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Home My WebLink AboutPermit Mechanical 1977-10-13e7e877 *'.{rfLl TRS, TL Written Directions il^ ( ) Building Permit Acreage or Lot Size Partitioning #( ) Completed( )Pe APPLICANT'S NAME AND ADDRESS OWNER'S NAME AND ADDRESS, if different from a pplicant CONTRACTOB'S NAME AND ADDRESS lil permit or results of site feasibility study to ( ) r ) Prefer to pick up. Call Job Locatio IN RMATION SHEET ( ) Site Feasibility Study for Septic Tank. Number of sites- Test holes wi dy Subdivision Lot S\T Bloc k Phone hone Phone.- Applicant ( )Owner ( (owner, etc. ) when ready [) Contractor Contractors O. S. #(Vr\O/Z<l<13 STRUCTURES NOW CN THE PROPERT PROPOSED USE (this per il PROPEBTY IS WITHIN ONE MILE OF CITY 6 BEDROOMS WATER SUPPLY {existing or proposed well. etc. tf pubtic, name of system) SEWAGEDlsPosAL(existingorproposedseptictank,etc.}s.| PLUMBING BY Address .+***r* oFFtcE usE oNLy BELOW THIS LINE Irlrl*i{*}** Lv New Address Necessary E I ,J ( ) Facitity Permit Necessary SETBACKS: Front (FROM CENTERLiNE OF RCAO} ( ) Special Permit Area. [Vlinir.num Elevation Side Facing Street lnterior Side Yard Hear - {FBOI\,1 PROPERTY LINES) To: Planning/Building lnspector/Sanitarian/Surveyor This applicant appears to have a problem wit Your assistance will be appreciated. By Permit Processing Section Response By DEPARTMENT OF ENV I RONMENTAL MANAGEMENT Permit Processing Section 125 East gth Avenue 687-4394c55-12 Division 1tt .4 ( PERIVlIT # TRS, T JOB LOCATI LANE COUNTY PERMIT Acreage or Lot Size- Partitioning #-( )completed Subdivision- Contractor's O.S. #Lot -- B lock APPLICANT'S NAIVIE AND ADDRE SS Phone--- Phone-- Phone---- OWNER'S NAME AND ADDRESS CONTRACTOR'S NAME AND ADDRE Mail permitto ( )Applicant ( )Owner ( )Contractor. ( )Prefertopickup. Cait--(owner. etc.) when ready STRUCTURES NOW ON THE PROPERTY_- THIS PERMIT IS FOR .b B E D R OC I,{ S--_ -+ P LU I\,1 B I N G CO N N E CT I O r.J S--* TffATER SUPPLY SEWAGE DISPOSAL---s.l. # THIS PROPERTY IS WITHIN ONE MILE OF THE CITY OF- PLUIUBING BY I hereby certily that the above statements are true and accurate, and that I have the {ollo\ding legal interest in the propeny: _owner of record; -contract purchaser; - potential buyer; - realtor or agent. I lurther certify that 1if not the owner) I am authorized to act for the owner oirecord, and that 9id owner is aware and approves of this action. I hereby agree to comply with all applicable Ccdes relating to this permit. Fee Paid S-Signature Date __..----( } NEW ADDRESS ( } FACILITY PERMIT TO TBANSPORTATION DEPT.-- ! SPECIAL PI\4T, AREA. I!1IN. ELEVATION: --SANITATION BU ILD ING Minimum Septic Tank Capacity (Gallons) Drainfield Required - Lineal Feet l.'laximum Depth Type of Construction ___Group ----_Fire Zane -omments: ;--""* Use classificatior: B Date By UdLE PLANN ING REOUI EEMENTS SATISFI ED By Date Date lssuedZONESETBACKS: FRONT SIDE FACING STREET (FROr\{ CiL) lNT. SIDE YARD REAF (FBONl P/L) LANE COUNTY DEPARTINENT OF ENVIRONMENTAL IVIANAGEIVIENT, 125 EAST BTH AVE., EUGENE, OREGON g]4O1 POST THIS PERMIT ON MAIN BUILDING AT SITE RI NA DFDN'IT ' v,ni i E; trurLUil\G GFiEEN: pi-uruillNG -- CANARy; SANITATTON GOLfjENROD; OFFTCE COF r !!rjt rE c55-1 3 PHONE: 687-4394 E ' SQLtt-tc1= | r,Lo o[-nttcl+ Z- l<>\- -+-E+.-t: _ \ {. ln ) ewM Y PE R IVIIT TRS, TL Acreage or Lot Size Contractor's O.S. # APPLICANT'S NAME AND ADDR OWNER'S NATVIE AND ADDRE LANE COUNTY PERMIT Partitioning #----( ) Cornpleted Subdivision JOB LOCATION L- 1, C- tL- t4-g> Lot , B loc Mail permitto ( )Applicant ( )Owner ( )Contractor. ( )Prefertopickup. Calt-(owner. etc.) when ready CONTRACTOR'S NAME AND ADDRESS , STRUCTURES NOW ON THE PROPERTY_-, Phone Phone- Phone---- = B ED ROCI\4S__+ P LUI\48 I NG CO N N E CT tO hjs___ Use Classification THIS PERMIT IS FOR- WATER SUPPLY - SEWAGE DISPOSAL-s.i. # THIS PROPERTY IS WITHIN ONE MILE OF THE CITY OF- PLUI/IBING BY I hereby cenity that the above stalements are true and accurate, and that I have the lollouJing legal interest in the property: _owner of record; -contract purchaser; - potential buyer; - realtor or agent. I further certity that (if not the owner) I am authorized to act ,for the owner of record, and thal said owner is aware and approves of this action. I hereby agree to comply with all applicable Codes relating to this permit. Fee Paid $ Signature I NEW ADDRESS () FACILITY PERMIT TO TRANSPORTATION DEPT Date ( )SPECIAL PlVlT. AREA. NllN. ELEVATTON:__-- SANITATION BUILD|NG Minimum Septic Tank Capacity (Gallonsl Drainfield Required - Lineal Feet l.4aximum Depth Type of Construction roup __* Fire Zone i -omments By Date Comments B Date PLANN ING REOUI BE[NENTS SATISF lED. By Date Date lssued ZONE SETBACKS: FRONT SIDE FACING STREET (FROTV Cit_) tNT. slDE YARD (FROM PiL)REAR LANE COUNTY DEPARTMENT OF ENVIRONMENTAL N4ANAGEMENT, 125 EAST BTH AVE., EUGENE, OREGON 97401 POST THIS PERMIT ON MAIN BUILDING AT SITE BLDG. PERMIT - UJHITE; BUILDING - GREEN; PLUMBING - CANARY; SANITATIoN -_ GoLDENRoD; oFFICE CoPY .VYTli E c55-1 3 PHONE:687-4394 -4?r5a7 trcq SITE INSPECTION Appnov E o Rruanxs D Drsappnove o f-7 Dar r I r.rspr_ c lon FOUNDATION INSPECTION AP pRov E o Rruaars n DrsappRovEo fa Darr I ruspecron FRAMING INSPECTION AppRovro Reuanx s f/ DrseppnovE, D Dare l Nspr cron LATH OR SHTETROCK AppnovrD RrxaRx s I NSPECT I ON Dt slppnovEo 0a I nser cton FINAL INSPICTION AP pRov E o Rrua nx s d DrsappRove o D oarr/2-//i-:Et7 lr.tspe cron CERTIFICATE OF OCCUPANCY Rraoy ro lssuE Rruanr s / / Nor Rraov ro I ssuE t--7 Drrr I Hsprcroa TRS, TL P lot PIan Permit /l Permit Subdivision Lot *3 AE '/eE Job Locatton (Add Pernlr lt /36?a ) 26G7 For For r Pptpe 6Ld, Permlt /l For - For ForFor Permlt Permlt Block E \ s i1 80' l"-30' scALE T^ to(-+-- \ r | ''l- Irlt- - - -. I-) t ,/ )>- u\ii 2S 2c: c, D o 4 I l c74-T50 Vlclnlty Map N I