HomeMy WebLinkAboutPermit Building 1977-10-072-mq-11
TRS, T
(x ) Building Permit
Acreage or Lot Size 9Or x lOO'
Partitioning #( ) Completed( ) Pending
APPLICANT'S NAIVIE AND ADDRESS
OWNER'S NAME AND ADDRESS, if different from applicant's
CONTRACTOR'S NAIVIE AND ADDRESS
Job Location
INFORMATION SHEET
( ) Site Feasibility Study for Septic Tank. Number of sites_( ) Would like to meet on site. Call (owner, etc.)
Test holes will be ready-
Subdivision First tton to Vera Delle Lot 19 g 1o"
Phone
Phone
Phone
7 2q
tt ll
lVlail permitorresultsof sitefeasibilitystudyto (x )Applicant ( )Owner ( )Contractor( ) Prefer to pick up. Call (owner, etc. ) when ready
IRUCTURES NOW ON THE PROPE
PROPOSED USE (this permit)tld a hone
WATER SUPPLY
SEWAGE DISPOSA Sont{a ta (oronased )
PLUMBING BY Tyln Cltles P lumbins
(x ) pRoPERTY tS WtTHtN ONE MtLE OF CtTy
* n* * * n* ** *r( ** ** * * ** * * ** r. * ** * rFn *t6 * *t+ * * * * * * * * O F F I CE USE O N LY BE LOW
( )New ecessa ry
ZON
IFROtVI CENTERLINE OF ROAD)
(existing or proposed well, etc. lf public, name of system
(existing or proposed septic tank, etc.) S.l V^
Address
( ) Facility Permit Necessary
SETBACKS: Front Side Facing Street
THIS Ll\f xxx****n**********+**+****
( ) Special Permit Area. lVlinimum Elevation
lnterior Side Yard Rear
(FROI\,1 PROPERTY LI NES)
* * *l+* l(* tt*x* ** ** t6 *
(
.j: Planning/Building lnspector/Sanitarian/Surveyor.
This applicant appears to have a problem with
Your assistance will be appreciated.
By Permit Processing Section
Response
By
D E PA RTIVI E NT O F E N V I R ON tVI E NTA L IVIANAG E IVI E NT
Permit Processing Section
125 East 8th Avenue
687-4394c55-12
Division
I
TRS, TL
Acreage or Lot Size
Contractor's O.S. +
33 frg7M PERMIT #
JOB LOCATIO
Partition ing
LANE COUNTY PERMIT
( ) Completed Subdivision
Lot- Blo
APPLICANT'S NATVIE AND ADDRE ss
OWNER'S NAME AND ADDRE
CONTRACTOR'S NAME AND ADDR
Mail permitto ( )Applicant ( )Owner ( )Contractor. ( )Prefertopickup. Call-(owner, etc.) when ready
THIS PERMIT IS FO # BEDROOIMS-# PLUIVIB I NG CONNECTIONS
STRUCTURES NOW ON THE PROPERTY
Phone
Phone
Phone
s.l. #iATER SUPPLY SEWAGE DISPOSA
THlSPRoPERTYlSWlTHlNoNEMlLEoFTHEClTYoF.PLUIVlBlNGBY
I hereby certify that the above statements are true and accurate, and that I have the {ollowing legal interest in the property:
-owner
of record;
-contract
purchaser;
-
potentiat buyer;
-
realtor or agent. I further 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 applicabie Codes relating to this permit.
Fee Paid $-Signature Date
NEW ADDRESS () FACILITY PEBMIT TO TRANSPORTATION DEPT.- () SPECIAL PIV]T. ABEA. MIN. ELEVATION
SANITATION
Minimum Septic Tank Capacity (Gallons)
Drainfield Required - Lineal Feet
Maximum Depth
BUILDING
Type of Construction
-Group
Use Classification
Comments
ire Zone
Comments
B Date
PLANNING REOUIREIVIENTS SATISFIED. By:Date
Date
Date lssued
ZONE SETBACKS: FRONT SIDE FACING STREET (FROIVI C/L) INT. SIDE YARD REAR (FROM P/L)
LANE COUNTY DEPARTMENT OF ENVIRONMENTAL TVIANAGEMENT, 125 EAST BTH AVE., EUGENE, OREGON 97401
POST THIS PERMIT ON MAIN BUILDING AT SITE
C55-13 BLDG. pERMtr - WHrrE; BUtLDTNG - GREEN; PLUMBtNG - GANARy; sANrrATroN - coLDENRoD; oFFtcE cop\/ - wHrrE
PHON E; 687-4394
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