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Home My WebLink AboutPermit Mechanical 1977-10-11&tt--( al 4s,,7 n- !,Iritten Directions Job Location ). //4 !NFORMATION SHEET ( ) guilding Permit ( ) site Feasibility Study for septic Tank. Number of sites- Acreage or Lot Size - Partitioning#-.-.-- ( ) Completed( ) Pending APPLICANT'S NAME AND ADDRESS OWNER'S NAME AND ADDBESS, if d ifferent from applicant's ^.)NTRACTOR'S NAME AND ADDR ESS or results of site feasibility study to ( ) Applicant ( ) Owner ( ) Contractorto pick up. Call (owner, etc.) when ready. Test holes will be ready Subdivision Lot L1 Bto 746-qos7Phone Phone Phone.il permit( ) Prefer STRUCTURES NOW ON THE PROPE RT PROPOSED USE (tnis permit) WATER SUPPLY SEWAGE DISPOSA () PROPERTY IS WITHIN ONE MILE OF CITY * * * * * * * * * * * ** * * * + * * * * * * r * ** * +* + * * ** i * * * * * * * Contractors O. S. # 2 existing or proposed well, etc. lf public, name of system) (existing or proposed septic tank, etc.) S. I PLUMBING BY-Address OFFICE USE ONLY BELOW THIS LINE ZON F r ) New Address Necessary ( ) Facility Permit Necessary ( ) Special Permit Area. Minimum Elevation side Facing street lnterior Side yard -- RearENTERLINE OF ROAD) (FROM PROPERTY LINES) SETBACKS: Front urveyor (FROM C To: Planning/Building lnspector/Sanitarian/S This applicant appears to have a problem Your assistance will be appreciated. with By Permit Processing Section Response: By DEPARTMENT OF ENVIRONMENTAL MANAGEMENT Permit Processing Section.l25 East Bth Avenue 687-4394c55-12 n ivision ) *******************t********tr******* *i+++t TRS, TL Acreage or Lot Size Contractor's O.S. # APPLICANT'S NATVIE AND ADDR LANE COUNTY PERMIT PERIVIIT # JOB LOCATIO Partitioninq #) Completed Subdivision Lot - B loc OWNER'S NAME AND ADDRE cq Phone-- Phone- -Phone-CONTRACTORlS NAIVIE AND ADDRESS Mail permitto( )Applicant ( )Owner STRUCTURES NOW ON THE PROPERTY ( ) Contractor, ( ) Prefer to pick up. Calt (owner, eic.) vuhen ready r HIS PERMIT lS FOR_ _ _= B EDROOI,4S____# PLUI\18 I NG CONNECT lOfiiS__ Use Classific;ation WATER SUPPLY SEWAGE DISPOSAL-s.l. # THIS PROPERTY ISWITHIN oNE MILE oF THE C|TY oF- pLUt\IBlNc By I hereby certify that the above statements are true and accurate, and that I have the following legal interest in the property: -owner of record; -contract ptlrchaser; - potential buyer; - realtor or agent. I {urther certily that (if not the owner) I am authorized to act for the owner ofrecord, and that 9id owner is aware and approves of this action. I h-ereby agree to compiv with all applicable Coies relating to this permit. Fee Paid $-Signatu re{ ) NEW ADDRESS ( } FACILITY PERMIT TO TRANSPORTATTON DEpT.__ ( ) SPECtAL pMT. AREA. tV N. ELEVATION: _ sANtrATtoN BUILDING Minimum Septic Tank Capacity (Gallons) Drainf ield Required - Lineal Feet l,4aximum Depth Type of Construction ---__Group __=-=.Fire Zone vomments Comments: By:Date B Date Date lsued PLANN ING R EOUIREI\4EN TS SATISFIED. B ZONE:SETBACKS: FRONT Date SIDE FACING STREET (FROIVI CiL) INT. SIDE YARD REAB (F ROM P/L) LANE COUNTY DEPARTMENT OF ENVIBONMENTAL INANAGEMENT, 125 EAST 8TH AVE., EUGENE, OREGON 97401 POST THIS PERMIT ON MAIN BUILDING AT SITE BLDG. PERMIT -WHITE: BUILDtNG - GREEN; pLiJMBtNG - CANARy; SANTTATTON _ GOLDENROD; OFFTCE COpv. _ u/ritTE ^qR-1 ? PHONE: 687 4394 / 7-o 3- < (,S.ct il b Oo tree Date - \ PERIVIIT # TRS, TL Acreage or Lot Size Contractor's O.S. # APPLICANT'S NAME AND ADDRES OWNER'S NAME AND ADDRE CONTRACTORlS NAIV{E AND ADDRESS JOB LOCATIO LANE COUNTY PERMIT Partitioning #----( ) Completed Subdivision Lot -._- B lock Phone- Phon e_Mailpermitto ( )Applicant ( )Owner STRUCTURES NOW ON THE PROPERTY ( ) Contractor. ( ) prefer to pick up. Calt (owner. etc.) when ready THISPERMIT lS FoR-'-- ---- + BEDROoivts-:pLU[4BINGC6NNECT,OI\jS__- \^/ATER SUPPLY-SEWAGE DISPOSAL- S.I. # THIS PROPERTY ISWITHIN ONE MILE OF THE CITY OF PLUMB ING BY - %I hereby certify that the above statements are true and accurate , and that I have the follorrying legal interest in the property owner of record;_contract purchaser;potential buyer;realtor or agent.I further certify that (if not the owner) I am a uthorized to act for the owner ofrecord, and that said owner is aware and approves of this action. I hereby agree to comply with all applicable Codes relati ng to this permit. Fee Paid $Signatu re() NEW ADDRESS l FACILITY PERMIT TO TRANSPORTATION DEPT Date( )SPECIAL PIVIT. AREA. I\4IN. ELEVATION SANITATION Minimum Septic Tank Capacity (Gallonsl Drainfield Required - Lineal Feet L4aximum Depth BUILDING Type of Construction c"-r."""., ' Use classification roup ire Zone uOmments B PLANN IN ZON E LAN E COUNTY DEP Date G REOUIREINE NTS SATISFIED. B Date Date Date lssuedSETBACKS: FRONT SIDE FACING STREET (FROM CiL)INT. SIDE YARD REAR {F BOTVI P/L) ARTMENT OF ENVIRONMENTAL IVIANAGEIVIENT, 125 EAST BTH AVE.,EUGENE, OREGON 97401 POST THIS PERMIT ON MAIN BUILDING AT SITEBLDG. pERMIT -WHITE; BUtLDtNG -GREEN; pLUMBING -CANARv; SANTTATTON __cOLDENROD; OFFTCE COp./ --vvHtTE B c55-13 PHON E: 687-4394 qc at S ITI lNSPICTION Appeov E o Rrul nx s C/ Dr srppnove o D Darr FOUNDATION INSPECTION AP PRov E D Rruanxs D DrsappRovr o [--l Darr lruspecron rRAM I NG AppRoveo Reuanx s I NSPECT ION D DrsrppnovEo C/Dare I trs r t c ron LATH OR SHEETROCK INSPTCTION AppRovro Rrxanx s n DrsAPPRovEo [-a DalE I rusercTon F I NAL I NSPTCT ION Ap pnov r o Rruanx s Dr srppnovto oo'r//-3-?'l I NSPEcToR CERTIFICATT OF OCCUP^NCY Rraov ro lssuE RruaRx s Nor Rcaov ro lssur Darr I ruspecroR I Hsprcron D