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Home My WebLink AboutPermit Building 1977-12-29t 7-tr;-/7r'a *S?aa T RS,,TL -4,, aJOB LOCATIO Partitioning # LANE COUNTY PERMIT /%ElAcreage or Lot Si ze- Contractor's O.S. # THIS PERMIT IS FOR ( ) Completed Subdivision APPLICANT'S NAME AND ADDR ESS Phone Phone Phone OWNER'S NAME AND ADDRESS CONTRACTOR'S NAME AND ADDR lvlail permit to ( ) Applicant { )Owner ( }ContrEctor. I ) Pre{er to pick up, Call- (owner, etc.) when ready. STRUCTURES NOW ON THE PROPERTY - # BEDROOIVIS-# PLUIVIB I NG CONNECTIONS WATER SUPPLY ,"" -..'.SEWAGE DISPOSAL s.l. # TH lS PROPERTY lS WITH lN ONE Ml LE OF TH E CITY OF-.i'PLUMBING BY - I hereby certity that the above statements are true and accurate, and that I have the following legal interest in the properly: -owner o{ record; -contract purchaser; - potential buyer; - realtor or agent. I lurther certify that (iI not the owner) I am authorized to act for the owner of record, and that said owner is aware and approves ot this action. I hereby agree to clmply with all applicable Codes relating to this permit. Fee Paid S-Signatu re Date () NEW ADDRESS () FACILITY PERIVIIT TO TRANSPORTATION DEPT () SPECIAL PIVIT. AREA. IVIIN. ELEVATION It \A SANITATION Minimum Septic Tank Capacity (Gallons) Drainfield Required - Lineal Feet Maximum Depth BU ILD ING -:l- Type of Constt:::?; Comments roup ire Zone cation Comments B B Date PLANNING REOUIREMENTS SATISFIED. Bv Date Date lssued LANE COUNTY DEPARTI\4ENT OF ENVIRONMENTAL IV]ANAGEMENT, 125 EAST 8TH AVE., EUGENE, OREGON 97401 PHONE: 687.4394 POST THIS PERMIT ON MAIN BUILDING AT SITE BLDG.PERMIT-WHITE; BUILDING-GREEN; PLUMBING-CANARY; SANITATION-cOLDENROD; OFFTCECOPY-WHtTEc55-1 3 trce ( Date: ZONE: i SETBACKS: FRONT SIDE FACING STREET (F ROIVI CILI INT. SIDE YARD REAR (FROMI P/L) 333 1-77 TRS ,TL /: 7*ae-/?-.*Loo ^J 3E* **t oo(*orra o F F t4 Av t) Ett/tten Job Location 3n /Dc E /< -D./ 1{ euitoing Permit Acreage or Lot Size 7 7 Y' i 4 o Partitioning #- ( )Completed( ) Pending APPLICANT'S NAME AND ADDRESS OWNER'S NAME AND ADDRESS, if dif-.)NTRACTOR'S NAME AND ADDRESS ,,,ail permit or results of site feasibility studyto ( )Applicant ( ) Owner ( ) Contractor.( ) Prefer to pick up. Call (owner, etc. ) when ready. STRUCTURES NOW ON THE PROPE PROPOSED USE (this permit) WATER SUPPLY INFORMATION SHEET ( ) Site Feasibility Study for Septic Tank. Number of sites- Test holes will be ready Subdivision VAIEo)r/' PA,( Lot// Btock E *h PnoneT 4/ ''-r 4 6 o pplicant's Phone Phone SEWAGE DISPOSA L AIA "\, existing or proposed well, etc. lf public, name of system) (existing or proposed septic tank, etc.) S.l 4 AddressPLUMBING B tl* () PROPERTY IS WITHIN ONE MILE OF CITY *******oFFtcE usE oNLY BELOW THtS LtNE *+*ri*.* r+. ( ) New Address Necessary ZONE- ( ) Facility Permit Necessary SETBACKS: Front ( ) Special Permit Area. Minimum Elevation Side Facing Street (FROM CENTERLINE OF ROAD) lnterior Side Yard Rear --(FROM PROPERTY LINES} To: Planning/Building lnspector/Sanitarian/Surveyor This applicant appears to have a problem w Your assistance will be appreciated. By Permit Processing Section Response By DEPARTMENT OF ENV I RONMENTAL MANAG EIMENT Permit Processing Section 125 East 8th Avenue 687-4394c55-12 D ivision t- Contractors O. S. # 4r TRS, T Acreage or Lot Size Contractor's O.S. # JOB LOCATIO Partitioning # LANE COUNTY PERMIT ) Completed Subdivision Lot Block- APPLICANT'S NAME AND ADDR FSS OWNER'S NATVIE AND ADDR Phon Phon Mail permitto ( )Applicant ( )Owner ( )Contractor. ( )Prefertopickup. Call-(owner, etc.) when ready. CONTFACTOR'S NAIV1E AND ADDRESS Phone--- Fire Zone STRUCTURES NOW ON THE PROPERTY THIS PERTVIIT IS FO # BEDROOIVIS-# PLUMBI NG CONNECTIONS WATER SUPPLY-- SEWAGE DISPOSAL- S.I. # THlSPRoPERTYlSWlTHlNoNEl\4lLEoFTHEclTYoF-.PLUlv]BlNGBY-- I hereby certi{y that the above statements are true and accurate, and that I have the following legal interest in the property: -owner oI record; -contract purchaser; - potential buyer; - realtor or agent. I further certify that (iI not the owner) I am authorized to act for the owner ot 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. Fee Paid $Signatu re Date { )NEWADDBESS { ) FACILITY PERM IT TO T RANSPOf,TATION D EPT.- { ) SPECIA L PI\4T. AR EA. IV]IN. ELEVATION: - SANITATION BU ILD ING [Vlinimum Septic Tank Capacity (Gallons) Drainfield Required - Lineal Feet lVlaximum Depth Type of Construction Use Classification Comments: roup Comments Date:Date Date lssuedPLANNING REOUIREMENTS SATISFIED. B v:Date ZONE SETBACKS: FRONT SIDE FACING STREET (FROtVl C/L) rNT. SrDE YARD REAR (FROlVl P/L) LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT. 125 EAST 8TH AVE., EUG ENE, OREGON 97401 PHONE: 687-4394 POST THIS PERNIIT ON MAIN BUILDING AT SITE BLDG.PERMIT*WHITE; BUILDING-GREEN; PLUMBING-CANARY; SANITATION-cOLDENROD; OFFICECOPY-WHITEc55-1 3 tree By Bv: S I TE INSPECTION AppRoveo RruaRx s Dt sappnoveo Darr I ruspectoR FOUNDATION I NSPTCTION AP PRov E D Rruanxs Dr sappRovED Dare I Nseecron FRAMING INSPECTION AppRovro Rr uanx s Dr sappRovro Darr I xsprcron LATH OR SHEETROCK Appnovro RexaRx s I NSPECT I ON Dr sappRoveo DarE I rsrecron FINAL INSPECTION Ap pRov r o m DrsrppRovE, D R ARKS 4' rNsprcron &kJ C€^*&.tr CERTIFICATE OF OCCUPANCY Rrrov ro lssuE RrueRx s D Nor Rraov ro tssuE D DarE I Hsprcron D ..1-