HomeMy WebLinkAboutPermit Building 1977-02-07*z03 PERMIT #
JOB LOCATIO
LANE COUNTY PERMIT
Partitioning #-( ) Completed Subdivision \fc\ o^tebc\lo Qs ers-!-------T-..r-Lot J Blo
tl
TRS, Tr-
Acreage or Lot Size
Contractor's O'S' #
APPLICANT'S NAIVIE AND ADDRE
-
Ss phone
OWNER'S NAIVIE AND ADDRESS-Phone- -Phone-CONTHACTOR'S NAME AND ADDRE
Mail permitto ( )Applicant ( )Owner ( )Contractor. ( )Prefertopickup. Call-(owner, etc.) when ready
STRUCTURES NOW ON THE PROPEBTY
THlsPEBl\,lTlsFoB#BEDRool\4s-#PLUMBlNGcoNNEcTloNL
"./ATER SUPPLY-SEWAGE DISPOSAL s.l. #
THlSPRoPERTYlSWlTHlNoNEMlLEoFTHEclTYoF.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;
_ _"ontract pr.chaser;
-
potential buyer;
-
realtor or agent. I lurther certify thal (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 permit.
FeePaidg \ Fsrru Signatu re Date
( )NEWADDRESS ( ) FACILITY PE RMIT TO TRANSPORTATION DEPT.- ( ) SPECIAL PMT. AREA. MIN.ELEVATION:-
SANITATION BU ILDING
Type of Construction
-Group -FireZone
c",n,n""*
use classification
Comments
Bv: Date: BY: Date:
PLANNING REOUIREMENTS SATISFIED. By:Date Date lssued:
Minimum Septic Tank Capacity (Gallons)
Drainfield Required - Lineal Feet
Maximum Depth
ZON E SETBACKS: FRONT SIDE FACING STREET (FRONN C/L) INT. SIDE YARD REAR (FROM P/L)
PHONE: 687 4394LANE COUNTY DEPARTMENT OF ENVIRONMENTAL IVIANAGEMENT, 125 EAST 8TH AVE., EUGENE, OREGON 97401
POST THIS PERMIT ON MAIN BUILDING AT SITE
C55-13 BLDG. PERMIT - WHITE; BUILDING - GREEN; PLUMBING - CANARY; SANITATION - GOLDENROD; OFFICE COPY - WHITE I
TRS, TL -o
( ) guitOing Permit
Acreage or Lot Size-
Partitioning #- ( )Completed( ) Pending
APPLICANT'S NATVIE AND ADDRESS D
OWNER'S NAME AND ADDRESS, if different from a licant's
CONTRACTOR'S NATVIE AND ADDRESS
HL+q b Location 51v M- i+ ''f S+, S
BP
INFORMATION SHEET
( ) Site Feasibility Study for Septic Tank. Number of sites( ) Would like to meet on site. Call (owner, etc.)
Test holes will be ready-
Subdivision Lot
-
Bloc
ba\-\'1
Ll,o
Phone 6f tr -?6'.8 i
Phone 2q>'&483
Phone 6t,f - >:Fr
>1>-Zd)9Mail peqmit( f)-frdfer
efliqit".g.qlH lor results of site
to pick up. Call
}TRUCTURES NOW ON THE PROPE
.A
Applicant ( )Owner ( )Contractor.
( owner, etc. ) when ready.
$cm <-
PROPOSED USE (this permit)Fqhnilu K,.. rz'Kt9' Rrn".rnfc )'Xl?'
WATERsUPPLY(existingorproposedweil,etc.lfpublic,nameofsystem)
SEwAGEDlsPosAL{existingorproposedseptictank.etc.)s.l
PLUMBING BY Address
!
( ) pRoPERTY rS WTTHTN ONE MtLE OF CrTY
.rii*** oFFlcE usE oNLY BELOW THtS LINE *r****r*r****
( ) New Address Necessary
zoN F
( ) Facility Permit Necessary ( ) Special Permit Area. [Vlinimum Elevation
SETBACKS: Front Side Facing Street
(FROM CENTERLINE OF ROAD)
lnterior Side Yard Rear
-
(FROM PROPERTY LINES}
I o: Planning/Building lnspector/Sanitarian/Surveyor
This applicant appears to have a problem
Your assistance will be appreciated.
By Permit Processing Section
Respon
By
DEPARTNN ENT OF E NV I RON MENTAL MANAG EIVI ENT
Permit Processing Section
125 East 8th Avenue
687-4394c55-12
ivision
PERI\NIT #
/,
RS, 'T L JOB LOCATIO
Partitioning #
LANE COUNTY PERMIT
Acreage or Lot Size
Contractor's O.S. #
( ) Completed Subdivision
Lot Block-
APPLICANT'S NAME AND ADDRE ss Phon
OWNER'S NAME AND ADDRESS Phone-
CONTBACTOR'S NAUe aruO noonrs Phone-
Mail permit to ( )Applicant ( ) Owner ( ) Contractor. ( )Preferto pick up. Call- (owner, etc.) when ready.
STRUCTURES NOW ON THE PROPERTY
THlsPERMlTlsFoR#BEDRoolv1L#PLul\,BlNGcoNNEcTloNL
.t/nTen SUPPLY SEWAGE DISPOSAL s.l. #
THlSPRoPERTYlSWlTHlNoNEIVllLEoFTHEClTYoF.PLUlVlBlNGBY
I hereby certify that the above statements are true and accurate, and that I have the following legal interest in the property: owner oI record;
--cont€ct purchaser;
-
potential buyer;
-
realtor or agent. I further certify that (if not the owner) I am authorized to act for the owner ol
record, and that said owner is aware and approves oI this action. I hereby agree to comply with all applicable Cgde.s relating to rhis permit.
Fee Paid $Signatu re Date
{ }NEwADDRESS ( } FActLrry pEBMrr ro rBANspoRTATroN DEpr.- ( ) spEbrAL pMT. AR EA. MTN.ELEVATToN:-
SANITATION BUILDING
Comments
By
Minimum Septic Tank Capacity (Gallons)
Drainfield Required - Lineal Feet
lVlaximum Depth
Date:By
Type of Construction
se Classification
roup
-Fire
Zone
Date
PLANNING REOUIREMENTS SATISFIED. By Date:Date lssued
ZONE:SETBACKS: FRONT SIDE FACING STREET (FROIVI C/L) INT. SIDE YARD REAR (FROIVI P/L)
LANE COUNTY DEPARTMENT OF ENVIRONMENTAL IVIANAGEMENT, 125 EAST 8TH AVE., EUGENE, OREGON 97401
POST THIS PERMIT ON MAIN BUILDING AT SITE
C55-13 BLDG. PERMtT - WHtrE; BUtLDTNG - GREEN; pLUMBtNG - cANARv; sANrrATroN - coLDENRoD; oFFtcE coprz - wHtrE
PHONE:687-4394
Comments:
I
I
SITE INSPECTION
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FINAL INSPECTION
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CERTIFICATE OF OCCUPANCY
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