture !,'ithout tlre pemisslon of the Bu.ilding Division. f fur-tirer certify that registration w-ith lhe Builderrs Board.is in futl force:rn.i effect ds required bv oRs 701.055, tha! if exempt the basis for exenptionis noled hereon, and that onl.y subcontractors ad employees who are in conpliance Hith ORS 701.055 will be used on this project. I ITAVE READ AND
CITECKND THIS APPLICATION THOROUGHLY.
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READ TIJIS SECTION CAREFULLY. YOUR AUTHORIZATION 9AS BEEN BASED ON THE FOLLOWING CONDITIONS!
fl pr,ar-Nruc/zoNrNG Partition #Parcel #Parcel Size
trlininm Setbacks:
For loan rev'iew u
act'i on requ'i red .
cL, fro.t-- Ct, .idu-
oses onl Nos eci al 1 anni ng
.i nteri-crr re ar
Date:
SANITATION: s. I. #
Installation callon
Specifications:
-.
Tank
I er-aus EXA].trNATroN:
B. P. f Installation Record Issued?nv""[*"
Lineal lr..let
ot- ltr':r:r:f icIJ
Maximun Depth
of Trenches
f)ate :
(l L()l i l:-E
CCTI,IETJTS:
FOR INSPECTION INI'ORMATION
lr.r Le :
LANE COUNTY DEPARTMENT OF P
125 EAST 8TH
SEE REVERSE
woRKS LAND MANAGEMENT DtVtStON,687-4061, C t4-25
UE, EUGENE, OREGON 97401
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I
I
.1'bTJ!,PHQNU NU}1Bt]R
I:AME (please print)
bne coJnty
ACTIVI-^ ( INFORMATION ST.EET 6r
-
COMPLETE THIS SECTION. INCOMPLETE FORMS I,JILL BE REJECTED!
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C E 7-[cm ,STATE ZIP CODE
74?- ?70/Lg g -lt3s_ffi
2 PROPERTY ADDRESS
NOME TFLE?HONE # BUSINESS TELEPHONE #H-0fiTTETEFFONET
( IF DIFFERENT F IL
3 rvrarr B PAFIeEL NLTMEIEFI
( REQU IRED I NFORPIATION )
(from tax maps in Department of Assessment and Taxation
or from tax statement)
AEY
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TOI^,NSHIP RANGE SECTION
b/odW zoNlne
M-WNSHTP RANGE SMTMN S ORP L ZON I NG
nlro w TOWNSE]T RINGE SEETI-ON W ZON I NG
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP:ACRES
4 SUBDIV IS I0N ( i f appl i cabl e )LOT BLOCK
5 REQUEST (state exactly what you plan to do)
6 DIRECTIONS TO SITE:d,-
FOR STAFF USE ONLY **
ZONE/LAND USE:
BY:
-
DATE:- TIME IN:- 0UT:-
NUMBER
DATE
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LAND MANAGEMENT DIVISI0N / 125 E. Bth AVE., LUGENE, 0R 97401 / 687-4061
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PROPERTY OWNER
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d.rrrY STATE
House
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TRS# 17-03-24-4-3 6100 DATE ISSUED: 4/22/86 prRyrr# /144-Aco
OI,JNER'S NAME PHONE NUMB ERGEORGE F. & MARY CARRINGTON 7 47 -5803CONTRAOR'S NA}'IE PHONE N ERSA}fi(tr
C1
QU I REME TS
SIDE
T BACK RE t\i BING FiXTURES
FRONT I NTERI OR REAR
I^JORK RiZED RMIT
WOOD STOVE INSERT IN FIREPLACE
TE
SDS APPROVAL REQUIRED
E T
BEHIND YOLANDA STREET/THRIFTWAY GROCERY STORE.
SiTE ADDRESS
195
TI NG itlt T t\Approved Date
0R9 4l
H E PLACEMENT N
Correcti on Date
S
P L ON
Insp ector
LUMBIApproved Date Correct'ion Da te
K INSPE
Inspe ctor
UNDERSLAB PL
App roved Date Correcti on Da te I nsp ector
OTHER INSPECTIONApproved Date Correcti on Date Ins p ector
RoUGH-
Approved Date /Correcti on Date Ins ectorp
le
ve S-B-?G /Correct'ion Date Inspe tor
I nspe ctorr0{-r3-fu /Correct'ion Date
INSULATION / VAPOR BARRIER IN SPECTi ON
App roved Date /Correcti on Date-----.------_-Inspector-
LATH / GYPSUM BOARD INSPE CTi ONApproved Da te Correcti on Date I nspe c tor
D n
roved Da t Correcti on Da tep I nspector
FINAL PLUMBING INSP
Approved Date Correct'ion Da te
ECTi Inspector
FINAL INSPECTION BUILDING EApproved Date
TEOB-ITE_H-O{',1E D /AG PLAOEMENT ECorrection Date Inspe ctor
CERTIFICATE OF OCCUPANCY DApproved Date_InsP.
TEMPORARY CERTIFICATE OF O CCUPANCY E
N17 4-tgl
Ap proved_Date Ins p.
LANE COUNTY INSPECTION RECORD
/UNDERFLR PLBG. tr INSPECTION
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