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Home My WebLink AboutPermit Building 1977-07-114'7( PHgnSArlr 0Lvp- EdGeNE uruJ, (cu,/a,,TRS, TL 17<3-??--/3 fzToo Job Location INFORMATION SHEET ()() Building Permit ( ) Site Feasibility Study for Septic Tank. Number of sites- Acreage or Lot Size Lo( * tzol ( ) Would like to meet on site. Call (owner, etc.) Test holes will be ready- Partitioning #- ( )Completed( ) Pending Subdivision Lot- Bloc k APPLICANT'S NAME AND ADDRESS SusTteE- J€TT 47t PHEASAilT ELVD- €oG€y€ q?@t pnon" z(6 - dt?j OWNER'S NAME AND ADDRESS, if different from a p licant's CONTRACTOR'S NAME AND ADDRESS c Rsa potl E S ve Ztt-?'t*1 Phone- Phone 72b'o*g t l4ail permitorresultsof sitefeasibilitystudyto (X) Applicant ( )Owner ( )Contractor. I ) Prefer to pick up. Call ( owner, etc. ) when ready STRUCTURES NOW ON THE PROPER plooBe Ar./0 GPFfre € PROPOSED USE (this permit)ERRT A tlu LL WATER SUPPLY () PROPERTY IS WITHIN ONE MILE OF CITY ( lu.d aJa d a?d v{ existing or proposed well, etc. lf public, name of system) SEWAGE DISPOSAL (existing or proposed septictank, etc.l S.l PLUMBING BY Address ******* oFFtcE usE oNLY BELOW THtS LtNE ***r*r+**+r+l ( ) New Address Necessary ;N F ( ) Facility Permit Necessary SETBACKS: Front ( ) Special Permit Area. [Vlinimum Elevation Side Facing Street (FROM CENTERLINE OF BOAD) lnterior Side Yard - Rear (FROM PROPERTY LINES) To: Planning/Brrilding lBpector/Sanitarian/Surveyor. This applicant appears to have a problem with Your assistance will be appreciated. By Permit Processing Section Respon By DEPARTMENT OF ENVIRONMENTAL MANAGEIVIENT Permit Processing Section 125 East 8th Avenue 687-4394c55-12 rvrston ) ( t ., ;s"d"' 7F L L, rlE dl+reLo LL) ( lrtfrufrFA I $ N J \, \b T ...dr5: .r,4., '{'iif' t PERMIT # TRS, T Acreage or Lot Size Contractor's O.S. # JOB LOCATIO Partition ing LANE COUNTY PERMIT ) Completed Subdivision Lot- Block- APPLICANT'S NAIV1E AND ADDR FSS Phone-- OWNER'S NAIVIE AND ADDRE Phon CONTBACTOR'S NAIVIE AND ADDf,ESS- Phone- lvlailpermit to ( )Applicant ( )Owner ( ) Contractor. ( ) Prefer to pick up. Call- {owner, etc.) when ready. iHIS PERIVIIT IS FO # B ED ROOIVS-# PLUIVIB I NG CO NN ECT IONS STRUCTURES NOW ON THE PROPERTY WATER SUPPLY SEWAGE DISPOSAL s.l. # THlSPRoPERTYlSWlTHlNoNEIVllLEoFTHEClTYoF.PLUlVlBlNGBY I hereby certify that the above statements are true and accurate. and thar I have the following legal interest in the property: -owner of record; -contract purchaser; - potential buyer; - realtor or agent. I f urther certify that (if not the owner) I am authorized to act for the owner oI record, and that said owner is aware and approves oI this action. I hereby agree to comply with all applicable Codes relating to this permit. Fee Paid S-Signature Date il NEW ADDRESS () FACILITY PERIVIIT TO TRANSPORTATION DEPT.-l SPECIAL PIVIT. AREA. IVIIN. ELEVATION SANITATION BUILDING lVlinimum Septic Tank Capacity (Gallons) Drainfield Required - Lineal Feet lVlaximum Depth Type of Construction se Classification roup ire Zone -Jmments By:Date:By:Date PLANN ING REOUIREIVIENTS SATtSFtED. Bv Date Date lssued ZONE SIDE FACING STREET (FROIVI C/L) INT. SIDE YARD REAR (FROIVI P/L) LAN E COUNTY D EPARTI\,IENT OF ENVIRONIVIENTAL MANAG EMENT, 125 EAST 8TH AVE.. EUG ENE. OBEGON 97401 PHONE: 687-4394 POST THIS PERMIT ON MAIN BUILDING AT SITE BLDG.PERMIT-WHITE; BUILDING-GREEN; PLUMBING-CANARY; SANITATION GOLDENROD; OFFTCECOPY-WHtTEc55-1 3 Comments: SETBACKS: FRONT SITE INSPECTION Appnov r o Rruenx s FOUNDATION INSPECTION APPROV E D REMA RK 5 Dr sappRoveo Dare I NsPEcroR FRAM I NG AppRovro Reuanx s I NSPECT I ON D DrsappnovEo D Drrr I xsprcron LATH OR SHEETROCK I NSPECT I ON Dr sAPPRovEo Drr e I xsprcronApenovro Rruanx s FINAL INSPTCTION Ap pnov e o Rrulnr s Dr SAPPRovED I Nsprcron CERTIFICATE OF OCCUPANCY Reaov ro lssur D Nor Rerov ro lssur D Dare- Rruanx s I Hsprcron DTsAPPRovED D oorr@rrrrrr*-$25{ D oorr-A* //- 7 7- PERMIT # TRS, TL JOB LOCATIO Partitioning # LANE COUNTY PERMIT Acreage or Lot Size Contractor's O.S. # ) Completed Subdivision Lot Block- APPLICANT'S NAME AND ADDR trqe OWNER'S NAME AND ADDR CONTRACTOR'S NAME AND ADDRESS Mail permitto ( )Applicant ( )Owner ( )Contractor. ( )Prefertopickup. Call-(owner, etc.) when ready Phone Phone Phone STRUCTURES NOW ON THE PBOPEBTY THlsPERl\4lTlsFoR#BEDRooMS-#PLUlv]BlNGcoNNECTloNS- WATEB SUppLy SEWAGE DISPOSAL_- S.l. # THlSPRoPERTYlSWlTHlNoNElVllLEoFTHEClTYoF.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 purchaser; - potential buyer; - realtor or agent. I f urther certify that (iI not the owner) I am authorized to act for the owner of record, and that said owner is aware and approves ol this action. I hereby agree to comply with all applicable Codes relating to this permit. Fee Paid $-Signatu re Date INEWADDRESS () FACILITY PEEMIT TO TRANSPO RTAT ION D EPT.- l SPECIA L PIV]T. AR EA. MIN.ELEVATION:- SAN ITATION BU ILD ING Type of Construction -Group -Fire Zone c".,,r-,rtr, Use classification \.omments By:Date By Date lVlinimum Septic Tank Capacity (Gallons) Drainfield Required - Lineal Feet Maximum Depth PLANNING REOUI REIVIENTS SATISFIED. By:Date Date lssued ZONE: SETBACKS: FBONT SIDE FACING STREET (FROM C/L) lNT. SIDE YARD REAR (FROM P/L) LAN E COUNTY D EPARTMENT OF ENVIRONIM ENTA L MANAG EM ENT, 125 EAST 8TH AVE,, EUG ENE, O R EGON 97401 PHON E: 687-4394 POST THIS PERMIT ON MAIN BUILDING AT SITE BLDG.PERMIT-WHITE; BUILDING-GREEN; PLUMBING-CANARY; SANITATION-GOLOENROD; OFFICECOPY-WHITEc55-1 3 trqq (