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Home My WebLink AboutPermit Building 1976-09-29n Owner LANE COUNTY PERMIT FOR PERIV IT NO CONSTRUCTION [ ] IVIOBILE HOIVIE [ ] PLAN REVIEW [ ] CHANGE OF OCCUPANCY t ] NAIVIE ADD R ESS C ITY ZIP CODE PHONE n Contractor ADD z,a, lr* =.o, rQoE code-Twp- Range- Sectio.n Subd ivision Lot NAI\1E RESS C ITY ZIP CODE Census Tract NE O.S. Reg. + Access to Property (Road Name) B lock Acreage Width Depth Existing Structures on Property: Directions to Property - Address STRUCTUR E (# BEDROOIVIS)SO. FT VALUATION SEWAGE DISPOSAL: PUBLIC [ ] SEPTICTANK I ] OTHER [ ] PLUIVIBING INSTALLED BY OWNER OTHE R NAIVI WATER SUPPLY: PROPOSED t ] EXISTING t] PUB LIC COMIVIUNITY. NAI\4E E- BUILDING PLUIVIB ING 3% SURCHARGE: IVIOBILE HOME . WASTE DISPOSAL PLAN REVIEW TOTAL PRIVATE WELL OTHER .SPECIFY ttt CONSTRUCTION PERMITS & INSPECTIONS AND WATER POLLUTION CONTROL SPECIFICATIONS IVIIN. SEPTIC TANK CAPACITY: LIN. FT IVIAX. TRENCH DEPT I NCHES t). STAY 1OO' FROI\4 ALL WELLS TYPE OF CONSTRUCTION GROUP- FIRE ZONE USE CLASSIF SETBACKS FT. FROI\4 CTR. OF r,AN FRONT SIDE EXT FT. FROIVI PROP. LINE SIDE INT REAR_ ZONE . r AUTHORIZED SIGNATURES lsl ISSUANCE DATE BLDG. PERI\4IT - WHITE OFFfCE COPY - WHITE cotrrurv rAX - PINK PLUMBING - CANARY BUILDING - GHEEN SANITATION - GOLDENROD IMPORTANT Call 687-4065 to schedule all required construction inspections. Call 687-4061 to schedule all required septic system inspections. All construction shall comply with the State Buidling Code, D.E.Q. standards for subsurface sewage disposal and the State Plumbing Code. All buildings require a certificate of occupancy before being occupied. (See Details on Reverse Side) POST THIS PERMIT ON MAIN BLDG. AT SITE LANE COUNTY, DEPT. OF ENVIFONI/ENTAL MANAGEMENT COUBTHOUSE ANNEX, 135 EAST 6th. EUGENE, OEEGON 97401c5s-13 /v / PRoDASED INSTALLER: ComPlete toP Part oi /rm uJq sEwAGE D I sPosAL rsltlil.-ll?t ""otto signature ano es wi th aPP licat ion. PERM T NO y n9 n tS rooms Bat ll n ConcreteSteel f t No Pub ater suPP lic the r-L ist No c a Ft. f rorn we ns e mens ons: wid NAHE }tAILING ADDRESS r Date ES . ComPartments / sPosa e Gal . CaPaci tY o No 'ound Side ar e D h Di stribution Box: Yes t str ut Orl-A eet rorn r r IJ aR,otL ne Front F EOFSA ts ov, tn For Sanitarian Use 0nly:Dateln accordance with 1973 Oregon Laws Chapter 835, Section 214 this certificate is i as evidence of satisfactory completion of a subsurface sewage dlsposal system at the above I ocat i on. $Z npproved: System I nstal I at i on conforms to current standards l-l Oisapproved: Does not conform to current standards Remarks: 9tr" dJued 41? 7< 6 L nes-Ft. 4 Trench t/ i dth Total Sq. FI, IH Ft. Between Lines tn er Dept Til ot an see n5 r bns tt\^ .0f {\o\ f o,rlh U { \ {-b{ II/ I I /o I LANE COUNTY ENYIBONMEITTAL MGMT. EfrWHffi l/ vo nature an t an LANE c55-1I STATE OF OREGON OEPARTMENT OF ENVIRONMENTAL QUALITY ure 4 s ! Owner LANE COUNTY PERMIT FOR PERIVIIT NO CONSTRUCTION t ] IVIOBILE HOIVIE [ ] PLAN REVIEW [ ] CHANGE OF OCCUPANCY [ ] ZIP CODENAIVlEADD R ESS CITY PHONE ! Contractor NAME ADD RESS CITY Code Census Tract Acreage- Width ZIP CODE PHO NE O.S. Reg. +r Tw Subd ivision Lot Access to Property (Road Name) Range-- Section Tax B lock Depth Existing Structures on Property: Directions to Property - Address STRUCTUR E (# BEDROOIVIS)SO. FT VALUATION SEWAGE DISPOSAL: PUBLIC [ ] SEPTICTANK [ ] OTHER I ] PLUIVIBING INSTALLED BY: owNER[]OTHERtI NAt\4 tr BUILDING PLUIVIB ING 3% SURCHARGE- IVIOBILE HOIVIE WASTE DISPOSAL PLAN REVIEW TOTAL WATER SUPPLY: PROPOSED I ] EXISTING t ] co NSTRUCTION PERMITS & INSPECTIONS AND WATER POLLUTION CONTROL SPECIFICATIONS IVIIN. SEPTIC TANK CAPACITY GALS MIN. DRAINFIELD LIN. FT MAX. TRENCH DEPTH- INCHES TYPE OF CONSTRUCTION-- GROUP FIRE ZONE USE CLASSIF FRONT SIDE EXT ZON E AUTHORIZED SIGNATURES lsl ISSUANCE DATE BLDG. PERMIT - WHITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUN4BING - CANARY BUILDING _ GBEEN SANITATION - GOLDENBOD IMPORTANT Call 687-4065 to schedule all required conslruction inspections. Call 687-4061 to schedule all required septic system inspections. All construction shall comply with the State Buidling Code, O.E.Q. standards for subsurface sewage disposal and the Stale Plumbing Code. All buildings require a certiricate of occupancy before being occupied. (See Details on Reverse Side) POST THIS PERMIT ON MAIN BLDG. AT SITE LANE COUNTY, DEPT. OF ENVIRONMENTAL MANAGEMENT COURTHOUSE ANNEX, 135 EAST 6th, EUGENE, OBEGON 9740,I ] PUB LIC ] COIVIVIUNITY.NAME: ] PRIVATE WELL ] OTHER SPECIFY: STAY 1OO' FROIVI ALL WELLS SETBACKS- FT. FROI\4 CTR. OF rAN:FT. FBOM PROP. LINE: SIDE INT. - REAR SLAB FLOOR PLUMBING GROUNU/ORK Ap pnov e o Re ttlRx s Dr sappRovro Dar r I rusercron GAS PIPING GROUND^/ORK AppRovro Reuanxs D DrsAPPRovEo D Dare I tsprcron ROUGH PLUMBING AppRoveo M Drsappnovro Rexanxs DArE /2-ee-76 lrsprc ROUGH GAS PIPING Ae pnov e o Reuanr s DrsappRoveo Dnr r ItrspEcron F I NAL PLUMB I NG APPROv E D Rr Manx s VorsAPPRovEo D DnrrJ- X-.)n lNsp FINAL GAS PIPING AppRoveo Rr uaRx s Drsnppaoveo Drre I NSPEcToR CERTIFICATE OF OCCUPANCY Reaov ro lssue Reuanrs D Nor RErov ro lssur D Dore-I NsPEcroR LANE COUNTY PERMIT FOR: -PERN/lIT NO. CONSTRUCTION I & rvoBtLE HorvlE t I pLAN REVTEW I ] CHANGE OF OCCUPANCY [ ] n Owne ADD R ESSE DE PH NE n Contractor \"; NAI\,1E ADD R ESS CITY ZI CODE Census Tract NE O.S. Reg. +r T*p i Range Section r Tax Lo t_Code Subdivision- Lot Access to Property (Road Name) B lock Acreage width Depth Directions to Property - Address LUATION SEWAGE D ISPOSAL: PUBLIC[] SEPTIC BUILDING P LU IVlB ING 3%S IVIOB WASTE DISPOSA PLAN REVIEW ANK oTHER [ ] PLUIVIBING INSTALLED BY R t ] OTHER NAIVI WATER SUPPLY: PROPOSED t EXISTING t PUB LIC COVIIVIUNITY- NAIVIE l l PR IVATE WELL OTHER - SPECIFY TOTAL #' CONSTRUCTION PERMITS & INSP IVIIN. SEPTIC TANK CAPACITY GALS IVIIN. DRAINFIELD TYPE OF CONSTRUCTION- GROUP ATER POLLUTION CONTROL S IFICATIONS IVIAX. TRENCH DEPT H I NCHESLI.FT FIRE ZONE USE CLASSIF IVIA SETBACKS- FT. FROIV CTR. OF rArV FRONT SIDE EXT FT. FROIVI PROP. LINE: SIDE INT. .; REAR ZONE \'t ,f AUTHORIZED SIGNATURES ISSUANCE DATE BLDG. PERlvllT - WHITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUt,4BING - CANARY BUILDING - GREEN SANITATION - GOLDENROD IMPORTANT POST THIS PERMIT ON MAIN BLD G. AT SITE Call 687-4065 to schedule all required construction inspections. Call 687-4061 to schedule all requiredseptic system inspections. All construction shall comply with the State Buidling Code, D.E.e. stanbardsfor subsurface sewage disposal and the State Plumbing Code. All buildings require a certificate ofoccupancy before being occupied. (See Details on Reverse Side) c55-1 3 LANE COUNTY, DEPT. OF ENVIHONMENTAL MANAGEMENT COUBTHOUSE ANNEX, 135 EAST 6th, EUGENE, OREGON 97401 1q t* Existing Structures on Property: . . x ii ETR'UCTUR E ( # BED RO.OI\4S)SO. FT. h i* tt SITE INSPECTION AP PROV E D REuaRx s ffi DI SAPPROVED D oor.- /O -K'76 I NSPEcToR FOUNDATION INSPECTION DISAPPROVED I rspecton tfui,Ae pRov e o ReuaRxs &o^r, &--/{'7f --( FRAM I NG APPRovED ReNanx s I NSPECT I ON #-{ DTsAPPRovED / / --' Dar -L I NSPEcToR RruaRxs ,a Dar E I Hspecron /-/ 3-"? oft FINAL INSPTCTION AP PRov E D ReManr s Ir.rspEcron CERTIFICATE OF OCCUPANCY RraoyrolssueDNorRraovrolssurDDorr-lNseecton- Rru rRx s LATH OR SHIETROCK INSPECTION / APPRovED /7#- DT sAPPRovE o , ,#' 4' DTsAPPRovE o D oorr-3' z * 77 \ PERMTT NOTE:NO PERMIT WILL BE ISSI'ED I'NTIL T1IIS APPLIC'ATION HAS BEEN APPROVED CONSTRUCTION +$q*! OWNER Clty zlp Phone Name Address -/(r--l CONTRACTOR o.s. REG. #e4 20 l\lp h) Subdlvision I { Section 4 I Lot ,t City oneAddress Tax Lo Code Acrea ACCESS TO PROPERTY (Road Name) Existing Structures on ProPertY Property Locatlon - Address/Dlrectlons: e Use c Existing Seriage D sal System Pub I w iEy Installed by Owner Other PLTJMBING Side Exterior U lon or New System ed Name of Comnunity or Public System l?ar' bc,a) Name "fl P/u tll Sewage WaEer ConnectionConnection PLANS FURNISHED FACILITY PERMIT YES YES NO Slgnature of Appllcant: Fee Received By Date 3 ired - Lineal Feet /.f?) I{axlmum Dep Zone 5 Use ClassificaElon Rear t K""*^^- DISPOSAL Slte InsPectlon WATER SUPPLY: Well Bldg. Plunblng 3Z Surcharge Waste Dl6p. Plaa Review Moblle Hone Sprlng _0ther ll \!c)oo L() TOTAL Mln. Septlc Tank CaPaci Dra Type of Constructl croup -Z Bldg Setbacks - from Center of Road Right of Way: front Side Int.Zoo Fr.edrooms5 leld cs5- 12 LANE COI.'NTY OF DATE: MANAGB{ENT DATE:PIANNING DATE: APPLICATION FOR: MSBTLE HoDfi l-_-_l PLAN REvlEw f---ld t00 d NO \ \ ( CORRECTION NOTICE IANE COUNTY DEPT. OF ENVIRONMENTAT MANAGE'VIENT Construction Permits & lnspections Division EUGENE, OREGON This building or structure does not conform lo Lone County building regulotions, ordinonces or codes os noted belowt RE.INSPECTION REQUIRED FOR APPROVAT lnspector- Date-c55 -7 3 Building Permit # (