HomeMy WebLinkAboutPermit Septic Tank 1989-01-24rH
Lane County Authori za,ttot:. for'
ea /-ay'
SEPTTC INSPECTION FOR LOAN REVIEW Permit #
L7
RA}JGE
03
SECTION
24 600
s'JBDrvrsroN/eanrrrrox GT appti
I
BLOCK
FRCPOSED USE OP PROPERTY
ffi nesidential
l-l cc,nunerciat
n lndustrral
flruuric
ZIP
),4M Yera Drive
Road to Harvest Iene,
STREET
1d
ON
oR 97477-L633
t on Delrose, left on Vera Drive, on the
PTION OF PROPOSED I,iORK - BE SPECIEIC
side of road
SEPTIC INSPECTION FOR LOAN REVIEW
= OF BEDF.OOI4S # oE sroRrEs # OF EI,IPLOYEES LY Proposed
Exi s ti
GIen & Bnenda Peterson
O;NER'S NAME AND ADDRESS
(site addr L TELEPHONE NUMBER
345-8591
TELEPHONE NWBER
paRrtrrr ro BE MATLED To (NA!4E ANt ADDRESSJ
Glen & Brenda Peterson (site addr)
r HAVE CAREFULLY EXAUTNED THE cotIPLETED APPLTCATTON !'oR PERMTT, a.rd do hl-r.Lt' certify that alL inforratj.on hereon is true and correct, and that r
have the folrwing legar interest in the property,fi|orn". of record; []co,rra,,,;. prrrchaseriIauthorizett agent.r f:rther certify that any and all work Perfomed shall be done in -"".-L1.,r,,- L.ith tL,- ordrnantes of Iane cowty and the raws of the state of oregonpertaining to the work described herein, and that No occuPANcY will be nade of ani srr,lctrrre qithout the pemission of tle Buj.laling Division. r fr-ther certify that registration with the Builderts Board is in fulr force and effect as required uy ons zoi.osi,-in"a-irli"rpt the basj.s for exenptionis noted hereon, and that only subcontractors dd enployees who are in compriance with oRa zor.oss will be used on this project- r HAVE READ N,tDCHECKED THIS APPLICA?ION THOROT'GHLY
Glen & Brenda Peterson L/24/8e
DArE I
Drop Off
NA}IE (please print)
YOUR AUTHORIZATION '{AS BEEN BASED ON THE FOLLOWING CONDITIONS:
IRED.
Date:
Installation Record Issued? f, """ f] ,"
Installation
Specifications: _ TEmk
tr 6fr'rlis
COMIlENTS:
Date
rear
caIlon
COI'lI'lENTS
\-
Use
tr SANITATION: S. I. *B. P. #
644P-.{: 4
Parcel Size
col'T}lENTS
READ THIS SECTION CAREFULLY.
fl pmuNruc/zoNrNG:
Lineal Peet
of l)rai rrfield
Uaxitnum Depth
of Trenches
NO SPECIAL PLANNING ACTION
Minimum Setbacks, CL, frort
Partition #_ Parcel #.
"", "id" interior
L '"-/2
BY BU
LANE COUNTY D
IALIDESIGNEE (per ORS 805 1))
ENT OF PUBLIC WORKS LAND MANAGEMENT DIVISION, 687
DATE
4061,
125 EASTSTH AVENUE, EUGENE, OREGON 97401
SEE REVERSE EOR INSPECTION INE'ORMATION cL4-2s R*
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A AtADD ,s ff
21 Ave.OREug
Please complete all lines inside white boxes, if possible.EXISTING BUILDINGS
ON PROPERTYfu Hor""
E:]Barn
E Garage
E lrrlobile. HomeE Shed
other-
Z /- zr/-t
:(r'oa
q74 /r
ztP3,/;gw
/O 7
OWNEFS ADDR * 1633 Dlrectlons to slte
tc Courthouse
/?
', PARCEL NUMBER (Found on tu mr!. ln?+
S.clbn
lh. At3sfm.nt & Turllon D.pL)t7 0?
@;i'-
-9l-Town.hlp Bmg.
r ownrnrp Fmga
1/4 Scctlm
Loo
-tFri-
S.ctbn
-E,;iEn-
1/4 Scction Tu Lot
Irl-$Aion Tii foI
(
FOR MOBILE HOME
PLACEMENT ONLY
MAIL PERMIT TO:lvlodel
Year
Sizedtu
No. of Tip-outs
-
No. of BedrmsAUUHtSl'License #
GIIY ztP
Land Management Dlv..tatl crn nol
be hcld responrlble lor rvaluatlonc or
mcommendatlonr barcd on lalec,
lneccurat. or lncomplotc lnformatlon