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Home My WebLink AboutPermit Building 1977-03-02/?-3*33*34 /tt TRS, TL Partitioning #- ( )Completed( ) Pending APPLICANT'S NAIVIE AND ADDRESS OWNER'S NAIVIE AND ADDRESS, if different f Job Location INFORMATION SHEET ( ) Site Feasibility Study for Septic Tank. Number of sites( ) Would like to meet on site. Call (owner, etc.) 3/ 7 -77 2"/ * // Test holes w ilt a be ready J @/1 * 94arr.l,,t.-'r^/ tr^AAcSubdivision Lot /6 Btoc CONTRACTOR'S NAME AND ADDRESS Phone Phone Phone Mail permit or results of site( ) Prefer to pick up. Call STRUCTURES NOW ON THE PROPE feasibility study rc t{l 7lazz Applicant ( )Owner ( )Contractor . (owner, etc.)when ready. PROPOSED USE (this permit) WATER SUPPLY SEWAGE DISPOSA thpnopeRTy rs wrrHrN oNE MrLE oF ctry existing or proposed well, etc. lf public, name of system) (existing or proposed septic tank, etc.) S.l 8R PLUMBING BY Address **i****oFFtcE usE oNLY BELOW THtS LtNE********.**** ( )Facility Permit N ec9ssa ry ( ) Special Permit Area. IVlinimum Elevation( ) New Address Necessary ZONE tr' /,.m,A4-+t- Side Facing Street (F CENTERLINE OF ROAD) By lnterior Side Yard 'f Aear VSETBACKS: Front To: Planning/Building lnspector/Sanitarian/Surve (FROIVI PROPERTY LINES)E Permit Processing Section This applicant appears to have a problem with Your assistance will be appreciated. Respon By D E PA R TIVI E N T O F E NV I R ON IVI E NTA L IVIA N AG EIVI E NT Permit Processi ng Section 125 East 8th Avenue 687-4394c55-'t2 Division ( ) Building Permit Acreageor Lot 31.g / ( ? /, lr-c +,/5/' t 1 funhe FfoT PERIVIIT # TRS, -i L JOB LOCATIO Acreage or Lot Size- Partitioning # Contractor's O.S. # APPLTCANT'S NATVIE AND ADDR ) Completed Subdivision Lot Blo ck Phone_-- LANE COUNTY PERMIT L OWNER'S NAME AND ADDR trcc CONTRACTOR'S NAME AND ADDRESS Mail permitto ( )Applicant ( )Owner ( )Contractor. ( )Prefertopickup. Call-(owner, etc.) when ready Phone Phone THIS PERMIT IS FO # B ED ROOIVIS-# PLUIVIB I NG CONNECTIONS wATER SUppLy- SEWAGE DISPOSAL.-= '--- S.l. # THIS PROPERTY IS WITHIN ONE MILE OF TH E CITY OF -. PLUMB ING BY - I hereby certify that the above statements are true and accurate, and that I have the {ollowing legal interest in the property: -owner of record; -contract purch"rer; - potential uuvei; -- ."attor or agent. t lurther certity that (iI not the owner) I am authorized to act Ior the owner of record, and thatsaid owner is aware and appr;ves of this action. t hireby agree to comply with all applicable Codes relating to this permit' Fee Paid $ -Signatu re ( ) NEW ADDRESS ( ) FAC|LtTy pERtVilT TO TRANSPORTATION DEPT.- () SPECIAL PIVIT. AREA. IVIIN. ELEVATIONi - Date - SAN ITATION Minimum Septic Tank Capacity (Gallons) Drainfield Required - Lineal Feet Maximum Depth BUILDING Type of Construction c",","."1- Use classification roup ire Zone Comments: By:Date By Date PLANN ING REOUIR EMENTS SATISFIED. By Date Date lssued LAN E COUNTY DEPARTMENT OF ENVIRONMENTAL MANAG EMENT, 125 EAST 8TH AVE.. EUG ENE, OREGON 97401 PHONE: 687'4394 POST THIS PERMIT ON MAIN BUILDTNG AT SITE c65-13 \ trec DtRh) STBUCTUBES NOW ON THE PROPERTY ZON E SETBACKS: FRONT SIDE FACING STREET (F ROTVI C/L)INT. SIDE YARD REAR (FROM P/L) SITE INSPECTION AppRovEo m Rruanx s D o^r, 7* f /-7 7Dr sappRoveo I NspEctoR FOUNDATION I NSPECTION AP PRoV E D REua nx s DrsappnovEo f-7 Darr /-,r -"7 l"seecro*'Q ,rZv* FRAMI NG I NSPECTION App nov e o Reuenx s DrsrppRovEo D Dar E tnt"rrro*CACr- LATH OR SHEETROCK INSPECTION oorr/-ri-zz rxspecronAP PRov E D REltanx s DI SAPPROVED FINAL INSPECTION DrsAPPRovEo D o',,-l- /5-J1 I NsprcronAp pRov e o Reuaexs CIRTIFICATE OF OCCUPANCY RraoY ro lssuE D Nor Reaov ro lssue D RruaRx s Dare I r.rs pE croR d PERMIT # TRS, T JOB LOCATIO Partition ing LANE COUNTY PERMIT ) Completed )r Acreage or Lot Size Contractor's O.S. # Subdivision Block- APPLICANT'S NATVIE AND ADDRES Phone Phone Phone OWNER'S NAME AND ADDR lVlail permitto ( )Applicant ( )Owner ( )Contractor. ( )Prefertopickup. Call-(owner, etc.) when ready STRUCTURES NOW ON THE PROPERTY THIS PERI\4IT IS FOR # BEDBOOIV]S --# PLUINB ING CO NNECTIONL Lot CONTRACTOR'S NAIV{E AND ADDRESS ' \I/ATER SUPPLY SEWAGE DISPOSAL s.t. # THlSPRoPERTYlSWlTHlNoNElVllLEoFTHEClTYoF.PLUlVlBlNGBY I hereby certify that the above statements are true and accurate, and that I have the tollowing legal interest in the property: -owner of record; -contract purchaser; - potential buyer; - realtor or agent. I further certily that {if not the owner) I am authorized to act tor the owner of record, and that 9id owner is aware and approves of this action. I hereby agree to comply with all applicable Codes relating to this permit. Fee Paid $-Date NEWADDRESS FACILITY PEBM IT TO TRANSPORTATION DEPT. '' SPECIA L PIV]T. AR EA. I\4IN. ELEVATION:- Signature SANITATION BUILDING Minimum Septic Tank Capacity (Gallons) Drainfield Required - Lineal Feet lVlaximum Depth Type of Construction se Classification roup ire Zone Comments Date B PLANNING REOUIREMENTS SATISFIED. B ZONE: Date:Date lssued SETBACKS: FRONT SIDE FACING STREET (FROIVI C/L) INT. SIDE YARD , '' REAR (FROIVI P/L) LANE COUNTY DEPARTNNENT OF ENVIRONIVIENTAL IVIANAGEIVIENT, 125 EAST 8TH AVE., EUGENE, OREGON 97401 POST THIS PERMIT ON MAIN BUILDING AT SITE c55-1 3 BLDG.PERMtT-wHtrE; BUTLDTNG-GREEN; pLUMBTNG-GANARy; sANrrATroN-coLDENRoD; oFFrcEcoprr-wHrrE PHONE:687-4394 trca ) Comments:) By:Date: SLAB FLOOR PLUMBING GROUNDdORK AppRov ro ReuaRx s Dr slppnovro I rusprctoR GAS PIPING GROUND/ORK Ap pnov r o REurnx s D I SAPPRovED Dar e I rspecron ROUGH PLUMBING Appnoveo D Drsrppnovro D Rrua Rx s Dar E IttspEcroR ROUGH GAS PIPING Ap pRov e o Reuanx s D r sappRovro Drr r I HsprcroR FINAL PLUMBING d D*,-/.!fn #tuI NseecronAPP ROV E D Rruanx s Dr sappnoveo F I NAL GAS AP PRov E o Re uanx s PIPING D l SAPPRovED Drr e I ruspEcron CERTITICATT OF OCCUPANCY Renov ro lssue D Nor REAoY ro lssuE D Dorr- RrulRx s I Hsercron D D Dore- D TRS, TL STRUCTURES NOW ON THE PROPERTY JOB LOCATIO Partition ing LANE COUNTY PERMIT PERIVIIT # Lot- Block_) Completed SubdivisionAcreage or Lot Size Contractor's O.S. # APPLICANT'S NAIV]E AND ADDR OWNER'S NAIVIE AND ADDRES lVlail permitto ( )Applicant ( )Owner ( )Contractor. ( )Preferto pick up. Call CONTRACTOR'S NAME AND ADDRESS Phone- Phone Phone (owner, etc.) when ready THIS PERIVIIT IS FO # B ED ROOIVIS-# PLUIVIB I NG CONNECTIONS WATER SUPPLY- SEWAGE DISPOSAL- S.I. # THlSPRoPERTYlSWlTHlNoNElVllLEoFTHEClTYoF.PLUIVIB ING BY 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 (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 comply with all applicable Codes relating to this permit, Fee Paid $Signatu re ( } NEW ADDRESS ( } FACILITY PERI\4IT TO TRANSPORTATION DEPT.- ( } SPECIAL PI\4T. AREA. I\4IN. ELEVATION SANITATION BUILDING lVlinimum Septic Tank Capacity (Gallons) Drainfield Required - Lineal Feet lVlaximum Depth Type of Construction -GroupComments By Date By Date Date - ire Zone c"n.',n.'"r* use classification PLANN ING REOU I R EIVIENTS SATISF I ED By Date Date lssued LANE COUNTY DEPARTIVIENT OF ENVIRONIVIENTAL IVIANAGEIVIENT, 125 EAST BTH AVE., EUGENE, OREGON 97401 POST THIS PERMIT ON MAIN BUILDING AT SITE c55-1 3 BLDG. PERMtT -wHtrE; BUTLDTNG -GREEN; PLUMBTNG - cANARy; sANrrATroN - GoLDENRoD; oFFrcE copy wHrrE PHONE:687-4394 ) ZONE:SETBACKS: FRONT SIDE FACI STREET (FROIVI C/L) INT. SIDE YARD REAR (F ROIVI P/L) fr+ ru, L,ftas,t v Job Location (Street, mile post B lockPIot Plan FOR SAN ITARIAN'S USE ON LY: E fyr,", Approved fJ System Disapproved fl Needs Correction COMMENTS: Si out"J -2{'t7 FOR INSTALLER'S USE: Trench DePth F iller h Below Tile TankCapacity ldg: I Manufacturer Measured distance to well from tank ,' ill w olA e from drainfield Jf , t'*.-F -/1 ESEIVED *R *l -+e BY 9li t(AF. ? 1 i asf h af Yv ENvl#lhfffier,ar. t -\ @o o) E! (,) E '(U o) E(o Pc(o C) o- LiJF o I uJE l fkz(, 6 N\lttill I I E 6 \ f\\ \ Y \ \t l.\ t) Lg (E Ptnc \.J L'Nr\zF {-.1 v tA isor \N { F ,b -\ .t oe.ta< (r, \ *\t o DT J +& m INSTALLATION RECORD AND CERTIFICATE OF SATISFACTORY COMPLETlON When signed by the County Sanitarian, this certificate is evidence as per ORS 454.665 of sat- isfactory completion of a subsurface sewage disposal system at the above location. Return this form to: Permit Processing Section, Department of Environmental Management, Public Service Building, 125 East 8th Avenue, Eugene 974O1 rll t o .f- c55-1 1 ') l \ \ #\l+ \B\$