HomeMy WebLinkAboutPermit Building 1978-09-20lR e ?A0A
OWNER'S NAME AND ADDRE
TRS, TL JOB LOCATIO
LANE COUNTY PERMIT
Acreage or Lot Si Partition ing ) Completed Subdivision
Lot- Block-Contractor's O.S. #
APPLICANT'S NAME AND ADDR Phone
Phone
Phone
hail permitto ( )Applicant ( )Owner ( )Contractor. ( )Prefertopickup. Call (owner, etc.) when ready
Fee Paid $( )NEWADDREss ( ) FAcrLrry pERMrr ro rRANspoBTATroN DEpr.- ( . 1 specta r pur. lR EA. MTN.ELEVATToN:'
STRUCTURES NOW ON THE PROPERTY
THlsPERl\4lTlSFoB#BEDBool\4S-#PLUl\4BlNGcoNNEcTloNS-
CONTBACTOR'S NAME AND ADDRESS
Signature
-
Date
WATER SUPPLY ' SEWAGE DISPOSAL s.t. #
TH IS PROPERTY !S WITH IN ONE MILE OF TH E CITY OF-. PLUMB ING BY
--
I hereby certily that the above statements are true and accurate, and that I have the lollowing legal interest in the propeny:
-owner
oI record;
-contract
purchaser;
-
potential buyer;
-
realtor or agent. I f urther certily 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 lo this permit.
lANrrArroN lVlinimum Septic Tank Capacity (Gallons)
Drainfield Required - Lineal Feet
Maximum Depth
BUILDING .
Use Classification
Comments
Comments
B Date
PLANNING REOUIREMENTS SATISFIED. By:Date Date lssued
ZONE SETBACKS: FRONT SIDE FACING STREET (FROM C/L) INT. SIDE YARD REAR (FROM P/L}
LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE., EUGENE, OREGON g74O1
POST THIS PERMIT ON MAIN BUILDING AT SITE
c55-13 BLDG. pERMtr - wHlrE; BUTLDTNG - GREEN; pLUMBING - GANARy; sANrrATroN - coLoENRoD; oFFrcE copy - wHrrE
PHONE: 687-4394
trqq
By:Date:
,I
FLOOD PLAIN MANAGEMENT
Department of Publ i c Works
I 25 East Bth Avenue
Eugene, Oregon
687-4.l 95
TO:
PERi,IIT PROCESSING
PLAI.INING
PUBLIC WORKS
PERIlIT NUMBER 2Zob-18
PARTiTION NUMBER
SUBDIVISION
OTHER
SITE ADDRESS
PERivlIT VALUE IS A SUBSTAI{TIAL IMPROVEI'IENT.YES NO
SITE IN FLOOD HAZARD AREA YES
SITE LOCATION IS I^IITHiN A FLOOD HAZARD APPROXIMATE STUDY AREA, EXTRA
PRECAUTIONS I,IAY BE APPROPRIATE TO ASSURE THAT THE BUILDING SiTE l,llLL
BE REASONABLY SAFE FROI.1 FLOODING.
SITE LOCATION iS WITHIN A FLOOD HAZARD DETAIL STU.DY AREA
I
L
J
MINiMUM FIRST FLOOR ELEVATiON OF
14INII4UI4 FOUNDATION ELEVATION OF
(M.S.L. ) REQUiRED.
(M.S.L. ) REQUIRED.
tlOBILE H0ME TIE DoWNS REQUIRED IF GR0UND ELEVATION THAT l40BILE H0l,1E
WILL BE PLACED ON IS BELOhj THE REQUIRED MINIMU}I FIRST FLOOR ELEVATION.
4. SITE LOCATED I.IITHIN A DESIGNATED FLOODI^IAY CHANI.{EL, BUILDING PROHIBITED.
=
RECOMMENDATIONS : EXTTZ.A PZ IV\.\Y BE araTE- -16
PRevEt*tT trt-olEL.ftoN t>uzu.l,c-H.l,c-H rr.la:f,e[..lllo
lNIr
l-oli
-{x
r-Oi
A.
:J
o
0
t
DATE 9-tB--18
_BY C.onA<-
,
NO
SE PT IC
TANx
_:-J i
-*s,;l
l'
t,
.?5
I
io
Jg_
x
-
E
T
I
I
g'l-, -.
cltttsut eii
E{o oFo&qrrl rrArE
1,,
o
'-toL
I
.$
.t
equrmeif
5].f.9
t,
)5
I
- a5'-'
l-lrl
SEPTTC: .--
74N,(.
t
-.L
l-
sEprrc
74tuX
n5
-as'-
afr
zDr
t
. t.-
]{
JO,
TG
LANE COUNTY DEPAFTMENT OF ENVIRONMENTAL MANAGEMENT
125 EAST 8TH-.VENUE, EUGENE, OREGON 97401</
@:
AVERAGE PROCESSING
p
tl
^P
IANNINC DIvISION Current Zoni
artltlonlng I
Parccl No._
PaEtltlonlnq Rcqulred
f]eendins f]completed
Othcr r y-
tr
to
loR
Permanent
Tcmporary
Renerra 1
HA?EI POLLUTION CONTROL
Ucu Slt. InEpcctlon(s)
I of Sltco--
6DS Constructlon [--l New
Nunb€r of Bedroornar
f] nePalr
CorErrarclr rlal -o!
CONSTRUCTION PERIIITS AND INSPECTION
(Seo abov. for I of bedroons,/l of employeea)
tr t{oblh Hotac I
rlFU,
lit
e
ocu,o
rEE
o
€
k
ro
o
FI
D
a
Ft. Valuatlon
Total vrluntion s
_- Plunbing fixtures at t
Sewer^{ater Conn. at t
Each S
Each 3
Subtota I
TOTAL BUILDINC PERHIT FEE
Ide
s
{t St6tc Surchargr
Plana Check Fac
Change of occupEncy
t{lnlnun atructurrl eelbacks :
Fron centerlinc of atreet: Front
Ext
ca am own et
ot,
r
Dnfl
Carh
Proro Intarlor Iot lines: Side
f[ Conuo'l plans lheet to app]lcant f] CurU cut. ro appltcant
PUBLIC IANDS t] Addresr t] uinimun Elev!rion
PUBLIC tIoRXS I Paciltty Perrnit
E}ryI RON:{ENTAL TH
Foc'd by TOTAI,
AFFIDAVIT: If thls lt ls for an agrlcul.tural. building, I hereby lare thrt thls build
vill be Itural prrrpolres ds alloued by zoning and/or the State Building Code,for no I further certify that the Etatemcnts and other information submi't ted on
this
propeto pu ly
i or that the r of record ia knovledgeable of t
true and accurate, and that I have the followlng legal inter.at in the
record; contract purchageri lesgeei holder of an exclulive oPtlon
authorizetl-Eo act for a person wEi-o has the f5flowing legal lntereet:
cab Iea
rng
and
hie
re La t ing
brre ccLrnty
fu r ther comply uith ll
Applicant'a Signa
THIS IS YOUR RECEIPT,DOES NOT GIVE YOU PERMISSION TO BUILD.
yee a
$
s
s\o
s
s
cr)
$
I
Lmum Elevation
Address
c74-L70
ION ABOUT THE PROGRESS OF YOUR APPLICATION, CALL PERMIA CONTROL, 687-{]57 (587-HELP)
s
s
)
- ?/n
(
?lG.tc Irlnt - t((tilm AtPlt(.tlon to
,l.c.l,t lonlrr Lien Cool'ltt rd
rD9n E$t
oylrEl (rl Dl ExT)
/urnEss
00BilAcT0l
Altlolrrrni-trt ltrtr'
Ql(1'-- ltrc 0n!yAPPTICATI O T\t
PHOi,IE
lry -94ia----;,;qw
PIIONE
cltv ztP
coNTnACT0R' s oR[,. sTA'l'E LICt:NSE
t
l
zo
.:!
Ni
r
I
c,
=c
aU
t
(crrcr.t: oxilffirrzrrR To PrcK uP.0i
B
0,. Dr3ctl!? S?IUCTUIE3 NOU oil TlrE ?XOPSiTY. NOrt ANY SIKUCTURES TO !E oEl,tOLlSttEr)
ttE Eo (o
t. lxleDl^rr Turs rcR THIS Pl0?ErTr (Tllls AP?LlCATloil) ArE:
.. IIJTURZ PIAtiS:&
I. PLOT ?LtI SLatch (r) rll
proporcd rarrje
(1) rercrntr
or lndu.trlal.
roadr (b) boodrrlrr of propcrty (c) extrt tng/propored bulldtn3r (d) rrtrttng/dlrpoerl lrcrr (c) crlrt lrrg,/proporrd vcllr (f) crtattnt/proposcd drlwvayr(h) dretnr8cays. rtrc.u, craetr,.ny otlirr pGrttnGnt fcrturer. II comrcltlthry frrrr!andtnt .ltnr. prrklnj errer. INDICATE DIXENSI.ONS.,..J
E
H
F"
c
I
I
I
I
;
It_;
I
I
I
ao
r
,
i..'t'
It...l.
i '.t't"'
t.
I
I
I
I
I
I
I
!
I
I
I
I
--'"t
:l
.t
I
I(.-&-;--
s
I
P
g
tnI
o2
FIo
-i'
I
I
I
I
-. i--.tt.i'
I.t
I
i
I.!.
I:l
I
I
I.l
__l
I
I
I
i
i
I
t
i
1
I
.oL
C, TOTAL LOI SIZE OR
^CR[.^GTt. xtl[oD of srr^cE DISPoS^L
t. lloPosfl) uAr[fl st rPLt
10. tl.rcTilcITY tuf\1s:tED EY
ll. llATUllL C.^S rY
sllt lsSttcTI()s T[.st u(rLEs Rt^r)y (rATi.)
lJr-Ll. slr llc l;Tt t.Ar{ 'Jx[ruBl. ic
II. FIiE DISTN ICT
lr. scllo()L DlsTrtcr
lr. ?Lllilltic lY
ala.a.a..a...arrtt.ara..arar.a.. iI) N(tT L'I{tTf BtltXJ l\f r..ri
ltlolE Y0ur Atfl.lclltos r \ !f. I'RocEsst.t) y()u tl.sT flh.it\lt DESC R u'TIOI
( D r xrNS los ED)
' : - - - : -"- ''':-'-l-' '1.'il 1--t-''r!7
125 EAST BTH AVEIiUE, TUGENE, ONEGON 97401
t
_ 8r;x I I lL0T I'LIXS __
bne @trrtyffi
L
1Y
Ir.- Y
USE OF lrl; typr of f rmlnti corrclrl or tndut rtel; vrcant i ?ac. )--- ..__
I
i
t
t.L
i
I
i
.:
I
I
l:-.'i---1
t::::1.. --1....t.,'.
I
I
I
I
I
I
I
t.\rt. _ _-
//
TRS, T JOB LOCATIO
Partition ing
LANE COUNTY PERMIT
Acreage or Lot Size
Contractor's O.S. #
) Completed Subdivision
Lot- Block-
OWNER'S NAME AND ADDRESS ;
APPLICANT'S NA[4E AND ADDRE cc Phone-
Phon
QO
)tta
NTRACTOR'S NAME AND ADDRE
il permitto ( )Applicant ( )Owner ( )Contractor. ( )Prefertopickup. Call
Phone-
(owner, etc.) when ready
WATER SUppLy-- SEWAGE DISPOSAL- S.l. #
THlSPRoPERTYlSWlTHlNoNElVllLEoFTHEClTYoF.PLUlVlBlNGBY
I hereby certify that the above statements are true and accurate, and that I have the lollowing legal interest in the property:
-owner
oI record;
-contract
purchaser;
-
potential buyer;
-
reallor or agent. I further certily that (il not the owner) I am authorized to act for the owner oI
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 $-Signature
() NEW ADDRESS () FACILITY PERMIT TO TRANSPORTATION DEPT.( ) SPECIAL PlVlT. AREA. lvllN. E LEVATION:
--
\AN|TATION BUILDING
lVlinimum Septic Tank Capacity (Gallons)Type of Construction
-Group -FireZone
Drainfield Required - Lineal Feet Use Classification
lVlaximum Depth Comments
Comments
By: Date: By: Date:
STRUCTURES NOW ON THE PBOPEBTY
THlsPEBl\4lTlsFoB#BEDRoolilS-#PLUl\4BlNGcoNNEcTloNL
Date
-
PLANNING REOUIREMENTS SATISFIED. B
ZONE SETBACKS: FRONT
Date lssued
SIDE FACING STREET (FRON/I C/L) INT. SIDE YARD REAR (FROM P/L)
LANE COUNTY DEPARTMENT OF ENVIRONMENTAL IV{ANAGEMENT, 125 EAST BTH 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
Date:
SITE INSPICTION
Ap pRov r o
RruaRx s
D t s rppnoveo Dare I Nspecron
FOUNDATION I NSPE
Appnov e o
RrulRxs
FRAMING I NSPECTION
Appnov e o
Rruanx s
T ION
Drsappnoveo n
D r sappnoveo
oot, F/a-?? t*t"rrro*-fu6?
Jc.
/-a -/T:73e{<
Datr I NSPEcToR
LATH OR SHEETROCK
AppRovro
Reuanxs
I NSPECT I ON
D r sappnoveo Dat r I xspecron
FINAL INSPECTION
AP PRov E o
REuanx s
Dr slppRoveo )o -?7 lNsercronDare
CERTIFICATE OF OCCUPANCY
Rerov ro lssuE
REuanx s
t= Nor Rrrov ro lssue D Dore_I NSPEcToR
D
TRS, T Job Location (Street, mile post
Plot PIan
9",.11" R,, t, *1O/ 284
FOR SANITARIAN'S USE ONLY: Ssystem
CO
FOR INSTALLER'S USE: Trench Depth
System Disapproved fl Needs Correction
"dr"as 6
Subdivision Lot- Block
-
i ,Pnr*Y/t.3 Si re
qd
Filler Depth Below Tile
Date
1/
Tank Capacrty /rCni@t- Manufactu NE
8f*o
4rf
De*/
Z<s \^
f\4easured distance to well from tank
-a6/-
- lot-
It-tfJ-
from drainfield
to'F** &lcR /Prepr* /ta,eT:
9",,y
Ztn<
Arr<cy',o.tlg
i,-l
;,
turJ\
t__
-Tafnt k^/gt/1 Of
O,<,qtrurtAA- 156'
Il0
o
l-\t\
q
\q
N
I
\
6AEs{
€\
E).clg'N
EN?tE\.]qUE]
UJElF
,I
)
-il\
E It
l9
I
q
.s
(,
Sca
A
N
$
N
1)
N
I
l/
loI
I
,, ?,
'From H
6
I
I }l-
',Q/a
6
Lg
(o
P6c o INSTALLATION RECORD AND CERTIFICATE OF SATISFACTORY COMPLETION
When signed by the County Sanitarian, this certificate is evidence as per ORS 454.665 of sat-
isfactory completion of a subsurface sewage disposal system at the above location.
Return this form to: Permit Processing Section, Department of Environmental Management,
Public Service Building, 125 East 8th Avenue, Eugene 97401N c55-1 1
/>-6-c- /t7
I
,;, ,Lj,i k{/',{t/
#9',
+o-'
co