HomeMy WebLinkAboutPermit Septic Tank 1978-08-18PERMTT - A{0A-1fr
TRS, T t7-o3-zz.\,\ 3too JOB LOCATIO e67o wevsroe Lrrue
LANE COUNTY PERMIT
Acreage or Lot 5;ru 2?'X 1\5'
Contractor's O.S. * NA
Partitioning #NA
APPLICANT'S NAME AND ADDR trcq V'/r uu rau C. StTEPPEnD. JR. . 1
OWNER'S NAME AND ADDRE
CONTRACTOR'S NAME AND ADDRE qs Srue
Mail permitto ( )Applicant ( )Owner ( )Contractor. (XX)Prefertopickup.
) Completed Subdivision NA
Lot Block-
Easr 27rH. Eucerur. On.Phone \85-q?7
Phone-Phone-
(owner, etc.) when ready
ASK FOR Jltt
ITRUCTURES NOW ON THE PROPERTY S r ruele FAM I LY REE r BENcE
THIS PERMIT IS FO Upolre Ex tsr tNG sEPT tc FRoM TO 5 B OR
WATER SUPPLY RarNeow VJlrsn Drsrnrcr
THIS PROPERTY IS WITHIN ONE MILE OF THE CITY OF NA
# BEDROONNS__5-+ PLUMBING CONNECTIONS NA
SEWAGE D;SpOSAL Ex tsr tnc S.l. #NA
PLUI\4BING BY NA
I hereby certify that the above statements are !r!e and accurate, and that I have the Iollowing legal interest in the property:
-owner
of record;
-contract
purchaser;
-
potential buyer; II- realtor or agent. I turther certily that (iI not the owner) I am authorized to act for the owner oi
record. and that said owner is awarc and approves of this action. I hercby agree to comply with all applicable Codes relating to this permit.
Fee paid $ 25.00 Si gnatu re /.1unru ;. MJLLEN Date B-t -78
( NtrNEW ADDRESS NA} FACILITY PERMIT TO TBANSPORTATION DEPT. NA 1 ) SPECIAL PIUT. AREA, MIN. ELEVATION: Nd
SANITA roN
Minimum Septic Tank Capacity (Gallons)
Drainfield Required - Lineal Feet
BUILDING
Type of Construction
Use Classification I
U Fire Zone
ments
Date:
SATISFIED. B DoNNluee Me ree Date Date lssued
SETBACKS: FRONT NA SIDE FACING STREET NA (FROM C/L) lNT. SIDE YARD NA REAR NA (rROM P/L)
*
PLANNING REOUIRE
ZONE: NA
LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE., EUGENE, OREGON 97401
POST THIS PERMIT ON MAIN BUILDING AT SITE
c55'13 BLDG. pERMrr -wHrrE; BUTLDTNG - GREEN; pLUMBTNG - GANARy; sANrrATroN - GoLDENRoD; oFFrcE copy - wHrrE
PHONE:687-4394
Daiar
4-*->
TRS, TL JOB LOCATIO
Partition ing
LANE COUNTY PERMIT
Acreage or Lot Size
Contractor's O.S. #
( ) Completed Subdivision
Lot Block-
S.l. #
Use Classification
Comments:
APPLICANT'S NAME AND ADDR Phon
OWNER'S NAME AND ADDR Phone
Phone
Mail permitto ( )Applicant ( )Owner ( )Contractor. ( )Prefertopickup. Call-(owner, etc.) when ready.
CONTRACTOR'S NAME AND ADDRESS
\AJATER SUPPLY SEWAGE DISPOSA
STRUCTURES NOW ON THE PROPERTY
THlsPERlvllTlSFoR#BEDRooML#PLUMBlNGcoNNEcTloNs-
THlSPRoPERTYlSWlTHlNoNEMlLEoFTHEclTYoF.PLUMBlNGBY
I hereby certify that the above statements are true and accurate, and that I have the lollowing legal interest in the property:
-owner
of record;
-contract
purchaser;
-
potential buyer;
-
realtor or agent. ! Iurther certify that (if not the owner) I am authorized to act {or the owner oI
record, and that said owner is aware and approves o{ this action. I hereby agree to comply with all applicable Codes relating to this permit.
Fee Paid $Signatu re Date
()NEWADDRESS () FACILITY PEBMIT TO TRANSPO RTATION D EPT.- () SPECIA L Pfu]T. AR EA. [NIN. ELEVATION:
-
SANITATION BU ILD ING
Minimum Septic Tank Capacity (Gallons)Type of Construction roup
-Fire
Zone
Drainfield Required - Lineal Feet
Maximum Depth
Comments
By:Date Bv Date
PLANNING REOUI REMENTS SATISFIED. By:Date
ZON E SETBACKS: FRONT SIDE FACING STREET (FROM C/L) INT. SIDE YARD REAR (FROM P/L)
LANE COUNTY DEPARTMENT OF ENVIRONMENTAL IVIANAGEMENT, 125 EAST BTH AVE., EUGENE, OREGON 97401
POST THIS PERNIIT ON MAIN BUILDING AT SITE
C55-13 BLDG.pERMTT-WHrrE; BUtLDtNG-GREEN; pLUMBTNG-GANARy; sANrrATroN-GoLoENRoD; oFFrcEcop\/-wHrrE
PHONE:687-4394
trqq
Date lssued:
,S*\tot*'\b
TRS, TL L7-03-22-4-4 T.L. /I 3100
Itlittgl Djrectiqts Waveide I.Ete is located off Hayda Bridg. Rod
INFORMATION SHEET
( ) Building Permit (* ) Sit. Feasibility Study for Septic Tank. Number of sites 1
Acreage or Lot Size 95, X 145' (Approx.Irg') f.st holes will be ready Jtt1-y 7,L978
Partitioning#-- ( )Completed( ) Pending
Lot 4 Blo
APPLICANT'S NAME AND ADDRESS Wi11itrr C.Jr.l-665 E. 27th.485-L937
OWNER'S NAME AND ADDRESS, if different from applicant's as
,NTRACTOR'S NAME AND ADDRESS
Subdivision Buene Vista
Pho ne
Phone
Phone
rvr€l(*il permit or results of site
) Prefer to pick up. Call
teasib^ilily study to ( ) Applicant686-8766 *' _ (owner. et@
( )Owner ( )Contractor
c. ) when ready.Contractors O. S. #
PROPE Oee single fanily residence,3 bedrocm, I bathSTRUCTURES NOW ON THE
PROPOSED USE (this permit)t t1d0*-8 ., 9kc3'lL.t,'rx 3, D .S . chanes to 6!{aql # Bedrocrns Change3to6bdrm.C
WATER SUPPLY Rainbcru Water District
SEWAGE DISPOSAL Existine septic tank
( *) pRopERTy ts wtrHtN oNE MILE oF crry ( )
existing or proposed well, etc. lf public, name of system)
(existing or proposed septic tank, etc.) S.l N/A
PLUMB|TvC eY N/A Address
********+*******+***************++****+** QfflCE USE ONLY BELOW THIS Ll[\f ****+***********]*****r***t*****rt***+*+++*
( ,*( ) Facility Permit Necessary
SETBACKS: Front Side Facing Street
(FROM CENTERLINE OF ROAD)
( ) Special Permit Area. Minimum Elevation
lnterior Side Yard Rear --(FROM PBOPERTY LINES)
zoN
To: Planning/Building lnspector/Sanitarian/Surveyor.
This applicant appears to have a problem with
Your assistance will be appreciated.
Response
By
By
DEPARTMENT OF ENVI RONMENTAL MANAGEMENT
Permit Processing Section
125 East Bth Avenue
687-4394
-rft-v^s*-__-/mit Processing Section
css-12
D ivision
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