HomeMy WebLinkAboutPermit Building 1975-11-14LANE COUNTY PERMIT FOR PERIVIIT NO
CONSTRUCTION [ ] I\IOBILE HOTVIE [ ] PLAN REVIEW [ ] CHANGE OF OCCUPANCY [ ]
n Owner NAN/E ADDRESS CITY ZIP CODE PHONE
n Contractor NAN,'IE ADDRESS CITY ZIP CODE PHONE
O.S. Reg. +
Tw Range- s."tion ,4# to '' fzlo-o
Code Census Tract
Subd ivision Lot B lock Acreage Width
DepthAccess to Property (Road Name): . , .:
IExisting Structures on Property:
Directions to Property - Address
STRUCTUR E ( # BED ROOIVIS)SO. FT VALUATION
SEWAGE DISPOSAL:
PUBLIC[] SEPTICTANK[]oTHER [ ]
PLUIVIBING INSTALLED BY:
OWNER[] OTHER[] NAIVI F
BUILDING
PLUIVIB ING
3% SURCHARGE-
IVIOB ILE HOIVIE
WASTE DISPOSAL
PLAN REVIEW
TOTAL
WATER SUPPLY: PROPOSED t ]
EXISTING t ]
PUB LIC
COVIVIUNITY NAIVIE
PR IVATE WELL
OTHER SPECIFY
CONSTRUCTION PERMITS & INSPECTIONS AND WATER POLLUTION CONTROL SPECIFICATIONS
IVIIN. SEPTIC TANK CAPACITY
GALS IVIIN. DRAINFIELD-LIN. FT IVIAX. TR ENCH D EPTH- INCHES
STAY 1OO' FRON4 ALL WELLS
TYPE OF CONSTRUCTION GROUP FIRE ZONE USE CLASSIF
SETBACKS- FT. FROIVI CTR. OF r/W
FRONT SIDE EXT
FT. FROIVI PROP. LINE
SIDE INT REAR ZONE
AUTHORIZED SIGNATURES
lsl
ISSUANCE DATE
'BLDG. PERT,4IT - WHITE
OFFICE COPY - WHITE
COUNTY TAX - PINK
PLUMBING - CANAFY
BUILDING - GBEEN
SANITATION - GOLDENBOD
IIVIPORTANT
Call 687-4065 to schedule all required construction inspections. Call 687-4061 to schedule all required
septic system inspections. All construction shall comply with the State Buidling Code, D.E.Q. standards
for subsurface sewage disposal and the State Plumbing Code. All buildings require a certilicate of
occupancy before being occupied.
(See Details on Reverse Side)
POST THIS PERM!T ON MAIN BLDG. AT S!TE)
LANE COUNTY, DEPT. OF ENVIRONMENTAL MANAGEi/4ENT
COURTHOUSE ANNEX, 135 EAST 6th, EUGENE, OBEGON 97401c55-l 3
EVALUAT ION
(BUTLOING PERHIT APPL ICATI ON NO
( ) strE tNsPEcrloN
PLANNING DIVISION
I " Zoning Ordinance Compl iance: Zon
2. Subdivision Ordinance Compl iance
3, Requi red Access
4. Building Site (Area, t.tidth, Fron
5. 0ther (see conrnents)
r 11 Mse3 rAxLor
SG'D'TVi- 5
LOT BLOCK:
APPL I CANT
DATE
cK'D BY , l@, 7 /l/or,,,7{
Setbacks frqn c/l 'of'road:
Front 1S-
5tde-tfEeFror
Setbacks from interior I ines:
Side
Rear
COilI{ENTS:
Not
Aoolicable No"-/&ry fl() ()
tage) () ()
() ()
Yesv6()(q-
(
(
PLANNING OIVISION ACTION PENDING: Y ( ) N0( )APPLICATI
BUILDING INSP l0N Dlvlsl0N
. Plans Submitted
. Soi I Stabi I lty (footings)
. Flood Plain
. 0ther (see connnents)
Not
I icable No
7
8
9
0 (
Yes
m()
()
r)()
()
()CK' D BY
I / -/)"9-
COMMENTS:
WATER POLUTION CONTROL Not
Appl icable No
(vI r)YesrTI l. i{eets Department of Envi ronmental
Qual ity Standards.
12. Other (see cornments)() ()()CKID BY:
E
COHMENTS:
TO APPLICANT:
PH,NE, 597-4o65
LANE COUNTY PLANNING DlVlSl0N PHONE: 687-4186
c55-28
G *?I
!t
Yourff Building / Site lnspection:
Can be approved.
Cannot be approved at this time as indicated on i tem N0. above
rough 5 contact the LANE-
r information on items 7
Ques tlons and further information on items I th
Your bui ldin
ems cated.^q Questions and furthe
\\t act turill be held in this
ls being returned.
rmi t
NG
ce unt you can reso vet
fee is
D V
9740r
LANE COUNTY PERMIT FOB PERI\4IT NO
CONSTRUCTION [ ] IVIOBILE HOIVIE [ ] PLAN REVIEW [ ] CHANGE OF OCCUPANCY [ ]
NAIVIE ADDRESS CITY D HONEn Owner
I Contractor
NATVIE ADD R ESS CITY ZIP CODE
O.S. Reg. +
Twp- Range- Section-Tax Lot.-=-- Code- Census Tract
Subd ivision Lot
-
B lock Acreage Width
Access to Property (Road Name)Depth
PHONE
Existing Structures on Property
Directions to Property - Address:
STRUCTURE (# BEDROOMS}SO. FT VALUATION
SEWAGE DISPOSAL:
PUBLIC[] SEPTICTANK[]oTHER [ ]
PLUIVIBING INSTALLED BY;
OWNER[] OTHER[] NATVI E
BUILD ING
PLUIVIB ING
37" SURCHARG E _-
MOBILE HOME
WASTE DISPOSAL
PLAN REVIEW
TOTAL
WATER SUPPLY: PROPOSED I ]
EXISTING I]
PUB LIC
COIVIMIUNITY NATVIE
PRIVATE WELL
OTHER.SPECIFY
CONSTRUCTION PERMITS & INSPECTIONS AND WATER POLLUTION CONTROL S PECIF ICATIONS
I\4IN. SEPTIC TANK CAPACITY
GALS IVI IN. DRAINF IELD-LIN. FT.MAX. TRENCH DEPTH I NCH ES
STAY 1OO' FROIVIALL WELLS
TYPE OF CONSTRUCTION GROUP FIRE ZONE USE CLASSIF
SETBACKS - FT. FROtVI CTR. OF r/W
FRONT SID E EXT
FT. FROIVI PROP. LINE
SIDE INT R EAR ZON E
AUTHOB IZED SIGNATURES
/sl
ISSUANCE DATE
BLDG. PERMIT - WHITE
OFFICE COPY - WHITE
COUNTY TAX - PINK
PLUMBING _ CANAFY
BUILDING _ GREEN
SANITATION - GOLDENROD
IMPORTANT
Call 687-4065 to schedule all required construction inspections. Call 687-4061 to schedule all required
septic system inspections. All construction shall comply with the State Buidling Code, D.E.O. standards
for subsurface sewage disposal and the State Plumbing Code. All buildings require a certilicate of.
occupancy before being occupied.
(See Details on Reverse Side)
(POST THIS PERMIT ON MAIN BLDG. AT SITE
LANE COUNTY. DEPT. OF ENVIRONN4ENTAL MANAGEMENT
COURTHOUSE ANNEX, 135 EAST 6th, EUGENE, OBEGON 97401c55 -l 3
a--
SITE INSPECTION
Ap paov E o
REFranx s
D r sappRovEo Darr I rusprcton
FOUNDATION I NSPECTION
AppRovto
Reuanx s
D r slppnoveo DarE I Hspecton
FRAMING INSPECTION
Appnov r o
Reuanr s
LATH OR SHEETROCK
Ap pnov r o
Rrliaex s
ry Drsrppnoveo D Dar E
/(-
I HsprcroR
fr lr'
I HspEcron
I NSPECT I ON
D r sappRoveo Dar e
F I NAL I NSPECT ION
Ap pRov e o
ReunRxs
Dt sappaovro oorr,/ "{''7 0 (.,
I Nspecr
CERTIFICATE OF OCCUPANCY
Reaov ro lssue
RruaRx s
D Nor Rraov ro lssuE D Dorr_
a o.fq-rd ri ?/l t-el i) L/\J
llrsprcron
D
NOTE: NO PERMIT W,
CONSTRUCTION
PERMTT +3655f\(
UAS BEEN APPROVED,-TE ISST]ED I,NTIL THIS APPLICA,T]
APPLICATION FOR:
MOBILE HOME PLAN REVIEW
Z 5/m,
City
City
d Code
tock--1tB--Ptop erty Acreage
CHAi{GE OT OCCUPANCY
zip
zip
Census Tract
o
Phone
Phone
i./idth Depth
I7OWNER
CONTRACTOR
Addr es s
Address
Lot
Name
O.S. REG. //
Twp
Sub
ACCESS To pRopERry (Road NaIJlo vi LLt+ uhL/
Existing Structures on Property:
Property Location - Address/Di,rections:ZgoS uiu-t vq?v
/
r e Use
DISPOSAL:
Slte Inspec tion /i
WATER SUPPLY:
LIe11 Spring
FEES:EFD
Bldg.
Waste Disp.
Plunblng
Plan Review
Moblle Home
12 Surcharge
TOTAL r_\\.s,
Mln. Sep tic Tank Capacity
nnt a,ffiXiL
^-b41,
Pub11c
Conmunity
tlon
or System RequLred f-l
Name Coflmunity or Public Systen
Name
Sewage Water
Connecti.onConnection
FACILITY PERMIT
YES NO YES NO
\
0ther
PLI]MBING:
Installed by OwnerH\C:Other
of Fixtures
PLANS
Signature of
Fee Received By
Required - Lineal Feet
Date
Maxi.mum D"pth-
L
V
---1]_
TyPe of Construction Fire Zone Use Classification
Bldg Setbacks - from Center of Road Right of Way:
Front Side Int \ Side \-
SANITATION:BUILDING:
cs5- 12 LANE COI]NTY DEPAR I},IENT OF ENVI
DATE
Rear
},IANAGE}{ENT
DATE z -7{
K
l* o usF * 6rf*+**'E * lmFut7
-'flK
Bxlstlng Ser^rage Disposal System l-_-l
Sq. Ft