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Home My WebLink AboutPermit Building 1975-09-25LANE CC_,rlTy BUILDING - BUTLDING PERMIT MHI oR MoBlth ,{oME UsE PERMIT PERMIT NO.e5-75 MAITING ADDRESS PHONE PROPERTY OWNER tlt48 veta t.IDA i er d lffiIl RE60r z&6-rto{DONALD Jrn t scn PHONE CONTRACTOR MAILING ADDRESS PROPERTY TOCATION _ INCLUDE POST oFflcE rl+I8 YoLANDA SPR t xe F r ELD OnreoN PROPERTY IEGAT DESCRIPTION _ M EIES, BOUNDS Surxx Esrereg Lor 7 Buccx \ z.L ,3r3 TAX LOT NO, CODExt7rtu CENSUS TRACTRANG E SECTI ON r7 EXISTING STRUCTURES ON PROPERTY Dotur-D JeN I scxAPPI.. NAME & MAITING ADDRESS Slus Yol rruol Srnr r t LEGAL ACCESS TO PROPERTY PROPERTY SIZE _ FT, WIDTH DEPTH AREA FOR MOBILE HOME PERMITS ONL Connect to Existing Sewog e System New SystemNo. of Bedrooms STRUCTURES TO BE BUILT THI S PERMIT TYPE CONSTRUCTION se. FT. # BDRMS VALUATIoN er$. mlrrlttv ButtDtttc 100 @ e.80 SEWAGE DISPOSAT PTUMBING INSTATTED BY [x ts'r sEprtc 1ANK n OTHERE OWNER E OTHER: NAMEPUBUC tr F EES WATER SUPPTY$_ t0 00 BUITDING WASTE DISPOSAT PTUMBING PTAN REVIEW PARK TRAITER PUBUC ! tr oIHER TOTAL cou NTY BUILDING & SANITATION SPECIFICAIIONS MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GAL. DRAIN FIEID REQUIRED tIN. FT TRENCH WIDTH FT,OR SQ. FT \lA, OCCUPANCY ZONE PUBI.IC UTII-. EASEMENTTYPE OF STRUCTURE J BLDG. SETBACKS FT. FROM CTR. OF ROAD RIGHT OF WAY USE CTASSIFICATION FR.NT it SIDE INT.5 stor exr,REAR AUTHORIZED SIGNATURE _ DATE DATE Bunxs roR SHooK/sAN I rAR I Artl qhn BLDG. PERMIT _ WHITE OFFICE COPY _ WHITE COUNTY TAX - PINK PLUMBING _ CANARY BUILDING _ GREEN SANITATION _ GOTDENROD FoRM=C55-13 Coll 687-4065 to schedule oll required inspeclions. All conslruc' tion sholl comply with Uniform Building Code, D.E.Q' stqndords ti PORTANT: for subsurfoce'sewoge disposol ond county regulotions covering plumbing. All buildings require o certificole of occuponcy before being occupied. (See Detoils on Reverse Side) (posT THIS pERMrr ON MAIN BLDG. AT SITE) LANE COUNTY, DEPT. OF ENVIRONMENTAT MANAGEMENT COURIHOUSE ANNEX, I35 EAST 6Ih, EUGENE, OREGON 9740I \), I,ANE COUNTY ENVIRONh-.IAL PLOT PLAN Name and Address o O'rnrner Telephone: The bu lng belng construcEed under this permiL will be used for Date this property was P urchased Do you now, or did you ever own property adjacent to this tax 1ot? If so, please list those lot numbers or draw those properti-es on the plot plan below.- Indicate on your drawing the location of all homes (including mobile homes) now on the property, as well as the location of the new building. I _l 7(Tt/q lt /- c. 4: III I _l I- I h I I I ( I4 t I ), l ( I -l I i t/I I ;( 4 l, (,[) 7 I I ;- l.I I E z I I / .;,i t.\ 1lll () -l v n T $ I I n_ )( N' rr il : }L IP ) U V LL tl il ( IEI I I\ L 1 T ') !.J { Ic ( Name of Appllcant (if different from owner): Address Telephon e !1ap Ta>r Lot Applicantrs Interest: BuYer M74-99 Se1ler Agent Permi Ell \ I t I I l I I / RE.FUND OF FEE Txe LlHe coururv Deplnrr,rEHr or ETvIRoNHENTAL MeT. I HAVING REQUESTEO REFUND OF FEE TO:. OF ADoRESS AND NO APPEAL OT SUCH DENIAL ApputcATloN FoR BUILDING PERMIT cANcELED' AppulcATloN FoR BUILoING PERMlr, ovERPAYMENT' ZoH rxc PEr tr toN. Appt-rcATltrN roR REsTIURANT Ltceruse. Naue APPL I CAT tON FOR BU I LO I NG PERM I T OEN I ED, HAVING BEEN MADE. x _ AreltcATloN'ron CenrlFlcATE ar SarulrATloN' AppttcATtoN roR PneLtutHlnv Stre lruspecttoN' Fon rxe FoLLowlNG REASoN: Dere 55-029-12 AHO txe ApPLtCANT OESIRING THAT THE FEE BE REFUNDEDT rxe DIREC1'R ar FTNANCE AND AuolrlNG ts REQUEsTED To RETuND THE AMouNT oF $-, .(uruoen ATPLIcATIoN NUMBER tN THE CASE OF APPLICATION FoR BUILDING PERMI?), WxtCx lS THE FEE CHARGED. tePt. t BUTLD{NG S I EVALUAT I ON BUtLDTNG pERHtr AppLiCnrt0N No. Zt6?'€-7E ( ) srrE lNsPEcTloN PLANN ! NG D tv ls l0N Not A cabl e No T- -R--S TAX LOT- SUbulVlSl0N:L0T:- BLOCK:- APPL I CANT DATE !fft w() fl() () () () CKID Setba romC ol. Zoning 0rdinance Compliance: Zone 2. Subdivision Ordinance Compl iance 3. Required Access 4. Building Site (Area, width, Front 5. Other (see conments) age ) ) ) ) ) ( ( ( Front ffi Setbacks from inter Side Rear or n6s: COHI{ENTS: PLANNTNG D IUI SION-TCTION P YEs(- I No (f APPTCAT I ON# Plans Submitted Soil Stabil lty (footings) Flood Plain Other (see connnents) COH}.IENTS: Not licable No wl7 8 9 0 r) () () () () ())CKID BY: 2z' WATER POLUT ION CONTROL Not Appl icableq (Jc No Yes 1-) TTll. l{eets Oepartment of Environmental Qual ity Standards. 12. 0ther (see cornments) ?() ()CKIO BY DATE CO}TI{ENTS: TO APPLICANT: q^ ilding / Site lnspection: be approved. not be approved at this time as indicated on item N0 oa contact the LANE-stions and furt her information on items I through 6 !NG 0rvlsl Questions and further information on items 7 bove. ou9 2 conta he LANE C0 BUILDING being returne ctt this d. rmi t I be held in office unt you can reso SAN TATION D ve the prob c55-28 Your bui ldi 135 Sixth Avenue East Eugene Oregon !/ PH0NE: 687-4065 LANE COUNTY PLANNING DlVlSl0N PH0NE: 687 ems S ON cated. lication f sbe 40r -4t 86 BUILDING INSPECTION DIVISION r L I LANE COUNTY BUILDING i._l BUTTDING PERMIT OR MOBITE I{OME UsE PERMIT MH tr PERMIT NO. PROPERTY OWNER MAILING ADDRESS PHONE CONTRACTOR MAILING ADDRESS PHONE PROPERTY I.OCATION _ INCIUDE POST OFFICE PROPERTY LEGAT DESCRIPTION -METES, BOUNDS RANG E SECTION TAX LOT NO CODE CENSUS TRACT APPL. NAME & MAILING ADDRESS EXISTING LEGAT PROPERTY PROPERTY SIZE _ FT. WIDTH TO PROPERTY DEPTH AREA FOR MOBILE HOME PERMITS ONLY No. of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT Connect to Existing Sewoge System f New System TYPE CONSTRUCTION se. FT B DRMS VALUATION * SEWAGE DISPOSAT PUBLIC N SEPTIC TANK tr oTHER! PLUMBING INSTALLED BY OWNER ! OTHER: N,AME BU ITDING WASTE DISPOSAT PTUMBING PI.AN REVIEW PARK TRAI[ER F EES WATER SUPPTY PUBLTC n tr OTHER TOTAT COUNTY BUILDING & SANITATION SPECIFICATIONS MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GA[. DRAIN FIELD REQUIRED tIN. FT TRENCH WIDTH FT OR SQ. FT TYPE OF STRUCTURE OCCUPANCY ZONE PUBI.IC UTII-. EASEMENT BLDG. SETBACKS FRONT FT. FROM CTR. OF ROAD RIGHT OF WAY SIDE INT. SIDE EXT. USE CTASSIFICATION REAR AUTHORIZED SIGNATURE _ DATE DATE BI.DG. PERMIT _ WHITE OFFICE COPY - WHITE COUNTY TAX _ PINK PLUMBING _ CANARY BUITDING _ GREEN SANITATION _ GOLDENROD Coll 687-4065 to schedule oll required inspections. All construc- tion sholl comply with Uniform Building Code, D.E.Q. stqndords IMPORTANT: for subsurfoce sewoge disposol ond counly regulolions covering plumbing. All buildings require o cerlificole of occuponcy before being occupied. (See Detoils on Reverse Side) (posr rHts pERMrr oN MAIN BLDG. AT SITE) TANE COUNW, DEPT. OF ENVIRONMENTAT MANAGEMENT COURIHOUSE ANNEX, I35 EAST 6th, EUGENE, OREGON 9740I FoRM_= C55-13 n SITE INSPECTION Ap pnov E o Reua nx s D r slppnoveo Dare Ir.rspEctoR FOUNDATION I NSPECTION Ae pRov e o ReuaRx s D DrsAPPRovEo V Darr I rusprcton FRAMING INSPECTION Appnov e o Re ulRx s D DrsappRovrc D Dar E I NsPEcroR LATH OR SHEETROCK INSPECTION AppRovED D Drsnppnoveo f---J Dorr_ ReuaRx s I NSPEcToR F I NAL I NSPECT ION - APPRovEo / 4 DrsappRoveo Reua nx s /7:..*r-vd / Dorffi rrrrr.roJ- "// CERTIFICATE OF OCCUPANCY Rerov ro lssur Rru aRx s D Nor Rerov ro lssue D Dote- 8-f 7,f ,/{{f, I Hsprcron D D ,r.rd?s<f OWNER NOTE: NO PER) coNsrrucrroN IFI WILL BE ISSI]ED I'NTIL TIIIS APPT APPLICATION FOR: MOBILE 1IOME PLAN REVIEW ess TTION HAS BEEN APPROVED CHAJ{GE OF OCCUPANCY City zLp Phone CONTRACTOR Name o.s. REG. /l s City Z7p Phone d X,a' / sy',% -fota: ? C-44 Rang Sectione3 Code Census Tract Subdivls ACCESS TO PROPERIY (Road Nane) Exlstlng Structures on Property: Property Location - Address/Directlons: for 1ce Use Slte Inspec tion // WATER Well ,Y: Spring 0ther FEES: Tax Lot Exls tlng Sewage Disposal System Public Comunlty ""t Z-property Acreage wid system Requlred n Trop. Bldg. lJaste Dlsp. Plunblng Plan Revlew Mobile Hone 1Z Surcharge TOTAL rh ValuatLon a Name of Community or Publlc Systen Nameo PLT]MBING: Installed PLI]MBING CASH Owner // of Flxt Sewage Connectlon NO Water Connection FACILITY PERMIT Date: o Slgnature of Fee Recelved Sq. Ft 4J Min. Septlc Tank Capaci Dralnfield Requir ed - Lineal Feet Maxfunum Depth Type of Construction Flre Zone Use Classiflcation cs5 - l2 I,ANE COT]NTY DEPARII"IENT OF ENVIRONMENTAL T Zone 7' Bldg Setbacks - Front ,:::';:."'y*'of Way: s,r*d+.FErlUF DATE: ? l-_-l {ara,a7 ,r{rrrync'-