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Home My WebLink AboutPermit Building 1977-10-24TRS, TL JOB LOCATIO LANE COUNTY PERMIT Acreage or Lot Size Contractor's O.S' # Partitioning #-( ) Completed Subdivision APPLICANT'S NAME AND ADDRE ss OWNER'S NAME AND ADDRESS CONTRACTOR'S NAME AND ADDRES s Mail permit to ( ) Applicant ( ) Owner () Contractor. ( ) Prefer to pick up. Call - Lot Block- Phone Phone Phone (owner, etc.) when ready. STRUCTURES NOW ON THE PROPERTY THIS PERMIT IS FO # B ED ROOIVIS-# PLUIUBI NG CONN ECT IONS ,d/RTER SUPPLY SEWAGE DISPOSA s.t. # THlSPRoPERTYlSWlTHlNoNEtVllLEoFTHEClTYoF,PLUlVlBlNGBY Fee Paid $-Signature Date () NEW ADDRESS ( ) FACILITY PERIVIIT To TRANSPORTATION DEPT.- ()SPECIAL PlVlT. AREA. MlN. ELEVATION:- SANITATION Minimum Septic Tank Capacity (Gallons) Drainfield Required - Lineal Feet Maximum Depth Date BUILDING .. .. . ! Type of Constructio Group Use Classification Comments ire Zone fi-l Comments By By:Date: r1 -'11 Date lssuedPLANNING REOUIREMENTS SATISFIED. B Date: ZONE SETBACKS: FRONT ING STREET (F otvt c/L) tNT. stDE YARD ., REAR (rROM P/L) LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 'I25 EAST BTH AVE., EUGENE, OREGON 97401 POST THIS PERMIT ON MAIN BUILDING AT SITE c55.13 BLDG. PERMIT _ WHITE; BUILDING - GREEN; PLUMBING - CANARY; SANITATION - GOLOENROD; OFFICE COPY - WHITE PHONE:687-4394 /t I hereby certify that the above stalements are true and accurate, and that I have the {ollowing legal interest in the propertv: -owner oI record; ____"i.,t.u"t prr"t"ser; - potential blyer; - realtor or agent. I further certi{y that (il not the owner) I am aLlthorized to act for the owner o, *-ra, ""j ifr"i,"ia .wner is aware and approves oI this action. I hereby agree to comply with all applicable Codes relating to this permit. SID 7) TRS, TL itten Directions /5 so 13 2 )5 a zy'//- rll tSrA *fr Spb )e/4-*ttt" *{ v,fiy Job Location o# 4*oEt<t g*t*# % ' 2&/at'ox)ffis+ Stot o# {'1, \1 Building Permit u'{rr""g"or Lot Size ?0 /7{ ( ) Prefer to pick up. Call | ."- ." STRUCTURES NOW ON T INFORMATION SHEET ( ) Site Feasibility Study for Septic Tank. Number of sites Test holes will be ready Partitioning #- ( )Completed( ) Pending division !t,)&u /( E</ APPLICANT'S NAME AND ADDRESS &trt l)o#:,* - go, Lte,u OWNER'S NAME AND ADDRESS, if different from applicant's CONTRACTOR'S NAME AND ADDRESS 1.Mail permit or results of site feasibility study to ( )Applicant ( ) Owner ( ) Contractor ( owner, etc. ) when ready /ru,B Phone Phone Phonet-.{.,t or,.-A-- Contractors O. S. # HE PROPER PROPOSED USE (this permit)f*s o**< P $p1 Ptec.# Pedrcrms WATER SUPPLY , SEWAGE DISPOSAL t/c C yr*"-/L existing or proposed well, etc. lf public, name of system) q6- A (existing or proposed septic tank, etc.) S.l AddressPLUMBING BY il'l. A V,I ) PROPERTY IS WITHIN ONE MILE OF CITY ( **..i.' oFFtcE usE oNLY BELOW THIS LINE ****+**+|*** ( )New cessa ry ( )Facil ZON SETBACKS: Fron To: Planning/Building lnspector/Sanitarian/Surveyor. ( ) Special Permit Area terior Yard Rear ROM PROPERTY LINES) Minimum _(/zE levation ng Street This applicant appears to have a problem with Your assistance will be appreciated. By Permit Processing Section Response By DEPARTMENT OF ENVI RONMENTAL MANAGEI\4ENT Permit Processi ng Section 125 East 8th Avenue 687-4394c55-12 ivision ,ork ) Necessary / Side (FROM TRS, T JOB LOCATIO LANE COUNTY PERMIT Acreage or Lot Si Partitioning # Contractor's O.S. # APPLICANT'S NAME AND ADDRE qq OWNER'S NAME AND ADDRE qq CONTFACTOR'S NAME AND ADDRESS Mail permitto ( )Applicant ( )Owner ( )Contractor ( ) Prefer to pick up. Call ) Completed Subdivision Lot- Bloc STBUCTURES NOW ON THE PROPEBTY TH;S pERMtT tS FOB # BEDROOML# PLUI\4BING CONNECTIONL (owner, etc.) when ready Phon Phone-- Phone s.l. #\AJATER SUPPLY SEWAGE DISPOSAL THlSPRoPERTYlSWlTHlNoNElVllLEoFTHEClTYoF'PLUIVlBlNGBY I hereby certify that the above statements are true and accurate, and that I have the {ollowing legal interest in the property: -owner ol record; .-clntract purchaser; - potentiat buyer; - realtor or agent. I further certify that (i{ 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 S-Signature ( I NEW ADDRESS ( ) FACILITY PERMIT TO TRANSPORTATION DEPT.- ( ) SPECIAL PMT. AREA. NllN. ELEVATION: - SANITATION BU ILD ING lVlinimum Septic Tank Capacity (Gallons)Type of Construction roup Fire Zone Drainfield Required - Lineal Feet c.r,n""", Use classification Maximum Depth Comments: Date - By:Date By: Date: PLANN ING REOUIREMENTS SATISFIED. By Date Date lssued ZONE SETBACKS: FRONT SIDE FACING STREET (FROIV C/L) INT. SIDE YARD REAR (FROtVI P/L) LAN E couNTy DEpARTMENT oF eruvtnouMeruial UAfAG EMENt, 12b EAsr 8TH Avt., EUG ENE, oREGoN 9740t pHoN E: 6t]7-4394 POST THIS PERMIT ON MAIN BUILDING AT SITE BLDG,PERMIT-WHITE; BUILDING-GREEN; PLUMBING-CANARY; SANITATION-GOLDENROD; OFFICECOPY-WHITEc55-1 3 r SITE INSPECTION APpRovEo RrmlRx s I rspecron FOUNDATION I NSPECTION AppRovro Rrulnxs D r s appnovEo Dare Z-NSPECTOR FRAM I NG AppRov e o Reuanx s I NSPECT I ON DrslppnovE, D Darr Z-I xspecton LATH OR SHTETROCK INSPECTION AppRovro D Dt srpPnovEo Det e I Hspecron Reurnxs FINAL INSPECTION Ap pnov r o Reuanx s DrslppRovEo ,^-,,/21 !_-?_7 I Nspecron CERTIFICATE OF OCCUPANCY REaov to I ssur Rrurnx s Nor Rraov ro lssue Drr e I Hs pe croR d DrsAppRovE o D aorr,/Z-JZ- 7_? l/ D