HomeMy WebLinkAboutPermit Building 1977-08-30U
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Job Location n2
!,iritten Directions
( ) guilding Permit
I oa" i'
Acreage or Lot Size
Partitioning#- ( ) ComPleted( ) Pending
INFORMATION SHEET
( ) Site Feasibility Study for Septic Tank. Number of sites-
Test holes wilt be ready
Subdivision Lot
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APPLICANT,S NAIV{E AND ADDRESS
OWNEB'S NAME AND ADDRESS, if d
L,Phone 7/t-a*ez
Phone 7f 7 2d i;(
Phone
ifferent from licant's
CONTRACTOR'S NAtVlE AND ADDRESS
ail permit or results of site feasibility study to (pplicant ( )Owner (
){,
/7?1, -A d1 7
M
l
(
ntractor
) Prefer to Pick uP. Call (owner, etc. ) when ready Contractors O. S. # /5.1-lSt
3
2-7STRUCTURES NOW ON THE PROPER
PROPOSED USE (this Permit)
WATER SUPPLY
'a4P
SEWAGE DISPOSA L
existing or proposed well, etc. lf public. name of system)
(existing or proposed septic tank, etc.) S.l
AddressPLUMBING B /
( ) pRoPERTY lS WITHIN ONE MILE OF CITY /?
+ * * * + * * * + * * +* * * * * *+ Jt ** * * * ** * * * * * ** * * * + * * * * *OFFICE USE ONLY BELOW THIS LlNf *+***+************+***i***+*************+++
:o N
) New Address Necessary ( ) Facility Permit Necessary
SETBACKS: Front
( ) Special Permit Area. Minimum Elevation
lnterior Side Yard Rear
(FROM PROPERTY LINES)
Side Facing Street
(FROM CENTERLINE OF ROAD)
To: Planning/Building lnspector/Sanitarian/Surveyor.
Thisapplicant appears to have a problem with
Your assistance will be appreciated.
By Permit Processing Section
Response:
By
DEPARTIVI ENT O F E NV I RONMENTAL MANAG EIVI ENT
Permit Processing Section
125 East 8th Avenue
687-4394c55-12
Division
t
. TRE", T .
,/,+ #Ysd PERIVIIT #
\
TRS, T JOB LOCATION
Partition ing
LANE COUNTY PERMIT
Acreage or Lot Size
Contractor's O.S. #
) Completed Subdivision
Lot- Block-
APPLICANT'S NATVIE AND ADDR FSS Phon e_
CONTRACTOR'S NAME AND ADDBESS Phone-OWNER'S NAIVIE AND ADDRE Phone_-_-_=--
tVlail permitto ( )Applicant ( )Owner ( )Contractor. ( )Prefertopickup. Call (owner, etc.) when ready
\^./ATER SUPPLY SEWAGE DISPOSAL s.l. #
THlSPRoPERTY|SWlTHlNoNElVllLEoFTHEClTYoF.PLUlVlBlNGBY
I hereby certify that the above statements are true and accurate, and that I have the following legal interest in the property:
-owner
oI record;
-contract
purchaser;
-
potential buyer;
-
realtor or agent. I further certify that (iJ not the owner) I am authorized to act for the owner of
record, and that said owner is aware and approves ot this action. I hereby agree to comply with all applicable Codes relating to this permit.
Fee Paid $Signature Date
()NEWADDRESS ( } FACILITY PERM IT TO TRANSPO RTATION D EPT.- () SPECIA L PN]T. AR EA, MIN.ELEVATION
STBUCTURES NOW ON THE PBOPERTY
]THlSPEBMlTlsFoR#BEDRoolvlL#PLUl\4BlNGcoNNEcTloNL
SANITATION
[Vlinimum Septic Tank Capacity (Gallons)
Drainfield Required - Lineal Feet
IVlaximum Depth
BUILDING
Type of Construction
c",,..'n.,""1,.
Use classification
roup
-Fire
Zone
Comments
B Date B Date
PLANNING REOUIRETVIENTS SATISFIED. B Date Date lssued
ZON E SETBACKS: FRONT SIDE FACING STREET (FROIVI C/L) INT. SIDE YARD REAR (F ROrvr P/L)
LAN E COUNTY D EPARTMENT OF ENVIRONMENTAL IV]ANAG EI\4 ENT, 125 EAST BTH AVE.. EUG EN E, O B EGON 97401 PHON E: 687.4394
POST THIS PERMIT ON MAIN BUILDING AT SITE
BLDG.PERMIT-WHITE; BUILDING-GREEN; PLUMBING-CANARY; SANITATION-cOLDENROD; OFFTCECOPY WHTTEc55-1 3
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LANE COUNTY PERMIT
Acreage or Lot Size
Contractor's O.S. #
Partitioning #) Completed
OWNER'S NAME AND ADDRE ss Phon
CONTBACTOR.S NAME AND ADDRESS PhONC-
lvlail permitto ( )Applicant ( )Owner { }Contractor. ( )Prefer to pick up. Call- (owner, etc.) when ready.
PERMIT #
APPL|CANT,S NAME AND ADDRESS Phone
-
STRUCTURES NOW ON THE PHOPERTY
THIS PERIVIIT IS FO
\A/ATER SUPPLY . SEWAGE DISPOSAL
# B ED ROOIVIS-# PLUIVIB I NG CO N N ECT IONS
s.t. #
THlSPRoPERTYlSWlTHlNoNElVllLEoFTHEClTYoF.PLUtVlBlNGBY
t hereby certify that the above statements are true and accurate, and that I have the following legal interest in the property:
-owner
ol record;
-contract
purchaser;
-
potential buyer;
-
realtor or agent. I further certify that (il not the owner) I am authorized to act for the owner of
record, and that said ow er is aware and approves of this action. I herebv agree to comply with all applicable Codes relating to this permit.
Fee Paid S-Signature
() NEW ADDRESS () FACILITY PERIVIIT TO TRANSPORTATION DEPT.( ) SPECIAL PlVlT. AREA. lvllN. ELEVATION:--
SANITATION BU ILDING
lVlinimum Septic Tank Capacity (Gallons)Type of Construction
-Group
ire Zone
Drainfield Required - Lineal Feet Use Classification
lVlaximum Depth Comments
Comments
By:Date By Date
bdivision
BlocLot
PLANNING REOUI REMENTS SATISFIED. By Date Date lssued
ZONE SETBACKS: FRONT SIDE FACING STREET (FROIM C/L) INT. SIDE YARD REAR (FROIVI PiL)
LANE COUNTY DEPARTMENT OF ENVIRONIVIENTAL IVIANAGEIVIENT, 125 EAST BTH AVE., EUGENE, OREGON 97401
POST THIS PERMIT ON MAIN BUILDING AT SITE
C55-13 BLDG. PERMIT - WHITE; BUILDING - GREEN; PLUMBING - CANARY; SANITATIoN - GoLDENRoD; oFFICE coPY - wHITE
PHONE: 687-4394
Date
-
SLAB FLOOR
PLUMB ING GROUNTI,JoRK
Appnov e o
Reilrnx s
DrsrppnovEo Drr e I NspectoR
GAS PIPING GROUND/ORK
AP PRov E D
Reuanx s
D DrsappRovco D Darr I HspEcron
ROUGH PLUMBING
Appnoveo n DrsappRovro
Rrua nx s
LrUz,P{Dare I Hsprcron
I Hspecron
F I NAL PLUMB I NG
Appnov e o
Rr uanx s
D r srepRoveo DarE I Nspecron
FINAL GAS PIPING
AppRoveo D DrsAPPRovE, L/
REHanx s
Dare I Nseecron
CERTIFICATE OF OCCUPANCY
Rrlov ro lssue
RrulRxs
D Nor Rerov ro lssur D Dare I NSPEcToR
ROUGH GAS PIPING
AppRoveo D DrsappRoveo El Doru_
RrurRx s
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JOB LOCATIO
Partition ing
LANE COUNTY PERMIT
PERMTT - ?35q-7
t t*B
lL-t z -$3
Acreage or Lot Size
Contractor's O.S. #
) Completed Subdivision-
Block.---
APPLICANT'S NAME AND ADDRE SS Phone
Phone
Phone
OWNER'S NAME AND ADDRESS
Mail permitto ( )Applicant ( )Owner ( )Contractor. ( )Prefertopickup. Call-(owner, etc.) when ready
CONTRACTOR'S NAIVIE AND ADDRESS
\AJATER SUPPLY SEWAGE DISPOSA
STRUCTURES NOW ON THE PBOPERTY
ITHIS PERMIT lS FOR # BEDROOIIS-# PLUI\4BING CONNECTIONL
THlSPRoPERTYlSWlTHlNoNEtVIlLEoFTHEClTYoF.PLUN/lBlNGBY
I hereby cenify that the above statements are true and accurate, and that I have the following legal interest in the property:
-owner
of record;
-contract
purchaser;
-
potential buyer;
-
realtor or agent. I Iurther certily that (if not the owner) I am authorized to act for the owner of
record. and that said owner is aware and approves of this action. I hereby agree to comply with all applicable Codes relating to this permit.
Fee Paid $Signatu re Date
( }NEWADDBESS { ) FACILITY PERIV] IT TO TRANSPORTATION DEPT.- ( } SPECIAL PI\4T. AREA. MIN. ELEVATION:
SANITATION
lVlinimum Septic Tank Capacity (Gallons)
Drainfield Required - Lineal Feet
lVlaximum Depth
BUILDING
Use Classification
Comments:
Type of Construction
-Group
ire Zone
Comments
Date By Date
PLANNING REOUIREMENTS SATISFIED. B Date lssued:
LANE COUNTY DEPARTIVIENT OF ENVIRONIVIENTAL IVIANAGEIVIENT, 125 EAST BTH AVE., EUGENE, OREGON 974O1
POST THIS PERMIT ON MAIN BUILDING AT SITE
-.-1 3 BLDG. PERMtT - wHtrE; BUtLDtNG - GREEN; pLUMBtNG - GANARy; sANtrATtoN - coLDENRoD; oFFtcE coplr - wHtrE
PHONE: 687.4394
Lot-
Date:v:
ZONE:SETBACKS: FRONT SIDE FACING STREET (FROIVI C/L) INT. SIDE YARD REAR (F ROIVI P/L)
SITE INSPICTION
Ap pRov E o
Rruanx s
D r s APPRovEo D oor-7- /z-'???>h,'-LI HseecroR zx-.-
FOUNDATION I NSPECTION
Ap pRov r o D r s APPRovEo Dnr r
Rrurnxs - /z-z
FRAMING INSPECTION
AppRovro
Reuanx s
DrsAPPRovEo oor,/L27- Z?
2
I NsPEcroR
LATH OR SHEET I NSPECT I ON
Dr sAPPRovEo ,^,, /Z -7- 2 ?,n,,,,,o^APPROVED
Rrxanxs
FINAL INSPECTION
AP PRov E D
ReMenx s
D ,o,,_lza3--93-D r sAPPRovEo I NSPEcToR
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CERTIFICATE OF OCCUPANCY
Rrroy ro lssuE D Nor Re rov ro lssue D DorE-lNseecron-
Rrua Rx s
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