HomeMy WebLinkAboutPermit Building 1975-06-17/t/bq
t45\-75
/)
IANE COUNTY BUILDING PERMIT oR MoBItE HoME USI'.prnmIr
OWNER
MHE
MAILING ADDRESS
PERMIT NOBUILDING
Txonr
PHOI.I E
CONTRACTOR
S rxr
MAITING ADDRESS PHONE
PROPERTY LOCATIO ,N-INCLUDE POST OFFICE
PLAcE SpRrxorter-o orr JrsptR QoAo:
PROPERTY LEGAL DESCRIPTION _ METES, BOUNDS
RANG E SECTION
06. t.lt
TAX LOT NO,
95ffi
CODE CENSUS TRACT
Txous F. Broonrxr
EXISTING STRUCTURES ON PROPERTY
h 'ioMEAPPI..
NAME
&
MAITING
ADDRESS
Slxr
TEGAT ACCESS TO PROPERTY
Sourx 4orn
PROPERTY SIZE _ FT.
WIDTH DEPTH AREA
FOR MOBILE HOME PERMITS ONLY
No. of Bedrooms Connect to Existing Sewoge System f New System I
STRUCTURES TO BE BUILT THIS PERMIT TYPE CONSTRUCTION sQ. FT. # BDRMS VALUATION
AoorrtoN oF Beonooil 3l x 21 65t e 16.10 gro,48r . ro
I xreR r on
Covrn Perro hoxn I}to@r.Io 56o.oo
I 1. l\t.10
SEWAGE DISPOSAT PLUMBING INSTALTED BY
PUBI.IC
BUILDING
WASTE DISPOSAI
PLUMBING
PLAN REVIEW
PARK TRAILER
TOTAL
SEPTIC TANK OWNER OTHER: NAME
WATER SUPPTY
PUBUC n tr OTHER
(FEES
t-
COUNTY BUILDING & SANITATION SPECIFICAIIONS
MIN. SEPTIC TANK CAPACITY
WITH DIST. BOX: GA[.
DRAIN FIEID REQUIRED
TIN. FT TRENCH WIDTH FT OR SQ. FT
No Pent oF xEy coxSlnucrioN To BE vrTHrlr tEr{ FEET oF Exrgtrilc sEwAdE DlspogAL sysrEx:
TYPE OF STRUCTURE
5N
OCCUPANCY ZONE PUBTIC UTII.. EASEMENT
BLDG. SETBACKS FT. FROM CTR. OF ROAD RIGHT OF WAY USE CLASSIFICATION
)rnt
FRONT SIDE INT,
I
SIDE EXT,[6r REAR 5'
AUTHORIZED SIGNATURE - DATE DATE
/s/ ,1. E. BoBs rv C Hrnarucn Cnurcxsnrrx Fon snoox/serrrARrAlr 6/tl/lS
BLDG. PERMIT _ WH ITE
OFFICE COPY _ WHITE
COUNTY TAX _ PINK
PI-UMBING _ CANARY
BUILDING _ GREEN
SANITATION - GOTDENROD
Coll 687-4065 ro 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)
(POST TH|S pERMtT ON MA|N BIDG. AT SITE)
LANE COUNW, DEPT. OF ENVIRONMENTAL MANAGEMENT
COURTHOUSE ANNEX, I35 EAST 6th, EUGENE, OREGON 9740Inoau fq55-13
oTHERfl
lilD N SITE EVALUATION
a\(,.) BUILDtNG PERHtT APPLIcATI0N N0"
( ) srrE rNsPEcrloN
PLANN llr0 p lv ls l0N
o cu(t@r"fitxLor-SUBDIVISION:L0T:_ BLOCK:_
APPL I CANT
DATE
Notti le CKID BY:
6. Setbacks
No Yesr)rI() ()
() ()
() ()
() ())
rom c o| . Zon i ng Ord i nance Compl i ance : Zone41-
2o Subdivision 0rdinance Compl iance
3. Requ i red Access
4. guitaing Site (Area, }Jidth, Frontage)
5. 0ther (see comments)
Front Yo
Side Exterior Vo
Setbacks f rsn i nter ioil-r neil
Side {
Rear
c0|tilENTS:
(
(
{
FLANtrING D IV IS ION_AET]OII PEND ING: Y
BUILDING INSPECTION DIVIS!ON
7. Plans Submitted
8. Soil Stability (footings)
9, Flood Plain
t O. Other (see conrnents)
rl APPA ICAT I
Not
I icable Nor)()ffi() ()
() ()
(
(
(CK'D BY
COMMENTS:
WATER POLUTI ON Not
App! i cabl e No Yes
ll. l{eets Department of Environmental
Qual ity Standards.
12. 0ther (see comments)
/q r) TT
() ()()CKIO B
DATE
COHHENTS:
TO APPLICANT:
q Your)d(')
Building / Site lnspection:
Can be approved.
Cannot be approved at this time as indicated on item N0"above.
V Questions and further information on items
DlVlSlON. Questions and f
t rough 2 contact the LANE COUNTY B ING AND SAN TATION DIV
Will be held in this of ce unt i you can reso vet prob
I through 5 contact the LANE-
urther information on items 7
()
)
c55-28
Your bui ldin
135 Sixth Avenue East Eugene Oregon t/
PHoNE: 687-4065
LANE COUNTY PLANNING DlVtSloN PHoNE:. 687
em5
S ON
cated.
ls being returned.
rmi t a licat ion fee is bein
ENTAL G ENT
40r
-4t 85
7,{7
NoTE: No PERMIT WILL BE Qul, UNTIL THIS APPLICATION *sQn*
/%q-7s-
PERMIT /T
APPROVED
CONSTRUCTION MOBILE }IOME
A?PLICATION FOR:
PLAN REVIEW C}IAi{GE OF OCCUPA.}ICY
€z sa(aryA-?/
,4 7Z
(l 74t -dc€-lOWNER
CONTRACTOR
Name S Cit zip Phone
o.s. REG. /l
aTwp
Subdivis
Name Address
Z Section A rax Lot %'a e
Lot 2 B1o
City
Code
zip
Census Tract
Phone
5-
.uJ-----:roperty Acreage t,l Tdth/b -Depthgt
Existine Structures on ProDertv:
e>
Property Locatlon - Address/Directions:
r Off
o
SEWAGE DISPOSAL:
Slte Iflspectlon
Sq. Ft
Exlstlng Sewage Disposal System
o
fl
#or New System Required
WATER SI'PPLY:
Irle1l
FEES
Spring
Public
Coromunity Name of or Pub1lc SystemOther
PLUMBING:
Installed by Owner Other Name
Bldg.
Waste Dlsp.
Plumbing
Plan Revlew
Moblle Home
12 Surcharge
TOTAL
22"60
PLUMBING Efrf-?
A U Cof Fixtures
Dra 1 Requlred - Lineal
Sewage
Connection
PI-ANS FURNISHED
ES
Signature of
Fee Received
Water
Connection
I'ACILITY PERMIT
YES
Date -/t-7
Maximum Depth
Z
Min. S
^A
heptic Tank Capacl
Type of Construct Group Fire Zone Use Classification
Bldg Setbacks - froo Center of Road Right of Way:
Fronr /A side rnt.
-
S Side Exterlor Y O Rear _f-
c55- I2 LANE RONMENTAL
Zone
PIANNING DATE:DATE:
4b
r--'l
AccESs ro pRopERfi <rc^a Nr "> J'a {dVfl/q: <
-------;78
--a7::7e
L
R.e