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HomeMy WebLinkAboutPermit Septic Tank 1987-12-08:-///zd- u6d (;,G /R-7 ID La,ne County Authori za"ttott for' '-7 rlonatr Flvi sti I)tr Sen r{c Svstert FOR OFPICE USE ONLY Applicatio Permit *7F7 1.7 03 IOI.I 24 TAX LO? 600 SJBDIVISION/PARTITION (if appficible)LOTIPAi.{('EL ALOCK ;FOT,()SED USE OF PROPERTY Gl nesidential [l cc,uunercial I-l rndustrral PubIic ION ADDRESS S'l'REET (-I,:'Y LLP 1e1d 3L444 Yera Drlve Orercin 97 477 -Sprln Ilxlgrln Single Fanil Dwellinl II;rvde ilr Ilarvest J.,,rne on Delrose PROPERTYSTRUCTURES CU left on Vera Drive on the rlght Irandrir,h q;i;l 1. 6rf 76r 'lDESCRIP?ION OF PROPOSED WORK - BE SPECIiTIC llepair exlstlng sepLic svstemr DECI.ARED S VALUE OF BEDROOI4S na f OF STORIES na H oT. EUPLoYEES none Proposed Existing lVAIEN SUPPLY Public O;I.}JER'S NAl,lE AND ADDRESS Gl-en 'f. Peterson, same as the job address atrove TELEPHONE NUMBER j/r 5-9!ol. CONTRACTORIS NA}TE AND OSR # S;rrne as a.l)oa'e TELEPHONE NUMBER 7 h7 -A^l\? , ra: :1.: .l r)1r'' P:RI\IIT TO BE MAIT,ED TO (NAME AND ADDRESS)TELEPHONE NWBER S lrre I I HAVE CAREFULLY EXMINED THE COi4PLETE:D APPLICATION POR PERMIT, dIJ (lo lrr:ri,l)i certrfi, that all rnformatiorr hereon is true and correct, and that I have the following lega1 j.nterest in the property,flo"n.r of recor<i; f]..,r,rra,.t p,rrclraseri!authorized agent.I f:rCher certify that any and all work perfomed shalL be done in occordal,:,- rii:l; tl..: OrdrnanceE of Lane Couty and the Laws of the State of Oregonpertainj.ng to the work described herein, and that No OCCUPANCY will be made of tr.r srr'lrctrrre Bithout ttre pemission of the Building Division. t io.-ther cerEify that regisiration with the Builder's Board is in fuLl torce dnd efrect as required by oRs 701.055. that if exempt the basis for exemptionis noted hereon, and that only subcontractors and employees who are in compliance with ORS 701.055 witl be used on this project. I HAVE READ AND CHECKED THIS APPLICATION THOROUGHLY. 1 ,,r SIGNATUR.E DATE '? ,"r; READ THIS SECTION CAREFULLY. YOUR AUTHORIZATION ttAS BEEN BASED ON THE l)l rear 'r'flo Date: fl senrthrrox,InstaLlation Record Issued? ! v." fl u" J.q1,Q:'-'T:- "4t.t.:!{11l t't, Da te t', - . .).I pr,eus CO}I}IENTS: DaLe (:/.'l f F. I:+4 COI'1,\lENTS -/ -/'r EXA.I4INA TI ON: lK /2" 7-6? 7 B. P. f (;rour, - Use t'linimr,m Setbacks: Parce1 #! plaxNrNcrzzoNrNG FOLLOWING CONDTTIONS: , Parcel Size rnstallation , , -7f-6aLlon specificationst -l' 4-rc.{ .l tanr,-I -t'-,.'/.COIIIIENTS: tA'\'4'*f l. _ l4-rl Maximum Depth of Trenches 1!.,,I ,,.-..!f*. ,*i lc,\ , fln nl nnn{no nn.l' {nn rnnrr{rnd D L4 cL, fro.t / \ J i-:;71. Lineal Eeet of t)r-a j r:fieId "", "tu.- interrcrr r,,,,,.(, !;',;1 .";/,---r'-" r rt /.?z-l.- ./ zone na Partiti.on il '1,..) E*o-?t1 I -PERMIT APPROVED BY BUILDING OFFICIAL/DESIGNEE DeT ORS 805 DATF LANE COUNTY DEPARTMENT OF PUBLIC WORKS LAND MANAGEMENT DIVISION, 687.4061, 125 EAST 8TH AVENUE, EUGENE, OREGON 97401 r atfr n i, n RAIIIJE lour oF ul.Rr;c1tuN5 IU 5M; NAME (please print) (lJ-pn 'f. Petersorr i T s. r. * 3- r-'l3r 8q3 I WATIASTY DTID.'I ArurorY t(f,r lxDrr l. @tL .rd tIllDf, D. GOEI&r ir.b.td .td vl'fe t = '---.f .-t' ',t l. 'Irlit ITIl ;I,ll .lt iirtI ri ii ii =i a II il$ Q 6A or€ I ..".-.--.Catc .C.n-r,.*a.o GLEI tlEon^s tErEn{ar ;*tsta#t'El.T-t*'?mg!'t'"--- dlt.a.-, tad. D. od.ll Grrurra E Dc t9 -t ! ....- -. -- rmI@rPAt ' lo, g ? o trl llt,r .l0tie 0 Iur.atF.aL.tilrd rrJd I: or- to?!f Of S.t-r.EF ,F-. rr O..<J I a -F'l't 911'Gqtrg G'',OC.dBxl Tlr $t rlocTtv . t* rr- r -iriltt"t t-"-eiti6t' r"ttlctjd'ri s.ct, oC s:cc{. 'TATEG o I l' 1 t.'.'l /--ii<:ry"F E-l-r- Glaa t.bat Dctarra, ac g iirl vcn ri- Sprilttl.lC, -ot.!c-,?13"'---'-- EEP a4.4-t--f S.E at .boa I J I i i I I ! Ii i ) I .-f u6r GG /&- 7D - Lane County Authori za,ttor: for, Reoair Existing Senti c Svstem FOR OFFICE USE ONLY i2ni:i"i'""/3597-F7 t7 RAIIGE 03 24 SECTION 2 600 LOTIPAii( IL BLOCKcable FFCP')SED USE OP PROPERTY J-i nes rdential [l cc,uunercial n rndustr:.al f]e,rur:." ('1't'Y ZIP 1444 Vera Drive 97477 STF-EET t 0r Dwe11 PROPERTY l_F ose left on Vera Drive on the r t handLaner existi temSCtic ,ION OF PROPOSED WORK . BE SPECITIC na IES na olr Et'1P none I.J^TER SUPPLY Public Proposed Exi s ting same as the job address above O;INERTS NAME AND SS Glen T. Peterson TELEPHONE NUMBER 591 CONTRACTORIS NAME AND OSR # Same as above TELEPHONE N1JMBER 82 ove Same I IIAVE CAREFULLy EXAMINED THE CO'IPLETED APPLICATION !'OR PL:RMIT, arJ (lo htrllJ) certifi, thit aLt infolTatiort hereon is true and correct, and that I 2. 7:8? DATE rni thehave tninterest the ofrlegaIfollowingproperty record COlrt ral cllage r1rSrr..uth zedoritf agenIcertif:rther that and workaI1 sha Ilfyanyperfomed donebe fn dr;r,OI otrCtnances andLane the ofLaws Statethe ofCouty OregoniniLope rta the dework cribed herein thatand NOn9 OCCUPANCY I ht1 oIinade lctrlre thoutwl the of ldinBui-Dipe ml ss 1on I lSlOn I fur-!hetherf,rti-that Eration rh Buithe f1de Svregis 1SBoard fullIN itnforce .t ft ASect re redul oRs 70 o5by 1that et the Ibasxempt for e xemptiasnotedheonreandonthatedu.bcontractors1y who INare a w1 thenployeescompl oRs 055701 1 beI used th 1S ecE.I READHAVE ANDprol CHECKED THIS THOROUGHLYAPPLICATION READ THIS SECTION CAREFULLY, YOUR AUTHORIZATION I{AS BEEN BASED ON THE FOLLOWING CONDITIONS: /z-7-? 7Date: rnstallatj.on Record Issued? f] v"" f, N" Date coltllENTs I COM}!ENTS tr tr PLANS of Itr';r i lf.eld G c SANITATION: s. I. #B. P. f rourl-- use Lineal Eeet interlc,r Partiti-on #Parcel # Installation Specifications: Maximrnn Depth of Trenches collrrENrs: No olannins ae-tion reoulred " OA4- I pnHurNc,zzoNrNG: zone_IIEI_ Mininum Setbacks, CL, front parcel Size na rear"", "ido- BUILDING IGNEE (Der oRs 456.805(I)) OF PUBLIC WORKS LAND MANAGEMENT DIVISION,687.4061, EAST 8TH AVENUE, EUGENE, OREGON 97401 LANE COUNTY SEE REVERSE EOR INSPECTION INT'ORMATION ak-zs R* = OF BEDROOMS Gleu T" Peterson NAME (please print) tr a-r#7 r :3?' ::' "'"'""'"::]:;,i:l':,,;:11:l ,0I , CI ^E^1_Jo_frr:tf peo: :o o5p3 ,0I ,0-l soull .',lradord roriatui :uo:.] prnrulE-1o rueJ, cr"dos ' i-esodsrq ow6 j ,,JrlIJn.1nS - .-'13, q-.q. 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I Townshlp Range Section Tax Lot lain Township Range Section Tax Lot Zoned Flood Plain Township Range Section Tax Lot Zoned Flood Plain TorAL coNTlcuous PROPERTY tN SAME owNERSHtp: ACRES *REQUESTlaescribe what you wanr to do Dire ons to s e arrr.arrrarrarfrrattstaff use onlytttrarf.ur.r.r.urrru Com ments: Land Management Division, Public Works Depailment 125 E. 8th Ave., Eugene, OR 97401 phone 6g74061 oiN