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Home My WebLink AboutPermit Building 1973-01-29BUIIDING PERMIT OR MOBIIE rIOME USE APPLICATIONLANE CC iTY PERMIT TYPE _ BUILDING MOBILE HOME TT OSC REG. # MAITING ADDRESS Il MAITING ADDRESS PERMIT /;L, PHONE PHONE PROPERTY TOCATION NCTUDE POST O PROPERIY LEGAT toT - BtocK -Ziff,',V!'"iltr- CUz a-I D(- METES & BOUNDS ATTACHED ffi TWP APPTICANT NAME AND MAITING ADDRESS RANGE TAx ror #CODESEC.CENSUSa32o DESCRIBE EXISTING STRUCTURES ON PROPERTY IF ANY - ROAD NAME OR # PROPERTY SIZE_WIDTH DEPTH TO AREA FOR MOBILE HOME PERMIT ONLY Number of Bedrooms Connect to Existing Sewoge Syste m f or New System Req STRUCTURES TO BE BUII.T THIS PERMIT FT 3 o3 6 ,50 c SEWAGE DISPOSAT PTUMBING INSTATTED BY PUBUC tr BTDG. WASTE DIS. PtUAAEING PLAN REVIEW PARK TRLR. SEPTIC TANK 2a-OO----3634 /3 6.50 WATER SUPPTY PUBTIC OWNER PLANS TURNISHED NO Z OTH ER NAME REAR YARD FACITITY PERMIT OTHER rEES cAsH D CHECK PTUMBING FEES .'/ ,rrru*r, YES SI DATE DATE 1- *)/ -Q_NECTION FEE PUBI.IC WATER CONNECTION FEE oTOIAI. AAIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GAL. TYPE OF STRUCTURE lco COUNTY BUILDING & SANITATION SPECIFICATIONS DRAIN FIELD REQUIRED uN. Fr. /32) TRENCH wrDTH FT. 3 OCCUPANCY SQUARE "" %O PUBTIC UTIT. EASEMENTj'A/,a'f DBY BLDG. SETBACKS _ FT. FROM CTR. OF ROAD RIGHT OF WAY USE CIASSIFICATION Form * css-tz REAR a Dofe srDE lNT. tE. t- IT IAN Dote NG Dote BIDG. Direclions to Find Pro COPY I _ OFFICE COPY 2 -JOURNATCOPY 3 - AUDIT "'SIDE EXT. 2 IANE ( 'NTY BUILDIN(,-J BUILDING PERMIT OR MOBI MHtr {OME USE PERMIT PERMIT NO. PHONE PROPERTY OWNER MAII.ING ADDRESS PHONE CONTRACTOR MAITING ADDRESS PROPERTY TOCATION - INCTUDE POST OFFICE DESCRIPTION - METES, BOUNDS SECTION .TAX LOT NO.CODE CENSUS TRACTRANGE ,3.2 xL EXISTING STRUCTURES ON PROPERTY APPT. NAME & MAITING ADDRESS TEGAT ACCESS TO PROPERTY PROPERTY SIZE * FI. WIDTH DEPTH AREA FOR MOBILE HOME PERMITS ONLY No of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT Connect to Existing Sewoge m New System BDRMS VALUATIONTYPE CONSTRUCTION SQ, FT SE\trAGE DISPOSAT PUBUC tr SEPTIC TANK n OTHERE PLUMBING INSTATLED BY OWNER E OTHERT NAME BUIIDING WASTE DISPOSAT PTUMBING PTAN REVIEW PARK TRAITER FEES WATER SUPPTY PUBUC tr tr OTHER TOTAT $' COUNTY BUILDING & SANITATION SPECIFICAIIONS MIN. SEPTIC TANK CAPACITY WITH DIST. 8OX: GAL. DRAIN FIEI.D REQUIRED I.IN. FT TRENCH WIDTH FT.OR SQ. FT. TYPE OF STRUCTURE OCCUPANCY ZONE PUBI-IC UTII.. EASEMENT BIDG. SETBACKS FRONT FT. FROM CTR. OT ROAD RIGHT OF WAY SIDE INT. SIDE EXT. USE CI.ASSIFICATION REAR AUTHORIZED SIGNATURE _ DATE DATE BIDG. PERMIT - WHITE OFFICE COPY _ WHITE COUNTY TAX _ PINK PTUMBING _ CANARY BUITDING - GREEN SANITATION _ GOI.DENROD Conslruclion to comply with uniform building covering plumbing ond sewoge disposol. All of occuponcy before being occupied. code ond county regulolions buildings require o certificole (See Stotement on Reverse Side) (posr THrs pERMtr oN MAIN BLDG. AT SITE) TANE COUNTY, BLDG. & SAN. DIV.. COURT HOUSE, EUGENE, OREGON 9740I ronu * 655- 13 z//,/-Za-- dz/-(S:z- ,A--Z L- 7 BU ILD IiIC S ITE EVALUAT ION ,r/_L, . CENSUS n a5s z TAX LOT TRACT /5a /() () APPL I CAN Building Permit App I icat ion No' ,/&:1 73 NAI,IE ADD S i te I nspect ion Pre-Permit lnvest igat ion ^L4-a/ PHONE DATE LANE COUNTY PLANNING DEPARTHENT Zon ing 0rd inance Compl iance (Zone ku\. )2. Subdivision 0rdinance Compl iance 3. Requ i red Access 4. Building Site (nrea, Width, Frontage, Setback) 5. 0ther (see comments) NOT NO IE6't icable -t)() YES () NA}4E DATE () () (.)/ (f (.1/() () () () ()() COHHENTS: BUILDING INSPECTION SECTION 6. Plans Submitted 7. Soil Stabil ity (footings) 8. Flood Plain 9. Other (see Corments) YES )r[ () () NONOT () () () kl lfi t(f NA}tE DATE aool icable ()-z-/- 27 CO}1}4ENTS: SAN ITAT ION SECTION Sewage Disposal Usable Area l,Iater Supp I y 0ther (see Conrnents) NOT appl icable NO YES () NAI"IE DATE 10. ll. 12. 13. (l () (),Y Nd () () () () () CO}IHENTS: TO APPL ICANT: Yourr,.B Pfc uilding Permit / Site lnspe n: an be approved. J- I - 1 3 ()Cannot be approved at this time as indicated on item N0. Questions and further information on items I th above. rough 5 contact t he ane-i6; 5 rou9 l3 contact t Lane Coun( ) will be held in this( ) ls being returned.( ) Your buitaing permit application fee is being returned under separate cover. LANE COUNTY PLANNING DEPART},iENT LANE COUNTY BUILDING E SANITATION DIVISION135 sixth Avenrie East, Eugene, Oregon 97401 135 sixth Avenue East, Eugene, 0regon 97401PH0NE: 342-t3tt EXT. Z3t pHoNE: 342_l3l I EXT. 4t I t c0 PLANN ING DEPARTMENT"Quest i dfons an Buildi of ice unt you can reso vet p rob ems urther informat ion on and Sanitation Divisi ."t"a. :-28 fc, %t l*z?*7"- + |' //--;ub, DfP /iE- IANE 'NTYBUILDINU 1---1 BUIIDING PERMIT OR MOB MHE HOME UsE PERMIT PERMIT NO. PROPERTY OWNER MAILING ADDRESS PHONE CONTRACTOR MAITING ADDRESS PHONE PROPERTY TOCATION - INCLUDE POST OFFICE PROPERTY TEGAT DESCRIPTION -METES, BOUNDS SECTION TAX LOT NO CODE CENSUS TRACTRANGE EXISTING STRUCTURES ON PROPERTY APPT. NAME & MAITING ADDRESS LEGAT ACCESS TO PROPERTY PROPERTY SIZE - FT. WIDTH DEPTH AREA FOR MOBILE HOME PERMITS ONLY No. of Bedrooms STRUCTURES TO BE BUILT TH PER M IT Connect to Existi Sewoge TYPE CONSTRUCTION m New m se. FT BDRMS VALUATION SEWAGE DISPOSAT PUBLIC ! SEPTIC TANK tr OTHER-OWNER E OTHER: NAME PTUMBING INSTATTED BY BUITDING WASTE DISPOSAL PTUMBING PLAN REVIEW PARK TRAITER FEES WAIER SUPPLY PUBUC n tr OTHER TOTAL COUNTY BUILDING & SANITATION SPECIFICATIONS MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GAL. DRAIN FIETD REQUIRED tIN. FT TRENCH WIDTH FT.OR SQ. FT OCCUPANCY ZONE PUBLIC UTIL. EASEMENTTYPE OF STRUCTURE BI,DG. SETBACKS -- FT. FROM CTR. OF ROAD RIGHT OF WAY FR.ONT SIDE INT. SIDE EXT. USE CLASSIFICATION REAR AUTHORIZED SIGNATURE - DATE DATE BTDG. PERMIT _ WHITE OFFICE COPY _ WHITE COUNTY TAX _ PINK PI-UMBING _ CANARY BUITDING - GREEN SANITATION _ GOI.DENROD Construction to comply with uniform building code ond county covering plumbing ond sewoge disposol. All buildings require of occuponcy before being occupied. (See Stotement on Reverse Side) reg u lotions o cerlif icote (POST THiS PERMIT ON MAIN BIDG. AT SlrE) TANE COUNTY, BTDG. & SAN. DIV., COURT HOUSE, EUGENE, OREGON 9740I roau*c55-13 SLAE TLOOR PLUMBING GROUNU/ORK Ap pnov e o Reulnx s D Drsappnoveo D Drre I rus pr cron GAS PIPING GROUNft/ORK AppRovro ReuaRxs Dr slppaovro Dare I Hspecron ROUGH PLUMBING I AppRove o /Zl Drsrppnove o REue Rx s oare 3 -2)-7 ) lNspe cron ROUGH GAS PIPING Ap pRov e o Rruenr s D r sappnovro Dare lltspe cron FINAL PLUMBING APPRovED RrMrnx s Drsrppnoveo D oo'ef-,5-73 lruspe c FINAL GAS PIPING AppRovro D DrsAppRovEo D Rrua ax s DarE I Nspecton CERTIFICATE OF OCCUPANCY Reaov ro lssuE Rruanx s D Nor Reroy ro tssuE D Dare l nspEcron -l Date No. PERM IT IN THE BOARD OF COUNTY COMMISSIONERS OF LANE COUNTY WHEREAS, the attached application has been fuIIy considered by the Board of County Commissioners of Lane County, and it rs the opinion and judgment of the Board that the said application should be granted, and that a permit should be issued, now, therefore, it is hereby ORDERED, that a permit be and is hereby issued to for the placing, building and constructing of the following facility: uflon tnu right-of-way of County Road No., in strict conformity to the exhibits attached thereto, and subject to aII terms, conditions, agreements, stipulations and pro visions contained in the application and permit, the Rules and Regulations Governing Facilities to be Permitted upon County Road Rights-of-Way, dated March 31, 1960 and any amendments thereto, and any other applicable regulation, law or ordinance. Special Provisions: This permit is revocable at any time, and will be strictly adhered to and no work other than that specifically mentioned above is hereby authorized. This permit shall be void unless the work herein contemplated shall have been completed before , 19 -. Expires ,19 Inspected and Approved Approved by Board of Commissioners By Date By WHITE GREEN OFFICE FILE RESIDENT ENGINEER PIN K BLU E Director of Public Works PERMITTEE ORANGE - BUILDING & SANITATION DEPT ROAD SUPERVISOR YELLOW . SURVEYOR c98 s2 J Date- APPLItrATION FOR FAGILITY PERMIT IN THE BOARD OF COUNTY CC)MMISSIONERS OF LANE COUNTY Your appli hereby rnakes application under Rules and Regulations Governing Facilities to be Per- mitted Upon County Road Rights-of-Way, to construct the following facility: Upon the right-of-way of County Road No., at the folloring location: a as shown on the exhibits which are attached hereto, in strict conformity to the state- ments of the exact nature and amount of work to be done, and to the description of the facilities contained in said exhibits. Your applicant witl be the beneficial owner of the facility as constructed, or otherwise primarily liable and responsible to members of the public for its proper mairilenance, repair, operation and use. Your applicant accepts all terms, conditions, agreements, stipulations and provisions, in Rules and Regulations Gorerning Facilities to be Permitted Upon County Road Rights-of-Way, dated March 31, 1960, and any arnendments thereto, and any other applicable regulation, law or ordinance. Signature WHITE - OFFICE FILE GREEN . NESlDEI{T ENGIIVEEi PlNl( - PEBMITTEE BLUE - EOAD SUPERVISOB ORAilGE. BUILDING AND SAI\I|TAT|ON DEPT. YELLOW . SURVEYOR Address Phone No. UNTY NI\r-I BUILDING MHE IANE BUILDI PERMTI OR MOI, HOME /USE PERMIT PERMIT NO. PR'f,PERTY OWNER MAITING ADDRESS PHONE CONTRACTOR MAII.ING ADDRESS PHONE PROPERTY LOCATION - INCTUDE POST OFFICE PROPERTY LEGAT DESCRIPTION _BOUNDS SECTION TAX LOT NO CODE CENSUS TRACTRANGE EXISTING STRUCTURES ON PROPERTY APPI.. NAME & MAILING ADDRESS LEGAI. ACCESS TO PROPERTY PROPERTY SIZE _ FT. WIDTH DEPTH AREA FOR MOBILE HOME PERMITS ONLY No. of Bedrooms STRUCTURES TO BE BUILT THIS PERM IT Connect to Existi Sewoge m New m se. FT BDRMS VALUATION tr TYPE CONSTRUCTION \qt INSTAttEDSEWAGE DISPOSAT PUBr-rc n SEPTIC TANK tr OTHERE OWNER ! OTHER: NAME BUITDING WASTE DISPOSAT PTUMBING PTAN REVIEW PARK TRAILER FEES WATER SUPPTY PUBUC tr n oTHER TOTAI COUNTY BUILDING & SANITATION SPECIFICATIONS MIN. SEPIIC TANK CAPACITY WITH DIST. BOX: GAL.\ DRAIN FIELD REQUIRED I-IN. FT TRENCH WIDTH FT.OR SQ. FT \ lt-t-a \ TYPE OF STRUCTURE OCCUPANCY ZONE PUBTIC UTIt. EASEMENT BLDG. SETBACKS,. FT. FROM CTR. OF ROAD RIGHT OF WAY FRONT SIDE INT. SIDE EXT. USE CLASSIFICATION REAR AUTHORIZED SIGNATURE - DATE DATE BIDG. PERMIT _ WHITE OFFICE COPY _ WHITE COUNTY TAX _ PINK PTUMBING _ CANARY BUII.DING _ GREEN SANITATION - GOTDENROD Construction to comply with uniform building covering plumbing ond sewoge disposol. All of occuponcy before being occupied. code ond county regulotions buildings require o certificole (See Stotement on Reverse Side) (posr THIS PERMTT oN MAIN BI.DG. AT SITE) LANE COUNTY, BIDG. & SAN. DIV., COURT HOUSE, EUGENE. OREGON 9740I FoRM = C55- 13 I PLUMBING SITt INSPTCTION AppRovro ReuaRx s DrsappRoveo Dare I ruspecron t/ FOUNDATION INSPTCTION AP PRov E D ReuaRx s Dr sepenovro FRAMI NG A ppnov e o Reuapx s I NSPECT ION D Drsrppnoveo D Drr r I xseecroc LATH OR SHEETROCK Ap pnov r o Rrxanxs I NSPICT I ON Dr saepaovEo Dar e I Nseecton FINAL INSPTCTION Ap paov e o Reuanx s Drsrppnoveo Darr -F3 I xspEcton CERTI F I CATE OF OCCUPANCY Rraov ro lssuE Rgurcx s D Nor Reaoy ro lssue D Dorr_I Nsprcron I ?cler l F?@z 20 L-t D Dor, z=-Ll:-zi- t*rrrr-o*--{ -- {t ( INDIT--IUAL SEWAGE DISPOSAL SYSTEM RECORD Inst -er: Complete top Part of forn signature and return both copies to Larr€ County Building Sanitation Department.I ta1 s Name JC No.v lLIS'r Supp v Public V Other-List InS Baths Basement yes E t'to il Bedrooms Ft. from well Steel il Concrete [[]/ No. Compartments Length width Diameter Depth Ga1. Capacity aoo T eD spos Distribution BoxzYesfu No fl r Feet Lot Line Front below Appli Name !4 ailing Address 5 t/ s-Ft. I 4. 5. 6. hartJ*ckson C l690 s. '|rAil st. Springfield,0r. widrh Tr Total soJft.betweenft U {d lti"""{t?Fi1le Type Filler depth i??X'-q. in- Sketch See instructions Date t .qSignature t at6 For Sanitarian Use OnIY: Approved: System Installation Conforms to Current Standards : Does Not Conform to Current Standards Date: rllltt H a o^s'BIENIEII \]7 1 4\ baq 4 ,i' -2 Remarks: Lane County Building & Sanitation t Sani c55-rr JI r'1 L I ir 1g 73 t{ LAIT s