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Home My WebLink AboutPermit Building 1978-02-2023s-78 TRS, TL /7-3 ) W?itten Direction = OS?TLlttasc- Job Location clJ Cu INFORMATION SHEET ( ) Site Feasibility Study for Septic Tank. Number of sites-( lrtuidins Permit 1 ) Prefer to pick up. Call Acreage or Lot Size cls'r- lAs'ready -. Partitioning #( ) Completed( ) Pending APPLICANT'S NAME AND ADDRESS lQ-oho-.-* 4^: lJr,.r lbto s. 'A" s{-. So"rrd. OWNER'S NAME AND ADDRESS, if dif T;;applican CONTRACTOR'S NAME AND ADDRESS r 'ail permit or results of site feasibility study to (plicant ( )Owner ( )Contractor D,JJl.r- l* Nd,Au;;rot fr abc&- z- enone7 tb-VVZZ (owner, etc. ) when ready. -tv6:TT27 contractors o. s. r l( 7 Phone Phone STRUCTURES NOW ON THE PROPE rAaaal: PROPOSED USE (this permit) WATER SUPPLY SEWAG E DISPOSAL PLUMB ING BY w existing or proposed well, etc. lf public, name of system) 3 proposed septic tank, etc.) S.l Arr*t-!* 2t -e I Address f a't {t llKopeHTy rs wrrHrN oNE MrLE oF crry ****+*** oFFtcE usE oNLY BELOW THtS LtNE .*.+***++1.+* ( ) New Address Necessary -JN tr ( ) Facility Permit Necessary SETBACKS: Front Side Facing Street {FROM CENTERLINE OF ROAD) ( ) Special Permit Area. Minimum Elevation lnterior Side Yard -- Rear (FROM PROPERTY LINES) To: Planning/Building lnspector/Sanitarian/SuNeyor. This appiicant appears to have a problem with Your assistance will be appreciated. By Permit Processing Section Response By DEPARTMENT OF ENVIRONMENTAL MANAGEMENT Permit Processing Section 125 East 8th Avenue 687-4394c55-1 2 tvtston t4r, TFS, T ,3.2 * 3 o? JOB LOCATION Partitioning # LANE COUNTY PERMIT Acreage or Lot Size Contractor's O.S. # APPLICANT'S NAME AND ADDRE OWNER'S NAME AND ADDRE CONTBACTOR'S NAME AND ADDRES s Mail permitto ( )Applicant ( )Owner ( )Contractor. ( )Prefertopickup. Call STRUCTURES NOW ON THE PROPERTY F..7 ) Completed Subdivision Lot , Block- Phone Phone Phone (owner, etc.) when ready r-HlS PERIVIIT lS FOR \IJATERSUPPLY , [./ / SEWAGEDISPOSAL # BEDROOIVIS .. # PLUIVIBING CONNECTIONS s.t. # >/{t, THIS PROPERTY ISWITHIN ONE TVIILE OF THE CITY OF PLUIVIB ING BY I hereby certify that the above statements are true and accurate, and that I have the lollowing legal interest in the property: -owner of record; -contract purchaser; - potential buyer; - realtor or agent. I further certiiy that (if not the owner) I am authorized to act for the owner oI record, and that said owner is aware and approves of thas action. I hereby agree to comply with all applicable Codes relating to this permit. Fee Paid $Signatu re () NEW ADDRESS () FACILITY PERIVIIT TO TRANSPORTATION DEPT ( )SPECIAL PtVlT. AREA. lvllN. ELEVATION:- SANITATION Construction i , Group -Fire Zone Use Classification ' -omments Comments: lVlinimum Septic Tank Capacity (Gallons) Drainfield Required - Lineal Feet Maximum Depth BUILDING Date - =effi wV* g suBl4lTTEpx- '- F?(;/a*w)le@lN 11l J,#,ZDB PLANNING REOUIREIVIENTS SATISFIED. B By Date: , Date Date lssued ZONE SETBACKS: FRONT.FACING STREET (TROMI C/L) INT. SIDE YARD REAR (FROM P/L) LANE COUNTY DEPARTMENT OF ENVIRONMENTAL IVIANAGEIVIENT, 125 EAST 8TH AVE., EUGENE, OREGON 97401 POST THIS PERMIT ON MAIN BUILDING AT SITE BLDG. PERMIT-WHlTEt BUILDING -GREEN; PLUMBING -CANARY; SANITATTON-cOLOENROD; OFFTCECOPY-WHITEc55-1 3 PHONE:687- / v{4 / /'fl /. Date: dn- Dote Z5 078 Permit No.re5-'.78 CURB CUT PERMIT IN THE BOARD OF COUNTY COMMISSIONERS OF LANE COUNTY WHEREAS, the ottoched opplicotion hos been fully considered by the Boord of County Com- missioners of Lone County, ond it is the opinion ond iudgment of the Boord thot the soid opplicotion should be gronted, ond thot q permit should be issued, now, therefore, it is hereby. ORDERED, thot o permit be ond is hereby issued to rlA '(td for plocing, building or constructing the following focility: Vn z-Dc-tls-(+az \)qro "") IJY A btock 2,,1{ upon the right-of-woy of County Rood No Mile Post stipulotions ond provisions contoined in the o in strict conformity to the exhibits ottoched hereto, ond pplicotion subi ond ect to oll terms, conditions, ogreements, permit, the Rules ond Regulotions Gov- os set forth by the Lone Mon-erning Focilities to be Permitted uol 50.190(2) ony omendments Speciol Provisions: unty Rood Righ ts-of-Woy, opplicoble 'ill be strictly odhered to ond no work other thon thorized. rein contemploted sholl hove been completed be- Expires 19_. Approved by Boord of County Commissioners By ond ony other regulotions, low or ordinonce. Drivewoy will be constructed in occordonce with the ottoched drivewoy opprooch specifico' tions (Drowing M98-50). Permittee will be responsible for the immediote removol of oll mud, dirt ond debris from the roodwoy ond right of woy coused by his operotion, leoving the roodwoyond oreo in o neot, occeptoble condition. Sidewalks will be constructed in accordance with the attached sidewalk specifications and drawing M9B-49. The Standard Curb Type shall be constructed unless otherwise specified. upon Co thereto, I 2 3 This permit is revocoble ot ony time, ond w thot specificolly mentioned obove is hereby ou This permit sholl be void unless the work her for. , Dfl . 0 lnspected ond Approved Dote By WHITE - OFFICE FIIE YETTOW - REAI ESTATE PINK - PERMITTEE ORANGE _ BUITDING & SANITATION DEPT Director of Pu Works c74-t29 rt v-) 4 I ,,t 8.4 r,l ,t1 I t- ".i t 1 il. /:ia-, fl I+- +)ra- tII I t a* | /<<r l?t -'r -*kt;J TRS, T JOB LOCATIO LANE COUNTY PERMIT Acreage or Lot Si ?e Partitioning #) Completed Subdivision Contractor's O.S. #Lot Block- APPLICANT'S NAME AND ADDR FSS OWNER'S NAIVIE AND ADDRESS CONTRACTOR'S NAME AND ADDRESS Mail permitto ( )Applicant ( )Owner ( )Contractor. ( )Prefertopickup. Call-(owner, etc.) when ready. STRUCTURES NOW ON THE PROPERTY Phone- Phone-- Phone- s.r. # Fire Zone THIS PERMIT IS FOR . I # BEDROOI\4L# PLUMBING CONNECTIONS-- WATER SUPPLY SEWAGE DISPOSAL THISPROPERTYISWITHINONEMILEOFTHECITYOF' . PLUMBING BY-- I hereby ceftiiy 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 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 oI this aclion. I hereby agree to comply with all applicable Codes relating to this permit. Fee Paid $Signature Date ()NEWADDRESS () FACILITY PERI\4IT TO TRANSPORTATION DEPT.- () SPECIA L PMT. AB EA. I\4IN. ELEVATION:- SANITATION BU ILDING Minimum Septic Tank Capacity (Gallons) Drainfield Required - Lineal Feet Maximum Depth Type of Construction -Group Use Classification Comments: Comments Date: PLANNING REOUI REMENTS SATISFIED. By Date Date lssued: ZONE SETBACKS: FRONT SIDE FACING STREET (FROIVI C/L) INT. SIDE YARD REAR (FROIVI P/L) LANE COUNTY DEPARTMENT OF ENVIBONMENTAL TVANAGEMENT, 125 EAST 8TH AVE., EUGENE, OREGON 974O1 POST THIS PERMIT ON MAIN BUILDING AT SITE c55-1 3 BLDG.pERMtT-wHtrE; BUtLDTNG-GREEN; pLUMBtNG-cANARy; sANrrATroN-coLDENRoD; oFFrcEcoprr-wHtrE PHONE:687-4394 I By:Date: tro&- stilg FL00R PLUMB ING GROUNO^/ORK Appnov r o E Drsappnoveo RsManx s oorJ- ,f- 7/rNSpEcroR R *- GAS PIPING GROUNU,VORK Ap pnov r o RsManx s Dar e I ruspecron ROUGH PLUMBING Appnoveo D Drsappnovro D Rrue nx s Dar r I rusprcron ROUGH GAS PIPING APPRovED D DrsappnovE, D Reuenx s NSPEC F I NAL PLUMB I NG Appnoveo E DrsAPpRovEo D Re urnx s 7 f I xspecron ee-,€oorrT- 7 FINAL GAS PIPING Ap pRov E o RrxaRx s Drsrppnovro I t'rs pE cron CERTIFICATE OF OCCUPANCY Reaov ro lssur Re uaRx s D Nor REaov ro lssue D Darr I Hseecron D DrsrppRovro D D Dorr- CP T RS, TL t-T- 7-2 4 Job Location (Street, mile .post /,/-z A D€ Subdivision ft at 8 Btocft Z-, FOR SANITARIAN'S USE ON LY: p Syrtu, Approved fl System Disapproved E Needs Correction COMMENTS Si Date FOR INSTALLER'S USE: Trench Depth Filler Depth low * ,9 Manufactu E.,/ Irlot PIan Tank Capacity ltr -,iE 6 t fr /!ia' /Y ts -lI 4, i o \\,Y'l- [, 1o' ,l 'd I t$sqr- lo s\s s"9$q vJAlk INSTALLATION RECORD AND CERTIFICATE OF SATISFACTORY COMPLETION When signed by the County Sanitarian, this certificate is evidence as per ORS 454.665 of sat- isfactory completion of a subsurface sewage disposal system at the above location. Return this form to: Permit Processing Section, Department of Environmental ft/lanagement, Public Service Building, 125 East 8th Avenue, Eugene 97401 rc)e i 'q\ LIJF o -/ B f, = r) o$ 91 tno o)LE! u, ='6 q) E(oZ J'PC(oo o-o. 6 6 6 l!q q.l o.]C3 .B D I6tt' Io c0 c( b uJ cclt- zo a Sca le o Lg (o#@c +o-m N cs5-1 1 rtrc Measureddistancetowellfromtankfromdrainfield- ---6i.-i'* JU[rja s Water p6r, Cc,, , Larr. TRS, T JOB LOCATIO LANE COUNTY PERMIT Acreage or Lot Size Contractor's O.S. # Partitioning APPLICANT'S NAME AND ADDRE ss OWNER'S NAME AND ADDRE ss CONTRACTOR'S NAME AND ADDR Mail permitto ( )Applicant ( )Owner ( )Contractor. ( )Prefertopickup. Call ) Completed Subdivision Lot Phone Phone Phone THIS PERMIT IS FOR (owner, etc.) when ready # B ED ROOIVIS-# PLUIVIB I NG CO NNECTIONS STRUCTURES NOW ON THE PROPERTY- \A/ATER SUPPLY SEWAGE DISPOSAL s.l. # THlSPRoPERTYlSWlTHlNoNEMlLEoFTHEclTYoF'PLUIVlBlNGBY I hereby certify that the above statements are true and accurate, and that I have the following iegal interest in the property: -owner o,f record; -contract purchaser; - potential buyer; - realtor or agent. I lurther certify that (it not the owner) I am authorized to act for 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 $-Signatu re Date ()NEWADDBESS () FACILITY PERI\4IT TO T RANSPO BTATION DEPT.- { )SPECIALPMT. AREA. MIN. ELEVATION SANITATION Minimum Septic Tank Capacity (Gallons) Drainfield Required - Lineal Feet Maximum Depth Date BUILDING Type of Construction Comments: By: roup Fire Zone Comments By Date PLANNING REOUIREMENTS SAT|SF|ED. Bv Date Date lssued ZONE: SETBACKS: FRONT SIDE FACING STREET (FROI\4 C/L} INT. SIDE YARD REAB (FROM P/L} LAN E COUNTY DEPARTMENT OF ENVIRONM ENTAL |\4ANAG EMENT, 125 EAST 8TH AVE., EUG ENE, OREGON 97401 PHON E: 687-4394 POST THIS PERMIT ON MAIN BUILDING AT SITE c55-13 a Block- trss \, ,J IIf I t ] I i I i I - -t. i i ,*,t t {,.f ll t I I ' ",,..: \ I I {r I I L r#t!t# TRS, T Acreage or Lot Size Contractor's O.S. # APPLICANT'S NAME AND ADDR OWNER'S NAME AND ADDRESS JOB LOCATIO LANE COUNTY PERMIT Partitioning #-( ) Completed Subdivision Lot- Blo ck CONTRACTOR'S NAME AND ADDRESS Phone- Phone-- Phone-- Mailpermitto()Applicant()owner(}contractor.()PrefertopickUP.call-(owner,etc.)whenready. STRUCTURES NOW ON THE PROPERTY THlSPERMlTlsFoR#BEDRooMS-#PLUMBINGcoNNEcTloNL \I/ATER SUPPLY SEWAGE DISPOSAL--s.t. # TH IS PROPEBTY IS WITHIN ONE IV] ILE OF TH E CITY OF-. PLUIVIB ING BY - I hereby certify that the above starements are true and accurate, and that I have the following legal interest in the prcperty: -owner of record; -contract purchaser; - potential buyer; - realtor or agent. I f urther certily that (if not the owner) I am authorized to act for the owner of record, and that said owner is aware and approves oI this action. I hereby agree to comply with all applicable Codes relatinq to this permit. Fee Paid $- Signature () NEW ADDRESS () FACILITY PERTVIIT TO TRANSPORTATION DEPT Date ( )SPECIAL PlVlT. AREA. IVllN. ELEVATION:- SANITATION Minimum Septic Tank Capacity (Gallons) Drainfield Required - Lineal Feet Maximum Depth Date BUILDING a",nr""* Use classification By: Type of Construction -Group -FireZoneComments By: PLANNING REOUI REMENTS SATISFIED. By Date Date I fi: ZONE SETBACKS: FRONT SIDE FACING STREET (FROI\4 C/L) INT. SIDE YARD REAR (FROM P/L) LANE COUNTY DEPARTMENT OF ENVIRONMENTAL IVIANAGEMENT, 125 EAST 8TH AVE., EUGENE, OREGON 974O1 POST THIS PERNIIT ON MAIN BUILDING AT SITE c55-1 3 BLoG. pERMrr-WHrrE; BUTLDTNG -GREEN; pLUMBTNG -GANARy; sANrrATroN-GoLDENRoD; oFFtcEcopy-wHrrE PHONE:687 4394 trqq il Date: SITE INSPECTION Appaov e o R E ltrnx s Dorc2->8-7l,"rr..ro*D r sappRovEo FOUNDATION I NSP t0N AppRov Eo Rrur nx s D r s aepnovED oor, 6 -% -? ?%4I Nspecton FRAMING INSPECTION Appnoveo Re uanx s ./ ./ ootc 6'7-G -76 rNSPEcroRDrslppnovro LATH OR SHTETRO PICT I ON Ap pRov r okffi'Dr sappnoveo Drr r I xspecton aZ C F I NAL I NSPICT I ApPnov e o Reuenx s Dr SAPPRovED Dar r I Nspecron CERTIFICATE OF OCCUPANCY Reaov ro lssuE ReuaRx s D Nor Rrrov ro lssue D Dore-lNsre croR- A*Z Dote Permit No. CURB CUT PERMIT IN THE BOARD OF COUNTY COMMISSIONERS OF LANE COUNTY WHEREAS, the ottoched opplicotion hos been fully considered by the Boord of County Com- missioners of Lone County, ond'ii is the opinion ond iudgment of the Boord thot the soid opplicotion should be gronted, ond ihot o permit should be issued, now, therefore, it is hereby. ORDERED, thot q permit be ond is hereby issued to for plocing, building or constructing the following focility: upon the right-of-woy of County Rood No.Mile Post in strict conformity to the exhibits ottoched hereto, ond subiect to oll terms, conditions, ogreements, stipulotions qnd provisio ns contoined in the opplicotion o itted upon Co Rood Right nd permit, the Rules ond Regu s-of-Woy, os set forth by thebe Perm lotions Gov- Lone Mon-erning Focilities to uol 50.'190(2) ony Speciol Provisions: unty ondqmendments thereto,ony other opplicoble regulotions, low or ordinonce. I 2. 3 Drivewoy will be constructed in occordonce with the ottqched drivewoy opprooch specifico- tions (Drowing M98-50). Permitfee will be responsible for the immediote removol of oll mud, dirt ond debris from the roodwoy ond right of woy coused by his operotion, leoving the roodwoyond oreo in o neot, occeptoble condition. Sidewalks will be constructed in accordance with the attached sidewalk specifications and drawing M98-49. The Standard Curb Type shall be constructed unless otherwise specified. This permit is revocoble ot ony time, ond will be strictly odhered to ond no work other thon thot specificolly mentioned obove is hereby outhorized. This permit sholl be void unless the work herein contemploted sholl hove been completed be- lnspected ond Approved fore , 19-.. ExPires 19_. Approved by Boord of County Commissioners By Dote By WHITE - OFFICE TILE YELTOW _ REAI ESTATE Director of Public Works c74-t29 LJ PINK :RMITTEE ORANsE - BUIIDING & SANIIATION DEPT.