HomeMy WebLinkAboutPermit Building 1975-01-02Pm{rr{i A573 -?f
IAI{E CCI]NTY Building
DPARIMM{T OF EIWIROMENIIAL MAMGIMENI MCbilC IICTTE
AFPLICATION FOR zuILDI}G PERMIT G. }OBIIE HCD,IE USEIUIE: t{o permit will be issued r:ortil this applicaticn has been aprprorred.
PLEA^SE PRINI -Lt / t
PROPBTY tfr}g::cltt D4 4" hoeU ,Z{TZ. ,1r.r-- r-- U
rr,ip ,7 RAIGE oa sEC. /? ux ror 4_?8t_;ccnu Qmrsrrs mecr :j_!!$B,mro.%=rp *ru flw
ACCESS TofroYRTy ltlo.ertq , Zda wruiu DErrJ oR ACBEAGE
DESCRIBE DilSTIIG STRUCf,URES oN IIIE wovw:Y SOttz ii,i )lnUf
APPLICAIU
MME
I',IAILIM
ADDRESS
-th
MME
ttres to
/O
Site hspection JL
1ts
ter
R:blic
tj
E>cis ting sen^iage disposal systern or nehr systgn
Well [] Spring I Ocher
Phrbi:rg Installed by Owner Other
D
wffi
inspection fee
trict Nare
Bldg.
Waste Dis.
Pfurbirg
Plan Revievi
Ttailer
1% sr-rctrarge
TOTAL
Min
/ Fees
I Cash
E Check
Pltrrbing
JL
1r
Sexrer connec
inspection
No
Fees
of fixtr-res
Plans
Signature of App
Fee received
Facility
Yes E No
te
ty
with dist. box: Gallons Lineal Feet
c55-r2
t
Side Int. S Sidcrftterttn
SE
Rear 6/,<)center way
ZorteFront
/rn
II Depth_ or Sq. Ft
. ,T dfc t2-27
Bu-rLBlNG s tre l!ALU4I-!-Ql'l
t!
(fsutDtNG pERmlr APPL!cATloN No.
( ) srrE tNSPECTIoN
,/_ts/ck r / 7 n :rZ s O" BrAx Lorj$bo
SUBD IV I S*fl:
LOT:BLOCK:
PLANNING DIV!SION
Zoning Ordinance Compl iance: Zone @
Subdivision 0rdinance Compl iance
Requi red Access
Building Site (Area, Width, Frontage)
0ther (see conments)
APPL I CANT
DATE
Not
furpl icabl e Yes CK!D6. Setback
11
I
2
3
4
5
()
()
()
()
()
w(.)*
LYuY
)
(
(
(
Nofl()
()
()
()
Ffant . ,
Setbacks from inter
Side
or nes:6r
Rear iF, ,
CO}tilENTS:
FLANNTNG DrvrsroN-AeTlorpENDtNG: YES( ) No(APPTTCAT ION#
BU ILD I NG I NS.PECT ! ON O IV IS ION Not
I icable No
()
()
()
7
8
9
0
Plans Submitted
Soil Stabil ity (footings)
Flood Plain
0ther (see ts)
COHI.IENTS:
Yes
8()
()
r)
CKI D BY
U'ATER POLUTION CONTROL
I I . ileets Department of Envi ronmental
Qual ity Standards.
12. 0ther (see cornments)
Not
I icable No Yesr) rT
)() ()CKID BY:4
DATE
COHI,IENTS:
TO APPL I
{ )"''
CANT
q5 Your Building / Site lnsPection:
tl Can be approved.
Cannot be approved at thi s time as indicated on item N0
Questions and further inf ormation on items I through 6 contact t LA
LANNING DIVIS Questions and further informa tion on iteilil
above.
c
t rou 2 contact t e E CoUNTY BUILDING AND SANITATIoN DIV-!!I-QN.
IJill be held in this ofmce unafft,ou can resolve the problems
!s being returned.
c55-28
()
()
Your bui Idin
pHoNE. 697-4065
LANE COUNTY PLANNING DlVtSlON PHONE: 687-4186
i nd i cated.
rmi t li tion fee is n
AL HA
135 Sixth Avenue East Eugene Oregon 974o1
I
IANE COUNT sUILDING PERMIT OR MOBITE HO
MHI
UsE PERMIT
PERMIT NO.BUILDING
I ItOPERTY OWNER MAILING ADDRESS PHONE
CONTRACTOR MAILING ADDRESS PHONE
PROPERTY TOCATION _ INCTUDE POST OFFICE
PROPERTY TEGAL DESCRIPTION _METES, BOUNDS l*r Aoort
RANG E SECTION TAX LOT NO CODE CENSUS TRACT
EXISTING STRUCTURES ON PROPERTY
APPI-.
NAME
&
MAITING
ADDRESS
LEGAI. ACCESS TO PROPERTY
NI
PROPERTY SIZE - FT. I
WIDTH DEPTH AREA
FOR
No
MOBILE HOME PERMITS ONLY
of Bedrooms Connect to Existing Sewoge System f New System !
TYPE CONSTRUCTION se. FT # BDRMS VALUATIoN
T
SEWAGE DISPOSAT
Puiuc n sEPTlc rANK tl OTHERD
PLUMBING INSTATI.ED BY
OWNER n OTHER: NAME
F EES WATER SUPPTY
PUBI.IC tr N OTHER
BUILDING
WASTE DISPOSAT
PTUMBING
PtAN REVIEW
PARK TRAILER
(.
TOTAL
COUNTY BUILDING & SANITATION SPECIFICATIONS
MIN. SEPTIC TANK CAPACITY
WITH DIST. BOX: GAL.
DRAIN FIELD REQUIRED
tIN. FT TRENCH WIDTH FT OR SQ, FT.
TYPE OF STRUCTURE OCCUPANCY ZONE PUBTIC UTII. EASEMENT
BLDG. SETBACKS FT. TROM CTR. OF ROAD RIGHT OF WAY
FRONT SIDE INT, SIDE EXT.
USE CTASSIFICATION
REAR
AUTHORIZED SIGNATURE _ DATE
I
DATE
BIDG, PERMIT _ WHITE
OFFICE COPY _ WHITE
COUNTY TAX _ PINK
PTUMBING _ CANARY
BUITDING _ GREEN
SANITATION _ GOLDENROD
. Coll 687-4065 to schedule oll required inspections. All construc-
. \ \ , tjon .rholl comply with Uniform Building Code, D.E.Q. slondqrds-- r '\. nnpORTANT: fbr subsurYoce se\/oge:diqpoool, ond counly regulolions covering
plumbing. All buildirtgs require o ceriificote of occuponcy before
i being occupied.
\ '" (see Detoils ori Reversci.{aefA&lut
\!.\
(posT THrs PERMTT ON MAIN BIDG. AT SITE) ,(
IANE COUNTY, DEPT. OF ENVIRONMENTAT MANAGEMENT
COURTHOUSE ANNEX, I35 EAST 6Ih. EUGENE, OREGON 9740I
ronu * 655- 13
STRUCTURES TO BE BUILT TH PER
SITE INSPICTION
AP PRov E o
Rruanx s
Drsappnoveo Dare I Hspecton
d
FOUNDATION I NSPECTION
Ap paov e o
Reuanxs
SAPPROVED Dar e I Hspecron
FRAM I NG
Appnov r o
Re uanx s
I NSPECT I ON
D DrsrppnovEo D Dare I NspcctoR
LATH OR SHEETROCK INSPECTION
Ap pnov r o
RrxaRx s
D DrsAPPRovEo f7 Dar r lr.rspe cTon
FINAL INSPECTION
AP PRov E D
Rrnenx s
CERTlFICATE OF
Rcaov ro lssue
Rruenx s
Dt PPROV E D Darr lNsp TOR
PANCY
D Nor Rraoy ro lssue D Dere I NsprcloR
A6as-R{{rfr"il 0,,
D
fl
fl
J
H
Hg
fl
$FI*l
s]
rit
I
IANE COUNT BUILDING PERMIT OR MOBILE HO
BUTLDTNG [_] MH E
USE PERMIT
PERMIT NO.
PROPERTY (aWNER MAILING ADDR ESS PHOI.IE
CONTRACTOR MAITING ADDRESS PHONE
PRO PERTY LOCATION - INCTUDE POST OFFICE
PROPERTY I-EGAT DESCRIPTION _METES, BOUNDS
Lcr 2lil $ ttl.t-Er,l'i-lN:: PAr{K lsr Aonrrr,}r'i:
RANG E SECTION1,4"2 e*Sm ,-,r S TRACTCODECENSU
EXISTING STRUCTURES ON PROPERTY
Dr*gr-t t t-rc
APP[.
NAME
&
MAITING
ADDRESS
a\43 Nonrx Jlrx
TEGAT ACCESS TO PROPERTY
tlonrn Jlttt
PROPERTY SIZE _ FT.
WIDTH DEPTH AREA
FOR MOBILE HOME PERMITS ONLY
No. of Bedrooms Connect to Existing Sewo e stem New System I
VALUATIONSTRUCTURES TO BE BUILT THIS PERlvllT TYPE CONSTRUCTION BDRMS
SEWAGE DISPOSAT
,rr,.,a t SEPTIC TANK tr oTHERn fxlSTlt{G
PTUMBING INSTAIIED BY
OWNER n OTHER: NAME
(FEES WATER SUPPI-Y
PUBuc dH tr orHER
BUILDING
WASTE DISPOSAT
PLUMBING
PTAN REVIEW
PARK TRAILER,:,'
TOTAL
t-
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 OCCUPANCY ZONE PUBTIC UTI[. EASEMENT
J
BI.DG.
FRONT
SETBACKS FT. FROM CTR. OF ROAD RIGHT OF WAY USE CTASSIFICATION
SIDE INT,5 t srDE ExT,REAR
AUTHORIZED SIGNATURE _ DATE DATE
BLDG. PERMIT _ WHITE
OFFICE COPY _ WHITE
COUNTY TAX - PINK
PLUMBING _ CANARY
BUILDING _ GREEN
SANITATION _ GOLDENROD
Call 687-4065 to schedule oll required inspections. All conslruc-
tion sholl comply with Uniform Building Code, D.E.Q. stondords
IMPORTANT: for subsurfoce sewoge disposol ond counly regulotions covering
plumbing. All buildings require o cerlificole of occuponcy before
being occupied.
(See Detoils on Reverse Side)
(POsT TH|S PERMIT ON MA|N BLDG. AT SITE)
IANE COUNTY, DEPT. OF ENVIRONMENTAT MANAGEMENT
COURTHOUSE ANNEX, I35 EAST 6th, EUGENE, OREGON 97,(OIronv * 655- 13
TAX LOT NO,
se. FT
s