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HomeMy WebLinkAboutPermit Septic Tank 1973-06-28Bl'"MOBITE HOME USE APPIICAIIONLANE COUNTY PERMIT TYPE _ BUILDING P owN NTRACTOR PROPERIY TOCATION - INCLUDE POST OFFICE PROPERTY LEGAL DESCRIPIION tOT_BIOCK-SUBDIV. TWP RANGE DING PERMIT OR MOBILE HOME NG ADDRESS MAILING ADDRESS TAX I-OT PERMIT >//-,OSC REG. # CODE DESC RI BE NG PROPERTY SIZhWIDTH PHONE E MEIES&BOUNDSEYES ATTACHED NO SEC CENSUS DEPTH 36--L APPTICANT NAilE AND MAITING ADDRESS PROPERTY AREA ROAD FOR MOBILE HOME PERMIT ONLY Number of Bedrooms STRUCTURES TO BE BUITT THIS PERMIT Connecl to Existing t TYPE SQ. FT or New System R"q. D ROOMS VATUATION PTUMBING INSTALTED 8Y owNER! OIHERnNAME FU RN ISHED FACII-ITY PERMIT 5e.30 58.5,! Cherl OTHER REAR NO APPTICANT OR FEET REAR YARD USE CTASSIFICATION PUBI.IC UTII.. EASEMENT YES YES NO ,TEst BYP tt, I SR Z:''rr FEE <t__ ; & SANITATION SPECI TIONS REQUIRED ,T TREN.H wrDTH FT, ZONE I r'ansaet rort rka$r.u;jr'y B3 t T( It ! ! 0X rrr LLE ) ( lvr ectrr'IcalBtc FROI Dire, To+.'al I Amt tteeervedr f,irecil * I Thanl'l YotJ, nsn ltt Form # g55-12 Dole BIDG.b -'l I Dote COPY COPY - - e,!rrA! COPY 3 - AUDIT IANE COUNT I BUILDING PERMIT OR MOBITE HOME USE PERMIT BUTLDTNG tr MH I PERMTT NO. PROPERTY OWNER MAITING ADDRESS PHONE CONTRACTOR MAIIING ADDRESS PHONE PROPERTY TOCATION - INCTUDE POST OFFICE PROPERTY LEGAT DESCRIPTION _ METES, BOUNDS RANG E SECTION TAX LOT NO.CODE CENSUS TRACT EXISTING STRUCTURES ON PROPERTY APPt. NAME & MAITING ADDRESS TEGAT ACCESS TO PROPERTY PROPERTY SIZE - FI. WTDTH DEPTH AREA FOR MOBILE HOME PERMITS ONLY No. of Bedrooms STRUCTURES TO BE B LT THIS PERMIT Connect to Existi TYPE CONSTRUCTION New m FT BDRMS VALUATION SEWAGE DISPOSAT PUBilC tr SEPTIC TANK OTHERE OWNER T1 OTHER: NAME PIUMBING INSTAILED BY F EES WATER SUPPTY BUITDING WASTE DISPOSAI. PTUMBING PTAN REVIEW PARK TRAITER PUBr.lc tr OTHER COUNTY BUILDING & SANITATION SPECIFICA ONS MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GA[. DRAIN FIEID REOUIRED TIN. FT TRENCH WIDTH FT.OR SQ. FT. OCCUPANCY ZONE PUBTIC UTIt. EASEMENTTYPE OF STRUCTURE BTDG. SETBACKS FRONT FT. FROM CTR SIDE INT. OF ROAD RIGHT OF WAY SIDE EXT, USE CTASSIFICATION REAR DATEAUTHORIZED SIGNATURE - DATE BLDG. PERMIT - WH ITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUITDING _ GREEN SANITATION _ GOTDENROD Conslruction to comply with uniform building covering plumbing ond sewoge disposol. All of occupo'ncy before being occupied. code ond counlY regulotions buildings require o cerlificole (See Stotemenl on Reverse Side) (POST THIS PERMIT ON MAIN BLDG. AT SlrE) TANE COUNTY, BIDG, & SAN. DIV., COURT HOUSE, EUGENE, OREGON 9740I ronr,r lt c s5 - 13 sloq o: \,1' oocz{ 5I ,o o I r-f ) . ,94626 C) ot L\///' /a, 9 U ro (,ra o fo '.orv t, Noo t 1 ! I ii li I, [, I I J .' fu'o-!o CN '.o c to IC(o t t /I iF Foobl.'tr * dt , /I /iNo ,t *ll: lr - rt'.3"**€--r I,c II t II t !l 7 2-)\, ooo //4.€' {oo t- .i; (l(- )-) ).J), 6-.>25r @oo"a/c.p t a d{. \ t l. \I -b. 1si- (ooo ,+i*- /'/ .{.r rd LvaozgE ) \/,'.a.)7.t '' /I r,lI \ ClrI BUILDlNG SITE E VALUAT ION () Building Permit Appl ication No. S i te lnspect ion Pre-Perm it lnvest igat ion *. rJZR A s ld_3rAx CENS]JS TRACT LOT -5-A O C$7J APPL I CANT: NA},IE ADDR ( PHONE DATE LANE COUNTY PLANNING DEPA RT}IENT NOT NO YES NAI1 E DATE appl icabler)Zoning 0rdinance Compl iance(zone_) Subdivision 0rdinance Compl iance () () () () () () () ( ( () () () () ) 2 3 4 5 Requ i red Access Bu ild ing S ite (Area, Width, Frontage, Setback) 0ther (see comments) COMHENTS: BUILDING INSPECTION SECTION NOT NO YES NA},IE DATE cable6. Plans Submitted 7. Soil Stabil ity (footings) B. Flood Plain 9, 0ther (see Conments) COfi},IENTS: () () () () () () () () ( ( (fi-2f,4 SAN ITAT I ON SECT I ON 10. n. 12. t3. Sewage Disposal Usable Area Water Supply 0ther (see Comments) NOT NO Ei'6't i cab le -(l () YES NA}{E DATE e{ A * () ( ( () () () () COH}lENTS: TO APPL I CANT: You r (') () Building Permit / Site lnspection: Can be approved. Cannot be approved at this time as indicated on item N0 Questions and further information on items I through ! COUNTY PLANNING DEPARTMENT. Questions and further info above. contact the Lane- rmat ion on iG,; 6 through l3 contact the Will be held in this of Lane Count Buildin ce unt I you can reso vet and Sanitation Division p rob I ems cated. ls being returned. Your building permit appl ication fee is being returned under seParate cover. L/\NL CoUNTv pLANNING DEpARTMENT LANE COUNTY BUILDING s SANITATION DlVlSlON l'ir) Sixth l\rente Iast, Euqerre, Oregon 97401 135 Sixth Avenue East, Eugene, 0r'egon 97401 t,ilrlNl : tlr?-Hil rxt. ?'il Pll0Nl-: 142-llll EXT. 4ll () () () ) T"VF = IANE COUNI BUTLDTNG f BUILDING PERMIT OR MOBILE HO.USE PERMIT PERMIT NO. PROPERTY OWNER MH MAIIING ADDRESS PHONE CONTRACTOR MAIIING ADDRESS PHONE PROPERTY LOCATION _ INCI.UDE FA5T QTFIC,E PROPERTY TEGAL DESCRIPTION _ METES, BOUNDS RANG E SECTION TAX LOT NO CODE CENSUS TRACT EXISTING STRUCTURES ON PROPERTYAPPI.. NAME & MAITING ADDRESS TEGAT ACCESS TO PROPERTY PROPERTY SIZE - FT. WIDTH DEPTH AREA FOR MOBILE HOME PERMITS ONLY No. of Bedrooms Connect to Existin Sewo e TYPE CONSTRUCTION New System I BDR MS VALUATION m STRUCTURES TO BE BUILT THIS PERMIT SQ. FT SEWAGE DISPOSAT PUBr.tC [l SEPTTC TANK n oTHERfl PTUMBING INSTALLED BY owNER n oTHER: NAlv{E BUITDING WASTE DISPOSAT PLUMBING PtAN REVIEW PARK TRAII.ER $FEES WATER SUPPTY PUBLIC tr E OTHER TOTAL 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 PUB[IC UTII.. EASEMENT BIDG. SETBACKS FT. FROM CTR. OF ROAD RIGHT OF WAY TRONT SIDE INT. SIDE EXT. USE CTASSIFICATION REAR AUTHORIZED SIGNATURE _ DATE DATE BIDG. PERMIT _ WHITE OFFICE COPY _ WHITE COUNTY TAX _ PINK PtUMSING _ CANARY BUITDING _ GREEN SANITATION _ GOI.DENROD Construction to comply with uniform building code ond county regulotions covering plumbing ond sewoge disposol. All buildings require o certificote of occuponcy before being occupied. (See Stotement on Reverse Side) (posT THls pERMlr ON MAIN BrDG. AT SITE) TANE COUNTY, BTDG. & SAN. DIY., COURT HOUSE, EUGENE, OREGON 9740I FoRM=C55-t3 r I - SITE INSPECTION AppnovEo RruaRx s D r sappRovro Dare Ir.rspEcroR FOUNDATION I NSPTCTION AppRoveo REua Rx s Drsappnoveo Darr I Nspecton FRAM I NG Appnoveo Rr uenx s I NSPECT I ON Drr r I NSPEcToR LATH OR SHEETROCK Appnoveo ReurRxs I NSPICT I ON Dr sappnoveo Dar E I NSPEcToR FINAL INSPECTION AePRovEo D DrsappRove, D Reua nx s Darr I NsercroR CERTIFICATE OF OCCUPANCY Reaov ro I ssue REuanx s D Nor Rraoy ro lssuE D Dore_lNsee cron_ l_- DrsAPPRovE, D