HomeMy WebLinkAboutPermit Miscellaneous 1974-05-06A
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3',1 4 W.;QUEST FOR S ITE FEAS lB lL I TUD\
Tax Lot No.0wner of Property
No. of Sites ,
s.t.# 7 /-q7/
THIS IS A PRELIMINARY REPORT WHICH DOES NOT INSURE THE ISSUANCE OF A FUTURE BUILDING PERHIT.
PLANS OR EXPENDITURES MADE IN RELIANCE UPON THIS REPORT ARE AT YOUR OI^JN RISK.
PLEASE PRIIIT -.l
d !s r n - Name:ga Lot#3
Yes y' No
0wner I s Consent
25,-
Block # rl
"l
-l
Townsh ip
bs _dRange Sect ion
K r rr.t N e TT ar'll.sl tl--$
$
$
Name
16 8o D &l Rose 5P Fd.o?e No. of Acres
fiSifTns-IaAress
.L
Tota I
Cas h7 crreck {
Proposed Use
of Property:
Te eP gnat u cant te 0wne r Sel I er
Rcsid c*rrAi , l{cnt
N c r1T ll ( :trtt --Property S ize Legal Access - Road Name ist ing tructures on rty
Property Locat ion (D i rect ions) :
'l os
(€ FT Th
VJhen Wil I Test Holes Be Ready?
MARK TEST HOLES I^i ITH OUR FLAGS
Location of Test Holes on Property:
Draw diagram of property showing location of any landmarks and relationship of test holes to
these I andmarks :
Appl icantrs lnterest Puyel -Realtor
-
in- Property: 0ther (Speci ty) t 6iell. Cn tt PAc-Ta?-
e
c
^A7r Pue.
Nt
o
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".\s 2-573 Nt,l/74
I
Phcn e : 687-4065
5th Ave., Eugene. 0re
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,
MAKE cHEcK PAYABLE T# CJfrJJJ*,t1 Tft hy 6,
MAlL TO:
c55-55
ENTAL MANAGEMENT
es ,-{,_ What C i ty ?
e of CityneI s Property t n ter
ecr v
UPP
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roPos
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T,H,
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LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, I35 E
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APPROVED NOT APPROVED
---L I), /o l.n "-{f>,]oE ,/v^,./o*/, J:,- 5Dr,r'A tA.
Authorized Signature
ate
Permit #-L/
rIELD INSPECTION SHEETcm
Location , sectQLl t.)1 R. O 3 Tax r,ot or Acct. No.4 h;,^ ^1".L
Lf$ i ah. 7
ere public set^Iers available or ne,
Are there zoning or environmentalI
arby? (Distance)
considerations?
No
No
Size of property:lol
Are other systems in area malfunctioning?Nlo
Is there room for future e:<Pansion?Ye-9
Surface feature considerations: (Explain)
Slope,
----O
- -Flood plain: - -Plants:
Rocks:
Low area:
Drainage way:
Streams:
Water supply and util
Conununity water:
ities:'U/-
Private water:
Water lines:
Location:
Gas lines:
Wells on adjacent properties:
TEST HOLE RESULTS
#I Test IIoIe #2 Test Hole #3 Test HoIe
o" -a(*" /, /or,,.---o" -bo S*,/, /o, o-0t'
'{r
Soil Classification (If Known)
Is curtain drain required?
REMARKS:
Interim Form #6
X Rrr ?"t
-..-r_
BUILDING S iTE EVALUATION
( ) Building Permit Appl ication No.
( ) Site lnspection
( ) Pre-Permit lnvestigation
)5 /c t+\!-' . eJ=, Z'{Ehi ror-
CEI - TRACT
'7V- L/7/
PHONE
DATE
LANE COUNTY PLANNING DEPART},IENT NOT NO YES NAHE DATE
appl icable()()(+"
({
({
l. Zoning 0rdinance Compl iance(zone1lgrlgf,
2. Subd ivis ion 0rd inance Compl iance
3. Requ i red Access
4. Bu i ld ing S ite (Area, }Jidth,
Frontage, Setback)
5. 0ther (see comments)
()
()
(r 77 : -----,,
()
()
()
()
(
()
()
CO},IHENTS:
BUILOlNG INSPECTION SECTION NOT NO YES
le -
NA}1E DATE
li
6. Plans Submitted
7. Soi I Stab i I ity (foot ings)
8. Flood Plain
9. 0ther (see Comments)
CO},IMENTS:
() ()
(
(
(
()
()
()
()
()
()J--2 o"'?,
SANITATION SECTION
Sewage Disposal
Usable Area
Water Supply
0ther (see Comments)
NAHENOT DATE
aool icable---n-( ) (rfe10.
ll.
12.
13.
()
()
()
()
()
()
)
)
(
(
(
COMHENTS:
<-Lo ?1
Can be approved.
TO APPLICANT:
I Your Building Permit / Site lnspection:
b Cannot be approved at this time as indicated on item N0 above.
Questions and further information on items I through 5 contact the Lane-
COUNTY PLANNING DEPARTMENT" Questions and further information on items 5
Lane Count Buildin and Sanitation Division.
ce unt i I you can reso ve the problems indicate d.
ls being returned.
Your building permit application fee is being returned under seParate cover.
!
LANE COUNTY PLANN tNG DEPART}'IENT LANE COUNTY BU ILD tNG S SAN ITAT ION D IV IS ION
135 Sixth Avenfie East, Eugene, Oregon 97401 135 Sixth Avenue East, Eugene, Oregon 97401
PHoNE | 342-l3tt Exr. 231 PHoNE | 342-1311 Exr. 4l I
Ir
through l3 contact the
Will be held in this o()
()
()
c55-28
#i!^_rMf-s G-7
NAnE ft,'"t n€7f @ttfT ( n ,
ADDRESS
NO YES
Surname m. Ranse Se;iTon TEI-tffi ffiIE-Census Tract
Rece Dt No.
Yes
REQUEST FOR SITE FEASIBILITY STUDY
THIS IS A PRELIMINARY REPORT WHICH DOES NOT INSURE THE ISSUANCE OF A FUTURE
BUILDING PERMIT. ANY PI.ANS OR EXPENDITURES MADE IN RELIANCE UPON THIS REPORT
ARE AT YOUR OWN RISK:
$
No.-Tiaat
No. Acres
TOTAL
Tel e e No.Propos Use o Property
rope rty tze Ur n9 reanz
Yes No
rs Consent
No
Name
and
Addres s $
$
st n9 t ructures I s Property t in One Mi eo a ty?
Yes NoWhat Cit ?
P ropose
Publ i c
Water UPP vDistrict Sprinq Well
0t er
Soec i fv
OwnerDate
nterest in PropertycantsPP
Permi t Area
No
Special
Yes
Legal Access - Road Name
P rope r ty Locat i on : (D i rect i ons )
APPROVED NOT APPROVED
BEFSRE CONSTRUCTI0N lS STARTED bring this form to the Department of Environmental
Management and rnake application for a building permit. lf the ProPerty is a por-
tion only of a tax lot, a metes and hounds description of the parcel must be fur-
nished. Exact specifications for the sewage disposal system will appear on the
building permit. Two sets of building plans and a plot plan will be required.
LANE COUNTY DEPT. OF ENVIRONMENTAL MANAGEMENTI35 EAST SIXTH AVENUE, EUGENE, OREGON 9740I Authorized Signatufe
c55-32 Da te
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