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Home My WebLink AboutPermit Building 1973-01-10IANE COUN- BUIIDING PERMIT OR MOBILE H( : BUILDING E MH E USE PERMIT PERMIT NO. PROP;,.'Y OWNER MAILING ADDRESS PHONE CONTRAT-TOR MAITING ADDRESS PHONE PROPERTY TOCATION _ INCI.UDE POST OFFICE PROPERTY LEGAT DESCRIPTION _METES, BOUNDS RANG E SECTION ,4, A ,TZ2O CODE CENSUS TRACT E EXISTING STRUCTURES ON PROPERTYAPPt. NAME & MAII.ING ADDRESS LEGAL ACCESS TO PROPERTY PROPERTY SIZE _ FT. WIDTH DEPTH AREA FOR MOBILE HOME PERMITS ONLY No of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT Connect to Existing Sewoge m tr New System TYPE CONSTRUCTION se. FT BDRMS VALUATION SEWAGE DISPOSAT PUBUC tr SEPTIC TANK E oTHERn PI.UMBING INSTATTED BY OWNER E OTHER: NAME t FEES WATER SUPPTY PUBilC n N OTHER BUILDING WASTE DISPOSAT PTUMBING PIAN REVIEW PARK TRAITER TOTAI" COUNTY BUILDING & SANITATION SPECIFICATIONS MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GAt. DRAIN FIETD REQUIRED tIN. FT TRENCH WIDTH FT.OR SQ. FT TYPE OF STRUCTURE OCCUPANCY ZONE PUBI-IC UTI[. EASEMENT BLDG. SETBACKS , FT. FROM. CTR. OF ROAD RIGHT OF WAY FRONT SIDE INT. SIDE EXT, USE CTASSIFICATION REAR AUTHORIZED SIGNATURE _ DATE DATE BTDG. PERMIT _ WHITE OFFICE COPY _ WHITE COUNTY TAX - PINK PLUMBING _ CANARY BUITDING - GREEN SANITATION _ GOTDENROD Construction to comply with uniform building covering plumbing ond sewoge disposol. All of occuponcy before being occupied. code ond county regulotions buildings require o certificole (See Stotement on Reverse Side) (posT THIS PERMIT ON MAIN BIDG. AT SITE) TANE COUNTY, BLDG. & SAN. DIV,, COURT HOUSE, EUGENE, OREGON 9740I roaufc55-13 Ax)r lz ._ax-Q3s LZ rr\X Lor TRECT zTzbo BG APPL Nr\HE D=*^s Lr- ADDRESS PHONE DATE G.G 6€)3-I CANT:J,u,r CE s X Building Permit Appl ication No. S ite lnspect ion Pre-Perm it lnvest igat ion l5-1 ) () LANE COUNTY PLANNING DEPAR T},1ENT NOT NO YES NAI-{E DATE aool icable Zon ing Ord inance comp I iance *rr (Zone ?;.7 I o() 2. Subd ivis ion Ord inance E6mp'TTance ( ) ( ) (/ 3. Requ i red Access 4. Bu i ld ing S ite (nrea, Width, Frontage, Setback) 5, Other (see comments) ( ( ( () () () () () ) CO}tHENTS BUILDING INSPECTION SECTION 6. Plans Submitted 7. Soil Stabil ity (footings) 8. Flood Plain 9, 0ther (see Comments) aool icable-ffio *t w (y) (r\ ) NOT NAI.IE DATE () () () () () CO},IHENTS: SANITATION SECTION Sewage Disposal Usable Area Water Supply 0ther (see Comments) aool icable..*-rT-()NOT NO YES NA}18 10. I l. t2. 13. ( ( () () () (J ) ) ( ( ( )(l-7 COIVIIT1ENTS: TO APPL ICANT: You D{() () () () r Building Permit / Site lnspection: cannot be approved at this time as indicated on item N0. above. Questions and further info COUNTY PLANN ING DEPART}4ENT contact the rmat ion on items I through !. Quest ions and further inf contact the ane- ormat ion on iffi 6trou g Will be held in this ols being returned. Your building perrnit application fee is being returned under separate eover. Coun Buildin and San i t ion D iv is ion.ff i ce unt you can reso vet P ems indicated. LANE COUNTY PLANNING DEPARTI4ENT 135 Sixth Avente East, Eugene, Oregon gTUOl PH0NE: 342-l3lt ExT. z3l LANE COUNTY BUILDING S SANITATTON DIVISION 135 Sixth Avenue East, Eugene, 0regon 9ll+Ol PHoNE: 342-13il EXT. 4il M55- 28 E-q..!-Lq,_!.Nc s trE EVALUAT NO YES /- r'lg DATE SITE INSPICTION D r slppnoveo Dnre I xs eecronAppnovEo Reua nx s 7? FOUNDATION INSPECTION D r s appnoveo oatt ,L'?4 ?,*r"rrro* F-APPRov E D Rr uanx s E FRAMING Ap pnov e o I NSPECT ION I NsPEcroR RENanx s LATH OR SHEETROCK INSPECTION Drsrppnoveo D Darr Dr sappRoveo Dar EAppnovro RexaRxs I NSPEcToR FINAL INSPECTION Ap pRov e o Reuanx s -m DrsaPPRovE, D Dar e I NSPEcToR CERTIFICATE OF OCCUPANCY ReaoY ro lssue RruaRx s Nor Reaov to I ssuE I NSPEcToR /g-73 e,-3 Dare P t-4 oo n.,,?- ,5 t L LANE COUN: }UIIDING PERMIT OR MOBITE HC BUILDING T MH E USE PERMIT PERMIT NO. PROPERTY OWNER MAIIING ADDRESS PHONE CONTRACTOR MAITING ADDRESS PHONE PROPERTY TOCATION _ INCTUDE POST OFFICE PROPERTY TEGAI. DESCRIPTION -METES, BOUNDS RANGE SECTION TAX LOT NO CODE CENSUS TRACT EXISTING STRUCTURES ON PROPERTYAPPL. NAME & MAITING ADDRESS s (-b I.EGAT ACCESS TO PROPERTY PROPERTY SIZE _ FT. WIDTH DEPTH AREA FOR MOBILE HOME PERMITS ONLY No. of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT Connect to Existi Sewoge System I New TYPE CONSTRUCTION FT BDRMS VAL s:\,- \ - \ \u"-s\ "s *-\ Nxr \ SEWAGE DISPOSAI PUETIC N SEPTIC TANK N oTHERn OWNER Tl OTHER: N,AME I BUITDING WASTE DISPOSAT PI.UMBING PI.AN REVIEW PARK TRAII.ER FEES WATER SUPPLY PUBUC !LI OTHER TOTAi COUNTY BUILDING & SANITATION SPECIFICAIIONS MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: cAL. DRAIN FIETD REQUIRED TIN. FT TPENCH WIDTH FT.OR SQ. FT {r OF STRUCTURE OCCUPANCY ZONE BI-DG. SETBACKS FT. FROM CTR. OF ROAD RIGHT OF WAY FRONT SIDE INT. SIDE EXT. USE CIASSIFICATION REAR AUTHORIZED SIGNATURE - DATE DATE B[DG. PERMIT _ WH ITE OFFICE COPY _ WHITE COUNTY TAX _ PINK PTUMBING _ CANARY . BUITDING _ GREEN. ... SANITATION - GOTDENROD Conslruction to comply with uniform building code ond county, .covering plumbing ond sewoge disposol. AII buildings requireof occuponcy before being occupied. (See Stotement on Reverse Side) reg u lotions o certif icote (posT THts PERMIT oN MAIN BLDG. AT SITE) TANE COUNTY, BTDG. & SAN. DIV,, COURT HOUSE, EUGENE, OREGON 9740I FoRM * C55- 13 PLUMBING INSTATLED BY PUBLIC UTlL. EASEIY1ENT Date trtO. PERM IT IN THE BOARD OF COUNTY COMMISSIONERS OF LANE COUNTY WHEREAS, the attached application has been fully considered by the Board of County Commlssioners of Lane County, and it is the opinion and judgment of the Board that the said application should be granted, and that a permit should be issued, now, therefore, it is hereby ORDERED, that a permit be and is hereby issued to for the placing, building and constructing of the following facility: upon the right-of-way of County Road No., in strict conformity to the exhibits attached thereto, and subject to all terms, conditions, agreements, stipulations and pro. visions contained in the application and permit, the Rules and Regulations Governing Facilities to be Permitted upon County Road Rights-of-Way, dated March 31, 1960 and any amendments thereto, and any other applicable regulation, law or ordinance. Special Provisions: This permit is revocable at any time, and will be strictly adhered to and no work other than that specifically mentioned above is hereby authorized. This permit shall be void unless the work herein contemplated shall have been completed before , 19-. Expires ,19 Inspected and Approved 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 PINK BLUE c9r - s2 Date APPLIGATIITN FOR FAtrILITY PERMIT IN THE BOARD OF COUNTY COMMISSIONERS OF LANE COUNTY Your applicant hereby makes application under Rules and Regulations Governing Facilities to be Per- mitted Upon County Road Rights-of-Way, to construct the following facility: Upon the right-of-way of County Road No., at the following location: 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 beneficial owner of the facility as constructed, or othenrvise primarily liable and responsible to members of the public for its proper maintenance, repair, operation and use. Your applicant accepts all terms, conditions, agreements, stipulations and provisions, in Rules and Regulations Governing Facilities to be Permitted Upon County Road Rights-of-Way, dated March 31, 1960, and any amendments thereto, and any other applicable regulation, law or ordinance. Signature WHITE. OFFICE FILE GREEN . RESIDENT ENGINEER PINK . PERMITTEE 8LUE. ROAD SUPERVISOR ORANGE . BUILDING AND SANITATION DEPT. YELLOW . SURVEYOR Address Phone No. IANE COUN BUILDING PERMIT OR MOBILE H, MHE : UsE PERMIT PERMIT NO.BUTLDTNG E PROPERTY OWNER MAITING ADDRESS PHONE CONTRACTOR MAITING ADDRESS PHONE PROPERTY I.OCATION _ INCTUDE POST OFFICE PROPERTY TEGAT DESCRIPTION -METES, BOUNDS RANGE SECTION TAX LOT NO.CODE CENSUS TRACT EXISTING STRUCTURES ON PROPERTYAPPt. NAME & MAITING ADDRESS TEGAT ACCESS TO PROPERTY PROPERTY SIZE - FT, WIDTH DEPTH AREA FOR MOBILE HOME PERMITS ONLY No. of Bedrooms Connect to Existing Sewoge TYPE CONSTRUCTION New m BORMS VALUATION m tr STRUCTURES TO BE BUILT THIS PERMIT se. FT SEWAGE DISPOSAT PUBUC ! SEPTIC TANK tr OIHERN PLUMBING INSTALLED BY OWNER E OTHER: NA/{E F EES WATER SUPPTY PUBUC n N OTHER BUITDING WASTE DISPOSAT PTUMBING PTAN REVIEW PARK TRAITER { TOTAI. COUNTY BUILDING & SANITATION SPECIFTCATIONS MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GAt. DRAIN FIETD REQUIRED TIN. FT TRENCH WIDTH FT.OR SQ. FT TYPE OF STRUCTURE OCCUPANCY ZONE PUBI,IC UTIT, EASEMENT BIDG. SETBACKS FRONT FT. FROM CTR. OF ROAD RIGHT OF WAY SIDE INT, SIDE EXT. USE CI.ASSIFICATION REAR AUTHORIZED SIGNATURE _ DATE DAIE BLDG. PERMIT _ WH ITE OFFICE COPY _ WHITE COUNTY TAX _ PINK PTUMBING _ CANARY BUITDING _ GREEN SANITATION _ GOTDENROD Conslruction to comply with uniform building code ond county covering plumbing ond sewoge disposol. All buildings reguire of occuponcy before being occupied. (See Stotement on Reverse Side) reg ulolions o cerlif icote (posT THIS PERMTT ON MAIN BIDG. AT SITE) I.ANE COUNTY, BTDG. & SAN. DIV., COURT HOUSE, EUGENE, OREGON 9740I ronu lf 955-13 WtooR PLUMBING GROUND/ORK D r sappnovrDAp pnov r o ReuaRx s &Dar t1L -Z cl-7 , lHsercron GAS PIPING GROUNU/ORK AP PRoV E D REua nx s D DrsaepRoveo D Darr I usprcron ROUGH PLUMBING AppRoveo N DrsaPpRovro Rexanxs D ont?-Z0-)z I Nsprc I rusprcton ROUGH GAS AP PRoV E D Rr ltaRx s PIPING Dr sAPPRovEo Dare F I NAL PLUMB I NG Appnov e o Rrulnxs FINAL GAS PIPING AP PRoV E D RrMeRx s D r sAPPRovEo Dare I NSPEcToR CERTIFICATE OF OCCUPANCY Renov ro lssuE RruaRrs D Nor Reaov ro lssue D Dare I NsPEcroR W DlsAppRovE o D ootr{-T-23- t*t"rr'ro* Xfu- / D INDIVIDUAL SEVTAGE DISPOSAL SYSTEM RECORD nstaller3 Complete top part o 'orm to signature and return both copies -o Lane /{-73Coun'1d ing Sanitation Department. Wa'c Pub.lic Other-List INS No.v r c yes E uo fl Et. from well Steel ! Concrete I No. Compartments Length width .{Diameter Depth Gal. Capacity.6@e T sposa Distribution Box *es V No fl D str Feet Lot Line t below Applican Name M ailing Address Lenqth1.@ cQ 3. 4. 5. 6. Sketch See instructions Date Signature For Sanitarian Use OnlY: X approvea,System Installation Conforms to Curre Standards Date: fl Pisapproved: Remarks: Does Not Conform to Current Standards ++3 / Trench widrh 5 Ft.between lines f Tota1 sq ft-. b oo Filler rype /J, Filler depthabove ,ti'le A in- D ECIEIV/ E lD f'/.)t- Llo *r, LANE COUNTY HEALTH OEPI t riD .r Lane County Building & Sanitati on Dept. Sani c55-tt Bectrooms Batns IANE COUNTY BUITDING PERMIT OR MOBITE HOMF='JsE APPLICATTON PERMIT TYPE _ BUILDING MOBILE HOME EOSC REG.#PERMTT #/f>23 PROPERTY OWNER MAILING ADDRESS PHONE MAILING ADDRESS , - 30 Z,* A7* 84,6fr/ PHONE METES & BOUNDS ATTACHED tocATroN -UDE POST OFFICE PROPERTY I.EGAL DESCRIPTION TOT_BI.OCK_SUBDIV. TWP RANGE 8,%9,YES NO sEc.TAX tOT CODE c NSUS TRACT/z 23q))/- Loa APPI-ICANT NAME AND MAITING ADDRESS DESCRIBE EXISTING STRUCTURES ON PROPERTY IF ANY TEGAT {o AME OR PERTY SIZE-WIDTH AREAreDEPTH//7 FOR MOBILE HOME PERMIT ONLY Number of Bedrooms Connect to Existing Sewoge System f] or New System Req. E TO BE IS PERMIT SQ. FT,e)a a3 TYPE ON BEDROOMS VATUATION OF APPTI SEWAGE DISPOSAL PUBTIC OTHER FEES WATER SUPPTY PUBI.IC OTHER FEES /o ,r*ru*r,d,O A cAsH E .o0CHECKN FEE PTUMBING INSTALIED BY OWNER PTANS FURNISHED YES NO PERM BTDG. WASTE DIS. PTUMBING PLAN REVIEW PARK TRTR. TANK Sotoo FACITITY YES NO DATE/ -7* DAIE ,3 3..fo S -73 IOTAT PUBTIC WATER CONNECTION FEE # 7r- 2-z COUNTY BUILDING & SANITATION SPECIFICATIONS AAIN. SEPTIC TANK CAPACITY DRAIN FIETD REOUIRED V/IIH DIST. BOX: GAL. SETBACKS TIN. FT PANCY L TRENCH WIDTH FT ZONE OR SQUARE FEET PUBTIC UTII. EASEMENTgr/ form # css-tz nd Property: (//Dole BIDG. I USE C TION ? Dole BTDG. FRONT SANIT - FT. FROM CTR. OF ROAD R ). SIDE INT. Dole PIANNI IIGHT OF WAY SIDE EXT.REAR -71 Direclions to COPY I _ OFFICE COPY 2 _JOURNAT COPY 3 _ AUDIT 'fra /.f 10a-4-h-d-,/ar#rux25 /trn ,/, cz