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Home My WebLink AboutPermit Building 1977-06-173-) btrc lLz3-a7 TRS, TL Job Location S rz yr'Z o{,b rt (),,-T -7 I,.Iritten Directions I y{auing Permit Acreage or Lot Size 4cvc-t Partitioning #- ( "-Kompleted( ) Pending INFORMATION SHE ( ) Site Feasibility Study for Septic Tank. Number of sites Test holes will be ready Subdivision Lot - B loc k APPLICANT'S NAME AND ADDRESS OWNER'S NAME AND ADDRESS, if different from app lica nt's ^.)NTRACTOR'S NAME AND ADDRESS il permit or results of site feasibility study to ( ^t-Appl cant er ( ) Contractor {) Prefer to pick up. Call (owner, etc. ) when ready Contractors O. S. # STRUCTURES NOW ON THE PROPER P. PROPOSED USE (this permit)B, ' I ?^ t bo .' , ua6r-A^ A1antrc.9.'U'' Phone Phone Phone WATER SUPPLY SEWAGE DISPOSA L =9e >1-e u *k' r proposed well, etc. lf public, name of system) (existing or proposed septic tank, etc.) S.l Addressit;Z;7-- PLUMBING BY I PROPERTY IS WITHIN ONE MILE OF CITY ( ) rstln ****+r* oFFtcE usE oNLY BELOW THtS LtNE **r+***+ii*** ) New ress Necessa ry ,N ( ) Facility Permit Necessary SETBACKS: Front ( ) Special Permit Area. Minimum Elevation lnterior Side Yard - Rear (FROM PROPERTY LINES) Side Facing Street (FROM CENTERLINE OF ROAD) To: Planning/Building lnspector/Sanitarian/Surveyor. This applicant appears to have a problem with Your assistance will be appreciated. By Permit Processing Section Response By DEPARTMENT OF ENVIRONMENTAL MANAGEMENT Permit Processing Section 125 East 8th Avenue 687-4394c55-12 D ivision 4H*t, ( a PERMIT # TRS, T JOB LOCATIO LANE COUNTY PERMIT Acreage or Lot Size Contractor's O.S. + Partitioning # APPLICANT'S NAME AND ADDRE ss CONTRACTOR'S NAIVIE AND ADDRE ss lVail permitto ( )Applicant ( )Owner ( )Contractor. ( )Prefertopickup. Call ) Completed Subdivision Lot- Blo Phon P OWNER'S NAME AND ADDRESS Phone Phone (owner, etc.) when ready STRUCTURES NOW ON THE PROPERTY- .llsPERl\4lTlSFoR#BEDRooMS-#PLul\4BlNGcoNNEcTloNs- \AJATER SUPPLY SEWAGE DISPOSAL s.l. # THlSPRoPERTYlSWlTHlNoNEMlLEoFTHEclTYoF.PLUMBlNGBY I hereby certily 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 (if not the owner) I am authorized to act lor the owner of record, and that said owner is aware and approves of this action. I hereby agree to comply with all applicable Codes relating to this permit. Fee Paid S-Signature Date () NEW ADDRESS () FACILITY PERMIT TO TRANSPORTATION DEPT () SPECIAL PIVIT. AREA. IVIIN. ELEVATION SAN ITAT ION lVlinimum Septic Tank Capacity (Gallons) Drainfield Required - Lineal Feet lVlaximum Depth BUILDING Type of Construction -Group -FireZone Use Classification Comments Jmments B Date: PLANN ING REOUI REtVIENTS SATISFIED. By B Date Date lssuedDate ZONE: SETBACKS: FRONT SIDE FACING STREET (FROM C/L) INT. SIDE YARD REAR (FBOIV] P/L} LANE COUNTY DEPARTIVIENT OF ENVIRONIVIENTAL |\4ANAGE[nENT, 125 EAST 8TH AVE., EUGENE, OREGON 97401 PHONE: 687-4394 POST THIS PERMIT ON MAIN BUILDING AT SITE BLDG. PERMIT - WHITE; BUILDING - GREEN; PLUMBING - CAruANV; SANITATION - GOLOENROD; OFFICE COPY - WHITEc55-r 3 i Du\q,r^"iTRS, T (&t Job Loca 3>f lt4* 29ei 4oO*r INFORM SHEET ( ) Site Feasibility Study for Septic Tank. Number of sites_ Test holes will be ready_ Subdivision Lot -- B eA Contractors O. S. # I I I i l{ritLen Di-rections ( ) Building Permit Acreage or Lot Size Mai t^t / ).e#, Partitioning #( ) Completed( ) Pending APPLICANT'S NAME AND ADDRESS OWNER'S NA ME AND ADDRESS, if different from a nt CONTRACTOR'S NAME AND ADDRESS I permit or results of site feasibility study to ( ) Ap icant o wner ( ) Contractor(Prefer to pick up. Call ( owner, etc. ) when ready STHUCTURES NOW ON THE PROPER e Z-1. "t t aarv' phone" /4-? lg A Phone_-Ph;:";atliffi/C PROPOSED USE (this permit) WATEH SUPPLY SEWAGE DISPOSA I c-' ( ) pRopERTy ts wlTHtN ONE MILE OF ClTy ( ) z,a rdS \ BEDROOMS existing or proposed well, etc. lf public, name of system) (existingorproposedseptictank,etc.)S.I.*- t PLUMBING BY AcjdTess **t***r ***************+*+*+*** ****+*+***+**OFFICE USE O NLY BELOW THIS LlNf *+*++***++*** *{ * r+* *+ ++**** *+++*r*+++ +* ++ + * ) New Address Necessary 'E_ ( ) Facility Permit Necessary SETBACKS: Front Side Facing Street (FROM CENTERLINE OF ROAD) ( ) Special Permit Area. l/linimurn E levation lnterior Sioe Yard4;Rear - lFROM PROPERTY LINES) To: Planning/Building lnspector/Sani tarian/Surveyo This applieant appears to have a problem w Your assistance will be appre ciated. By Permit Processing Section Response By DEPARTMENT OF ENV I RONMENTAL MANAGEMENT Permit Processing Section 125 East Bth Avenue 687-4394c55-1 2 D tvrsron J {i 1z ( ('I f/ /t, ( ---\\-Iress) - .' o/ ITRS, TL Subdivision Lot Flrrt Plan Job Locatlon (Add Permlt /l f- PermLt *,hqtfC..ff ermlt Permlt# For - Perolt For #For PermLt *-ForFor B]-ock S 0eK ,f U \)) ((.,"\'d **,',)""" \^\,a().^J 3r< t(A cl t\t S Lr ,s$u 7 bart't ( ( 0I I t0 I 1)+ -,.., c74-L50 Vl-clnlty DIap N 5uq{lv n€ - I Ylla r t ) ,lPff$t h) c7'a-fr*fi g TRS, TL Acreage or Lot Size Contractor's O.S. # APPLICANT'S NAN4E AND ADDRE qq lVlail permitto ( )Applicant ( )Owner ( )Contractor. ( )Prefertopickup. Call PERTVIIT # JOB LOCATION LANE COUNTY PERMIT Partitioning #-( ) Completed Subdivision Lot- Bloc Phon OWNER'S NAIVIE AND ADDRESS- - Phone CONTRACTOR'S NAME AND ADDRESS Phone (owner, etc.) when ready STBUCTURES NOW ON THE PROPEBTY ,]lSPEB[4lTlSFoB#BEDRooML#PLUMBlNGcoNNEcTloNL WATER SUPPLY SEWAGE DISPOSAL s.t. # THlSPRoPERTYlSWlTHlNoNElVllLEoFTHEClTYoF.PLUlVlBlNGBY I hereby certify that the above statements are true and accurate. and that I have the rollowing legal interest in the property: -owner of record; -contract purchaser; - potential buyer; - realtor or agent. I further certify that (il 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. Fee Paid $Signature Date ( }NEWADDRESS I FACILITY PERI\4IT TO TRANSPOBTATION DEPT.- ( } SPECIAL PMT. AREA. MIN. ELEVATION SANITATION lVlinimum Septic Tank Capacity (Gallons) Drainfield Required - Lineal Feet TURE BUILDING Type of Construction Use Classification DATE roup ire Zone lvl axi m u m Deotfu 9gr5,.,JNaTrct{ wITFr BUTLDTNG pE^rv{r.i u co m ments : BUTLD'NG, r ir!:rr,y ne:rs.;i,r.\i,ilJ uurr,,",,,,.,* iirl,,iiBl."l1itt1lfHi:yT..AG,',rCULrUii"',i. r"'-ioDUCTS :j:,.s:p c* iirl}uoi,sas, ranna voc'rNrn" oR THE RArsrNG&irEEDiNG, gR,irrEprNc oF,pERM,rT,i&D. L\;il or"iro.s, AND FoR ruo oiiren puRposE B } APPLICANT ) APP|ICNNT'S REPRESENTATIVE BY Date PLANNING REOUIREIVIENTS SATISFIED. B ZONE: Date Date lssued SETBACKS: FRONT SIDE FACING STREET (FROIVI C/L) INT. SIDE YARD REAR (FROIVI P/L) LANE COUNTY DEPARTMENT OF ENVIRONMENTAL IMANAGEMENT, 125 EAST 8TH AVE.. EUGENE, OBEGON 97401 PHONE: 687-4394 POST THIS PERMIT ON MAIN BUILDING AT SITE BLDG.PERMIT-WHITE; BUILDING-GREENi PLUMBING-CANARY; SANITATION-GOLDENROD; OFFICECOPY-WHITEc55-1 3 Jmments: SITE INSPECTION Ap pRov e o Rrua Rx s DrsAPPRovEo D Dar e //-?o -^l I nsprcron FOUNDATION I NSPECTION D DTsAPPRovE o 77 Darr I ruspecronAppnovEo REurnxs FRAMING INSPECTION App nov r o Reuanx s D DrsrppRovro D DarE I NSPEcToR LATH OR SHEETROCK INSPECTION AP PRov E D RruaRxs Dr srppRovro Dar e I Hspecron FINAL INSPECTION t2 - f-71 Ap pnov e o Reuaax s DISAPPROVE, D Dar I Nsprcton CERTIFICATE OF OCCUPANCY Reaov ro lssuE ReurRx s D Nor Reaov ro lssur D DrrE I rusprclon lane county ACT, /Environmental ManagemerJl ITY II\FORMATION SHEET 6D -o doo MAKING sL o \e So+rl-s ADDiIESS MAILING ADDRESS 7'l Sannr ST'hTE zrp CITY J 1l1t E ZIP CODE t.tG - hr ea _e- BUSINESS NUMBER TIOME TELEPHONE NUMBER BUSINESS TELEPIIONE I.IUMBER }IOME TELEPHONE NUMBER in Department of Assessment & Taxation or from a"fu*U]|.#""a, , rax Lot(s): e{b€\ueivt tq-O)- 'rfr.it qto @ tax MAp/pRopERTy DESCRrpl,roN NUMBER (from rax maps l{apr/parcerNumber\fU_ n3 OL \ .- | Townsh.ip Rdnge Scctjon\(]<l\oca )[o"t of rL #By Partition # Tax Map & Parce1 Number of Adjoining Property in Same Ownership rY 03 C )- rax Lot(s) Township Range I wone Secti.on n BLOCK: i StB 2LOT: )@ SUeorvrSfOU (if applicable): (> @ RUOUUST (briefly descri-be information needed); COIVIPLETE THIS SECTION. I COMPLETE THIS SECTION F'OR CONSTRUCTTON APPLICATIONS FORMS WILL BE REJECTED: LAND USE, OR PROPOSALS.SEE *NOTE BELOW.**FOR STAFF USE ONLY**-27"v- -NUI1BI]R: DATE: TIME INITIATED: CHECKED BY ATTACHED EXHIBT I erot Prans (2) I constr. Plans (2) f] sit" et..t f]"opy of rax Map f]ott "t_-- SCREENING VERIFICATION : Date: Time In : __()ut : __ I eccept I aelect Routed to By : ATTACH A COPY OF tax UeP; SHOW EXISTING STRUCTUR.ES AND TAX LOTS IN YOUR OIn'IERSHII . OE- TAIN TAX I'1AP IN SEIF HELP AREA OI' A & T. O ToTAL CONTIGUoUS PRoPERTY IN SAME OWNERSHIP 'P*=i NE{^s I trrsnqd=Ut-l_v @ MuMSrn oF STRUCTURES ON PROPERTY: Standard home Modular home RV in use as residence Ownrnn DrsrRrcr,@ acres JD Private Road Name Road Easement widrh a @ pnnsrxt usg oF PRoPERTY \m,r.\^^s - )o @ olsen EASEMENTS oVER PRoPERTY: @ nnrorNc PERMrrs oN PRoPERTY: @ pnopsnrv ADDRESS: -r/ Storage I Barn #of Users @ r'rnr DrsrRrcr $- O accrss To PROPERTY: public Road Name Garage_ Other (specify) c\ shop- 0 strVnnll - I 9/81 REV (OVER) ot.^/llER -&- Uo COMPLETE THIS SECTION FOR LANL_-JE OR CONSTRUCTTON APPLTCATIONS.* **FOR STAFF USE ONLY** @ pnoposnD usc oE PRoPERTv tN oetxrl:-J ZONE/LAND USE: By:AJ Date:a-n>\--O'.l.-) Np-,g ,,S-Q @ aurr-oruc REQUESTS Contractorts #(for mobile home sctup also) Directions to Site: Check the type of Permit requested: [-l owerlins: f] New [-l neplacement pfadaitionat; fl aaaition I elteratiou; I Modular Home I uot it. Home - Model Year- Z'"u ! standard construction; n Plan Check onlY - ') Floor Area By Zoninq: Comp. Plan Designation:- SANITAT]ON: Date: Time fn:_- Out:_ I accept f] neject ! constr. Permit IssLle f] site Evaluation rssue PERMIT ISSUED (SAME DAY ONLY): Permit # By: Date: Time In:Out: Commercial: Use @ uuuern or BEDRooMs @ sanrrarroN REeUESTS: fl site evaluation for SDS feasibili-ty I New system installation I nepair/replacement I alteration,/re location Q{uook to existing ADDTTIONAL INFORMATION : ]- f] agricurtural: use- f-l cr,.ng. of use - How?- I I Otf,ers: Use .rk- . ,\:\ r 1. ;- Floor Area \ - NUMBER OF STOR]ES rfepu Qs oJ.$/, + \trs.rf,.e-L Bq Cr[: u\pr,( )TARTE w t € t^r-os ou {IeD fPo-anrfS -? Pax 6.SD- pE,- rrt0, rime rn r6,OZlutr 3:17 fl accept I neject fl nlanning Application E constLUction Permit APP. ffor^ution onry I I