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Home My WebLink AboutPermit Building 1973-02-12a- LANE COUN'_ BUILDING PER.MIT OR MOBITE H(USE PERMIT PERMIT NO. PROPERTY OWNER BUTLDTNG E MH MAITING ADDRESS PHONE CONTRACTOR MAII.ING ADDRESS PHONE PROPERIY I.OCAIION _ INCI.UDE POSI OTf ICE PROPERTY LEGAT DESCRIPTION _ METES, BOUNDS (^/ RANGE aaarrr"ll , Z '+LZo{LOT NO,CODE CENSUS TRACT EXISTING STRUCTURES ON PROPERTY APPt. NAME & MAII.ING ADDRESS LEGAL ACCESS TO PROPERTY (Lue*t e*,f PROPERTY SIZE_FT. WIDTH DEPTH AREA FOR MOBILE HOME PERMITS ONLY No of Bedrooms Connect to Existing Sewoge System ! New Systern ! STRUCTURES TO BE BUILT THIS PERMIT TYPE CONSTRUCTION sQ. FT, # BDRMS VALUATION SEWAGE DISPOSAI PUBUC tr SEPTIC TANK n OTHERE PTUMBING INSTALLED BY OWNER E OTHER: NAME BUITDING WASTE DISPOSAI PTUMBING PTAN REVIEW PARK TRAITER FEES WATER SUPPLY PUBUC n tr OTHER 'toTAt- COUNTY BUILDING & SANITATION SPECIFICATIONS MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GAL. DRAIN FIETD REQUIRED TIN. FT TRENCH WIDTH FT OR SQ. FT TYPE OF STRUCTURE OCCUPANCY ZONE PUBTIC UTIt. EASEMENT BLDG- SETBACKS FT. FROM CTR. OF ROAD RIGHT OF WAY FRONT SIDE INT. SIDE EXT. USE CLASSIFICATION REAR AUTHORIZED SIGNATURE _ DATE DATE BLDG. PERMIT - WH ITE OFFICE COPY _ WHITE COUNTY TAX - PINK PIUMBING _ CANARY BUITDING - GREEN SANITATION _ GOLDENROD Conslruction lo comply with uniform building code ond county covering plumbing ond sewoge disposol. All buildings require of occuponcy before being occupied. reg ulolions o certif icote (See Stotement on Reverse Side){ (POsT THIS PERMIT ON MAIN BLDG. AT SITE) IANE COUNIY, BTDG. & SAN. DIV., COURT HOUSE, EUGENE, OREGON 9740I ronu f,655-13 EU; LO iI{G .1 ITE EVALUAT ION Building Permit Application No. S i te lnspect ion Pre-Permit lnvest igat ion A*,aJlt L')2t lld L<--i4'1 a cl d-JL orl r.4 R oss Z 6-ZL_28 TAX toTcuTTRACT APPL I CANT: NAttE AODRES PHONE fr. ) ()DATE i -St: -7.a - LANE COUNTY PLANNING DEPART}1ENT NOT NO f,Ef l icable - YES NA/,.1E DATE ng 0rdinance Compl iance(zone;!ftrf) ivision 0rdinance Compl iance 3. Requ i red Access 4. Bu ild ing S ite (Area, t'/idth, Frontage, Setback) 5, 0ther (see comments) Zon i Subd -r)() ( () () (t' () () () () () () () 2 (r-(f CO}l},IENTS: BUILDlNG lNSPECTION SECTION 6. Pl ans Subm itted 7. Soil Stability (footings) 8. Flood Pl a in 9. 0ther (see Comments) NOT NO ED! !caule () () () YES Ui () () () q1 $t NA}IE DATE )()()3-/ k 77 CO},[I'IENTS: SANITATION SECTION Sewage Disposal Usable Area Water Supply 0ther (see Comments) NOT NO EF'i't icabte - YES X DATE t0. il. 12. 13. r)-( ) () () () () ()IXvf*() () Cfi}IENTS: TO APPL ICANT: Your Building Permit / Site lnspecgiqn: (? can be app roved . J-/2- % (!q( ) Cannot be approved at ttris t iHas indicated on item N0. Questions and further info COUNTY PLANN ING DEPARTMENT above. tems I through 5 contact the Lane- and further information on i6; 5 n cated. rmat ion on i . Quest ions () () () through l3 contact the Lane Count Buildi and Sanitation Divisi n.Will be held in this ols being returned. ce unt i I you can reso ve the problems Your building perrnit application fee is being returned under separate cover. LANE COUNTY PLANNING DEPARTI,IENT | 35 S ixth Avenrle East, Eugene, 0regon 97401 PH0NE: 342-1311 ExT. 231 LANE COUNTY BUILDING S SANITATION DIVISION 135 Sixth Avenue East, Eugene, 0regon 97401 PHONE: 342-t3ll EXT. 4l I M55- 28 I )'-'t-31-75 NAI'IE I ) F I /, _\\_ o- 7j/ FHA FCRM NO.2573Rav. I0,/70 U.S, ARTMENT OF HOUSINC AND UPBAN DEVELOP[. i FEDERAL HOUSING ADMINISTRATION HEALTH AUTHORITY APPROVAL IVIDUAL WATER SUPPLY AND SE}YAGE DISPOSAL SYSTEM HEALTH AUTHORITY AP PROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM Form Approved Budget Bureou No.,f r=r FHA FORM NO.2573 Rev. 10 /70 PART drir-ffi,-nT?trat i on - Port land FHA Case No. Moftgegot ot Sponsor: 0ATMAN, Ueldon Earl a Sherry Ann IH t PrcpertvAddresg: r------- -<<'/,A6-<zz-""r@357t Sprtngf !eld, 0rcg$ 97477 8ce - Naee, Addrcgs and Zlp CodcrrFt RsT t{ATtoNAL BAt'rK oF o3EcoN Rral Estate loarr Divltion P 0 !}ox lTCi Eugnnc, Orego,r q7l+Ol -l __JL Lot No.Thlrd Mdition to Farrnriele 8!ock 2 Subdivision: :R PATHS BASEMENT I 3 t*fl Yes E No ffi New Installation x CanAttic or otherAreabe made into additiooal No bedrooms? (It yes, how nany?) fl ves SYSTEM DESIGNED FORWATER SUPPLY BY: filPrttl. System I Community System f--l Indlvidual No. of Bedrooms Garbase Disoosal l-l Community System El Individual SEWAGE DISPOSAL BY: Public System I ves No PART !I. _ TO BE COMPLETED BY HEALTH DEPARTMENT HEALTH DEPARTMENT TNSPECTOR'S SKETCH tto-7t It is the opinionof the f] State f_] County Local Department of Health thatthis individual water-supply system f] i" f] is not satisfactory as a domestic water supply fot the subject property. ITITIIIIIIIITTTITIIIIIIIITIIIIIITIIIIIIIIIITIIITII It is the opinion of the fl State [E County f] Local Depattmert of Health that this individual sewage-disposal system with proper maintenance: [E] Can be expected to function satisfactorily, and f] Cannot be expected to function satisfactorily is not likely to create an insanitary condition DATE 5-2-73 SIGNATURE ,/ RICHARD &; KIR8Y, R.S. .SUPERU |SIXG SAlt tTAr lAl TITLE NOTE: The heolrh outhori(should complele the oppropriote opnion stotemenl obove ond offix dote, signoture ond tirle in the spoces provided. Use of the obove grid for Heolth Deportment lnspeclor's sketch os well os use of the bock of this form is ol the opinion of the heolth outhorily. PART ilt, _FOR USE OF FHA OFFTCE TO T}E CHIEF UNDERWRITER: I have reviewed the foregoing and the pertinent FIIA Compliance Inspection Report, and recommend that the Individual water-supply system be considered ff Acceptable f] Not Acceptable Sewage disposal be considered ff Acceptable r f] Not Acceptable. DAT E SIGNATUR E CHIEF ARCHITECT DEPUTY FOR CHIEF ARCHITECT REPO RT OF INSPECTION_INDIVIDUAT SEWAGE.DISPOSAL SYSTE'N PtlmAtY IttAfm:NT consis(s ()fE SePtic tank. ! Cessgxxrl. ,bcr of compar,-.r,t | ;;; ;: Colepool: f)istance from: rVell, feet; f<rundatioo feet, nearest lot line at I front, I side, I rear,-fect. Insi{e {iameter,-fect. f)epth,--fcct. Liquid capacity,-gallons. Lining material s.GolilDAIY'lIAtm:iflconsistsofflTikrlisposallield'f]Scepagepits.()ther. llb Dlrpcrol llold: Disance from: well,-feet; foundatior, l0 feet, nearcst lot line attfi front, flside,fi r."r,- I 0 f..t. Total length of umber of lines,j Distaoce between. lines,7 q feet Trench width effective absorption area in bottom of trenches,feet. lrngth of cach fcet. Depth, top of tile to 6nish grade,-inches. Tyf. of filter material: I Grarel. I Broken stone. Other- Depth of filter matcrial .bcneath tile -inches. Depth of filter material over . inches. Soopogo Phr: Numbcr of pits--. . Outside diameter f)epth,-feet. Lining material- f)istance from: lVell,---feet; building foundation,-feet; nearest lot line at I front, ! side, ! rear,-feet. larpocrton :nodo by: ! State. f, Grunty. D l-ocal Health Authoriry. Inspccted by Jotrn Crul R^S f)ate of insp<tirxr *12-11 l9 Senl tarl an ( TrrLE ) REPORT OF TNSPECTION_INDIVIDUAL WATER.SUPPIY SYSTE T Distance to ncarest public water main,---feet. Size of main,-inches. Indivi.lual wells I arc I are n()( custornary in neighbgrhrxil. Give m<>st recent rer()rd of failure of wclls in immediate vicinrty to furnish adequate supply o[ water-...- Properties in neighborh<nd ! are fl are not bcing developed with both individual water-supply Lot size:-feet wide,-----feet deep. Dwelling set back from front propcrty and sewalge-disposal Ii-. systrms. feet. tndividual water supplv tiom: I Drrllcr] well. I l)riven well. ! Dug well. ! Bored well. Dlrtorrc. ol woll l:om: Building f<rundatirrn,--feet; nearest lot line at I front, ! side, I teot,- cast iron sewer tile sewer, --feet; sePtic tank,-feet ; disposal seepage pit,-feet; cessgrol,-fcet; other sources oi possible Diameter,nches. Total depth,-feet. Type of Depth of casing, -feet. Approximate depth to pumping levcl of water in well,-fcet. Approximatc yield, gallons per minutc. Scaled watertight to &pth of-feet. Exterior spac'e around casing scaled with: I Crment grout. I Rrddled clay. I Ordinary beck6ll. 'Well cover: I Concrete. O W""d. I Maal. Openings in well cover watertight: I Yes. O N". ?ump: I Shallow well. ! Decp well. Length of drop pipc,-feet. Prlmp capacity,-gallons pcr minutc. Locateri in: I Bascment. I hrmproom off basement. I Pumphousc above ground. I hrmp pit. hrmproom properly draincd: E Yes. 0 No. Rrmp mounting watenight: I Yes. D No. Typc of storage: ! Pressure. I Graviry. Capacity,-gellons. Has bacterkrlogical examioation of water been madc? [ Yes. D No. If answer'is yes," grve &te-, 19- Quality of water E is O is not satisfactory for human consumption. lnstaltation I docs ft does not comply with approved exhibits, if any. Inspection made by: I State. ! County. I tocal Health Authority. Inspectcd by -- Date of inspcction ( rlrlE )GPO 900-682 feet, t9_ inches. 50 ;i la , Date No. PERM IT IN THE BOARD OF COUNTY COMMISSIONERS OF LANE gOUNTY WHEREAS, the attached application has been fu1ly considered by the Board of County Commissioners of Lane County, and it is the opinion and judgment of the Boardthat [he said application should be granted, and that a permit should be issued, now, [herefore, it is hereby ORDERED, that a permit be and is hereby issued to for the placing, buildingand constructing of the following facility upon the right-of-way of County Road No. - in stnct conformity to the exhibitsattached thereto, -and subject to aII terms, conditions, agreements, stipuiations and provisions contained_ in the application and permit, the Rules and Regu-Iations GoverningFacilities to be Permitted upon County Road Rights-of-Way, dated March 81, 1960 and any amendments thereto, and any other applicable regulation, Iaw or ordinance. Special Provisions: This permit is revocable at any time, and will be strictly adhered to and no workother than that specifically mentioned above is hereby authorized. This permit shall be void unless the work herein contemplated shall have been completed before Inspected and Approved , 19 -. Expires ,19 Approved by Board of Commissioners By Date --_- By WHITE GREEN OFFICE FILE RESIDENT ENGINEER Director of Public Works PERMITTEE ORANGE. BUILDING & SANITATION DEPT ROAD SUPERVISOR YELLOW - SURVEYOR PIN K BLUE c98- s2 Date APPLItrATION FOR FAGILITY PERMIT IN THE BOARD OF SOUNTY COMMISSIONERS OF L'\NE COUNTY Your appli hereby makes application under Rules and Regulations Governing Facilities to be Per- mitted Upon County Road Rights-of-Way, to construct the following facility: Upontheright.of-wayofCountyRoadNo.-,atthefol!oruinglocation as shown on the exhibits which are attached hereto, in strict conformity to the state- ments of the exact nature and amount of work to be done, and to the description of the facilities contained in said exhibits. Your applicant will be the benelicial owner of the facility as constructed, or otherwise primarily liable and responsible to menrbers of the public for its proper maintenance, repair, operation and use. Your applicant accepts all telms, conditions, agreements, stipulations and provisions, in Rules and Regulations Gorerning Facilities to be Permitted Upon County Road Rights-of-Way, dated March 31, 1960, and any arnendments thereto, and any other applicable regulation, law or ordinance. Signature WHITE . OFFICE FILE GREEN . RESIDENT ENGINEER PINl( . PERMITTEE BLUE - ROAD SUPERVISOR ORANGE - BUILDING ANO SANITATION DEPT. YELLO{Y . SURVEYOR Address Phone No.- LANE COU} BUTLDTNG E BUILDING PERMII OR MOB MHE E USE PERMIT PERMIT NO. PROPERTY OWNER MAITING ADDRESS PHONE CONTRACTOR MAII-ING ADDRESS PHONE PROPERTY LOCATION _ INCTUDE POST OFFICE PROPERTY I.EGAL DESCRIPTION _ METES, BOUNDS RANGE SECTION TAX LOT NO CODE CENSUS TRACT EXISTING STRUCTURES ON PROPERTY TEGAL ACCESS TO PROPERTY PROPERTY SIZE - TT. WIDTH DEPTH AREA FOR MOBILE HOME PERMITS ONLY No. of Bedrooms Connect to Existing Sewoge System ! New System I STRUCTURES TO BE BUILT THIS PERMIT TYPE CONSTRUCTION se. FT. # BDRMS vALUATtoN SEWAGE DISPOSAT PUBLIC N SEPTIC TANK N oTHERn PLUAABING INSTATLED BY OWNER E OTHER: NAME t BUITDING WASTE DISPOSAI PTUMBING PTAN REVIEW PARK TRAITER FEES WATER SUPPIY PUBUC tr T1 OTHER TOTAI. COUNTY BUITDING & SANITATION SPECIFICAIIONS MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GA[. DRAIN FIETD REQUIRED tIN. FT TRENCH WIDTH FT OR SQ. FT TYPE OF STRUCTURE OCCUPANCY ZONE PUBTIC UTIt. EASEMENT BIDG. SETBACKS , FT. FROM CTR, OF ROAD RIGHT OF WAY FRONT SIDE INT. SIDE EXT. USE CTASSIFICATION REAR AUTHORIZED SIGNATURE - DATE DATE BIDG. PERMIT - WH ITE OFFICE COPY _ WHITE COUNTY TAX - PINK PTUMBING _ CANARY BUILDING _ GREEN SANITATION _ GOLDENROD Construction lo comply with unif orm building code ond county regulotions covering plumbing ond sewoge disposol. All buildings require o certificote of occuponcy before being occupied. (See Stotement on Reverse Side) (POST THrS pERMtT ON MArN BLDG. AT S|TE) tANE COUNTY, BIDG. & SAN. DIV., COURT HOUSE, EUGENE, OREGON 9740I ronu .f, 6 55 - 13 APPt. NAME & MAITING ADDRESS slra rloon PLUMBING GROUNU/ORK Appnoveo H Drsrppnoveo Reurnxs Dare.f' Y-7 3 lHsprcron GAS PIPING GROUND,VORK AppRovro Reua nx s DrslppRoveo Dare I Hspecron ROUGH PLUMBING Appnovro N DTsAPPRovED ReuaRxs Dare-7 -14 -2, lNspec ROUGH GAS PIPING AppnovEo ReuaRr s Dr sAPPRovEo Dar e I uspEcron FI NAL PLUMBING AppRovEo K DrsrppRovro D oorr*-/{-?3- Re uanx s lNspr FINAL GAS PIPING AppRoveo D Dtsrppaoveo D Rr uaRr s Drre llrsprcton CERTTFICATE OF OCCUPANCY Renov ro lssuE RruaRxs' Nor Relov ro lssuE Drrr I NSPEcToR D D > LANE COUI BUIIDING PERMIT OR MOBITE I. BUTLDTNG ! MH r IE USE PERMIT PERMIT NO. PROPERTY OWNER MAII.ING ADDRESS PHONE CONTRACTOR MAITING ADDRESS PHONE PROPERTY TOCATION _ INCLUDE POST OFFICE \s \A h$-$\N- \\N\N PROPERTY IEGAT DESCRIPTION -METES, BOUNDS RANG E SECTION TAX LOT NO cooE CENSUS TRACT EXISTING STRUCTURES ON PROPERTY APPI.. NAME & MAITING ADDRESS LEGAL ACCESS TO PROPERTY PROPERTY SIZE _ FT. WIDTH DEPTH AREA FOR MOBILE HOME PERMITS ONLY No. of Bedrooms STRUCTURES TO BE BUILT THIS PER Connecl to Existi Sewoge System New TYPE CONSTRUCTION se. FT BDRMS VALUATION SEWAGE DISPOSAL PUBTIC N SEPTIC IANK !OTHERE PTIJMBING INSTALTED BY OWNER E OTHER: NAME BUITDING WASTE DISPOSAT PI.UMBING PTAN REVIEW PARK TRAII.ER F EES WATER SUPPTY PU OTHER TOTAT COUNTY BUILDING & SANITATION SPECIFI CATIONS MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GAL. DRAIN FIETD REQUIRED tIN. FT TRENCH WIDTH FT OR SQ. FT, d r'- ( OCCUPANCY ZONE PUBTIC UTIT. EASEMENTTYPE OF STRUCTURE rT. FROM CTR, OF ROAD RIGHT OF WAY SIDE INT. SIDE EXT. USE CI.ASSIFICATIONBTDG, SETBACKS FRONT REAR AUTHORIZED SIGNATURE _ DATE DATE BTDG. PERMIT _ WHITE OFFICE COPY _ WHITE COUNTY TAX - PINK PI.UMBING _ CANARY BUITDING - GREEN SANITATION _ GOLDENROD Construction to comply with uniform building covering plumbing ond sewoge disposol. All of occuponcy before being occupied. code ond county regulotions buildings require o certificote (See Stotement on Reverse Side) (POsT THIS PERMTT ON MAIN BLDG. AT SITE) IANE COUNTY, BTDG. & SAN. DIV" COURT HOUSE, EUGENE, OREGON 9740I roav 11655-13 SITt INSPECTION Ap pnov r o Re tta Rx s Dtsap OVED Dare I rspectoR 2 FOUNDATION INSPECTION APPRovEo Rruanx s Dr sappRovro oorc /',2 I "?7 L--- I NspectoR FRAMING INSPECTION APPRovED n Drsrppnoveo Reuanx s orrrJ -N'-U X I NSPEcToR { LATH OR SHIITROCK Ap rRov r o RruaRx s I NSPECT I ON D r sappRoveo Datr I HspectoR FINAL INSPTCTION (,---</r/Dr srppnoveo oor, {- Z $"7 )I NspEcroRAppRov eo Reuaaxs -)-2 ) CERTI FICATI OF OCCUPANCY REaoY ro I ssur RrMaRx s n Nor Rraov ro lssuE D I ruspecron /t/o-73- /asV7*- -3 e Dar e "2 /- z$a .-it) D )-E -ISDIVIDUAI, SEWAGE DISPOSAL SYSTEM RECORD ,staller: Complete toP Part o1 rm to signature and return both copies Eo Lane County Building Sanitation Department. SS Pinedale Other-List t40-73 s Name No Bedrooms \, BathsI ilBasement Yes E No Wa r Public Ft. from well Steel I Concrete No. Compartments Depth y',J- Gal. CapacLty /OOA T Distribution Box:Yes NoE rD str loLot Linelo I 0 aear lO er below Date: Length - width 4s'Diameter Applican Name M ailing Address I 2 3 Ske See instructions Date For Sanitarian Use OnIY: flapproved, System Installation Conforms to Current Standards I oisapproved: Does Not Conform to Current Standards Remarks: Mr.0atman 2589 N. 35th Pl " Feet Springfield, 0r. 'Ft. 5. 6. Trench vridrh d Totalfr o lines Ft.Fil Fillerabove dep th v{ fi l.; u t0\I ! i t 0 [1 lEr#fFIlru{F fB o ,(1 R APR 0 $ 1973 -ol rfirrrb $uurrll tthAttH uNlt b DI 1, )Pc Signature Lane County Building o Sanitation Sani 73 c55-ll I I I I f F- .-I TANE COUNTY BU'''IING PERMTT OR MOBILE HOME UCE APPLICATTON PERMIT TYPE _ BUILDING K MOBTLE HOME IOSC REG. # .? * -.? PERMTT +t y'a -73 MAILING ADDRESS PHONE & BOUNDS YES ATTACHED NTRACTOR ,ROPERII I.fGAI. DESCRIPIION .oT-BtocK-suBDtv. rwP RANGE NO SEC. 31 TAX tOT CODE CENSUS TRACT/7 3 &/-ze*a JMAILING ADDRESS POST OFF 7z /zz APPTICANT NA,rtE AND MAITING ADDRESS DESCRIBE EX I-EGAT ACC STRUCTURES ON PROPERTY IF ANY NAME oR # SIZE_WIDTH DEPTH AREA FOR MOBILE HOME PERMIT ONLY Number of Bedrooms PERMIT Connecl to Existing Sewoge Sysrem ! or New System Req TYPE SQ. FT VAIUATION PTUMBING INSTAI.IED BY OWNER OTHER NAME PLANS FURNISHED 33{ DATE - 3a-73 DATE a3 6 DtsPosAr PUBTIC BTDG. WASTE DIS. PTUMBING PI,AN REVIEW PARK TRTR. SEPTIC TANK OTHER 3a6Z FEES cAsH E CHECK o WATER SUPPTY PUBI-IC FIXTURES PUBLIC WATER CONNECTION FEE I-IN. FT FAC t OTHER NO OF YES NO FEE ,AA oo S7TOTAT }TIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GA[. COUNTY BUILDING & SANIT N SPECIFICATIONS DRAIN FIETD REQUIRED H WIDTH IT OR SQUARE FEETB r TO BE TYPE OF STRUCTURE rtl """iwd ZONE REAR YARD PUBLIC UTIT. EASEMENT BI.DG. SETBACKS _ TT. FROM CTR. OF ROAD RIGHT OF WAYplt EA5A.-J'I-/ L.L-r54"- gA<-USE CLASSIFICATION Form $ g55-12 SIDE EXT,REAR Dote SO(Jt hr SIDE INT. Dote Dote BLDG. INSP, l-7 -/2-, Directions to Find Property: COPY I - OFFICE COPY 2 - JOURNAT COPY 3 - AUDIT d2