HomeMy WebLinkAboutPermit Building 1974-04-03IANE COUNTY B_.DING
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PERMIT OT MOBILE HOME .,E PERMIT
PERMIT NO.
PROPERTY OWNER MAITING ADDRESS PHONE
, ore
CONTRACTOR MAILING ADDRESS PHONE
PROPERTY TOCATION - INCLUDE POST OFFICE
to V!lctinc Perk
RANG E SECTION TAX LOT NO.CODE CENSUS TRACT,4,A #27H
rrcl I L. Ulm
EXISTING STRUCTURES ON PROPERTY
llr 'i[rAPPI..
NAME
&
MAITING
ADDRESS
LEGAT ACCESS TO PROPERIY,.;-
PROPERTY SIZE - FT.
WIDTH DEPTH AREA
FOR MOBILE HOME PERMITS ONLY
No. of Bedrooms Connecl to Exisling Sewoge System ! New Sysrem !.,. *_
lcprir of Saage Dispoeal Systse
SEWAGE DISPOSAT
PUBTIC N SEPTIC TANK U OTHERE
PTUMBING INSTALI.ED BY
OWNER fl OTHER: NAME
BU ITDING
WASTE DISPOSAI.
PTUMBING
PLAN REVIEW
PARK TRAII.ER
(FEES WATER SUPPTY
PUBUC n tr OTHER
TOTAT :
COUNTY BUILDING & SANITATION SPECIFICATIONS
MIN. SEPTIC TANK CAPACITY
WITH DIST. BOX: GAt.
DRAIN FIEID REQUIRED
tIN. FT TRENCH WIDTH FT.OR SQ. FT
TYPE OF STRUCTURE OCCUPANCY ZONE PUBTIC UTIt. EASEMENT
BLDG. SETBACKS
FRONT
FT. FROM CTR. Of ROAD RIGHT OF WAY
SIDE INT. SIDE EXT.
USE CTASSIFICATION
REAR
AUTHORIZED SIGNATURE _ DATE DATE
BTDG. PERMIT _ WHITE
OFFICE COPY _ WHITE
COUNTY TAX _ PINK
PI-UMBING _ CANARY
BUILDING _ GREEN
SAN ITATION _ GOI.DENROD
Coll 687-4065 to schedule oll required inspections. All conslruc-
tion sholl comply with Uniform Building Code, D.E.Q. stondords
IMPORTANT: for subsurfoce sewoge disposol ond counly regulotions covering
plumbing. All buildings require o cerlificole of occuponcy before
being occupied.
(See Detoils on Reverse Side)
(posT THrs PERMTT ON MAIN BrDG. AT SITE)
IANE COUNTY, DEPT. OF ENVIR,ONMENTAT MANAGE'ilENI
COURTHOUSE ANNEX, I35 EAST 6th, EUGENE. OR,EGON 97,10Ironu 1t g55- 13
PROPERTY TEGAI- DESCRIPTION _ METES, BOUNDS
BU I LD IN6 S ITE EVALUAT ION
Ts ,/c,L/,, oLs /o
TRACT,1 Vffiffi
rJZ^
CENS US
Qnd o
APPL lCt,
NAfiE
ADDR
TAX LOT
-)
/d, K L'2 3
R-ttg''( ) Building Permit Apptication-No.
( ) site lnspection
( ) Pre-Permit lnvest igat ion
PHONE
DATE
L/iNE COUNTY PLANNING DEPARTI4ENT N0
I . Zon i ng Ord i nance Comp I i ance
(Zone
Subdivis ion 0rdinance Comp an
Requ i red Access
4. Bu i ld ing S ite (Area, }Jidth,
Frontage, Setback)
5. 0ther (see comments)
NO YES N;+1*1E Di\TE
I icabl
) ()
)(2
't))
)
()
)(
COHHENTS:
BUILDING INSPECTION SECTION
6. Pl ans Submitted
7. Soil Stabil ity (footings)
8. Flood Pl a in
g. 0ther (see Comments)
COHHENTS
NOT NO
!f,i't icable -
YE NAHE DATE
(
(
)
)
)
)
)
)
SANITATION SECTION
10. Sewage Disposal
ll. Usable Area
12. l./ater Supply
it3. 0ther (see Comments)
aool icable*rr-(
)
)
)
NOT NO YES E DATE
)
)
)
(
COM}4 ENTS
TO APPL ICANT:
u,3 e(h-
Your Building Permit / Site lnspection
Can be approved.
Cannot be approved at this time as indicated on iten, N0. above.
Quest ions and further infornrat ion on itenrs I through S cofr't"cfTf,u-Lane-
COUNTY PLANNING DEPARTHENT" Q"uesl ions and further infornat ion on itenE 5
throuqh l3 contact the Lane Courr!.y__Br_!_!_qlfp__:!g 5ani_tat ion D iv is ion.
( ) Will be held in this off icc until you can re-.;olve tlre problenrs indicatt:d.
( ) ls being returned.
( ) Your buildinq pernr it appli<.at ion fee is being returned under separate c,r'€r.
LANT COIIN'I Y I'I I\NN ING DEI'/\RTMENT
l l5 5i7tl1 r\vcnte Iast, Eugerre, 0tcgtrn 9740 I
l'ntrNE 3{2, llll E)tl.271
lANt- COUNIY tlt,ltl)lNG 6, S/\NlTATl0N DlVlSl0N
135 Sixth Av€rrurr E.iSf , Errqert,', ()reqon 9740 I
,'llt)Nl : 3t2-llll tXT. 4ll
Mss:rt- -'
)
)
()
)
)
)
()
IANE COUNTY r-COltlO
BUILDING E MH E
PERMIT
,O1 MOBITE HOME :JE PERMIT
PERMIT NO.-l
PROPERTY OWNER t MAILING ADDRESS PHONE
CONTRACTOR MAITING ADDRESS
Irl $prsg Flctrtnt lll I l, 0rcqoll
PHONE
PROPERTY TOCATION _ INCIUDE POST OFFICE
I l5th Etrcit, Sprlngf lcld
PROPERTY LEGAL DESCRIPTION _ METES, BOUNDS
Yalctllrc Prrk
RANGE SECTION TAX LOT NO CODE CENSUS TRACTrt
0rrnl I L. Ula
EXISTING STRUCTURES ON PROPERTY
APPT.
NAME
&
MAII.ING
ADDRESS
LEGAT ACCESS TO PROPERTY
PROPERTY SIZE _ FT.
WIDTH DEPTH AREA
FOR MOBILE HOME PERMITS ONLY
No. of Bedrooms Connect to Existing Sewoge Sysrem ! New System I
STRUCTURES TO BE BUILT THIS PERMIT TYPE CONSTRUCTION sQ. FT. # BDRMS VALUATIoN
SEWAGE DISPOSAT
PUBUC tr SEPTIC TANK !oTHERn
PTUMBING INSTATLED BY
OWNER n OTHER: NAME
BU ITDING
WASTE DISPOSAL
PTUMBING
P[AN REVIEW
PARK TRAITER
FEES WATER SUPPLY
PUBUC n N OTHERa
TOTAT
COUNTY BUILDING & SANITATION SPECIFICATIONS
MIN. SEPTIC TANK CAPACITY
WITH DIST. BOX: GA[,
DRAIN FIETD REQUIRED
TIN. FT TRENCH WIDTH FT.OR SQ. FT.
TYPE OF STRUCTURE OCCUPANCY ZONE PUBTIC UTIT. EASEMENT
BLDG. SETBACKS
FRONT
FT. TROM CTR. OF ROAD RIGHT OF WAY
SIDE INT. SIDE EXT.
USE CTASSIFICATION
REAR
AUTHORIZED SIGNATURE _ DATE DATE
J
BTDG. PERMIT _ WHITE
OFFICE COPY _ WHITE
COUNTY TAX _ PINK
PLUMBING _ CANARY
BUII.DING _ GREEN
SANITATION - GOLDENROD
Coll 687-4065 to schedule oll required inspections. All construc-
tion sholl comply with Uniform Building Code, D.E.Q. stqndqrds
IMPORTANT: for subsurfoce sewoge disposol ond counly regulolions covering
plumbing. All buildings require q cerlificote of occuponcy before
being occupied.
(See Detoils on Reverse Side)
(POST THIS PERMTT ON MAIN BLDG. AT SITE)
TANE COUNTY, DEPT. OF ENVIRONMENTAT MAN,AGEMENT
COURIHOUSE ANNEX, I35 EAST 6th, EUGENE, OREGON 9740I
nonv * 955- 13
E
SITE TNSPECTION
Ap pnov E o
RruaRxs
D r sappnoveo Darr I Ns pecron
FOUNDATION INSPECTION
Appnov eo
REulnx s
D DrsAppRovE, n Dare I ruseecron
FRAMI NG
AP PROV E D
ReNanr s
I NSPECT I ON
D DrsappnovEo D Darr I NseEcroc
LATH OR SHIETROCK
Ap pnov E o
Rrulnx s
I NSPECT I ON
Dr srppRoveo Dar r I HspectoR
FINAL INSPECTION
Ap pRov e o
ReManx s
D r slppRoveo I NsPEcroR
CERTIFICATE OF OCCUPANCY
Rraov ro lssuE
Rruenx s
Nor Rraov ro I ssuE Drr E llrsprcton
U.n -'Rop,sED
sEt,AGE Drsp,sAL sysrE, F ,RD
Complete topvpart-.of form to signature and submit'troth copies with appliI NSTALLER:
PERHIT NO :7
No. Living Units Bedrooms Baths Basement
Yes No
Water Supply
Publ ic Other-List
Sept i c Tank:
Ft. fron wel I Steel tr Concrete l No. Conpartments Gal . Capaci ty
NS
NAME
}tA I L ING
ADORESS
mens ons:
t.,i D i ameter
4/?-
{ ru 3s_*7,
//t/6FtEtD
e sPosa e
th Di stribution Box
r str u On-
eet rom
tJEl I
Lot L
Front
Yes No
t
F d
ne
Side
Length nes-Ft.er e ov,
4 6 ile in
For Sanitarian Use Only:
ln accordance wi th 1973 0regon Laws Chapter 835, Section 214
as evidence satisfactory cornpletion of a subsurface sewage disposal system at the above
I ocat i
Approved: System lnstallation conforms to current standards
l-7 Oisapproved: Does not conform to current standards
Remarks:
r
L
'::::-"".t
i ricate',:'?:!ld 7 T
Trench
u/ i dth
Total Sq.
Ft.
Ft. Between
Lines
er
,t Plan (see instructions,
,l /-
I
s?-
f*l
I /u,, 3{a1-
\,2-l z1;.att
Si tur
tar an
E COUNTY
c55-r1
STATE OF OREGON DEPART}.IENT OF ENVIRONIIENTAL QUALITY
gnat ure
tn
er
,
IANE COUNTY BU!t. ".{G PERMIT OR MOBILE HOME US.- APPLICATIO
PERMIT TYPE - BUILDING MOBILE HOME OSC REG. #PERMIT
ING ADDRESS
7
PROPERTY OWNER
CONTRACTOR
zqo s*s-b.
MAILING ADDRESS
PH
PHONE
5PR #tt-t-
PROPERTY LOCATION _ INCI.UDE POST OFTICE
?-40{ /U,97,
PROPERTY TEGAL DESCRIPTION
LOT_BTOCK_SUBDIV.
TWP RANGE
Btoc x fuU,nrraTb METES&BOUNDS EYES
ATTACHED NO
SEC
i
TAX tOT CODE CENSUS TRACT
t7 )-?,T -ED iOL
DESCRIBE EXISTING ON PROPERTY IF ANY
APPTICANT
NAME
AND
MAILING
./
f?/,-*
TEGAT ACCESS NAME OR
PROPERTY SIZ DTH DEPTH AREA
Connect to Existing Sewoge Sysrem f or New System R"q. tr
FOR
Number of Bedrooms
HOME PERMIT ONL
s BE BUITT THIS IT S TYPE CONSTRUCTION se. FT. # BEDRooMS vAtuATloN
s
SEWAGE DISPOSAT
PUBTIC
PTUMBING INSTATTED BY
BLDG.
WASTE DIS.
PTUMBING
PTAN REVIEW
PARK TRLR.
TOTAT
SEPTIC TANK tr oTHER n
WATER SUPPTY PTANS FURNISHED
OF APPTI
FACITITY PERMIT
NO
FEES
CASH !
CHECK
PUBTIC
PTUMBING FEES
RES
OTHER YES
DATE
DATE
NECTION FEE
PERMIT
PUBTIC WATER
CONNECTION
COUNTY BUILDING & SANITATION SPECIFICAIIONS
MtN. SEPTTC TANK CAPACITY r
wlTH DIST. BOX: GAL. Z f ( A
DRAIN FIEID REQUIRED
J.r LLrN. FT.'2 r> O TRENCH WIDTH FT OR SQUARE FEET {60
TYPE OF STRUCTURE OCCUPANCY ZONE REAR YARD PUBLIC UTIL. EASEMENT
BLDG. SETBACKS _ FT. FROM CTR. OF ROAD RIGHT OF WAY USE CTASSIFICATION
Form # css- tz
SI DE REAR
Dole
IRONT SI DE
PTANNING
7
Dole BIDG. I
Directions to Find Property:
COPY I _ OFFICE
COPY 2 _ JOURNAL
COPY 3 - AUDIT
I