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Home My WebLink AboutPermit Building 1974-06-07?IANE COUNTY IILDING PERMIT OR MOBILE HOM IsE APPTICATION*\ PEKMIT TYPE - BUILDING MOBILE HOME OSC REG. # MAIIING ADDRE PERMIT PROPERTY OWNER (' CONTRACTOR MAII.ING l/1 PHONE PRO IOCATI _ INCTUDE PROPERTY I.EGAI RI TOT_BI.OCK-SUBDIV TWP RANGE APPI.ICANT NAME AND MAII.ING ADDRESS OFFICE METES&BOUNDSNYES ATTACHED NO SEC.TAX tOT CODE DESCRIBE EXISTING I.EGAL ACCESS TO CENSUS TRACT PROPERTY IF ANY oR# DEPTHRTY AREA 7b l2o FOR MOBILE HOME PERMIT ONLY Number of Bedrooms Connect to Existing Sewoge System I or New System Req BE BUILT TH -tYxtz SQ. FT # BEDRooMS vAruATroNLTYPE CONSTRUCTION L F fo maxe TH E R€o'*ineo Oenaacf i,tt Yirult go lnls oF tssbAye| SEWAGE DISPOSAI PUBUC n SEPTIC T R|;,,i. OTHER PE nn tr- 7-tt-7frHp)";::i'J **, $ 5'--- it,'.wlrrnsrlerrv PLANS FURNISHED FACII.ITY PERMITBI.DG. WASTE DIS. PIUMBING PTAN REVIEW PARK TRTR. TOTAI. PUBTIC OTH ER NO PTUMB FEES RE APPL - FIXTURES CASH [ 5 PERMIT #PUBI,IC WATER CONNECTION FEE COUNTY BUITDING & SANITATION SPECIFICATIONS YES NO 4- DATE CHECK FEE IVED MIN. SEPTIC TANK CAPACITY WITH DIST. BOX' GA[. DRAIN FIEID REQUIRED TIN. FT. TRENCH WIDTH TT.ARE FEET TYPE OF STRUCTURE BLDG. SETBACKS _ FT. FROM occu ROAD RIGHT OF \ryAY REAR YARD USE CTASSIFICATION PUBTIC UTIL. EASEMENTZONE Form # 655-12 SIDE EXT REAR - RONT SIDE INT ions to Find Property: 6 -,/o -7 Dote P Dqte BI-DG. INSP, coPY I - OFflCE COPY 2 _JOURNAI COPY 3 - AUDIT e-- 7- I LANE COU BUITDING BUILDI MH .--\ PERMIT OR MOBILE Hr E USE PERMIT PERMIT NO.110i0-?ll 7{ PH OI.IE r N MAILING ADDRESS CONTRACTOR MAITING ADDRESS PHONE PROPERTY LOCATION _ INCLUDE POST OFFICE PROPERTY LEGAT DESCRIPTION - METES, BOUN DS RANGE17 03.SECTION TAX LOT NO,CODE CENSUS TRACT Fler Fnev EXISTING STRUCTURES ON PROPERTY , 1... I APPI.. NAME & MAII.ING ADDRESS TEGAI. ACCESS I TO PROPERTY I 6at srn r NaDALE PROPERTY WIDTH DEPTH AREA srzE - FT. 80 FOR MOBILE HOME PERMITS ONIY No. of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT Plr ro CovEn Connecl to Existin TYPE CONSTRUCTION New 5Q,FT BDR MS 1-l x 12 e2 ON .00 Prrto yAg ButLT soilE TtLE Aoo i/h. Fnty rcnstD To xAl(E THC REQUIRED coRREcrloNg wlrHlH p orvr or rssulrcf, or rHrs PERr{tt 811611I{. SEWAGE DISPOSAT PU BL IC BUIIDING WASTE DISPOSAL PTUMBING PTAN REVIEW PARK TRAITER SEPTIC TANK PTUMBING INSTATTED BY OWNER OTHER: NAME \MATER SUPPTY PUBilC n n oTHER FEES 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 5N OCCUPANCY J ZONE PUBI.IC UTII.. EASEMENT BLDG. FRONT SETBACKS REAR FT, FROM CTR, OF ROAD RIGHT OF WAY SIDE INT. SIDE EXT. USE CTASSIFICATION..,'PU: AUTHORIZED SIGNATURE _ DATE J. $noox/sAN r rAR rAr.i B/tc)/t\DATE BLDG. PERMIT _ WHITE OFFICE COPY _ WHITE COUNTY TAX _ PINK PI.UMBING - CANARY BUILDING _ GREEN SANITATION _ GOTDENROD Coll 687-4065 to schedule oll required inspections. All consfruc- tion sholl comply with Uniform Building Code, D.E.Q. stondords IMPORTANT: for subsurfoce sewoge disposol ond county regulotions covering plumbing. All buildings require o certificole of occuponcy before being occupied. (See Detoils on Reverse Side) (POST THIS PERMIT ON MAIN BrDG. AT SITE) LANE COUNTY, DEPT, OF ENYIRONMENTAI. MANAGEMENT COURTHOUSE ANNEX, I35 EAST 5Th, EUGENE, OREGON 9740I FoRv = C 55 - I l PROPERTY OWNER OTHERE JJ C*q AX LOT {zoo L-d B- L ( ) Buitdins Permit Appticat r"" *". I Ol O*7{ ( ) S ite lnspect ion / ( ) Pre-Permit lnvest igat ion NA}4E ADD PHONE DATE LANE COUNTY PLANNING DEPARTHENT NOT YESNO () NA}lE DATE appl icable--()I . Zon ing 0rd inance Compl iance (Zonea1,<- r .l2. Subdivision 0rdinance Compl iance 3. Requ i red Access 4. Bu i ld ing S i te (Area, Uidth, Frontage, Setback) 5. 0ther (see comments) ) ) ) ) ) () () () (t () () () () 6 -za-?/ CO},IMENTS: BUILDING lNSPECT!ON SECTION 5. Plans Submitted 7. Soil Stability (footings) 8. Flood Plain NOT E66't icable() NO YES I ( ) ( ') NAI'IE () () () ()()() 9. Other (see Cornrnen ) CO}1},IENTS: ()()()/ ytr",c u SANITATION SECT!ON 10. ll. t2. t3. Sewage Disposal Usable Area Water Supply 0ther (see Comments) NOT NO YES able - DATE () () () () () () () () ) ) ( COHHENTS: TO APPL ICANT: q Y, Your Bu i ld in g Permit / site lnspection: through I 3 contact the Lane Count Bui di and Sanitat Will be held in this of ce unt i you can resolve the pro ems ind ls being returned. Your building permit aPPlication fee is being returned under separ Can be approved. Cannot be approved at this time as indicated on item N0 Questions and further information on items I through 5 COUNTY PLANNING DEPARTMENT. Questions and further info above. contact the Lane- rmation on items 5 ion Division.,5 () i cated. ate cover. I,ANE COI.NIY PI,ANNING DIVISION 135 Sixth Avenue East, Eugene, Oregon 9740L Phone (503) 687-4186 LANE COUMY ENVIRONMENTAL },IAI{AGM{EM L35 Sixth Avenue East, Eugene, Oregon 974OL Phone (503) 687-4065 c55-28 B ! I LD iiYG S ITE EVALUAT I 0N -# ( ( ( ( DATE 'bln BUILDING PERMIT OR MOBILE H. IE USE PERMIT MH E PERMIT NO. IANE COUI BUTLDTNG E ' pRoprRtv OWNER MAILING ADDRESS PHONE CONTRACTOR MAILING ADDRESS PHONE PROPERTY LOCATION - INCLUDE POST OFFICE PROPERTY IEGAL DESCRIPTION _METES, BOUNDS RANGE SECTION CODETAX LOT N CENSUS TRACT EXISTING STRUCTURES ON PROPERTYAPPI". NAME & MAITING ADDRESS I.EGAL ACCESS TO PROPERTY PROPERTY SIZE _ FT. WIDTH DEPTH AREA FOR MOBILE HOME PERMITS ONLY No. of Bedrooms Connect to Existing Sewoge System fl New System ! STRUCTURES TO BE BUILT THIS PERMIT TYPE CONSTRUCTION SQ FT # BDRMS TION I SEWAGE DISPOSAT PTUMBING INSTAI-LED BY PUBI.IC BU ITDING WASTE DISPOSAI" PTUMBING PLAN REVIEW PARK TRAITER TOTAL SEPTIC TANK F EES OWNER OTHER: NAME WATER SUPPTY PUBHC tr tr OTHER COUNTY BUILDING & SANITATION SPECIFICATIONS MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GAL. DRAIN FIEI.D REQUIRED IIN. FT TRENCH WIDTH FT,OR SQ. FT. TYPE OF STRUCTURE OCCUPANCY ZONE PUBI.IC UTIL. EASEMENT BLDG. SETBACKS FT. FROM CTR. OF ROAD RIGHT OF WAY FRONT SIDE INT. SIDE EXT. USE CTASSIFICATION REAR AUTHORIZED SIGNATURE _ DATE DATE BLDG. PERMIT _ WH ITE OFFICE COPY _ WHITE COUNTY TAX _ PINK PTUMBING _ CANARY BUILDING _ GREEN SANITATION _ GOLDENROD Coll 687-4065 to schedule oll required inspections. All construc- tion sholl comply with Uniform Building Code, D.E.Q. stondords IMPORTANT: for subsurfoce sewoge disposol ond county regulolions covering plumbing. All buildings require o certificote of occuponcy before being occupied. (See Detoils on Reverse Side) (POST THIS PERMTT ON MAIN BrDG. AT SITE) TANE COUNTY, DEPT. OF ENVIRONMENTAI. MANAGEMENT COURTHOUSE ANNEX, I35 EAST 6Th, EUGENE, OREGON 9740I FoRM = C55- ll SITE INSPECTION AppRov r o RruaRr s D r srppnoveo Dare I Nspeclon FOUNDATION I NSPECTION AppRovto Rrua nx s Dr sappnovro Dar e I ruspecron FRAMING INSPECTION AppRov e o Re uanx s DTSAPPRovED Dar E I NSPEcToR LATH OR SHIETROCK Ap pRov r o RExa Rx s I NSPECT I ON Dr sappnoveo Dar e I NSPEcToR FINAL INSPECTION D r s APPRovEo oorr{-4 -?/I HspecronAp pRov E o Reu anx s CERTIFICATE OF OCCUPANCY Reaov ro lssur Reua nx s D Nor RErov ro lssur D Drrr _ /o//'ry /o z/ I NsPEcroR D D