HomeMy WebLinkAboutPermit Building 1975-06-23[ANE COUNTY
/q'7 3"'7s
u.-,TDING PERMIT OR MOBITE HOME. .JE PERMIT
MH I PERMTT NO. 'lBUILDING
texlus InvAstment
MAILING ADDRESS
Eugene, Oregon
PHO}.I E
9740?
CONTRACTOR MAITING ADDRESS PHONE
PROPERTY I.OCATION _ INCTUDE POST OFFICE
Turr l{. m N.I6th frurr Hayden Brldge Rd. to flrst culdsac on left. Corner lot.
PROPERTY LEGAL DESCRIPTION _ METES, BOUNDS
RANG E
03
SECTION TAX LOT NO CODE CENSUS TRACT
20-ED-l 5017,e.{ # 3 8oo
EXISTING STRUCTURES ON PROPERTY
none
APPT.
NAME
&
MAITING
ADDRESS
TEGAT ACCESS TO PROPERTYI. l6th
PROPERTY SIZE - FT.
WIDTH DEPTH AREA
FOR MOBILE HOME PERMITS ONLY
No. of Bedrooms Connect to Existing Sewoge
TYPE CONSTRU ON
n New
se. FT BDRMS VALUATIONSTRUCTURES TO BE BUILT THIS PERMIT
SEWAGE DISPOSAL
PUBUC n SEPTIC TANK n OTHERE
PLUMBING INSTATI.ED BY
OWNER n OTHER, NAME
(F EES \MATER SUPPLY
PUBUC n
BUII.DING
WASTE DISPOSAT
PIUMBING
PTAN REVIEW
PARK TRAII,ER
TOTAT
25.00
$_''-
--
X OTHER
COUNTY BUILDING & SANITATION SPECIFICATIONS
MIN. SEPTIC TANK CAPACITY
wrTH D|ST. BOX: GAI-. '1,
DRAIN FIELD REQUIRED
uN.FT'. TRENCHwrDTHrt.i
-'-;
oRse.FT,300
TYPE OF STRUCTURE OCCUPANCY ZONE PUBTIC UTI[. EASEMENT
BLDG. SETBACKS FT. FROM CTR. OF
FRONT SIDE INT.
ROAD RIGHT OF WA Y
SIDE EXT.
USE CLASSIFICATION
REAR 7, PUE
AUTHORIZED SIGNATURE - DATE DATE
/r/ ,t. E. Boss av Cx. HrnBruoH Sxoox/srrrrARrlN
BI.DG. PERMIT _ WHITE
OFFICE COPY _ WHITE
COUNTY TAX - PINK
PLUMBING - CANARY
BUII.DING - GREEN
SANITATION - GOTDENROD
Coll 687-4065 to schedule oll required inspections. All construc-
tion sholl comply with Uniform Building Code, D.E.Q. stondords- Ii PORTANT: for subsunfoce sewoge disposol ond counly regulolions covering
plumbing., All buildings'require o certificqle of occuponcy before
. bqing occupied.' I (See Detoils on Reverse Side)
(posT THls PERMTT ON MAIN BIDG. AT SITE)
LANE COUNTY, DEPT. OF ENVIRONMENTAT MANAGEMENT
COURTHOUSE ANNEX, I35 EAST 6th, EUGENE, OREGON 9740I
ronu t 655- 13
OWNER
I,AIr{E COI]NTY ENVIRONMENTAL T"IANACTMENT PLOT PLAN
Name and Address of Owner
Telephone:=--
The building being constructed under this permit will be used for
Date this property was Pu rchased
Do you now, or did you ever own property adjacent to this tax lot? If so, please
list those tax 1ot numbers or draw those properties on the ploE plan below.-
Indicate on your drawing the location of a1l homes (including mobile hornes) now on
the property, as well as the location of the new building.
A
-1 l
l
eL
\).,,_,,
!
t
1 t
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Ip ,1,u
Name of Applicant (if different from owner):
Address
Teleph one
Map
Tax Lot
Applicantrs Interest: Buyer
M74-99
Sel-l-er Agent Permit /i
J
t
/
\
{n
()
ggl!0 r NG
"s lrE. EV4LUAT I oN
BUI!DING PERHIT APPLICATION NO. /479-?<
SITE INSPECTION
Not
I ic ble
Zon i ng 0rd i nance Cornp I iance: Zone
\?-r
Subdivision 0rdinance Compl iance
Reoui red Accessguitaing Site (Area, VJidth, Frontage)
Other (see conrnents)
TlL oS s z* rAx Lor
SUBDIVISIO,*LOT: BLOCK:
APPL I CANT
DATE
PLANNING DIVISION
cK'D BY &f alu /xSetbacksffi
Front
Side Ex
Setbacks from
Side
Rear
ter i or
i nter
I
2
3
4
5
No YesI-l CtI 6.
lrtyi()(A)
() ()
()
()
()
or nes:
COI{HENTS:
PLANNTNG DlVlSl0N ACTION PENDING: Y (TNo( ) APPLIcATIo
BUILDING INSPECTION DIVIS ION
Plans Submitted
Soil Stabil ity (footings)
Flood PIain
0ther (see conrnents)
Not
7
8
9
0
Aool icable*--Tr
U)(l )()
w()
()CKID BY
Nor)()
()
()
COHMENTS:
t.,ATER POLUT ION CONTROL Not
I l. l'leets Department of Environmental
Qual ity Standards.
12. Other (see comments)
Aool icable No
CI TD
(,
Yes
()()CK'D BY:
DATE
CO}t}lENTS:
TO APPL ICANT:
V through l2 contact t
( ) tli I I be held in this
,h
\4; 6
Your Building / Site lnsPection:
f\) C"n be approved.
tJc"nnotbe.approvedatthistimeasindicatedonitemN0.#bove.
Questions and further information on items I through 5 contact the LANE-
COUNTY PLANNING DlVlSt0N" Questions and further information on items 7
he LANE NTY BUILDING AND SANITATION D VISION.
ce unt you can reso vet ePr
c55-28
Your buildin
LANE COUNTY PLANNING DlVlSlON PH0NE: 687-4186
I ems cated.
) ls Ueing returned.
rmit a I ication fee is bein
NTAL
135 Sixth Avenue East Eugene Oregon t
pH9NE | 6gl_4065
74ot
Re*itrE Tr.J,
lt't'''t
I
I NSTALLER:
^?POSEO SEWAGE DISPOSAL SYSTEH R lDComplete toP parl uf form to signature and submit borh copies with application
PERI'1 TNO 't\t3-Jj
JSNonrn 16rn
No. L V rooms Basement
Yes No
s ater u P
Publ ic v
0ther-L i st
ePt c
Ft. frorn well Steel
ns ons:
th 1,,id
NA},TE Rrx tus lr'rvrsruerur
MAILING
ADDRESS
P0 Box
No. Cornpartments Gal .capacl ty I AOO
e sPosa e
Di tribution Box Yes NoterstrutOn-
ne
Concrete
h
Foundat i on
Eueenr, OREGoT'r Front 5t /a
Be oh,
ile tn
OF F c0H
For Sanitarian Use 0nly:l4c 76
ln accordance wi th 1973 Oregon Laws Chapter 835, Section 214 this certifica i s i ssued
as evidence of satisfactory cornpletion of a subsurface sewage disposal system at the above
I ocat i on.fF npproved: System lnstallation conforms to current standards
fJ Disapproved: Does not conform to current standards
Remarks:
r
L
I
P
iameter -
t.J lteet
L nes-Ft.
4 Width
r I sq.
tod
etween/oFt. B
Lines
er ept
ove Ti le Vin
r c on
,
d b
{b 0I RECEIUf,".
D By
1 f
JAN 2 i.r 1970
LANE COUNTY
ENVIRONMENTAL MGMT.
I na ure
tar an
LANE COUNTY
STATE OF OREGON DEPARTHENT OF ENVIRONHENTAL QUALITY
c55-1I ure
tr
I
i
s
PERMIT /I
NOTE: NO PERMIT WILL * ISSI]ED UNTIL MIIS APPLIC'ATION ., BEEN APPROVED
APPLICATION FOR:
CONSTRUCTION K MOBILE }IOME PLAN REVIEW CTIA}IGE OF OCCUPA}ICY
rx owxsn/PFdlftS Ta) Vps*naAff P,O,Dox AzTb 4t*Evr ?t\o* ? gb!+ Z-t"L
----
N;;;Add;Es s City zip Phone
CONTRACTOR 6A*te
Name Address
Tax Lot
City
Code
zip Phone
o. s. REG. /i d/ 5-y
*r. l7 *"gu O 3 s."
subdivlslon Dlge=l(OS f
ACCESS TO PROPERfi (Road Name)fi/,/6tft
tion
"t--A-property
census trr.t 20 -rD- /-$7
Lot B1o
Exlsting Structures on Property ?lo--,o
Property Location - Address/Oirections:rP
L
?? t A %, /6
Below for Offlce Use
Sq. Ft Valuatlon
SEWAGE DISPOSAL: A>Z3a-.a,a!)
sire rnspecrr"" k*.8*,Existing Sewage Disposal System or New System Required
WATER SUPPLYI
Well
FEES:
B1dg.
I,laste Disp.
Plumbing
Plan Review
Moblle Home
1Z Surcharge
Public
Community fu,DSpring0ther
PLUMBING
Installed by Owner
.?tf; eD PLI'ltsING FEES
--**tt of Fixtures
Dr
Name of Conmunity Public System
Other
r
Signature of Applicant
Fee Received By
Water
Connection
FACILITY PERMIT
YES
Date:
S
tlon
HED
CASH NO
TOTAL 2'f, o tl
Mln. Septlc Tank Capacl 8o'u ed - Lineal Feet l(=o 2ield
Type of Construction Group \--- Fire Zone
LANE COI]NTY D OF EIWIRONMEN
Use Classlflcation
,2J-
Bldg Setbacks - from Center of Road
Fronr 40: slde rnt. .{
Right of Way:h'Side Exterior Rear
cs5- 12
DATE:
i---l
A\+
Acreage tr/ iarl[Do"pth-/.!r,
+---*"