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Home My WebLink AboutPermit Building 1977-09-15PERIVIIT # TRS, TL Acreage or Lot Size Contractor's O.S. # APPLICANT'S NAME AND ADDR JOB LOCATIO Partition ing LANE COUNTY PERMIT ) Completed Subdivision Lot Blo ck OWNER'S NAME AND ADDRES s Phone Phone PhoneCONTRACTOR'S NAME AND ADDRESS Mail permitto ( )Applicant ( )Owner ( )Contractor. ( )Prefertopickup. Call-(owner, etc.) when ready ,fRUCTURES NOW ON THE PROPERTY THIS PERMIT IS FO # B ED ROOIVIS-# PLUIVIB I NG CONNECT IONS WATER SUPPLY e SEWAGE DISPOSAL 6L s.t. # THtSPRoPERTYlSWlTHlNoNElVllLEoFTHEclTYoF.PLUlVlBlNGBY I hereby certify that the above statements are true and accurate, and that I have the lollowing legal interest in the property: -owner of record; -contract purchaser; - potential buyer; - realtor or aqent. I further certify that (if not the owner) I am authorized to act for 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 peJmit. Fee Paid S-Signature Date () NEW ADDRESS () FACILITY PERIVIIT TO TRANSPORTATION DEPT ( ) SPECIAL PIVIT. AREA. IVllN. ELEVATION: - SANITATION Minimum Septic Tank Capacity (Gallons) Drainfield Required - Lineal Feet lVlaximum Depth Date BUILDING Type of Construction U se Classification Comments By roup ire Zone Comments By:Date PLANN ING REOUI REIVIENTS SATISFIED. By Date Date lssued: ZONE SETBACKS: FRONT SIDE FACING STREET (FROIVI C/L)INT. SIDE YARD REAR (F ROTVI P/L) LANE couNTy DEpARTMENT oF ENVTRoNMENTAL MANAGEMENT, 125 EAsr grH AVE., eucerue, ogecoru gztrot pHoNE: 687-4394 POST THIS PERMIT ON MAIN BUILDING AT SITE BLDG.PERMIT-WHITE; BUILDING-GREEN; PLUMBING-CANARY; SANITATION-GOLDENROD; OFFICECOPY-WHITEc55-1 3 #/tr1 TRS, T l- Acreage or Lot Size Contractor's O.S. # APPLICANT'S NAIVIE AND ADDR PERIVIIT # JOB LOCATIO Partition ing LANE COUNTY PERMIT ) Completed Subdivision Lot Block- OWNER'S NAIVIE AND ADDR trss Phone Phone- Phone- s.t. # Mail permitto ( )Applicant ( )Owner ( )Contractor. ( )Prefertopickup. Call-(owner, etc.) when ready. CONTFACTOR'S NAME AND ADDRESS WATER SUPPLY : SEWAGE DISPOSA ]TRUCTURES NOW ON THE PBOPERTY TH|S pERt\,ltT tS FOR # BEDROOMS-# PLUI\4BING CONNECTIONS- THlSPRoPERTYlSWlTHlNoNElVllLEoFTHEClTYoF.PLUlVlBlNGBY 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 purchaser; - potential buyer; - realtor or agent. I further certify that (if not the owner) I am authorized to act for the owner of record, and that said owner is aware and approves of this action. I hereby agrce to comply with all applicable Codes relating to this permit. Fee Paid S-Signature Date ()NEWADDFESS () FACILITY PERI/] IT TO T RANSPO RTATION DEPT.- () SPECIAL PI\4T. AREA. I/IN. ELEVATION: - SANITATION Minimum Septic Tank Capacity (Gallons) Drainfield Required - Lineal Feet Maximum Depth BUILDING Type of Construction c".."*, Use classification roup ire Zone Date: PLANNING REOUIREMENTS SATISFIED. By:Date Date lssued ZONE:SETBACKS: FRONT SIDE FACING STREET (FROIVI C/L) INT. SIDE YARD REAR (FROM P/L) LANE COUNTY DEPARTIVIENT OF ENVIRONINENTAL N/IANAGEN/IENT, 125 EAST 8TH AVE., EUGENE, OREGON 97401 POST THIS PERMIT ON MAIN BUILDING AT SITE C55-1 3 BLDG.PERMIT-WHITE; BUILDING-GREEN; PLUMBING-CANARY; SANITATION-GOLDENROD; OFFICECOPY-WHITE PHONE: 687-4394 Comments: By:B y: Date: -d- r,*1,34 \^)*5f \=\ Grl-. I., H. /o R rr t> I , / ./-O --, - /a- f SITE INSPECTION Ap pRov E o R ruanx s Drsappnoveo I ruspectoR FOUNDATION INSPECTION APPRovED Reunnxs D r srppnoveo 'fl rNsPEcroDrlr /a FRAMI NG AppRovro Reuanxs I NSPECT I ON Dar E I xsprcron LATH OR SHEETROCK INSPECTION Ae eRov r o Re tt rRx s Drsappnoveo I Hspecron FINAL INSPECTION AP PRov E o REuanx s D I SAPPROVED I NspectoR /?-/ CERTIFICATE OF OCCUPANCY Reaov ro I ssuE Reua Rx s Nor ReIoy TO ISSUE Dare I ruspeclon Drsappnove, D D ,orr./O -z{-?1 D o^,,J /-y'4-1 1'T'- oz- p ,'> *t Job Locati A1'*ct rN >18 *?28-7) Lot /o gtock ? ,no^u23Vzzzgr Phone Phone Contractors O. S. #/o $s- g TRS, T $ritt n ciiections ,i t*) eritoins Permit Acreage or Lot Size Partitioning# , ( )Completed( ) Pending ORMATTON SHEET ( ) Site Feasibility Study for Septic Tank. Number of sites- Test holes ll be ready Subdivision O from a nt y to DA) Applicant ()Owner ( )Contractor ( owner, etc. ) when ready. D ( ) Prefer to pick up. Call $srnucruBES Now oN THE PRoPE 5" tr-. PROPOSED USE (this permit) WATER SUPPLY C,-}.-.,f LJ <\ SEWAGE DISPOSA PLUMBING BY /., O-ft 8a<- ?.e)(>rrt 4o tyt:>x, ,->5, F. D.BEDROOMS existing or proposed well, etc. lf public, name of system) ! J - 3s--6 J-(existing or proposed septic tank, etc.) S.l AddressI ()PROPERTY IS WITHIN ONE MILE OF CITY r r+ I * + * *+ * a * * + * r * * * t * * r * * * + + * * * * * * + * * * * * * * * O F F ICE ONLY BELOW THIS LINE **+**+*****t * +{ **++r* ** +*+ * *+*+**+++r +* + + ++ tl New Address Necessary F ( ) Facility Permit Necessary ( ) Special Permit Area. Minir-nurn Elevation Side Facing Street lnterior Side Yard R"", 7/ Pl/E (FROM CENTEHLINE OF ROAD)(FBOI\4 PROPEFiTY LINES) ZON SETBACKS: Front To: Planning/Euilding Inspector/Sanitarian/SuNeyor. Thisapplicant appears to have a problem with Your assistarEe will be appreciated. By Perrnit Processing Sect ion Response By DEPARTMENT OF ENVIRONMENTAL MANAGEMENT Permit Processing Section 125 East 8th Avenue 687-4394c55-1 2 Division .7 f{. ,a )