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Home My WebLink AboutPermit Building 1975-08-22C\-Y #lrlsNOTE: NO PERMIT WILL BE ISSUED I]NTIL THIS APPLIC.ATION HAS BEEN APPROVED lEpntras APPLICATION FOR: CONSTRUCTION MOBILE }IOMEE OWNER S@t t Name Address Ctty zip Address ty o.s. REG. /l T\.rp Subdivis lon t-I- 3-"*-.1-t2+ +,traxt-"t'5DO I coa"ot 7'O4c.o".r" rr."t Lot k ?roperty Acr ea te__-____tr{1d th_Dep th_ ACCESS ro pRopERry 1n""a N"..1 *lr- YotAr.{DAF Exlsting Structures on Property: ProperEy Location - Address/Directions Below for Offlce Use Sq. Ft Valuatlon SEWAGE DISPOSAL Slte Inspectlon # WATER SUPPLY Well Spring Other Exlstlng Sewage Dlsposal Systen New Systen Required Public Comunlty @me of Coumunlty or Public systen FEES: Bldg. Waste Dl,sp. Pluoblng Plan Review Moblle Hone 12 Surcharge TOTAL PLI}{BING: Insta11gd by Orrner PLI'MBING FEES: Name // of Flxtures Sewage Connectlon Water Connection FACILIfi PERMIT Date PLANS II'RNISHED YES Signature of Fee Recelved Mln. Septlc Tank Capaclty Dralnfleld Required - Lineal Feet Maxlmun Depth Type of Constructl Fire Zone LANE COI]NTY DEPARIMENT OF ENVIRONMENTAL Use Classification -'j1 - Bldg Setbacks - frm Center of Road Right of Way Front___________Slde Int.. PIANNING: Slde Exterior DATE:SANITATION:DATE: c55-12 t<-oo Rear I- ' -,-- a lt ) i.-.+ ''; tt-<-z BUITDING PERMIT OR MH t-l a,4, MOBILE HOME USE PERMIT PERMIT NO. 2 J. LANE COUNTY BU ILDING PROPERTY OWNER HARoLD D MAITING ADDRESS PHONE Grtr. rs ?[f8 Yorrror Snnrxcrrero OnEeor CONTRACTOR MAILING ADDRESS -3755 MAtr Srnret SpR r rucr r ero Zl+6- t 6bI PHONE PROPERTY TOCATION _ INCI.UDE POST OFFICE 2i.rir ariPYqLAlioA Avel*ur PROPERTY TEGAL DESCRIPTION _ METES, BOUNDS RANG E SECTION TAX LOT NO all.ll. r CODE CENSUS TRACT l7 olg---olt EXISTING STRUCTURES ON PROPERTYAPPt. NAME & MAITING ADDRESS SauE TEGAT ACCESS TO PROPERTY PROPERTY SIZE _ FT. WIDTH DEPTH AREA FOR MOBILE HOME PERMITS ONLY No. of Bedrooms Connect to Existing Sewoge System fl New System I STRUCTURES TO BE BUILT THIS PERMIT TYPE CONSTRUCTION So. FT. # BDRMS VALUATIoN SEWAGE DISPOSAT PTUMBING INSTALLED BY PU BL IC . i sEPTtc TANK BU ITDING WASTE DISPOSAL PI.UMBING PIAN REVIEW PARK TRAITER TOTAT F EES OWNER OTHER: NAME WATER SUPPTY PUBUC tr ! OTHER COUNTY BUILDING & SANITATION SPECIFICATIONS MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GAL. DRAIN FIETD REQUIRED TIN. FT TRENCH WIDTH FT.OR SQ. FT TYPE OF STRUCTURE ,N OCCUPANCY ZONE PUBLIC UTIL. EASEMENT J BI-DG, SETBACKS FRONT FT. FROM CTR. OF ROAD RIGHT OT WAY SIDE INT. SIDE EXT. USE CTASSIFICAIION REAR AUTHORIZED SIGNATURE _ DATE DATE/r/J b/?1/75 oi-H BTDG. PERMIT _ WHITE OFFICE COPY _ WHITE COUNTY TAX _ PINK PTUMBING _ CANARY BUILDING _ GREEN SANITATION _ GOTDENROD Coll 687-4065 to schedule oll required inspeclions. All construc- tion sholl comply with Uniform Building Code, D.E.Q. stondords IMPORTANT: for subsurfoce sewoge disposol ond counly regulolions covering plumbing. All buildings require q certificote of occuponcy before being occupied. (See Detoils on Reverse Side) (POS Hrs PERMTT ON MAIN BrDG. AT E) [a..; COUNIY, DEPT. Ot ENVIRONMENTAL MANAGE/I'{ENI COURTHOUSE ANNEX, I35 EAST 6th, EUGENE, OREGON 97lt0lronv 1 655- 13 $ '- IANE COUNTY BUILDING - BUILDING PERMIT OR MOBILE HOME USE PERMIT MH E PERMIT NO. PROPERTY OWNER MAITING ADDRESS PHONE CONTRACTOR MAII.ING ADDRESS PHONE PROPERTY LOCATION _ INCLUDE POST OFFICE PROPERTY TEGAL DESCRIPTION - METES, BOUNDS RANG E SECTI ON TAX LOT NO,CODE CENSUS TRACT EXISTING STRUCTURES ON PROPERTYAPPL. NAME & MAII.ING ADDRESS TEGAT ACCESS TO PROPERTY a PROPERTY SIZE _ FT. WIDTH DEPTH AREA FOR MOBILE HOME PERMITS ONLY No. of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT Connect to Existin Sew TYPE CONSTRUCTION New System I BDRMS VALUATIONSQ, FT SEWAGE DISPOSAI. PUBr.rC ! SEPTTC TANK tr OTHERE PIUAABING INSTATLED BY OWNER E OTHER: NArltE BUITDING WASTE DISPOSAL PLUMBING PTAN REVIEW PARK TRAII.ER FEES WATER SUPPTY PUBUC D tr OTHER TOTAL COUNTY BUILDING & SANITATION SPECIFICATIONS MIN. SEPTIC TANK CAPACIIY WITH DIST, BOX: GAI.. DRAIN FIETD REQUIRED TIN. FT TRENCH WIDTH FT,OR SQ. FT TYPE OF STRUCTURE OCCUPANCY ZONE PUBLIC UTIt. EASEMENT BLDG. SETBACKS FRONT FT. FROM CTR. OF ROAD RIGHT OF WAY SIDE INT. SIDE EXT. USE CI.ASSIFICATION REAR AUTHORIZED SIGNATURE _ DATE DATE BTDG. PERMIT _ WH ITE OFFICE COPY _ WHITE COUNTY TAX - PINK PTUMBING _ CANARY BUITDING _ GREEN SANITATION _ GOTDENROD Coll 687-4065 to schedule oll required inspections. All construc- tion sholl comply with Uniform Building Code, D.E.Q. stondordsIi PORTANT: for subsurfoce sewoge disposol ond county regulolions covering plumbing. All buildings require o certificote of occuponcy before being occupied. (See Detoils on Reverse Side) (POS', HIS PERMTT ON MAIN BrDG. AT :) 1.. , COUNTY, DEPT. OF ENVIRONMENTAL MANAGEMENI COURIHOUSE ANNEX, I35 EAST 6Th, EUGENE, OREGON 9740Iroav f 655- 13 SITE INSPECTION App nov r o RruaRx s DI SAPPROVED Dare I Hsrectoa FOUNDATION I NSPECTION Aeenov ro Dt SAPPRovED Dar r I NsPEcroR a Reu anx s FRAMING INSPECTION Reuanr s Drsap.OVED Drrr NSPECTOR LATH OR SHEETROCK INSPECTION D DTsAPPRovE o Fa Dar E I NspectonAppaovEo Rexnax s FINAL INSPECTI DtsAPPRovEo oorrP'{-l(I NSPEcroAP PRov E D REuanx s CERTIFICATE OF OCCUPANCY REaov ro lssuE RruaRx s f7 Nor Rraov ro lssue D {6'7f "2 fff DarE I xspEcron Appnovro D '-*