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Home My WebLink AboutPermit Building 1977-10-284ax str Ytrrlf. Lot 2hoo , I Ur,"* Ui"tta, s 3 Lueo, ad./L V w 3c;r1 ) ,il2 !^Iritten Directions INFO TION SH (X) guitolng Permit 1 ( ) Site Feasibility Study for Sep tic Tank. Number of sites Acreage or Lot Size ioa <)?d Test holes ready Partitioning #- ( )Completed( ) Pending APPLICANT'S NAME AND ADDRESS OWNER'S NAME AND ADDRESS, if different f.rom appltn De licant's .ONTRACTOR'S NAME AND ADDRESS c.l ( il permit or results of site feasibility study tL tYl Applicant ( ) Owher ( XiContra"tor 1 ) Prefer to pick up. Call ( owner, etc. ) when ready STRUCTURES NOW ON THE PROPERT A PROPOSED USE (this permit)$r n WATER SUPPLY *a Location Subdivision Lot 4tt Bloc Pnon"?%,f ?Z€ Phone ----= {a,^t-Phone h nt Qomtf, ,f,e f ,,,SEWAGE DISPOSA PLUMBING B t 7 Contractors o. s. # OOF/ existing or proposed well, etc. lf public, name of systeml (existing or proposed septic tank, etc.) S.l 4 Addressh (t ttorrRTY rs wrrHrN oNE MrLE oF crrY **r..r..oFFtcE usE oNLY BELOW THtS LINE***I*i**.ri** ) New Ad 2T"rY ( ) Facility Permit Necessary SETBACKS: Front Side Facing Street (FROM CENTERLINE OF ROAO) ( ) Special Permit Area. Minimum Elevation lnterior Side Yard - Rear (FROM PROPERTY LINES} ztjN E To: Planning/Building lnspector/Sanitarian/Surveyor This applicant appears to have a problem Your assistance will be appreciated. By Permit Processing Section Response By DEPARTMENT OF ENV I RONMENTAL MANAGEMENT Permit Processing Section 125 East 8th Avenue 687-4394c55-1 2 D ivision ?ttts p (lo/,,o f/ &a*r' ) *e a1fi*Jr a o d: TRS, TL JOB LOCATIO Acreage or Lot S t7e LANE COUNTY PERMIT Partitioning #-( ) Completed Subdivision Lot- BlContractor's O.S. # APPLICANT'S NAME AND ADDR FSS OWNER'S NAME AND ADDRE qq CONTBACTOR'S NAME AND ADDRESS Mail permit to ( ) Applicant ( ) Owner () Contractor. ( ) Prefer to pick up. Call -.. a Phone- Phon Phon (owner, etc.) when ready STBUCTURES NOW ON THE PROPERTY ' ' '" THIS PERMIT IS FOR # BEDROOIVIS # PLUIVIBING CONNECTIONS tr',/ATEB SUPPLY - SEWAGE DISPOSAL_._'-_- S.I. # Fee Paid $- () NEW ADDRESS () FACILITY PERMIT TO TRANSP ORTATION DEPT.- () SPECIAL PIVIT. AREA. Signature Date - SANITATION Minimum Septic Tank Capacity (Gallons) Drainfield Required - Lineal Feet Maximum Depth BUILDING Type of Construction c"n..,,"""1, Use classification roup -Fire Zone Comments B Date B Date Date lssuedP LANN IN G REOUIREMENTS SATISFIED. B V:Date ZON E:SETBACKS: FRONT SIDE FACING STREET (FROtVI C/L)INT. SIDE YARD REAR (FROIVI P/L) LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE., EUGENE, OREGON 974O1 POST THIS PERMIT ON MAIN BUILDING AT SITE C55.1 3 BLOG.PERMIT_WHITE; BUILOING-GREEN; PLUMBING-CANARY; SANITATION-GOLOENROD; OFFICECOPY-WHtTE PHONE: 687 4394 3C62-7f-Iane county [^later Pol I uti on Control Di v'i s i on Envi ronmental Manaqement Department I 25 East 8th Avenue Eugene, 0reqon 97401 L0CATION: Twp.lTs nunq.-L Secti on Q2 Tax Lot *2tOO ( Conrp Lete the Number of drainlines Length of drainlines if apolicable)toi *'-=-Btock * ) GL No- / o-)1-d J system the gro a oth oc Subdivision Name:Kue^u U I have no information that the existing subsurface sewage disposal located on this property has ever failed by discharqing sewage upon und surface or into public waters, by clogging or backing up, or iner manner. I have information that the existing subsurface sewage disposal sys- ated on this property has failed in the oast by discharging sewage upon th e ground surface or into public waters, by cloggin g or backing up, orin some other manner, and that: The system has not been repaired. The system has been repaired and has operated continuously since the repair without other failures. Date(s) repaired- I have had personal knowledge of the performance of the exis ing subsurface sewage disposal system located on this property for years and - months. The existing sewage disposal system consists of: Septic tank has a bOO ga1 1on capacity.a b c d The existing septic system was installed under Lane County Eui'lding Permi t ** lot92- Lra This system last served a dwelling havi ng 2 bedrooms (include all rooms which could be used as a bedroom, though actual I used for other purposes such as for a den or a sewing room) OR;-i for commercial use, this system last served an establishment having-employees, and-gallons/ day sewage flow. Th'is system was last used on fuar^t ln @ (Date). In case of an addition, the new portion will be-feet away from the existing drainfield. APPLICANT:/ PROPERTY OWNER:CS DATE: c74-t56 Distribution box? Yes rl + (.^ 6 (Date), -l WATER POLLUTION CONTROL DIVISION / 125 EAST 8TH AVENUE / PUBLIC SERVICE BUILDING ENVIRONMENTAL MANAGEMENT DEPARTMENT EUGENE, OREGON 97401 / (503) 687-4061 t_SIruo t ) ) ) ) t I I ( N L\lrl i: ul I loZ,1' J q,fu N o n. : N () N ll lT) ) ,^,rl ; I.. i 1l ,), I L r t^ lr' /(' !, t I f.u/c,/v, ta0t 0a -a t t- 0 x t I' d t! I t 0 ,i r' n il -! rAl. r T / I ,l \i I t,N t,r I \' ll'll l. II u'J .- F!'t,t$;{ e'fr I F i l-- Wrr V=IDE L,s.N=- I I I I qt TRS, T Acreage or Lot S Contractor's O.S. + APPLICANT'S NAME AND ADDRE LANE COUNTY PERMIT Partitioning#-( )Completed Subdivision JOB LOCATIO Lot- Block OWNER'S NATVIE AND ADDRE CONTRACTOR'S NAME AND ADDR Phon ? Mail permitto ( )Applicant ( )Owner ( )Contractor. ( )Prefertopickup. Call-(owner, etc.) when ready Phone- STRUCTURES NOW ON THE PEOPERTY THIS PERMIT IS FO # BEDROONNS # PLUMBING CONNECTIONS WATER SUPPLY-- SEWAGE DISPOSAL- S.I. # THlSPRoPERTYlSWlTHlNoNEMlLEoFTHEClTYoF.PLUlVlBlNGBY I hereby certify that the above statements are true and accurate, and that I have the Ioilowing legal interest in the property: -owner ot record; -contract purchaser; - potential buyer; - realtor or agent. I further certily that (i{ not the owner) I am authorized to act for the owner of record, and thatsaid owner is aware and approves of this action. I hereby agree to comply with all applicable Codes relating to this permit. Fee Paid $Signature Date NEWAODRESS ( } FACILITY PERMIT TO TRANSPORTATION DEPT.- () SPECIAL PI/]T. AR EA. I\4IN. ELEVATION SANITATION Minimum Septic Tank Capacity (Gallons) Drainfield Required - Lineal Feet Maximum Depth BUILDING Type of Construction c"..""8 Use classification roup -Fire Zone iomments: Date: PLANNING REOUIREMENTS SATISFIED. By: Date Date lssued ZONE:SETBACKS: FRONT SIDE FACING STREET (FROIVI C/L) INT. SIDE YARD REAR (FROM P/L) LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE., EUGENE, OREGON 97401 POST THIS PERMIT ON MAIN BUILDING AT SITE C55-1 3 BLDG.pERMtT-wHtrE; BUtLDtNG-GREEN; pLUMBTNG-GANARy; sANrrATtoN-GoLoENRoD; oFFtcEcoPY-wHlrE PHONE: 687-4394 trce Bv:By: Date: SLAB FLOOR PLUMBING GROUNDu/ORK APPRovEo D Drsrppnovro Dnre I ruspecton Rru 7 1PA- GAS PIPING GROUND/ORK Appnov r o Reuenx s D DrsappRovro D Dare_I Nspecroa ROUGH PLUMBING Apenoveo F DrsrppRoveo Rruanx s oare / 2-a o-)T tHspe cron ROUGH GAS PIPING APPRovED Rerrnr s Dt slppRoveo Dare I rspecron FINAL PLUMBING APPRovEo M Drsrppnove, D Re ulnx s oart / - 3o* 7L tn""rr'ro^ e * FINAL GAS PIPING AppRoveo D Drsrppnove" D Re ttlnx s Dare I rs pe cron CERTIFICATE OF OCCUPANCY Reeov ro lssuE Re i{anx s D Nor Reaoy ro lssue D Dare I rsprcron TRS, TL JOB LOCATION Partitioning # LANE COUNTY PERMIT Acreage or Lot Size Contractor's O.S. # ) Completed Subdivision Lot Block- APPLICANT'S NAME AND ADDRESS Phone- CONTRACTOR'S NAME AND ADDRESS OWNER'S NAME AND ADDR Mail permitto ( )Applicant ( )Owner ( )Contractor. ( )Prefertopickup. Call- Phone Phone STBUCTURES NOW ON THE PROPERTY t-HtS PERMIT tS FOR # BEOROOIVIS-# PLUMBING CONNECTIONL Fee Paid $- \AJATER SUPPLY SEWAGE DISPOSAL s.l. # TH Is PBoPERTY Is WITH IN oNE Iv] ILE oF TH E CITY OF-. PLUIV]B IfiTG BY -- I hereby certify that the above statements are true and accurate, and that I have the following legal interest in the property: -owner oI record; -contract purchaser; - potential buyer; - realtor or agent. I further certify that {i{ 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 relating to this permit. Signatu re Date ( } NEW ADDRESS ( } FACILITY PER[/]IT TO TRANSPORTATION OEPT.- | SPECIAL PIVIT. AREA. I\,IIN. ELEVATION: - SANITATION BUILD ING Minimum Septic Tank Capacity (Gallons)Type of Construction roup -Fire Zone Drainfield Required - Lineal Feet c",.n,""".,, Use classification N/laximum Depth -omments: By Date By Date PLANNING REOUI REMENTS SATISFIED. By Date: SETBACKS: FRONT SIDE FACING STREET (FROIVI C/L) INT. SIDE YARD REAR (FROM P/L) LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE., EUGENE, OREGON 97401 POST THIS PERNIIT ON MAIN BUILDING AT SITE C55-1 3 BLoG.pERMrr-WHrrE; BUtLDTNG-GREEN; pLUMBtNG-GANARv; sANrrATtoN-GoLoENRoD; oFFrcEcoPY-wHtrE PHONE: 687-4394 l\' trac (owner, etc.) when ready. Date lssued: ZON E: SITE INSPECTION Appnov r o Rrurnxs D oo,,k-Ja_2aDr slppRoveo I Nspecton FOUNDATION I NSPECTION APPRoVED Rrlranx s Dt sAPPRovEo n Darr I Hspecron FRAMING INSPECTION Appnoveo Re t,t a nx Drsapenoveo D^r, /*J -79 frlsI Hsercron LATH OR SHEETROCK INSPECTION Ap Pnov E o Rrxlnx s DrsappnovE o F7 Dar E 7 I xspecton F I NAL I NSPECT ION Ap pnov E o Renanx s D o^,,.7 - t( -71Drsrppnovgo I NSPEcToR CERTIFICATE OF OCCUPANCY Reaov ro I ssuE Reuanx s F D Nor Rrrov ro lssue D Dore_lNspEcroR_