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Home My WebLink AboutPermit Building 1977-03-15-72 r r\ Job Location s/s//A/-e& z"TRS, TL "f 4dd (T /il6 B k Phone Phone- Phone Jqf-zs7 rl INFORMATION SHEET ( ) Site Feasibility Study for Septic Tank. Number of sites- (owner, etc.) ( ) Building Permit ( )Would like to meet on site. Call Acreage or Lot Size- Partitioning #- ( )Completed( ) Pending APPLICANT'S NATVIE AND ADDRESS OWNER'S NAME AND ADDRESS, if different m appli ,s CONTRACTOR'S NAME AND ADDRESS {ail permit or results of site feasibility study to ( ' ) Applicant ( ) Owner () Con (owner, etc. ) when ready. 1 ,fA, Test holes will be read v Subdivision /U /9 ),( STRUCTURES NOW ON THE PROPER PROPOSED USE (this permit) WATER SUPPLY () PROPERTY IS WITHIN ONE MILE OF CITY g€- Srd. lN (- ,OO sCI(/<\.\\L-\ o C, SEWAGE DISPOSAL (existing or proposed septictank, etc.) S.l PLUMBING BY '. ' '' ' Address existing or proposed well, etc. lf public, name of system) 4 ( )<O 5,4/ ******* oFFtcE usE oNLY BELOW THtS LtNE *******r**r** { ) New Address Necessary ( ) Facility Permit Necessary SETBACKS: FrontJNF Side Facing Street lnterior Side Yard Rear (FROM CENTERLINE OF ROAD)(FROM PROPERTY LINES) To: Planninq/Building Inspector/Sanitarian/Surveyor. This applicant app€ars to have a problem with Your assistance will be appreciated. By Permit Processing Section Response: By DEPA RTIVI ENT O F E NV I R ON IVIE NTA L MANAG EIVI E NT Permit Processing Section 125 East 8th Avenue 687-4394c55-12 tvtston . ) Prefer to pick up. Call ,'l ) ( ) Special Permit Area. [Vlinimum Elevation: PERIVIIT # TRS, TL ,4,1 ,# 1360 JOB LOCATION Acreage or Lot Size Contractor's O.S. # APPLICANT'S NAME AND ADDRE SS OWNER'S NAME AND ADDRE CONTRACTOR'S NAIVIE AND ADDRES s Mail permitto ( )Applicant ( )Owner ( )Contractor. ( )Prefertopickup. Call LANE COUNTY PERMIT Partitioning #-( ) Completed Subdivision Lot- Bloc v Phone Phone Phone (owner, etc.) when ready STRUCTURES NOW ON THE PROPERTY .HlSPERMlTlsFoR#BEDRooMS_-#PLUlv]BlNGcoNNEcIloNL \I/ATER SUPPLY SEWAGE DISPOSAL-s.l. # THlSPRoPERTY|SWlTHlNoNEIVllLEoFTHEClTYoF.PLUIVlBlNGBY I hereby certify that the above statements are true and accurate, and that I have the lollowing legal interest in the property: -owner oI record; -contract purchaser; - potential buyer; - realtor or agent. I further certify that (if not the owner) I am authorized to act for the owner of record, and that 9id owner is aware and approves of this action. I hereby agree to comply with all applicable Codes relating to this permit. Fee Paid $Si gnatu re Date NEW ADORESS () FACILITY PERMIT TO TRANSPORTATION DEPT.- () SPECIAL PI\4T. AREA. I\4IN. ELEVATION SAN ITATION lVlinimum Septic Tank Capacity (Gallons) Drainfield Required - Lineal Feet lVlaximum Depth BUILDING Type of Construction c",n.""t- Use classification roup ire Zone -Jmments B Date: PLANNING REOUIREMENTS SATISFIED. By B Date lssuedDate LANE COUNTY DEPARTMENT OF ENVIRONI\4ENTAL I\4ANAGEMENT, 125 EAST 8TH AVE.. EUGENE, OREGON 97401 PHONE: 687-4394 POST THIS PERMIT ON MAIN BU I LDING AT SITE c55-t3 Date: ZONE:SETBACKS: FRONT SIDE FACING STREET (FROIVI C/L) INT. SIDE YARD REAR (FROIVI P/L) TRS, TL PERTUIT # JOB LOCATIO LANE COUNTY PERMIT Partitioning #-( ) Completed Subdivision_ Lot- Bloc Acreage or Lot Size Contractor's O.S. # APPLICANT'S NAME AND ADDRE ss OWNER'S NAME AND ADDRESS CONTBACTOR'S NAIV1E AND ADDRESS Mail permitto ( )Applicant ( )Owner ( )Contractor. ( )Prefertopickup. Call-(owner, etc.) when ready STRUCTURES NOW ON THE PROPERTY Phone Phone Phone rHlS PERIVIIT lS FO # BEDROOTVS-# PLUIVIB I NG CONNECTIONS WATEB SUPPLY- SEWAGE DISPoSAL_- =-'-- S.I. # THtSPRoPERTYlSWlTHlNoNEMlLEoFTHEClTYoF.PLUlVlBlNGBY I hereby certify that the above statements are true and accurate, and that I have the following legal interest in the property: owner ot record; -contract purchaser; - potential buyer; - realtor or agent. I further certily that (iI not the owner) I am authorized to act for the owner of record, and that said owner is aware and approves of this action. I hereby agree to oomply with all applicable Codes relating to this permit. Fee Paid $- Signature ( ) NEW ADDRESS ( ) FAC|LTTY pERtVltT TO TRANSPORTATTON DEPT () SPECIAL PIVIT. AREA. IVIIN. ELEVATION SANITATION lVlinimum Septic Tank Capacity (Gallons) Drainfield Required - Lineal Feet lVlaximum Depth BU ILD ING Type of Construction *--Group Use Classification Comments: ire Zone -Omments: B Date B Date: PLANN I NG REOU I REIVIENTS SATISF I ED By Date Date lssued ZONE SETBACKS: FRONT SIDE FACING STREET (FRONN C/L) INT. SIDE YARD REAR (FROM P/L) LANE COUNTY DEPARTINENT OF ENVIRONMENTAL IVIANAGEIV{ENT, 125 EAST 8TH AVE., EUGENE, OREGON 974O1 POST THIS PERMIT ON MAIN BUILDING AT SITE BLDG' PERMIT - WHITE; BUILoING - GREEN; PLUMBING - CANARY; sANtTATtoN - coLDENRoD; oFFtCE coplr - wHtrEcss-1 3 PHONE: 687-4394 Date - Ap pRov r o Rruanx s DI SAPPROVED Dar e I Hspecton SITE INSPECTION FOUNDATION INSPECTION APPRov E D REua nx s Dr sapeRoveo Dar e I ruspecton FRAM I NG A ppnov E o Reuanx s I NSPECT I ON la Dtsappnoveo D Dar E I NSPEcToR LATH OR SHEETROCK I NSPECT I ON Dr SAPPRovED I NspecronAPPROVED RruaRx s FTNAL INSPECTION ootrj' 2-y'-17 tNspEcronAP PRov E o REuanxs DI SAPPROVED CERTITICATE OF OCCUPANCY Reaov ro lssuE Rruanx s D Nor Rraov to lssuE D Dote-lnseecron- D Dore- D /'ru{ ,!l/ Dote Permit No./+17 - 7 7 CURB CUT PERMIT IN THE BOARD OF COUNTY COMMISSIONERS OF LANE COUNTY WHEREAS, the ottoched opplicotion hqs been fully considered by the Boord of County Com- missioners of Lone County, ond it is the opinion ond iudgment of the Boord thot the soid opplicotion should be gronted, ond thot q permit should be issued, now, therefore, it is hereby. ORDERED, thot o permit be ond is hereby issued to for plocing, building or constructing the following focility: upon the right-of-woy of County Rood No. --, Mile Post in strict conformity to the exhibits ottoched herelo, ond subiect to oll terms, conditions, ogreements, stipulotions ond provisions contoined in the opplicotion ond permit, the Rules ond Regulotions Gov- erning Focilities to be Permitted upon County Rood Rights-of-Woy, os set forth by the Lone Mon- uol 50.'l9O(2) ony omendments thereto, ond ony other opplicoble regulotions, low or ordinonce. Speciol Provisions: I. Drivewoy will be constructed in occordqnce with the ottoched drivewoy opprooch specifico- tions (Drowing M98-50). 2. Permittee will be responsible for the immediote removol of oll mud, dirt ond debris from the roodwoy ond right of woy coused by his operotion, leoving the roodwoy ond oreo in o neof, occeptoble condition. 3. Sidewalks will be constructed in accordance w'ith the attached sidewalk specificatjons and drawing M9B-49. The Standard Curb Type shall be constructed unless otherwise speci 'ied . * 1'lb'1 (rJ ,A'/' ^/ This permit is revocoble ot ony time, ond will be strictly odhered to ond no work other thon thot specificolly mentioned obove is hereby outhorized. This permit sholl be void unless the work herein contemploted sholl hove been compteted be- /4 r? 77 lnspected ond Approved fore , 19-..Expires 19_. Approved by Boord of County Commissioners By Dote By WHITE - OFFICE FILE YETTOW _ REAT ESTATE PINK _ PERMITTEE ORANGE_ BUITDING & SANITATION DEPT. Direclor of Public Works c74-t29 J*