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Home My WebLink AboutPermit Building 1977-06-01r1s,rt /7d3 2-f .r./ //aa Subdivision Lot - Block- INFORMATION SHEET (f) auitains Permit ) Site Feasibility Study for Septic Tank. Number of sites ) Would like to meet on site. Call (owner, etc.) Acreage or Lot Size Test holes will be ready Partitioning #- ( )Completed( ) Pending AppLrcANT.s NAI\4E AND ADDREII trE2ral, t- h)u2rE .e?a ,Prtqrura 2tQ pnon Zl'72C OWNER'S NAME AND ADDRESS, if different from applicant's Phone PhoneCONTRACTOR'S NAIV1E AND ADDRESS Mail permit or resultsof site feasibility studyto (r-fApplicant ( ) Owner ( ) Contractor( ) Prefer to pick up. Call (owner, etc.) when ready. ( ( ( rRucruRES Now oN THE PRoPE PROPOSED USE (this perm WATER SUPPLY SEWAGE DISPOSA il PROPERTY IS WITHIN ONE MILE OF CITY (existing or proposed well, etc. lf public, name of system) (existing or proposed septic tank, etc.) S.l PLUMBING BY Address *..*.*.* oFFlcE usE oNLY BELOW THtS LtNE **********r*. ( ) New Address Necessary ZON F ( ) Facility Permit Necessary SETBACKS: Front Side Facing Street (FROM CENTERLINE OF ROAD) ( ) Special Permit Area. Minimum Elevation lnterior Side Yard Rear _- {FROM PROPERTY LINES) I o: Planning/Building lnspector/Sanitarian/Surveyor. This applicant appears to have a problem Your assistance will be appreciated. By Permit Processing Section Response c55-1 2 DivisionBy D E PA R TIVI E N T O F E NV I R ON IVI E NTA L IVIANAG E IVI E N T Permit Processing Section 125 East 8th Avenue 687-4394 k 0 d \bet\\ Job Location /S?a iit&ztl€ 2P -tfiilccl€a0 ! PERTVIIT # TRS, T JOB LOCATIO Acreage or Lot Size- Partitioning # Contractor's O.S. # LANE COUNTY PERMIT ) Completed Subdivision Lot Block- APPLICANT'S NAIVIE AND ADDRE ss Phone-- Phone- Phone- OWNER'S NATVIE AND ADDRESS CONTRACTOR'S NAME AND ADDRESS Mail permitto ( )Applicant ( )Owner ( )Contractor. ( )Prefertopickup. Call-(owner, etc.) when ready STRUCTURES NOW ON THE PBOPEBTY- THIS PERMIT IS FOR- # BEDROOIV]S-# PLUMBING CONNECTIONL IA/ATER SUPPLY SEWAGE DISPOSAL s.t. # THlSPRoPERTYlSWlTHlNoNEtVllLEoFTHEClTYoF.PLUN/BlNGBY I hereby certify that the above statements are true and accurate. and that I have the following legal interest in the property: -owner oI record; -conlract purchaser; - potential buyer; - realtor or agent. I further certify that (if not the owner) I am authorized to act for the owner of record, and that said owner is aware and approves of this action. I hereby agree to mmply with all applicable Codes relating to this permit. Fee Paid S-Signature Date ()NEWADDRESS I FACILITY PERM IT TO TRANSPO RTATION DEPT.- ( }SPECIALPI\4T. AREA. MIN.ELEVATION:- SANITATION lVlinimum Septic Tank Capacity (Gallons) Drainfield Required - Lineal Feet lVlaximum Depth Date: BUILDING Type of Construction .Use Classification Comments: By Comments By: roup Date ire Zone PLANNING REOUI RETVIENTS SATISFIED. B v:Date Date lssued ZONE: SETBACKS: FRONT SIDE FACING STREET (FROM C/L) tNT. SIDE YARD REAR (FROM p/L) LAN E COUNTY DEPARTMENT OF ENVIRONMENTAL INANAGEIM ENT, 125 EAST 8TH AVE.. EUG ENE. OREGON 97401 PHON E: 687.4394 POST THIS PERMIT clN MAIN BUILDING AT SITE c55-13 \ PERMIT # TRS, T JOB LOCATIO LANE COUNTY PERMIT Partitioning #-( ) Completed SubdivisionAcreage or Lot Size Contractor's O.S. #Lot- Blo APPLICANT'S NAME AND ADDRE ss Phone CONTBACTOR'S NAME AND ADDRESS Phone Phone Mail permitto ( )Applicant ( )Owner ( )Contractor. ( )Prefertopickup. Call-(owner, etc.) when readY STRUCTURES NOW ON THE PROPERTY ' -:_ THls PERMIT ls FoR # BEDRooMS-# PLUMBING coNNEcrloNL ' ,rOra* arrra" SEWAGE DISPOSAL ' ; S l' # THIS PROPEBTY IS WITHIN ONE MILE OF THE CITY OF-- PLUI\'IBING BY I hereby certify that the above statements are true and accurate, and that I have the following legal interest. in the prop€rty: -olvner of record; ---"inii""t 'p*"t'aser; - potential buyer; - realtor or agent. I further certify that (if iot-the owner) | am authorized to act lor the owner of I"-,4, "nJ itui."iO owner is awire and approves oI this action. I hireby agree to compiy with all applicable Codes relating to this permit' OWNER'S NAME AND ADDRESS- Fee Paid $- il NEW ADDRESS () FACILITY PERIVIIT TO TRANSPORTATION DEPT () SPECIAL PIVIT. AREA. IVIIN. ELEVATION Signature - ' Date SANITATION Minimum Septic Tank Capacity (Gallons) Drainfield Required - Lineal Feet Maximum Depth BUILDING Type of Construction c.-.""1, Use classification roup -Fire Zone Date Comments B Date PLANN ING REOUIREMENTS SATISFIED. BY Date Date lssued LAN E COUNTY DEPABTMENT OF ENVIRONIV]ENTAL I\i]ANAGEIV] ENT, 125 EAST 8TH AVE.. EUG ENE, O REGON 97401 PHONE: 687'4394 POST THtS PERMIT ON MAIN BUILDING AT SITE c65-13 B ZON E SETBACKS: FRONT SIDE FACING STREET F ROIVI C/L) INT. SIDE YARD REAR F ROTVI P/L) ) SITE INSPECTION Appnov r o R rNenx s D r sappnoveo Dar e I NSPEcToR FOUNDATION INSPECTION AppRov to Rr uaRx s Dr SAPPRovED Dare I rseecron FRAM I NG AppRovro RE Manx s I NSPECT I ON Dr sappRovE0 C/ Datr I NSPEcToR LATH OR SHTETROCK INSPECTION Appnovro Revanx s N Drsappnoveo f-J Dar E -L a?I xspEcton FINAL INSPECTION Appnoveo /E/ DrsrppnovEo Re t'tanx s Darr -2 I NspEcron CERTIFlCATE OF OCCUPANCY Reaoy ro lssuE RruaRx s D Nor Rraoy ro lssue f7 Dare I ruspecton D t