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Home My WebLink AboutPermit Building 1976-06-25n Owner LANE COUNTY PERMIT F PERIVIIT NO CONSTRUCTION [ ] t\lOBILE HOIVIE [ ] PLAN REVIEW [ ] CHANGE OF OCCUPANCY t ] ADD R ESS CITY ZIP CODENA N,lE PHON E tr contractor NAIVIE A DD R ESS*s?a -rrr=Code Acreage ZIP CODE Census Tract C ITY PHONE O.S. Reg. + Twp- Range- s"rtion ,3'4u^ Subdivision- Lot B lock Access to Property (Road Name) Width Depth Existing Structures on Property Directions to Property - Address: STRUCTURE (# BEDROOTVIS)SO. FT VALUATION SEWAGE DISPOSAL: PUBLIC [ ] SEPTICTANK [ ] OTHER [ ] PLUIVIBING INSTALLED BY: OWNER[] OTHER[] NAIVI tr BUILDING PLUIVIB ING 3% SURCHARG E IVIOBILE HOIVIE- WASTE DISPOSAL PLAN REVIEW TOTAL WATER SUPPLY: PROPOSED t ] EXISTING t ] PUB LIC COIVIMIUNITY - NAN4E PRIVATE WELL OTHER-SPECIFY CONSTRUCTION PERMITS & INSPECTIONS AND WATER POLLUTION CONTROL SPECIFICATIONS IVIIN. SEPTIC TANK CAPACITY GALS IVIIN. DRAINFI ELD- LIN. FT MAX. TRENCH DEPTH I NCH ES STAY 1OO' FROIVI ALL WELLS TYPE OF CONSTRUCTION GROUP FIRE ZONE USE CLASSIF SETBACKS FT. FROIVI CTR. OF rAN FRONT SID E EXT FT. FROIVI PROP. LINE SIDE INT REAR ZON E AUTHOBIZED SIGNATURES lsl ISSUANCE DATE BLDG, PEFMIT WHITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUI\4BING - CANABY BUILDING - GREEN SANITATION - GOLDENBOD IMPORTANT Call 687-4065 to schedule all required construclion 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 certificate of occupancy before being occupied. (See Details on Reverse Side) (POST THIS PERMIT ON MAIN BLDG. AT SITE) LANE COUNTY, DEPT. OF ENVIRONN4ENTAL MANAGEMENT COUHTHOUSE ANNEX, 135 EAST 6th, EUGENE, OBEGON 97401c55-l 3 LANE COUNTY PERMIT F PERIVIIT NO coNSTRUCTION t I lvloBtLE HOtVtE t I PLAN REVTEW t I CHANGE OF OCCUPANCY t lI Owner tr Contractor NAIVIE A B ESS COD PH NAIVIE ADD R ESS CITY z IP CODE PHONE T Range_ Secti Tax Lo t Acreage .-----.-----.------.----.--B lock Access to Property (Road Name) Existing Structures on property: Directions to property - Address STRUCTURE (# BEDROOTVIS) SEWAGE DISPOSAL PUBLIC [ ] SEPTI SO. FT PLUIVIBING INSTALLED BY width Depth VALUATION CTANK [ ]oTHER [ ,]owNER I ] OTHE RI ] NAM tr BUILD ING PLUNNB ING WATER SUPPLY: PROPOSED t ] EXISTING t]3% SURCHARGE MOBILE HOIVIE=- WASTE DISPOSAL PLAN REVIEW TOTAL PUB LIC COIVIVIUNITY . NAI\4E PRIVATE WELL OTHER - SPECIFY:_ CONSTRUCTION PERMITS & INSPECT IONS AND WATER POLLUT ION CONTROL SPECIFICATIONS IVIIN. SEPTIC TANK CAPACITY GALS.MIN. DRAINFIELD- LIN. FT MAX. TRENCH DEPT I NCH ES STAY 1OO' FROIVI ALL WELLS TYPE OF CONSTRUCTION--- GROUP F IR E ZONE USE CLASSIF SETBACKS FT. FROIVI CTR. OF rAtu FRONT SIDE EXT FT. FROM PROP. LINE: SIDE INT. - REAR ZONE AUTHORIZED SIGNATURES /s/ ISSUANCE DATE BLDG. PERMIT - WHITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUMBING - CANAHY BUILDING - GREEN SANITATION _ GOLDENROD IMPORTANT POST THIS PERMIT ON MAIN BLDG. AT SITE LANE COUNTY. DEPT. OF ENVIRONMENTAL MANAGEMENT COURTHOUSE ANNEX, .I35 EAST 6th, EUGENE, OHEGON 97401 Call 687-4065 to schedule all required c.onstruction inspections. Call 687-4061 to schedule all reguiredseptic system inspections. All construction shall comply with the Stale Buidling Code, D.E.e. staniJardsfor subsurface sewage disposal and the State Plumbing Code. All buildingS require a certiticate o, occupancy before being occupied. (See Details on Reverse Side) Code- Census Tract._- 7 SITE INSPECTION Ap pnov E o RruaRrs FOUNDATION TNSPECTION APPRov E D Rrul nx s Dr srPenoveo FRAMT NG Appnoveo RE ulnr s I NSPE CTION DrsapPRovEo LATH OR SHEETROCK INSPECTION Ap enov E o Rrurnxs DtsapPnovro FINAL INSPECTION AP PROV E O D l SAPPRovED RruaRr s Dar e Dar r I HspectoR NSPECTO I NsPEc7-2/-16 )tDat E Dar E I HspEcton Dar e I Nspecroe g,tr CERTIFICATE OF OCCUPANCY REaov ro lssuE C/ Nor READv ro lssuE D Dote-llseucron- RruaRx s ?/( r r-F6 /( DrsAPPRovEo D p-ra,t D 7t-J LR ,TLL BE ISSI'ED IINTTL IHIS APPLI APPLICATION FOR: / qq?-7 b/ T IF ION HAS BEEN APPROVEDNOTE: NO PERMI Sq. Ft Existlng MOBILE HOME PLA}I REVIEW Dlsposal System "-[. J u a [t-f,-vus Signature of Fee Recelved rd Maxlmun Dep -l l) i!r NO OWNER a Y Name Name o.s. REG. # o afl ,)^ Twp 7 Sect Subdivision ACCESS TO PROPERfi (Road Narne) Existing Structures on ProPerEY: Property Locatlon - Address/Directlons: SEI.]AGE Slte Inspectlon # Address J_C f,,r Address zrp Phone f Lr-- ty 2 Code/Census Tract ?roperty Acreage Wldth-DePth- Name of Conmunlty or Pub1lc Systeu Sewage Water ConnectioflConnectlon PI.ANS FURNISHED FACILITY PERMIT Ci la (t LLD v{,3 Tax Lot 0ther Install PLIJMBING 0r-t rT B1o ,t WATER SUPPLY: Well Bldg. Plumblng 3% Surcharge Waste Dlsp. Plan RevLew Moblle llorne 2(,oo -- r?T Spring CASH NO 'l YES TOTAI, Min. Septlc Tank Capacl Date: Dralnfleld Requlred type of Constructl Fire Zone Use Classiflcation Bldg Setbacks - from Center of Road Right of Way: Front Slde Int.Slde Exterior c55-12 LANE COT]NTY DEPARII{ENT OF EIWIRONMENTAL Zone IIANNING:DATE:SANITATION:DATE:,TE cHA}rGE OE OCCUPAI.ICY l---l L) CONSTRUCTION T__-l - Lineal Feet I