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Home My WebLink AboutPermit Building 1974-05-16r-. COUNI ,IU NGtr 7tt,-zy tANE BUILDI ILDING PERMIT OR MOBILE H MH T USE PERMIT PERMIT NO.i PROPERTY OWNER MAILING ADDRESS PHOT.IE CONTRACTOR MAILING ADDRESS PHONE PROPERTY LOCATION - INCLUDE POST OFFICE PROPERTY TEGAT DESCRIPTION _ METES, BOUNDS RANG E SECTION CODE CENSUS TRACTTAX LOT NO, .*# EXISTING STRUCTURES ON PROPERTYAPPt. NAME & MAITING ADDRESS LEGAL ACCESS TO PROPERTY PROPERTY SIZE - FT. WIDTH DEPTH I AREA FOR MOBILE HOME PERMITS ONLY No. of Bedrooms Connect to Existing Sewo e TYPE CONSTRUCTION New BDRMS VALUATIONse. FTSTRUCTURES TO BE BUILT THIS PERMIT I oR SEWAGE DISPOSAT PUBLTC tr SEPTIC TANK PTUMBING INSTALTED BY FE ES OWNER OTHER: NAME WATER SUPPLY PUBTIC N tr OTHER BUITDING WASTE DISPOSAL PI.UMBING PtAN REVIEW PARK TRAILER TOTAT e' COUNTY BUILDING & SANITATION SPECIFICATIONS MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GA[. DRAIN FIETD REQUIRED tIN. FT TRENCH WIDTH FT,OR SQ. FT TYPE OF STRUCTURE 5-r OCCUPANCYi&J ZONE PUBLIC UTIL. EASEMENT BLDG. SETBACKS FT. FROM CTR. OF ROAD RIGHT OF WAY FRONT SIDE INT. SIDE EXT. USE CLASSIFICATION REAR AUTHORIZED SIGNATURE _ DATE 'a DATE BTDG. PERMIT - WH ITE OFFICE COPY - WHITE COUNTY TAX _ PINK PLUMBING _ CANARY BUILDING _ GREEN SANITATION - GOLDENROD Coll 687-4065 to schedule oll required inspections. rAll construc- tion sholl comply with Uniform tluilding Code, D.E.Q. stondqrds TMPORTANT: for subsurfoce'sewoge disposol ond counly regulotions covering plumbing. All buildings require o certificole of occuponcy before being occupied. (See Detoils on Reverse Side) (POST TH|S PERMIT ON MAIN BIDG. AT SlrE) IANE COUNTY, DEPT. OF ENVIRONMENTAT MANAGEMENT COURTHOUSE ANNEX, I35 EAST 6Th, EUGENE, OREGON 97'IOI ronu * 955-13 )s/c4-r l-1 ,. t3t-e4; CENSUS TRACTL-s 6-s-3Fd- ,) AX LOT ( ) Building Permit Appl ication No. ( ) Site lnspection ( ) Pre-Permit lnvest igat ion llt-arrnCorl€-- APPL I CANT: NAHE ADDR P HONE DATE LANE COUNTY PLANNING DEPARTHENT NOT NO YES :Y ii [) () ) () () NA}lE appl icable l. 2. 3. 4. 5. Zon ing 0rd inance Compl i ance (Zone.Ozr(r*\l Subdivision 0rdinance Compl iance Requ i red Access Building Site (Area, t.lidth, Frontage, Setback) 0ther (see comments) (( (( () () ))-s- >-7J/ CO},IHENTS: BUILDlNG !NSPECTION SECTION Plans Subrnitted NOT NO EF'F'l i ceL le (u NA}4E 6 7 ()() ()Soil Stabil ity (footings)( ( )( () () () () () 8. Flood Pl a in 9. 0ther (see Conrnents) COHHENTS: SANITATION SECTION NOT NO YES DATE cable - t0. ll. 12. 13. CO}AHENTS: Sewage Disposal Usable Area Water Supply 0ther (see Comments) (( ( ) ) I () ( () () ) () TO APPL ICANT: Your Building Permil / Site lnspect ion: Can be approved. Cannot be approved at this time as indicated on item N0.above. Questions and furt her information on items I through 5 contact the Lane- COUNTY P N ING DEP ARTMENT. Questions and further information on items 5 t rou gh 13 contact the Lane Count Buildin a nd Sanitation Division. Wil I be held in this o ce unt i you can reso ve the prob ems ind i cat ed. I s be i ng retu rned. Your building permit application fee is being returned under seParate eover' LANE COUNTy pLANN ING DEpARTHENT LANE COUNTY BUILD ING E sAN ITAT lON D lVlS lON 135 Sixth Avente East, Eugene, 0regon 97401 135 Sixth Avenue East, Eugene, Oregon 97401 PHONE: 342-l3ll ExT. 231 PHoNE: 342-l3ll EXT' 4ll 5-r;a () () () ,\c < at, BU I LD ING S ITE EVALUAT ION DATE YES DATE 6-/ 4-r4 D{.() IANE COUNTY T DING PERMIT OR BIIE HOMEh E APPTICATION PERMIT #7/6 "7/ PROPERTY OWNER PERMIT TYPE - BUILDING MOBILE HOME EOSC REG.# ILING ADDRESS PHONE IIING ADDRESS PROPERTY IOCATION - INCLUDE POST OFFICE PHONE PROPERTY LEGAL DESCRI I,OT _ BLOCK _ tit9 ,t /1 ?/-d I 2t'/n.Jo /e METES & BOUNDS ATTACHED YES NO sEc TAX LOT CODE CENSUS TRACT 6 DESCRI BE ISTING STRUCTURES ON PRO IF ANY TEGAL ACCESS TO PROPERTY _ ROAD NAME OR APPLICANT NAME AND MAITING ADDRESS 2c/ a,<adt4 ?,'nuJa lc I ve PROPERTY SIZE_WIDTH DEg)' x ldt:eb'o#rPTH AREA FOR MOBILE HOME PERMIT ONLY Number of Bedrooms STRUCTURES TO BE BUITT THIS PERMIT Connect to Existing Sewoge TYPE or New System RuC. E BEDROOMS VATUATIONSQ. FT SEWAGE DISPOSAL PI.UMBING INSTATTED BY PUBI-IC D BtDG. WASTE DIS. PTUMBING PLAN REVIEW PARK TRTR. SEPTIC TANK OTHER FEES WATER SUPPTY PUBTIC OWNER PI,ANS FURNISHED YES NO OTHER E NAME APPL IC OR SQUARE FEET FACILITY PERMIT OTHER YES NO PTUMB F IXTURES CASH ! 5gyy6p cHECK !CONNECTION FEE PERMIT # PUBI,IC WATER CONNECTION FEE COUNTY BUILDING & SANITATION SPECIFICATIONS DRAIN FIELD REQUIRED I-IN. FT. TRENCH IDTH TT, S FEE DATE DATEq- 50--TOTAL MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GAL. I NSP.G DoteDqte P OCCUPAN ZONE REAR YARD PUBTIC UTIt. EASEMENTTYPE OF STRUCTURE {t/ BLDG. SETBACKS _ FT. FROM CTR. OF ROAD RIGHT OF W srDE lNr. {SIDE EXT, reclions to Find PropertY: REAR Form lf 655 - 1 2 r€aI +. USE CLASSIFICATION -7, COPY I _ OFFICE COPY 2 _ JOURNAT COPY 3 - AUDIT of 4 3 /74 UEST FOR SITE FEASlBILITY STUDY s.t.# THIS IS A PRELIMINARY REPORT I,/HICH DOES NOT INSURE THE ]SSUANCE OF A FUTURE BUILDING PER}IIT. PLANS OR EXPENDITURES MADE IN RELIANCE UPON THIS REPORT ARE AT YOUR OI^/N RISK. PTEASE PRII{T fS Or .N 3 J Block # 3 7l 7/- q )L ,7 Townsh ip Yes t/'tto ro roperty Ownerrs Consent&-4//on 3 tu#/- -2JTffi;??, Sect ion t o. 7 i ax Name2z/A T$6,.-n No. of Sites No. of Acres 25 Owne r yer t/ $ $ $ Mailing Address s_la82,12_ Telephone # Proposed Use of Property: {x Tota I Cas h funeck ru'y@ ?rL-)'/. te Appl icantrs lnterest Bu in Property: 0ther (Specify): r?zyl€ ture o cant Sel ler , Real tor Yese 0nly Numbe r No ace6ae-A A aecacT Property Size Legal Access - Road Name Exist ing Structures on Property Property Locat ion (D i rect ions) : Trr.m I -{t ata. t 2n"J, l.-*tt u-, Lu#h -sec.J ls es eo'12'M0nettnv ?Wh ta c ty e- ty ect0ther v UPP vetro b c rlno District: I/el I *o 14 t Lo .'4 /rJ d t/hen I/ i I I Tes t Ho les Be Ready ? MARK TEST HOLES I^JITH OUR FLAGS Location of Test Holes on Property:c.-).ts Draw diagram of property showing location of any landmarks and relationship of test holes to these I andmarks : Ltx W+(Date) (a PU E 1 4\ \,1 Phm e: 687-4065 5th Ave. , Eugene . 0re. D g0 / MAKE CHECK PAYABLE TO: ENVIRONMENTAL MANAGEMENT MAIL T0: LANE C0UNTY DEPARTMENT 0F ENVIR0IIMENTAL MANAGEHENT, \35 E c5s-55 /Jrce Lot#8 -l /Y APPROVED NOT APPROVED Si-U )/r4*fg ( bttat U L.,l a*JE R^- sD s . \w\o-&v Authorized Signature ate Perrnit #L EIELD INSPECTION SHEET Completed By Sanitarian Location:sect. /'Lr. I-LR. O3rax r,ot or Acct. No. (Are public sewers available or nearby? (Distance) Are there zoning or environmental considerations?No Size of property: Are other systems in area malfunctioning?Y-s' Is there room for future expansion? Surface feature consli*d3ra tions: (Explain) Slope: Flood plain: Plants: Rocks: Low area: Drainage way: Streams: Water supply and utilitie W oi--Lru LlrD Dr;iConrmunity water: Private water:Location: Water lines: Gas lines: I'IeIls on adjacent properties: SoiI Classification (If Known): TEST HOLE RESULTS Is curtain drain required? #1 Test Ilole #2 Test HoIe *3 Test Hole ot' -%SoJ, /n.,^0'/A*-0t' sl4hf c-L, <-O t\''l Interim Form #5 N{a REMARKS:A Yos / BUILD ING S ITE EVALUATION .JS Bu i I d ing Perm it App I i cat ion No.__ s i te lnspect ion 7 V- q Z Z Pre-Permit lnvest igat ion rlz 2]s Z Z rAx Lor-- CENSU. , RACT *rfr{nfri%,l q// b-INAI'IE /u ///€) ()ADDRESS PHONE )DATE LANE COUNTY PLANNING DEPARTHENT NOT NO YES NA}lE DATE appl icablel. Zoning 0rdinance Compl iance (Zone :!;T )2. Subdivision 0rdinance Compl iance 3. Regu i red Access r)()) <14D-B ( () () () () () () () ( ) 4. Bu i ld ing S ite (Area, I.ridth, 5. ot her (r"u "of,l:ll:i" ' setback) CO},IilENTS: BUILDl,NG INSPECTION SECTION NOT NO YES le NAI'1E 6, PIans Submitted 7, Soil Stabil ity (footings) 8. Flood Pla in 9. 0ther (see Conrnents) CO}4I4ENTS: () () ( ( () () () () () () ) .-2 SAN ITATION SECTION Sewage Disposal Usable Area l,Iater Supp I y 0ther (see Comments) aool icable-*Tl-( NA}4E,*F/ Zott< g NOT NO YES fff- 10. ll. 12. 13. () () ( () ( ( ) ) ) ()() TO APPLICANT: q*o':7'l 6? t{ Your Building Permit / Site lnspection: ed. roved at this time as indicated on item N0.-above' further information on items I through 5 contact the Lane- NG DEPARTMENT. Questions and further information on items 5 through l3 contact t Wil I be held in this Can be approv Cannot be app Quest ions and COUNTY PLANN I () () () he Lane Count Buildin and Sanitation Division of ice unt I you can reso ve the prob ems cated. I s be i ng retu rned. your building permit application fee is being returned under separate cover. LANE COUNTY PLANNING DEPARTMENT 135 Sixth Aven[re East, Eugene, 0regon 97401 PHONE: 342-l3l I EXT. 231 LANE COUNTY BUILDING E SANITATION DIVISION 135 Sixth Avenue East, Eugene, Oregon 97401 PHoNE z 342-t3ll ExT. 4l I c55-28 DATE COMHENTS: DATE - - -'Surname TfrF; Eanse SeZtTon Tax GT eoTe-trensus T-ract Recei pt No Owners Consent Yes No Name and Addres s REQUEST FOR SITE FEASIBILITY STUDY THtS IS A PRELIMINARY REPORT WHICH DOES NOT INSURE THE ISSUANCE OF A FUTURE BU ILD ING PERM IT. ANY PI.ANS OR EXPEND ITURES MADE IN REL IANCE UPON TH IS REPORT ARE AT YOUR OWN RISK: $tro'Tites Tel ephone No.roPoS e Property Property S i ze rban i zi ng Area Yes No Exi st i ng Structures I s Prope rt1,t n One e of a City? Yes NoWhat Ci t Propos ater UPP v 0t er Publ ic District Spri nq Wel I Spec i fy $ $ i cants I nterestApp n Property Legal Access - Road Name Special Yes Permit Area No Property Location:(D i rect i ons ) APPROVED NOT APPROVED BEFOR,E CoNSTRUCTI0N lS STARTED bring this form to the Department cf Environmental Management and rnake application for a building permit. lf the property is a por- tion only of a tax lot, a metes and bounds description of the parcel must be fur- nished. Exact specifications for the sewage disposal system will aPpear on the building permit. Two sets of building plans and a plot plan will be required. LANE COUNTY DEPT. OF ENVIRONMENTAL MANAGEMENT I35 EAST SIXTH AVENUE, EUGENE, OREGON 9740!Authorized Signature c55-32 Date Da 0wn fr6], /Lres - TOTAL