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Home My WebLink AboutPermit Building 1973-09-12g*z€4Fz IANE COUNT.'--UILL*.G. PERMIT OR MOBILE HOA. USE .:RMIT PERMIT NO.BUTLDTNG E MHL PROPERTY OWNER MAITING ADD PHONE CONTRACTOR MAITING ADDRESS PHONE PROPERTY TOCATION _ INCI.UDE POST OFFICE PROPERTY I DESCRIPTION - METES, BOUNDS RANG E SECTION TAX LOT NO,CODE CENSUS TRACT *),o EXISTING STRUCTURES ON PROPERTY APPt. NAME & MAITING ADDRESS LEGAI. 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 System TYPE CONSTRUCTION se. FT New 'slem BDRMS VALUATION SEWAGE DISPOSAL PUBTIC tr SEPTIC TANK E OTHERN PTUMBING INSTALTED BY OWNER E OTHER: NAME F EES WATER SUPPTY PUBTIC D tr OTHER BUITDING WASTE DISPOSAL PTUMBING PLAN REVIEW PARK TRAITER $ TOTAI. COUNTY BUILDING & SANITATION SPECIFICATIONS MIN- SEPTIC TANK CAPACITY WITH DIST. BOX: GAL. DRAIN FIETD REQUIRED tIN. FT TRENCH WIDTH FT,OR SQ. FT, TYPE OI STRUCTURE OCCUPANCY ZONE PUBTIC UTIT. EASEMENT BI.DG. SETBACKS -- FT. FROM CTR. OF ROAD RIGHT OF WAY FRONT : SIDE lNT. ' stOe ext. USE CLASSIFICATION REAR AUTHORIZED SIGNATURE - DATE DAIE BTDG. PERMIT _ WHITE OFFICE COPY _ WHITE COUNTY TAX - PINK PI.UMBING _ CANARY BUITDING _ GREEN SANITATION _ GOIDENROD Construction to comply with uniform building code ond county regulotions covering plumbing ond sewoge disposol. All buildings require o certificote of occuponcy before being occupied. (See Stotement on Reverse Side) (posT THIS PERMIT ON MAIN BLDG. AT SITE) I.ANE COUNTY, BLDG. & SAN. DIV., COURT HOUSE, EUGENE, OREGON 9740I ronu#c55-l3 JllA Totm 2573 tev. July 1958 l---.ralHousrNcADmrNrsTrAiloN _ w-12 HEATTH AUTHORITY APPROVAL T ,'form Approvcd Budgct Burcou No. 63-t296.8 FHA Form 2573 Rev. JulY 1958 INDIVIDUAT WATER SUPPLY AND SEWAGE DISPOSAT SYSTE}T PARI III.-FOR UsE OF FHA OFFICE IO THI CHET UNDERWRITER: I have reviewed the foregoing and the pertinent FHA Compliance Inspection Repon, and recomrnend that the Individual warer-supply svstem be considere.t E Acceptable ! f.f", Acceptable Sewage disposal be considered E Acceptable I No, Acceptable. AU'IIORIIY APP AI SERIAL NO on PART I._IO BE COMPLETED BY FHA MORTGAGEEINSURING OTFICE Portlancl. L I,larfe MORTGAGOR OR SPONSOR BtocK No. 1 3568 Yolanda street, SBringfleldr Oregpn 971+ PROPERTY ADDRESS TOT NOSUBDIVISION NAME \22 IOIAL NUIIBER: lEotoors !AIHS BASEMENT UVTNG UNlls one 3 I bathaal+u x Can ol,tlc oi othar ci.o bo modc into (lf Yes, how mony?) Yes No! v.' El "o S N"*installatiorr sYsrEm DtstGHtD ror ot Botxs.NO G RSAGI OISPOSAI[] e"uti. s),srem ! Cornrnuniry system WATTR SUPPIY BY: I ndividual 3 l:o} v.' E *o3IWAGI DISPOSAI BY: ! ruuti. sysrem I Co--,rnity svsrem PART II._TO BE COIIPLETED BY HEALTH DEPARIiIENT HEATTH DEPARTMENT INSPECTOR'S SKETCH BLDG. PERMTT # t17B-13 It ftmffl Count)' fr;aatU.-pzrtment of Health that this individual water-supply sysrerr,lon 'not satisfacton' as a domestic q'ater supply for the subject proPertv It is the opinion of the n St^t tem with proper maintenance: I Coun.y ! focal Department of Health that this individual sewa-ge-disposal sys Can be expected to function satisfactorily. and is not likely to create an insanitary condition Cannot be expected to function satisfactorilytrtrDATE ls',G"^',yfu2L atz-zr,-ll | / frci-aE-o r. K ^_IRBY, R.S.,SupenY ts I NG StN trln tlN IITTE { NOTE; The heolth outhority should complete the oppropriote opinion slolemenl obove ond offix dote, signoture ond title in the spoces provided. Ure of the obove grid for Heolth Deporlment lnrpeclor'3 sketch os well os ure of lhe bork ol lhis form is ot the op?ion ol the heollh outhority. DATE SIGNATURE CHIEf ARCHIIECI DEPUIY TOR CH'EF ARCHITECI n tr INDIYIDUAI. WATIT SUPP]Y ATTID SEWAGE DISPOSAT SYSIEiI vA 65105 /rg u [El Indi,ldual REPORT OF INSPECTION-INDIVIDUAL SEWAGE.DISPOSAT SYSIEM ! Cesspool.PRImAIY ftEAfmENf consists of ! Septic tank 5opilc fonk: Distance from well, -feet ETE Total liquid gallons. Capacityinlet Inside Inside Liquid depth, Corepool: Distance from: Vell, - feet; foundation,feet; nearest lot line at I front, I side, I rear, .-feet, Inside diameter,-feet. Depth,-feet. Liquid capacity.-gallons. Lining material 5:coNDARYrREArmENrconsistsofpTiledisposal6eld.[Seepagepits.other flb Dhporol flold: Disancefrom:.Welt'-feet;foundation,lofeet;nearestlotlineatfif.ont,ptside,[t o feet. Total length of tile feet. Number of lines,Distance between feet Trench width,inches. Total effective absorption area in bottom of trenches,feet. length of each line,Depth, top of tile to 6nish grade,-inches. Number of compartmen,. I -8allons. ? Typeoffiltermaterial:QGravel.f|Brokenstone.other Depth of filter material beneath til.,-------5--in.h.r. Depth of filter material over tile, 2 inches. Scopogc Pltr: Number of pits-. Outside diameter,-feet. Depth,-feet. Lining material Disance from: Vell,-feet; building foundation,-feet; nearest lot line at E front, E side, f| rear,-feet. lnrpoctlon modo by: fl State. Q Crunry. I local Health Authoriry. Inspected by./s/ JoltN cRU OI(SHANK. R.S. Date of inspection OCrogER 25 , 19 ?3 Serutrln llN (rlrlE ) REPORT OF INSPECTION-INDIVIDUAT WATER-SUPPIY SYSTE'T Distance to nearest public water main,-----feet. Size of main,-inchcs. Individual wells ! are I are not custornary in neighborhood. Givemostrecentrc<ordoffhilureofwellsinimmediatevicinitytofurnishadequatesupplyofwater- Properties in neighborhrnd ! are f] are not being developed with both individual water-supply and sewage-disposal systems [ntsize:-feetwide,--feetdeep.DwelIingsetbackfromfrontProp€rty Individual water supply from: I Drilled well. ! Driven well. I Dug well. ! Bored well. Dlrloncc ol wcll from: * U S. covER{MEtT PnlxTlrG orFlCE : 1957 O'f-a2?0!6 GPO 934055 feet. Building foundation,-----feet; nearest lot line at I front. ! side, I rear,- cast iron sewer,-feeti tile sewer (iet'septic tank,-feet;disposal field,--- feetseepage pit,--feet; cessp(xrl,.--feet; other sources of possible pollution, Wcll conrlrucllon: Diameter,--inches. Total depth,feet. Type of casing,-- Deprh of casing, -fe€t. Approximate depth to pumping level of water in well,-feet. Approximate yield,--gallons per minute Sealed watertight to depth of -feet. Exterior space around casing scaled with: ! Cement grout. [] t\rddled clay. ! Ordinary backfill. Vell cover: f| Concrete. ! Wood. I Metal. Openings in well cover watertight: ! Yes. ! N.r. Pump: f) Shallow well. ! Deep well. Length of drop pipe,-feet. Pump capacity,lons per minute. Located in: ! Basement. ! Pumproom off basement. ! Pumphouse above ground. I Pump pit. Pumproom properly drained: ! Yes. n No. Pump mounting watenight: I Yes. E No. Type of storage: I Pressure. ! Gravity. Capacity,-gallons. Hasbacteriologicalexaminati<lnofwaterbeenmade?!Yes.f]No.Ifansweris,'yes,.,givedate-,t9_ Quality of water E is E is not satisfactory for human consumption. Installation ! does ! does not comply with approved exhibits, if any. Inspection made by: f] State. I County. I Local Healrh Authority. Inspected by Date of inspection l9_ (rrrLE ) feet, feet; \. BUILD INI S ITE EVALUAT ION 'J-L* @t /-f 'ox Lor--- CENSUS .ACTZil;Am,.ioM:o Paek Atx / zot'fri;i"^-5)i**j " ADDRESS <C, () () () Building Permit Appl ication No. Site lnspect ion Pre-Permit lnvest igat ion / 77r"73' PHONE DATE LANE COUNTY PLANNING DEPARTMENT NOT NO EFEI icable -()() YES DATE ({(r (tr (v 4 I 1I 2. 3. 4. 5. Zoning 0rdinance Compl iance(zoneZ-*\ ) Subd iv i s ion 0rd i nance d6rr!'lEice Requ i red Access Bu i ld ing S ite (Area, lJidth, Frontage, Setback) 0ther (see comments,() () () () () () () () () B U ILDING INSPECTION SECTION 6. Plans Submitted 7. Soil Stability (footings) 8. Flood Plain g, 0ther (see Cornments) NOT NO aool icable*,O-t I ttl () fi () YES l,(f () () NA},tE /, ()()dj ?'t z'?? COHHENTS: SAN ITAT ION SECT ION t0. ll. 12. t3. Sewage Disposal Usable Area lJater Supp I y Other (see Comments) NOT NO EiTt icable ---,O-t I YES $ ()()() NAI"lE DATE () (N () () () ('l COMHENTS: TO APPLICANT: Yo{r n Building Permit / Site lnspection: can be approved. ?-/2 -73'42-/ Cannot be approved at tfris time as ind Quest ions and further informat ion on i COUNTY PLANNING DEPARTHENT. Questions icated on item N0. tems I through 5 contact the and further information on () () () t hrough I 3 cont a.ct t he Lane Count Buildin and San i tat ion D visio Wi I I be held in th is of f.ice unt i ls being returned. you can resolve the pro blems ind Your building permit application fee is being returned under sePar above. Lane- i tems 5 n. i cated. ate cover. LANE COUN'Y P;NIJNING DEPARTI4ENT 135 Sixth Aven&e East, Eugene, 0regon 97401 PHoNE | 342-l3lt EXT. 231 LANE COUNTY BU I LD II.IG & SAN ITAT ION O IV 1S ICI'.i 135 Sixth Avenue East, Eugene, Oregon 97401 Pll0NE: 342- l3l I EXT. 4l I NAI'IE COMHENTS: DATE INDIVIDUAL SEWAGE DISPOSNT, SYS-EM RECORD Installer: Complete to, -td.tL - form to signature and return b<rth copies to Lane County Building Sanitation Department. Yes I No Water Public ,ng Units Bedrooms 3 Name Heryford I anda No Other-List c Ft. from well Steel ! Concrete No. Compartments r,ength 8 widrh Diameter Depth Ga1. Capacity T e sposa E' Applican Name M ailing Address 1 2 Distribution Box:ves ffi No E Other D S on-e Feet from rDt Lot 'ront of s-Ft. O Rear below4. 5. 6. n HomesStatel I Trench widrh 3 Total soJrt.betweenl Fillerrt.45O'lri""" $ + irrr" t[ *vr Filler depthabove^ ti le J in- Sketch See instructions Date For Sanitarian Use OnIY: F approv"a, i I oisapproved System Installation Conforms to Current Standards : Does Not Conform to Current Standards Date:n)>o/t: E\N10-v-d l0v \)ES5J t, s, 8+\=? '{;^ lo >\5' \ Signature) Remarks: Lane County Building & Sanitation Dept- Sani c55-ll J 's Signature ( I IANE COUNTY oUlLDr-G PERMIT OR BUTLDTNG I MH I /: MOBIIE HOIV,- USE -..rRMlT PERMIT NO. PROPERTY OWNER MAII.ING ADDRESS PHONE CONTRACTOR MAII-ING ADDRESS PHONE PROPERTY I.OCATION _ INCTUDE POST OFFICE PROPERTY tEGAt DESCRIPIION -METES, BOUNDS RANG E SECTION TAX LOT NO cooE CENSUS TRACT EXISTING STRUCTURES ON PROPERTYAPPT. NAME & MAITING ADDRESS LEGAT ACCESS TO PROPERTY PROPERTY SIZE - FT. WIDTH DEPTH AREA FOR MOBILE HOME PERMITS ONLY No. of Bedrooms Connecl to Existing Sewoge System I New m STRUCTURES TO BE BUILT THIS PERMIT TYPE CONSTRUCTION SQ. FT. # BDRMS VALUATION SE\ilAGE DISPOSAT PUBUC n SEPTIC IANK !oTHER! PTUMBING INSTAI.TED BY owNER E OTHER: NAA E eS b)4 BUITDING WASTE DISPOSAI. PTUMBING PtAN REVIEW PAR( TRAITER FEES WATER SUPPTY PUBUC D ! OTHER TOTAI. COUNTY BUILDING & SANITATION SPECIFICATIONS MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GAL. DRAIN FIEI.D REQUIRED tIN. FT TRENCH WIDTH FT.OR SQ. FT. TYPE OF STRUCTURE OCCUPANCY ZONE PUBTIC UTI[. EASEMENT BIDG. SETBACKS - FT. FROM CTR. OF ROAD RIGHT OF WAY FRONT SIDE INT. SIDE EXT. USE CLASSIFICATION REAR AUTHORIZED SIGNATURE _ DATE DATE BTDG. PERMIT - WHITE OFFICE COPY _ WHITE COUNTY TAX - PINK PI"UMBING _ CANARY BUILDING _ GREEN SANITATION - GOTDENROD Construction lo comply with uniform buildin covering plumbing ond sewoge disposol. Al of occuponcy before being occupied. code ond county regulotions buildings require o certificole s I (See Stotement on Reverse Side) (POST THls PERMIT ON MAIN BIDG. AT SlrE) TANE COUNTY, BI.DG. & SAN. DIV., COURT HOUSE, EUGENE, OREGON 9740I roau lic55-13 SLAB FLOOR PLUMB ING GROUNU^,ORK AppnovEo Rruanx s C Dr sappnovro t I Ns pe croa GAS PIPING GROUND/ORK Ap enov r o ReurRx s D DrsappRovro D Dore_I Hsprcron ROUGH PLUMBING AppRovro ffi Drsappnovrc D,^r/y'2-23-- Rexanxs I Nspecroe ROUGH GAS PIPING AppRoveo Reuanx s D DrsappRovro D Dar e I rusprcron FINAL PLUMBING APPRovED N DrsappRoveo Rr uaex s Da I Nspec FINAL GAS PIPING AppRoveo D Drsappnovro D ReuaRr s Drre I ruspEcron CERTTFICATE OF OCCUPANCY Reaov ro lssue Rrue Rx s Nor Rraov ro lssuE Dare llrspEcron D D Dore- LANE COUNTY --UI[D,*G PERfilIT OR MOBITE HOIV\ USE -RMIT BUTLDTNG r MH I PERMTT NO. PROPERTY OWNER MAITING ADDRESS PHONE CONTRACTOR MAITING ADDRESS PHONE PROPERTY TOCATION _ INCI.UDE POST OFFICE PROPERTY TEGAL DESCRIPTION _ METES, BOUNDS RANG E SECTION TAX LOT NO CODE CENSUS TRACT EXISTING STRUCTURES ON PROPERTYAPPL. NAME & MAITING ADDRESS LEGAT 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 Existin TYPE CONSTRUCTION Sysrem ! New System ! SQ. FT BDRMS VALUATION SEWAGE DISPOSAI PUBLIC tr SEPTIC TANK tr oTHERI PTUMBING INSTAI.I.ED BY OWNER n OTHER: NAME BUITDING WASTE DISPOSAI PI.UMBING P[AN REVIEW PARK TRAII"ER TOTAI. FEES WATER SUPPTY PUBLIC OTH ER COUNTY BUILDING & SANITATION SPECIFICATIONS MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GAL. DRAIN FIETD REQUIRED TIN. FT TRENCH WIDTH FT OR SQ. FT TYPE OF STRUCTURE OCCUPANCY ZONE PUBTIC UTIT. BTDG. SETBACKS FT, FROM CTR. OF ROAD RIGHT OF WAY rRONT SIDE INT. SIDE EXT. USE CTASSIFICATION REAR AUTHORIZED SIGNATURE - DATE DATE BLDG. PERMIT _ WH ITE OFFICE COPY _ WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING _ GREEN SAN ITATION - GOI-DENROD Construction to comply with uniform building code ond county regulotions covering plumbing ond sewoge disposol. All buildings require o cerlificote of occuponcy before being occupied. (See Stotement on Reverse Side) (posT THIS PERMIT ON MAIN BIDG. AT SITE) IANE COUNTY, BTDG, & SAN. DIV., COURT HOUSE, EUGENE, OREGON 9740I ronu = C55- l3 SITE INSPECTION Ap pnov E o RrunRx s Dtsappnoveo Dare lr.tSPcCrOnt;,A.E'n;( FOUNDATION I toN ar"*or ao Re trl nx s '-/D'\P lruspecton €Dr sAPPRovEo Dar r FRAMING INSPECTION AppRovro Reulnx s Dr srppaoveo /1:2 ?'7 3 tNsptcront-? LATH OR SHEETROCK I NSPECT I ON Dt sappRovEo Dar E lr.rsprctonAepRovEo Rexanx s FINAL INSPECTION Ap pnov r o Reuenrs DrslppRovEo DarE .30 y I NSPEcToR /') k:. e- e,4.4{rde CERTIFICATE OF OCCUPANCY Reaov ro lssue REuaRx s D Nor Reaov ro tssuE D -1r.rspe croa F/779-70 Drre 2 o-ur B E H IANE COUNTY BL PERMTT TYPE - BUTLDTNG E' )ING ERMIT OR MOBILE HOME I ''! AP' 'CATION MoBTLE HoME Iosc aee.*J/(d PERMTT# t773-73 )PERTY OWNER MAILING ADDRESS MAII.ING ADDRESS LP -/?7/ )NTRACTOR PHONE ,ROPERTY I.OCATION _ INCTUDE POST OFFICE t'11 -7d/e* PROPERTY TEGAT DESCRIPTION TOT_BLOCK-SUBDIV rwP RANGE t7 To & BOUNDS E YES ATTAC H ED NO sEc T,toT CODE CENSUS TRACT o:)/? T DESCRI BE NG ON PROPERTY IF ANY APPTICANT NArrtE AND MAITING ADDRESS *fltn€--tEGAt ACCESS TO PROPERTY - ROAD NAME OR)/oC"utan PROPERTY SIZE-WIDTH DEPTH AREA FOR MOBILE HOME PERMIT ONLY Number of Bedrooms Connect to Existin e m SQ. FT. or New System R"q. E BEDROOMS VIO BE BUITT THIS PERMIT CE*z {r /p@ 57{O 7 DISPOSAL PTUMBING INSTATTED BY PUBI.IC BLDG. WASTE DIS. PTUMBING PTAN REVIEW PARK TRI-R. SEPTIC TANK ..??.6(0 OTHER FEES WATER SUPPTY PUBTIC NG FEES OWNER PTANS FURNISHED YES PERM # OTHER NAME FACITITY PERMIT OTHER YES NO PTUMBIIla DATE FIXTURES .&(o DATECASH CHECK lt#T r.r,o* rer 07' AC) TOTAT / 3 3,€O PUBTIC WATER CONNECTION FEE l-/.do 77 &-73 COUNTY BUILDING & SANITATION SPECIFICATIONS MIN. SEPTIC TANK CAPACITY DRAIN TIETD REQUIRED NING BTDG, INSP.Dole DIST. BOX: GAI.tIN. FT Z2 rneNcn wrDTH FTq2 e P0 (r I e. PUBLIC 2 q OR SQUARE FEET REAR YARD USE CI,ASSIFICATION mS c2 I TYPE OF SIRUCTURE OCCUPANCY BIDG. SETBACKS _ FT. FROM OF ROAO RIGHT OF WAY FRONT SIDE INT Directions to Find P ZONE Dote Form # css-t2 SIDE EXT REAR y'z'?t COPY I _ OFFICE COPY 2 -JOURNALCOPY 3 - AUDIT t (I