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HomeMy WebLinkAboutPermit Building 1987-04-02D - Lane County Authori za,ttott for' s DJ A**/".,*.*- FOR OFFICE USE ONLY ",//a3-f7Applicatio Permit # P 1 RANGE SECTION LOT,/PARCEL BI.oCK PROPOSED USE OF PROPERTY s identia I I ndus tr iaI&. lo -1 ,l aul\ZIPSTREETCITY WORK - BE Wffoo # OF EI'IPLOYEES WA PPLY P ,posed xl,s = OF BEDROOMS f OF STORIES I TELEPHONE NUMBEROiINER'S !$AME AND AD.DRESS r I l,-to-r irn 0IutS S NAME osR 2 2E-%9 TELEPHONE NTJMBER4K5-ry'fl TELEPHONE NWBER I HAVE CAREFULLY EXAIIINED IHE COI.IPLE?ED APPLICATION FOR PERMTT, arrd do hereby cetti,fy that aM.nforration hereon is true and correct, and that I have the following f,egal interest in the property, Io*n". of record; f] contraut. prrrchaseri f authorizetl agent. I f:rther certify that any and aII uork perfomed sha1l be done in accordanr:e with the Orditrances of Lane Comty and the Iaws of the State of Oregon pertaining to the work described herein, and that No oCcUpANcY will be made of arrl strrrcture without the pemission of the Builaling Division. f fur- ther certify that registration with the Builder's Board is in full force and effect as required by oRs 701.055, that if exempt the basis for exempti is noted hereon, and that only subcontractors ad employees who are in conpliance with oRs 701.055 will be used on thj,s project. I HAVE READ AND CHECKED THIS APPLICATION THOROUGHLY. NaME (please Print)SIGNATUR.E DATE Date: rnstallation Record rssued? [l v.= [ *"P. /Installation Speci fications COMI1ENTS r Date: COM}IENTS: Date * JO { etr tr ItAS fPLANNING,/ZONINGtr of ainfie ld READ THIS SECTION l'linimum Setbacks SANITATION: s, I. * Parcel # BEEN BASED ON THE POLLOWING CONDITIONS: cor4}lENTS rear Parcel Tank llon LineaL Feet !,laximun Depth of Trenches BY BUILDING OFFICIAL/DESIGNEE E COUNTY DEPARTMENT OF PUBLIC WORKS LAND MANAGEMENT DIVISION, oRs 456.805 1 125 EASTSTH AVENUE, EUGENE, OBEGON 97401 SEE REVERSE FOR INSPECTION INT'ORMATION Fe* u^q 6E DATE 687-4061, ct4-2s R* T c L. T 2 II ) ,n-,t .--./1^. .t // - / qlJj. r /,n:r-.,' ,_- t " ( ,1 L-. w2675 Bonro.. ralro Eugene, Oregon 97401 485-4977 q)[r c N E 85' ^i -. i'i t'"a,\ i.: ., ...Jr;v :-'. l-l 6 i3B7F ^Q ADDIf ro rRo?os 28 2668 N.gro S?FD I +--> 4o, ,-oz n..;; 74,,f(o, ( EIN FIEL rFtu e>f u$F r' AIN4TE L1 lfr'"-d b 4ru .-P6r. tsal 5Er.7AN,(s Ptuc c'io ,/o W,*t 72' 7i i_ lRto lto' s *D sr. CATT EY PI^OT PLAN 9CA LE l'- ! 6' --..-Jr--.., -rl- I I ii (D