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Home My WebLink AboutPermit Septic Tank 1976-05-10n Owner I JE COUNTY PERMIT FOR:PERIVIT NO CONSTRUCTION [ ] I\IOBILE HOIVIE [ ] PLAN REVIEW [ ] CHANGE OF OCCUPANCY [ ] C ITY ZIP CODENAN/IE ADD R ESS PHONE n Contractor NAN,lE O.S. Reg. + Twp- Range-- Section Subd ivision Lot ADD R ESS CITY ZIP CODE Census Tract PHON E Tax Lo t Code Access to Property (Road Name) B Iock Acreage Width Depth Existing Structures on Property: Directions to Property - Address STRUCTURE (# BEDROOIVIS)SO. FT VALUATION SEWAGE DISPOSAL: PUBLIC [ ] SEPTICTANK [ ] OTHER [ ] BUILDING WATER SUPPLY: PROPOSED t ] EXISTING t ] PUB LIC COIVIIVIUNITY - NAN4E PLUIVIB ING 3% SURCHARGE IVIOBILE HOIVIE WASTE DISPOSAL PLAN REVIEW TOTAL PRIVATE WELL OTHER SPECIFY CONSTRUCTION PERMITS & INSPECTIONS AND WATER POLLUTION CONTROL SPECIFICATIONS IVIIN. SEPTIC TANK CAPACITY GALS.IVIIN, DRAINFIELD LIN. FT MAX. TRENCH DEPT I NCHES STAY 'IOO' FROiVI ALL WELLS TYPE OF CONSTRUCTION GROUP FIRE ZON USE CLASSIFE SETBACKS- FT. FROIVI CTR. OF rAfl FT. FROIVI PROP. LINE SIDE INTFRONTSIDE EXT.REAR ZON E AUTHOBIZED SIGNATUBES lsl ISSUANCE DATE BLDG, PERMIT - WHITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUMBING - CANABY BUILDING - GREEN SANITATION _ GOLDENROD IMPORTANT Call 687-4065 to schedule all required construction inspections. Call 687-4061 to schedule all required septic system inspeclions. 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 Fleverse Side) POST THIS PERMIT ON MAIN BLDG. AT SITE LANE COUNTY. DEPT. OF ENVIBONMENTAL MANAGEMENT COURTHOUSE ANNEX, 135 EAST 6th, EUGENE, OFIEGON 9740.1 PLUIVIBING INSTALLED BY: owNER t I OTHER [ ] NATVTE_ I.ANE COUNTY ENVIRONMENTAL MANAGEMENT PLOT PLAN Name and Address of ner Telephone:it{b The buildlng belng constructed under this permit w111 be used f ot '-f)''c/ c-/L"fZ Date thls ProPerty was P urchased / /17 or did Yo u ever own ProPertY adjacent to this tax lot? If so, Please draw those ProPerti es on the Plot Plan below'- ,t Do you now, list those t ax loE numbers 2- ocation of all homes (including moblle homes) now on Indicate on Y the proPertY, our drawi as well ng the I sEhel ocation of the new buil-ding' t / II I t.' I ,.1 .t N il V I l"l r La , ,i lr i' 1l il I r r I A Irl It H l/ .,.l/l 0 I i 1l I I 41 r1I A,I \ ;l I I ). T)I \ \\ M t, I Name of APPllcant Address (1f dlfferent from owner): Map Tax LotTelepIr ort e Appl tc'tntru Intcrcst: nufer l-l Sel ler AgenE Permlt ll x l n Owner L_ 'lE COUNTY PERMIT FOR PERIVIIT NO CONSTRUCTION [ ] IVIOBILE HOIVIE [ ] PLAN REVIEW [ ] CHANGE OF OCCUPANCY [ ] ZIP CODENAIV]E ADD R ESS CITY PHONE n Contractor NAIVIE ADD RESS CITY ZIP CODE PHO NE O.S. Reg. + Tw Range- Section-Tax Lot-_- Code Census Tract Subdivision Lot Access to Property (Road Name) B lock Acreage - Width Depth Existing Structures on Property: Directions to Property - Address STRUCTURE (# BEDROOIVIS)SO. FT VALUATION SEWAGE D ISPOSAL: PUBLIC[] SEPTICTANK[]OTHER t ] PLUTVIBI NG INSTALLED BY: OWNER[]OTHER[] NAIVI E BUILD ING PLUIVIBING 3% SURCHARGE - TVIOB ILE HOTVIE WASTE DISPOSAL PLAN REVIEW TOTAL WATER SUPPLY: PROPOSED t EXISTING t PUB LIC COMIIVIUN ITY NAIVIE PR IVATE WELL OTHER . SPECIFY CONSTRUCTION PERMITS & INSPECTIONS AND WATER POLLUTION CONTROL SPECIFICATIONS N4IN. SEPTIC TANK CAPACITY: GALS. VIIN. DRAINFIELD----LIN. FT IVIAX. TRENCH DEPTH- INCHES TYPE OF CONSTRUCTION GROUP FIRE ZONE USE CLASSIF SETBACKS - FT. FROtVI CTR. OF rM FRONT SIDE EXT FT. FROIVI PBOP. LINE: SIDE INT. - REAR ZONE AUTHOBIZED SIGNATURES ISSUANCE DATE lsl css.r 3 BLDG, PERMIT - WHITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUI",4BING - CANAFY BUILDING - GREEN SANITATION - GOLDENBOD IMPORTANT Catl 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 foi sub6urface sewage disposal and the State Plumbing Code. All buildings require a certificate of occupancy before being occupied. (See Details on Beverse Side) POST THIS PERMIT ON MAIN BLDG. AT SITE LANE COUNTY, DEPT, OF ENVIRONMENTAL MANAGEMENT COURTHOUSE ANNEX, 135 EAST 6th, EUGENE, OREGON 97401 I]tltltl STAY 1OO' FROIVI ALL WELLS SITE INSPECTION Appnovro Rruanx s D t sapPaovEo Dare I rusprcton FOUNDATION I NSPECTION AppRovro Rrulnxs Dr sappRoveo n Darr I HspEcron FRAM I NG AppRoveo Re uanx s I NSPECT I ON Dr slppnoveo Dar r I rsprcron LATH OR SHTETROCK Appnovro Rrtt r Rx s I NSPECT I ON D r sappRovro Drr e I Nseecron F I NAL I NSPECT ION Ap pRov E o ReMenxs D r sappRoveo Dar r I Nseecron CERTIFICATT OF OCCUPANCY Reaov ro lssuE RruaRr s Nor Rraov ro lssuE D DrrE I HsprcroR D PERMTT # \33^%NOTE: NO PERMIT WILL BE TSSUED I]NTIL THIS APPLIC'ATION HAS BEEN APPROVED CONSTRUCTION # ice Use ru. *Lt ?40{,J3-73Ll Phone Census Tract Acreage Width_Depth_ Valuation 6..r4OWNER CONTRACTOR Name Name Addres s Address Tax City a$a-*-<-- P O. S. REG. /I Ql:'l)a,e__=l-l \\Twp. Su Section Code Blockg ACCESS T0 PROPERTY (Road Narne) Existing Structures on Property:fUr'CJr)'(-9'-- Property Location - Address/Dlrections 3 53 a * ,a ."^^ I-\.: , SPOSAI,: Site Inspec tion /l WATER SI]PPLY: Well FEES: Bldg. Plumblng 3Z Surcharge Waste Dlsp. Plan Review Moblle Home TOTAL Sprlng Existing S Other PLUMBING: Installed by System or New System Requlred Name of Community or Publlc Systen Name Sewage Water ConnectionConnectlon FACILITY PERMIT YES Signature of App Fee Received By of es \ (?-) ttti 0t PI.A,NSg? NO r{89 seP tlc Tank Capacity.Requ ired - Lineal Maximum Tvpe of Construction Group Flre Zone Us e Classification Bldg S - from Center of Road Right of Way: slife*Tilt:*% '*-***-'*266" R*l c55 - l2 TLANE COI.INTY DEPARI},IENT//F EIWI RONMENTAL MANAGM{ENT DATE:puilIrrc: DATE: SANITATION: -/DATE: €-r/- 76" BUIIDING: APPLICATION FOR: MOBILE HOME T---l PI-AN REVIEW r-_l ( l- -l otrrer fl I NSTALLER: PROPOSED SEWAGE DISPOSAL SYSTEH 'CORD Complete top part of form to signature and submit poth copies with application. pERHtT No. 733-7G INSTALLERIS NAI.IE PROPERTY ADDRESS C f+n S !-yoOS 3fZ?--\olanda street GG No. Livinq I pt c Basement Yes No lJater Suppl y Publ i c 0the Uni ts Bedrooms Baths /i st Ft. frorn well - Steel tr Concrete lns e ons: dth Ft. n th I.,i Diameter De NA}'IE Freedom Hom es Inc }TA IL I NG ADDRESS 4980 West Hillside Drive Eugene 0regon No. Compartments 1 Gal . Capacity I OOO o e sPosa e Distribution Box:es t er str ut On- No Feet wEl I Lot L Front rofn ne nd ton 5Side R h L i nes-Ft .er ov, 4 5 ile tn CERTIFI TE OFForSanitarianUse0nly: Date: lg-/l-77 ln accordance with 1973 Oregon Laws Chapter 835, Section 214 tnis certificate is issued " as evidence of satisfactory completion of a subsurface seurage disposal system at the above I ocat i on. ft npproved: System lnstallation conforms to current standards [J Disapproved: Does not conform to current standards Remarks: L I F er Ti le2- in Trench llidtt\Z Total Sq. Fr. +7.O Ft. Between tines 1O an see nst ruct ons Ific*te: -a d rd-tz Uv 7 U [L o j u I /auS,Z fro'*SEPr'c L,,T {$ L fq E* l $,i, vrl,} f d 6' EPi'ge*'{i--* L - -'ill,fl I il[*.---yL (il Der,',l n€tol lo' o-(. ure gl t&*-. C55-II 5nriflgnafurG LANE COUNTYU STATE OF OREGON DEPARTHENT OF ENVIRONHENTAL QUALITY LANE COUNTY PERMIT FI PERIVIIT NO CONSTRUCTION [ ] IVIOBILE HOIVIE [ ] PLAN REVIEW [ ] CHANGE OF OCCUPANCY [ ] n Owner NAIVIE ADD R ESS C ITY ZIP CODE PHONE I Contractor NAIVIE ADD R ESS CITY ZIP CODE Census Tract PHONE O.S. Reg. + Tw Range- Sectio LotSubd ivision Tax Lot- Code B lock Acreage Access to Property (Road Name) Width Depth Directions to Property - Address: STRUCTURE (# BEDROOIVIS)SO. FT SEWAGE D ISPOSAL: PUBLIC [ ] SEPTICTANK [ ] OTHER [ ] PLUIVIBING INSTALLED BY: OWNER[] OTHER[] NAIVI tr BUILD ING PLUMB ING 3% SURCHARGE MOBILE HOIVIE-- WASTE DISPOSAL PLAN REVIEW TOTAL WATER SUPPLY: PROPOSED t EX IST ING t PUB LIC COMIVIUNITY . NATVIE PRIVATE WELL OTHER.SPECIFY CONSTRUCTION PERMITS & INSPECTIONS AND WATER POLLUTION CONTROL SPECIFICATIONS MAX. TRENCH DEPT I NCH ES STAY 1OO' FBOIVI ALL WELLS TYPE OF CONSTRUCTION- GROUP FIRE ZONE USE CLASSIF SETBACKS FT. FROIVI CTR. OF r,Atu FRONT SIDE EXT. FT. FROM PROP. LINE SIDE INT REAR - ZONE- AUTHORIZED SIGNATUBES lsl ISSUANCE DATE BLDG. PEBMIT - WHITE OFFICE COPY - WHITE COUNTY TAX _ PINK PLUMBING - CANARY 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.Q. standards for subsurface sewage disposal and the Stale Plumbing Code. All buildings require a certificate of occupancy before being occupied. (See Details on Beverse Side) POST THIS PERMIT ON MA!N BLDG. AT SITE LANE COUNTY. DEPT. OF ENVIBONMENTAL MANAGEMENT COUBTHOUSE ANNEX, 135 EAST 6Ih, EUGENE, OREGON 97401c55-13 Existing Structures on Property: VALUATION IVIIN. SEPTIC TANK CAPACITY: GALS. IVIIN. DRAINFIELD-LIN. FT.