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Home My WebLink AboutPermit Building 1973-06-05IANE COUNTY ''IILDING PERMIT OR MOBITE HOM' ISE APPLICATION PERMIT TYPE _ BUILDING MOBTLE HOME I OSC REG. # MAITING ADDRESS PERMTT # RTY OWNER PROPERTY TEGAT DESCRIPTION tOI_BLOCK-SUBDIV. IWP RANGE tUDE POST OFFICE MAIL RESS PHONE METES&BOUNDSEYES ATTACHED NO S TAX TOT CENSUS TRACTo- DESCRIBE EXISTING STRUCTURES ON PROPERTY IF ANY APPLICANT NAME AND MAITING ADDRESS FOR MOBILE Number of Bedrooms SEWAGE DISPOSAT PUBI.IC BE BUITT THIS PERMIT SEPTIC TANK t]oTHER ! PROPERTY SIZE-WIDTH Connect to Existin Sew TYPE CONSTRUCTION PLUMBING INSTATTED BY OWNER OTHER E NAME PLANS YES NO SIGNATURE OF APPTICANT AREA or New BEDROOMS VATUATION FACILITY PERMIT YES NO DATE TE ACCESS TO PROPERTY _ ROAD OR DEPTH PERMIT ONLY SQ. FT FEES WATER SUPPTY / PUBHC "/ orHER B[DG. WASTE DIS. PtU'ItBING PTAN REVIEW PARK TRTR. TOTAT ";. DO PTUMBING FEES FIXTURES cAsH E CHECK CONNECTION FEE PUBTIC WATER CONNECTION FEE a 3 FEE D DATE .1k 1 COUNTY BUILDING & SANITATION SPECIFICATIONS MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GA[. TYPE OF STRUCTURE DRAIN FIEI.D &EQUIRED tIN. FT OCCUPANCY TRENCH WIDTH FT ZONE OR SQUARE t REAR YARD USE CTASSIFICATION UTIT. EASEMENT t Form # 655-12 REAR b'.tr-7i Dote - FT. FROM CTR. OF ROAD RIGHI OT WAY srDE rNr. 5 slDE EXT.FRONT Direclions to Find Property: PI.ANNING INSPDole*C- COPY I _ OFIICE COPY 2_JOURNAT COPY 3 - AUDIT I IANE COUNI - BUILDING PEtur,iT OR MOBIIE HO..-; USE PERMIT BUTLDTNG E MH I PERMIT NO. PROPERTY OWNER MAII-ING ADDRESS PHONE CONTRACTOR MAILING ADDRESS PHONE PROPERTY LOCATION - INCLUDE POST OFFICE PROPERTY LEGAI DESCRIPTION _ METES, BOUNDS RANG E SECTION oNAXT CODE CENSUS TRACT ,4, I EXISTING STRUCTURES ON PROPERTY IEGAI. ACCESS TO PROPERTY PROPERTY SIZE - FT. WIDTH DEPTH AREA FOR MOBILE HOME PERMITS ONLY No. of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT Connect to Existing Sewoge TYPE CONSTRUCTION New m BDRMS VALUATIONse. FT SEWAGE DISPOSAT PUBLIC tr SEPTIC TANK tr OTHERE PTUMBING INSTALTED BY OWNER E OTHER: NAME BU ITDING WASTE DISPOSAL PTUMBING PI.AN REVIEW PARK TRAILER TOTAT F EES WATER SUPPTY PUBUC !tr oTHER s $ COUNTY BUILDING & SANITATION SPECIFICATIONS MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GAt.OR 5Q. FT TYPE OF STRUCTURE OCCUPANCY ZONE PUBLIC UTIL. EASEMENT BLDG. SETBACKS FT. FROM CTR. OF ROAD RIGHT OF WAY FRONT SIDE INT. SIDE EXT. USE CLASSIFICATION REAR AUTHORIZED SIGNATURE _ DATE DATE BLDG. PERMIT _ WHITE OFFICE COPY _ WH ITE COUNTY TAX _ PINK PLUMBING _ CANARY BUILDING _ GREEN SANITATION _ GOTDENROD Construction lo comply with uniform building code ond county regulolions covering plumbing ond sewoge disposol. All buildings require o certificote of occuponcy before being occupied. (See Stotemenl on Reverse Side) (posT THrs PERMTT oN MAIN BrDG. AT SITE) IANE COUNTY, BI.DG, & SAN. DIV., COURT HOUSE, EUGENE, OREGON 9740I ronu t655-13 APP[. NAME & MAITING ADDRESS DRAIN FIETD REQUIRED TIN. FT TRENCH WIDTH FT. BU I LD ING S ITE EVALUAT ION /,L Building Permit Appl ication No. ,tA.c/-ZJ S i te I nspect ion Pre-Perm i t I nvest i gat ion AX LOT ^adr-{ttr6 () ) ADDRESS PHONE DATE LANE COUNTY PLANNING OEPART}4ENT NOT l. Zoning Ordinance 2. Subd iv is ion Ord in 3. Requ i red Access aool icable () (tr_ fl 1; G-/J=- { ({ (-)/ NO YES NAI'IE () () () () () ( 4. Bu ild ing S ite (Area, Width, 5. other t."" "ol,l:l::i"' setback) ( () () () CO}II.IENTS: BUILDlNG INSPECTION SECT!ON 6. Pl ans Submitted 7. Soi I Stab i I ity (foot ings) 8. Flood Plain 9. Other (see Conments) NOT NO EEI icable ---TT-() dl () M () SYE ) () NA}'tE DATE ()()(.i 4-6' COMMENTS: SAN ITAT ION SECT ION 10. Sewage Disposal I l. Usable Area 12. Water Supply 13. 0ther (see Corments) NOT 6Et icable() NO w () NA}4E 6 7 -5x 6 ) () () () ) J COH}4ENTS: TO APPL ICANT: ' Your Building Permit / Site ln 2 ec ton: Can be approved. Kg Cannot be approved at thi time as indicated on item N0.above. Questions and further information on items I through 5 contact the Lane- COUNTY PLANNING DEPARTI.IENT. Questions and further information on i6.; 5 throug h l3 contact the Lane County Buildlng and_Sa!rt_qtloq_givieion. l./ill be held in this off ice until you can resolve the problems indicated. ls be i ng retu rned. ,! i : . ! Your building permit appl ication fee is being returned under separate cover. LANE COUNTY PLANNING DEPARTI.TENT LANE COUNTY BUILDING E SANITATION DIVISION f35 Sixth Avente East, Eugene, Oregon 97401 135 Sixth Avenue East, Eugene, 0regon 97401 PH0NI: llr2-llil ExT. 23t pHoNE: 342-t3il EXT. 4n M I 6 X I *() () v DATE a DATE LANE COUNI - BUITDING PERMIT OR MOBITE HOrvrE USE PERMIT PERMIT NO.BUILDING MHE PROPERTY OWNER MAIIING ADDRESS PHONE CONTRACTOR MAITING ADDRESS PHONE PRO PERTY I.OCATION - INCI.UDE POST OFFICE PROPERTY TEGAT DESCR IPTION - METES, BOUNDS RANG E SECTION TAX LOT NO CODE CENSUS TRACT EXISTING STRUCTURES ON PROPERTYAPPL. NAME & MAILING ADDRESS tEGAt ACCESS TO PROPERTY PROPERTY SIZE _ FT. WIDTH DEPTH AREAFORMOBILE HOME PERMITS ONLY No. of Bedrooms STR UCTURES TO BE BUILT THIS PERMIT Connect to Existing Sew TYPE CONSTRUCTION m tr New System SQ. FT BDRMS VALUATION SEWAGE DISPOSAT PTUMBING INSTAI.TED BY PU BL IC BUITDING WASTE DISPOSAT PTUMBING PtAN REVIEW PARK TRAII.ER SEPTIC TANK OWNER WATER SUPPLY OTHER: NAMEOTHE FEES PUBLIC tr N OTHER TOTAI- COUN TY BUILDING & SANITATION SPECIFICATIONS MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GAt. DRAIN FIETD REQUIRED I.IN. FT TRENCH WIDTH FT OR SQ. FT t TYPE OF STRUCTURE OCCUPANCY ZONE PUBLIC UTIL. EASEMENT BLDG. SETBACKS . FT FRONT FROM CTR. OF ROAD RIGHT OF WAY SIDE INT. SIDE EXT. USE CLASSIFICATION REAR AUTHORIZED SIGNATURE _ DATE DATE BLDG. PERMIT _ WHITE OFFICE COPY _ WHITE COUNTY TAX - PINK PTUMBING - CANARY BUITDING _ GREEN SANITATION _ GOTDENROD 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 ulotions o certificote (posT THIS PERMIT ON MAIN BLDG. AT SlrE) IANE COUNTY, BLDG. & SAN. DIV.. COURT HOUSE, EUGENE, OREGON 9740I .FoRNr = C55- l3 SITE INSPECTION AppRovro Rruaax s DTSAPPRovED D Datr I Nseecron FOUNDATION I NSPECTION APPRovED REMA RK S D r s APPRovEo Dar r l nsprcron FRAMING INSPECTION Appnovro /-7 DrsappRovEo f / Drrr I NSPEcToR REMARK S LATH OR SHEETROCK I NSPECT I ON Dr sappnoveo I NSPEcToRAepRoveo RruaRx s rINAL INSPTCTI Dr SAPPRovED oo* b- fi -7)lrusprcAp pRov E o RrManx s CERTIFICATE OF OCCUPANCY ReaoY To lssuE REuanx s Nor Reaov to lssuE I NSPEcToR /o t/- f l &,o72 Dare e"O -3oo D Dore_ J TNDIVIDUAL SE!{AGE DISPOSAL SYSTEM RECORD nstaller! ComPlete toP Part c crm to signature and return both copies to Lane County Building Sanitation Department. No8Yes BasementBedrooms7Baths ./14 Installer s Name SS tozt-73 ru s ank 2 i ewmount No.v r Public C Ft. from well Steel ! Concrete I No. Compartments 1y other-List Gal. Capacity. f,ength Applican Name M ailing Address widrh s Ft Diameter Depth o T sposa Distribution Box:Yes I No E Other D str on- Feet from Foundation Lot Line Front belowI3. 4. 5. 6. 1-rrri' Emerald Pools orth Trench ltotal sqJFt.between width 3 lr..J4alri""", -? Filler rype I Filler depth t?iX?" in. See instructions Date For Sanitarian Use OnlY: Signature Date:6/r,1r3 Sf n7,q 7ttj4' . :, _ tl .t t .:, ; el .-J i lf a li i In tTo p p(lpprovea, System Installation Conforms to Current Standards tl Disapproved: Does Not Conform to Current Standards Remarks:4 ture Lane CountY Buitding & Sanitation San tar sS c55-il .:_., 1... t /'