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Home My WebLink AboutPermit Building 1977-09-223.2 #70 y'PERTVIIT # Blo ck TRS, TL JOB LOCATIO Partitioning LANE COUNTY PERM!T Acreage or Lot Size Contractor's O.S. # ) Completed Subdivision Lot APPLICANT'S NAIVIE AND ADDR Phone_- OWNER'S NAME AND ADDR ESS Phon CONTFACTOB'S NAME AND ADDRESS Phone-lv]ailpermitto(}Applicant(}owner(}contractor.()PreIertopickup.call-(owner,etc.)whenready. STRUCTURES NOW ON THE PROPERTY \A/ATER SUPPLY SEWAGE DISPOSAL rHlS PERIVIIT lS FOR Fee Paid $- Signature il NEW ADDRESS () FACILITY PERTVIIT TO TRANSPORTATION DEPT # BED ROOIMS-# PLUIVIB I NG CONNECT IONS s.t. # Date THlSPRoPERTYlSWlTHlNoNEMlLEoFTHEClTYoF'PLUIVlB|NGBY I hereby certify that lhe above statements are true and accurate, and thal I have the following legal interest in the property: -owner of record; -contract purchaser; - polential buyer; - realtor or agent. I further certify that (iI not the owner) I am authorized to act for the owner oI record, and that said owner is aware and approves ot this action. I hereby agree to comply with all applicable Codes relating to this permit. ! SPECIAL PIVIT. AREA. IVIIN. ELEVATION SANITATION BUILDING lVlinimum Septic Tank Capacity (Gallons) Drainfield Required - Lineal Feet Maximum Depth Date Type of Construction -Group Use Classification Comments Fire Zone vOmments By By Date: PLANNING REOUIREMENTS SATISFIED. B ZONE SETBACKS: FRONT Date Date lssued SIDE FACING STREET (FROIV] C/L) INT. SIDE YARD REAR (F ROM P/L) LANE COUNTY DEPARTIVIENT OF ENVIRONIVIENTAL TVIANAGEMENT, 125 EAST 8TH AVE., EUGENE, OREGON 97401 POST THIS PERMIT ON MAIN BUILDING AT SITE c55-13 BLDG.PERMtT-WHrrE; BUtLDtNG-GREEN; pLUMBTNG-GANARy; sANrrATroN-coLDENRoD; oFFrcEcopy-wHrrE PHONE:687-4394 trqq \ ()721 2u3z^71.TRS, TL I&itten Di-rections ./6 (r() gu;toing Permit AcreageorLotsize /On >' / /L Partitioning #(X Completed( ) Pending APPLICANT'S NAME AND ADDRESS OWNER'S NAM E AND ADDBESS, if different f Job INFORMATION EET ( ) Site Feasibility Study for Septic Tank. Number of sites- Test hol will be rea Subdivision t B coNTTACTOR',Si' \l pCrmit or resu t ;)4refer to pick NAME AND ADDRESS Its of site feasibility study to ( up. Call STHUCTURES NOW ON THE PROPER PROPOSED USE (this permit) WATER SUPPLY pplicant ( )Owner ( )ractor ( owner, etc. ) when ready 74.2:='lP-- P Ph Phone ? ?€* *262 Contractors O. S. #(zs-r # snlnoous (existing or proposed well, etc. lf public, name of system) 2ne4K"t/ ?J SEWAGE DISPOSAL PLUMBING B PROPERTY IS WITHIN ONE MILE OF ITY rr**r***********r**t+*+****++****+******+**FICE US (existing or proposed septic tank, etc.) S.l Address 1 LY BELOW THIS LIN f +** +*+*+**r+ * *d***+** *+***+*+***+++++ ** { + + + ( ) New Address Necessary ir E ( ) Facility Permit Necessary SETBACKS: Front Side Facing Street (FROM CENTERLINE OF ROAD} ( ) Special Permit Area. tVlinirnum Elevation lnterior Side Yard Rear' - (FROI\.4 PROPERTY LI NES) To: Planning/Building lnspector/Sanitarian/Surveyor This applicant appears to have a problem wit Your assistance will be appreciated. By Perrnit Processing Section Response: By DEPARTMENT OF ENVIRONMENTAL MANAGEMENT Permit Processi ng Section 125 East 8th Avenue 687-4394css-1 2 D tvrston lr I I I \ --.'<h\lr:- - '_ -- _I I \'!.-.r,tq I I I t I I .l I -"1 *eJ ., E^l-\\at ! -+- -:' - \/E-B-H., " -r=r-\Y-:B{. - -. - --.- -, -r'----+iry-s'.':.#r'-'irt'rffis 5,4.-Y-- --\a-'".s\.Qs -'('+ L=>!r-\--\-\ -D\L\' G-€r' ,l (, il'' :0, 1il tl .rl (,; *G t,t lj ). vr a 3r J 0: ,i il' ,'/ >rfo ieo.O -:--:' . -=xe!i*,:E--* ----z-A.-o o ia' J --_q.. Q'i 0 r0 j q ( t, i, a I L :x<;;qa I It \<-+).<5 .. t' I I I I r,u \\'o Il II : t 16-+-5- #Zqoo C TRS, TL Job Lo Permlt Pernit Pernit (Addre Pernlt /l Permlt Permlt ForFor For ForPlcrt PIan Subdivisiot- Lot-Block lr For For ) c74-L50 Vlclnlty Map N ((' ) \, PERIVIIT # JOB LOCATIO .J} TRS, T LANE COUNTY PERMIT Acreage or Lot Size- Partitioning ) Completed Subdivision Contractor's O.S. #Lot Bloc APPLICANT'S NAIVIE AND ADDRE qq OWNER'S NAME AND ADDRESS CONTBACTOR'S NAME AND ADDRESS Phon e Phone- Phone- lVlail permitto ( )Applicant ( )Owner ( )Contractor. ( )Prefertopickup. Call-(owner, etc.) when ready STRUCTUFES NOW ON THE PROPERTY THlsPERl\4lTlSFoR#BEDRooMS-#PLUMBlNGcoNNECTloNL Date - \A/ATER SUPPLY SEWAGE DISPOSAL s.l. # THlSPRoPERTYlSWlTHlNoNEMlLEoFTHEClTYoF.PLUlVlBlNGBY 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 turther certify that (iI not the owner) I am authorized to act Jor the owner ol record, and that said owner is aware and approves of this action. I hereby agree to comply with all applicable Codes relating ro rhis permit. Fee Paid S-Signatu re NEWADDRESS FACILITY PERI\4IT TO TRANSPO RTATION DEPT.- SPECIALPIVIT.AREA. MIN.ELEVATION SANITATION Minimum Septic Tank Capacity (Gallons) Drainfield Required - Lineal Feet Maximum Depth Date BUILDING Type of Construction se Classification roup Fire Zone Comments By:By Date PLANNING REOUIREMENTS SATISFIED. B ZONE SETBACKS: FRONT Date Date lssued: SIDE FACING STREET (FROIVI C/L) INT. SIDE YARD REAR (FROM P/L) LANE COUNTY DEPARTIVIENT OF ENVIRONIVIENTAL IVIANAGEIVIENT, 125 EAST BTH AVE., EUGENE, OREGON 9]4O1 POST THIS PERMIT ON MAIN BUILDING AT SITE C55-1 3 BLDG. pERMtr -wHlrE; BUtLDtNG - GREEN; pLUMBtNG - cANARy; sANtrATtoN - coLDENRoD; oFFtcE copy wHtrE PHONE: 687-4394 Comments: SITE INSPECTION Ap pRov E o Reuenx s Drsrppnoveo Dare I Nseecton FOUNDATION INSPECTION Ap pnov r o DlsAPPRovEo Dr sAPPRovEo Darr I ruspecron Reurnx s FRAMING INSPECTION AppRovro MARK S oorz/d -"(-?? ?- I NSPEcToR -2- LATH OR SH NSPECT I ON D r sappnoveo Dar r Z-I rspectonAp pnov r o Rrurnxs FINAL INSPECTION Ap pRov e o ReuaRx s Dr sAPPRovEo oo,, 1-z{ 7 /9rR-I NspectoR CERTIFICATE OF OCCUPANCY RErov ro lssue D Nor Rerov ro lssuE D ReurRx s Dnre I NSPEcToR D Zaal s PERIVIIT # JOB LOCATION LANE COUNTY PERMIT Partitioning #-( ) Completed Subdivision Lot Block- RS, T Acreage or Lot Size Contractor's O.S. # APPLICANT'S NAME AND ADDR trcs OWNER'S NATVIE AND ADDRE lVlail permitto ( )Applicant ( )Owner ( )Contractor. ( )Prefertopickup' Call CONTRACTOR'S NAIVIE AND ADDRESS (owner, etc.) when ready Phone Phone Phone s.t. # STRUfiURES NOW ON THE PROPERTY THlsPERMlTlSFoB#BEDRooML#PLUlv]BlNGcoNNEcTloNL \A/ATER SUPPLY SEWAGE DISPOSAL THlSPRoPERTYlSWlTHlNoNElVllLEoFTHEClTYoF.PLUlVlBlNGBY 7t:I hereby certify that the above statements are true and accurate, and that I have the following legal interest in the propert -owner of record; T@r - -contract purchaser; - potential buyer; - realtor or agent. I further certify that {it not the owner) I am authorized to act for the owner of record, and that said owner is aware 6nd approves of this action. I hereby agree to comply with all applicable Codes relating to this permit. Fee Paid $-Signature Date I NEW ADDRESS il FACILITY PERIVIIT TO TRANSPORTATION DEPT.() SPECIAL PIVIT. AREA. IVIIN. ELEVATION SANITATION lVlinimum Septic Tank Capacity (Gallons) Drainfield Required - Lineal Feet Maximum Depth Date BUILDING Type of Construction se Classif ication Comments By roup Fire Zone IJ Comments: By Date PLANN ING REOUI REIVIENTS SATISFIED. By:Date lssued: ZONE SETBACKS: FRONT SIDE FACING STREET (FROIVI C/L) INT. SIDE YARD REAR (FROIVI P/L) LANE COUNTY DEPARTIVIENT OF ENVIRONIVIENTAL TVIANAGEIVIENT, 125 EAST BTH AVE., EUGENE, OREGON 974O1 POST THIS PERMIT ON MAIN BUILDING AT SITE C55-13 BLDG. PERMtT - wHtrE; BUtLDtNG - GREEN; pLUMBtNG - GANARy; sANtrATroN - GoLDENRoD; oFFtcE copy - wHtrE PHONE:687 4394 Date: &#rroo* PLUMB ING GROUNU./ORK AppRovro @ RrMrnx s Dtsappnoveo D D*,-?/a?bJ pb I Nsercron GAS PlPl NG GROUNDT^/ORK D DrsappRovrD D Dar eAP PRov E D Rrua nx s I rusprcron ROUGH PLUMBING Appnoveo n DrsappRovro D Dorr-/O&y'g Rexanxs I ruspecron ROUGH GAS PIPING Ap pnov E o ReManx s D t sapPRovro Darr I rus pr croR l F I NAL PLUMB I NG APPRovED n Drsrppnoveo Rruanrs Dart 1 2- ?=? lNspe ctoR n * FINAL GAS PIPING Ap pnov e o RrttaRx s D r srppRovro Dare I rusprcron CTRTIFICATT OF OCCUPANCY Rrrov ro lssue ReuaRxs D Nor Reaov ro tssuE D Drre I NsPEcroR -7 S,T t'7-03*Job Location (Street, mile post AAb J il(* De,UE- FOR SANTTARIAN'S USE ON LY: fl tystem Approved fl System Disapproved fl Needs Correction COMMENTS: Si oate'/6-/ FOR INSTALLER'S USE: Trench Depth Flller Depth ile Subdivision Lot- Block - PIot Plan { Tank Capacity Manufactu lVleasured distance to well from tank nf ield lo'/lousE- fr t \0 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 Management, Public Service Building, 125 East 8th Avenue, Eugene 97401 , ?o/ ulF o r-r mm -A P6 +o- co N 2 $J -0 ut =F d\)? t? }CJi N 0Ut(!) L E o) E '(E o) E(,z J'Pc tq =o- o- ,i rolE0 d( IIJE oI Sca le m g P @C c1 I Nater co\' Lat ,q77 !B'u 'nt) 1*jO$0 Pol\t ;o i-) -. riY geFf'o f" nk DT c55-1 1 ?