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HomeMy WebLinkAboutPermit Septic Tank 1975-09-084:) t/?t LANE COUNTY utJl[DING BU|LDING r MH I PERMIT OR MOBITE HOME-- USE PERMIT PERMIT NO.a4et-rl .OWNER MAITING ADDRESS PHONE CONTRACTOR Srare MAILING ADDRESS P ONE PROPERTY LOCATION _ INCLUDE POST OFFICE e4'l rtl t{ PROPERTY LEGAL DESCRIPTION - METES, BOUNDS RANG E SECTI ONtu.3.q * SZ8 CENSUS TRACTTAX LOT NO.CODE Htesr EXISTING STRUCTURES ON PROPERTY 't' r',JoN[ APPI.. NAME & MAITING ADDRESS Sltts TEGAI ACCESS TO PROPERTY PROPERTY SIZE - FT. WIDTH DEPTH AREA FOR MOBILE HOME PERMITS ONLY No. of Bedrooms Connect to Existing Sewoge System I New System I srnr..tcrunrs ro er er-rrur iuts peRt,ttr rypE coNsrRUCTroN se. FT. F BDRMS vALUATToN PnroR SEWAGE DISPOSAT PUBTIC tr SEPTIC TANK N OTHERE PLUMBING INSTALTED BY OWNER fl OTHER: NAME FEES WATER SUPPTY PUBLTC tr tr OTHER BUITDING WASTE DISPOSAT PI.UMBING PI.AN REVIEW PARK TRAILER TOTAT NOTE:hr, A l'i , - 'rtr: I'le:e-sorY Lou'e County Perrruts. $__.- COUNTY BUILDING & SANITATION SPECIFICATIONS , MIN. SEPTIC TANK CAPACITY WITH rDlST. BOX: GA[.900 DRAIN FIETD REQUIRED tIN. FT TRENCH WIDTH FT.OR SQ. FT. KEEP ALL PARTS OT SEUAGT OISPffiAL S}3TA{ IOO TEET FROH ALL WfLt'sI TYPE OF STRUCTURE OCCUPANCY ZONE PUBLIC UTIL. EASEMENT BIDG. SETBACKS FT. FROM CTR. OF ROAD RIGHT OF WAY lls SIDE INT. USE CLASSIFICATION FRONT SIDE EXT.REAR q AUTHORIZED SIGNATURE _ DATE DATE H 7 BLDG. PERMIT _ WHITE OFFICE COPY _ WHITE COUNTY TAX _ PINK PLUMBING _ CANARY BUILDING _ GREEN SANITATION _ GOTDENROD Call 687-4065 to schedule oll required inspections. All construc. tion sholl comply with Uniform Building Code, D.E.Q. stondords IMPORTANT: for subsurfoce sewoge disposol ond county regulolions covering plumbing. All buildings require o cerlificole of occuponcy before being occupied. (See Detoils on Reverse Side) (posT THIS PERMTT ON MA|N BLDG. AT SITE) IANE COUNTY, DEPT. OF ENVIRONMENTAT MANAGEMENT COURTHOUSE ANNEX, I35 EAST 6th, EUGENE, OREGON 9740Ironv -- C 55 - t3 att LANE COUNTY ENVIRONMENTAL }dNAGEMENT Name and Address of Oqrner PLO? PLAN Telepltone:-.--'_-_ The building being constructed under this permit will be used for Date this Property \^las 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 plot plan below'.--- IndicaEe on your drawing the location of.all homes (including rnobile homes)now on the property, as well as the location of the new building. Name of Appllcant (if different from owner): Address Telephone Applicantrs Interest: Buyer M74-99 Map Tax Lot T. I i I ,tl ,/ I t t i Y Dc s ) I I I -l (r I 1 t L I /d d 5 I I I I I ''i I I I I ,-. t I = t,I = I I I J / I I t- Se11er Agent permlr ll 9,/ 2l -7..- ) I r I I { I t lL0l 5'EE UAI 'OAI BUtLDtNc pERtltT AppLtcArtlr-No" ) /zy -z{ o 5'IE 'I{SPECTION Not I icable Zoning 0rdinance Comp I iance: Zone BLOCK: CK!D BY:h& , %(t/a>5/ SetbacksffiFront ./ O Side ExteriorZ- Setbacks from interior lines: S ide .{ I 2 3 4 5 Reoui red Access euitaing Site (Area, }Jidth, Frontage) 0ther (see comments) J5 TJ2 5U8D ' y' S O3s', 9f rar LOT l-.ri LOT: APPL t CANT DATE Subdivision 0rdinance Compl iance c0r{}.rENTS: No Yes7yffe.()vr8i?() () () () () () PLnNxING OIVISION ACTTON PENDTNG.YES( I No (l APPT=ICAT ION# BUILDING INSPECTION DIVISION Plans Submitted Soil Stabil ity (footings) Flood Plain 0ther (see conments) 7 8 9 0 No Yesr) TT() () () () () () Not Aool icable-*-T:r () () ()CK!D BY: DATE COMMENTS: WATER POLUTION CONTROL I I . l{eets Department of Envi ronmental Qual i ty Standards. 12. 0ther (see cornments) Not Aool i cabl e CKID BY:7r DATE COM},IENTS: f, {T ( ) ()() TO APPLICANT: qr& Your()c()c Building / Site lnsPection: an be approved. annot be approved at this time as indicated on item N0 Questions and furt her information on items I through 5 contact t LANE- COUNTY NG DIVISION"Questions and further information on items 7 t rou 2 cont ACt thE LANE COUNTY BUILDING AND SANITATION DIV S ION. urill be held in this off ce unt i you can reso vet eP em s indicated. ls being returned. above. rmit a lication fee is beinq returged LLLdg- sep-araJegqyef- nri['mEHiA 135 Sixth Ave nue East Eugene Oregon 97401 pnorue | 697_4065 LANE COUNTY PLANNING DlVlSl0N PH0NE: 587-4185 c55-28 Your bui ldin PLANNING DIVISION I NOTE: CONSTRUCTION MOBILE HOME APPLICATION FOR: PLAN REVIEW Ad No pERMrr rflr - ,r rssuED rrNfir, THrs ApplrcA?roi.---as BEEN of,ngu tt-* h/ - 7f sP.V1 zOOWNER Name s clr l-r CONTRACTOR Name O. S. REG. // Tvp ection Subdivision 6 ACCESS TO PROP (Road Name) Existing Structures on Property: Property Location - Address/Direct.lons: Address Ctty zip Tax Lot 1- code Census Tracta/ Phone o l./ t--J-rroperty /oo g*Jd, 9( /.r 4t, 17,'4 'rf^o v e SEWAGE DISPOSAL: .n ( Slte InspecEion ll l|lfu+al-/' -T-Exlsrlng DLsposal System Pub1lc Comunity or New System Requlred Name of CoumuniEy or Publlc System WATER SUPPLY: Well Sprlng Other € "-l FEES Bldg. Wa6te Dlsp. P1-umblng Plan Revlew Moblle Hone 1Z Surcharge PLUI'EING: Installed by Or^mer Other Name ,/O ) , oO PLLIMBING FEES: of Fixtures Sewage Connectlon Water Connection PLANS FURNISHED Signature of Applicant Fee Recelved By FACILITY PERMIT Date: CASH PcofEvss YESNO TOTAI ./oD,oo Mln. Sep tlc Tank Capaclty_Drainfleld Requ ired - Llneal Feet 16R) u"xinum Dep Eh 3 type of Constructlon Flre Zone Use Classification Bldg Setbacks - from Center of Road e Int. Rieht ot-f Way ide Exterior (/a ^-Rear \ c55- t2 DATE:BUILDING: I.ANE COI]NTY DE OF EIWIRONMENTAL MANAGEMENT DATE I G-d ;. I ,osED sEurAGE DISPoSAL SYSTEM RE ) INSTAELER: Complete top part of form to signature and submit both copies with application. PERI IT NO.z\zt-75 INSTAIIER_I-S_NAI,I=E m JonN Snoox &D,t.Nonrn llrn PlaceI ng n s Bedrooms BathsV asement Water uPp vYes No Publ i c Other-Li st Sept i c Tank: Ft. f rorn wel I Steel tr Concrete l No. Cornpartments Gal. Capacity I L nsi r mens ons: Ft. th NAI'IE W. E. lJreHr HAILING ADDRESS Leng th L i nes-Ft . 4 6 ate e sPosa width Diameter D h Distribution Box t er str u On- e B rn eet rorn tJ il ne Front Y Side No er Be ou,it 1n S i gnature I.,id T a F I nes o t. Between F T er ns rUs t Vs >, t Avc uftr .t3 ,leIt, a a l-tre pu r lco?eJ H- <t7 Phr. + 0o CERTIFICATE OF SATISFACTORY COMPLETION For Sanitarian Use 0nly: Date ln accordance with 1973 0regon Laws Chapter 835, Section 214 this certificate is i ,fr"p*4,/?€o as evidence of satisfactory completion of a subsurface sewage disposal system at the above I ocat i on.p. epproyed: System lnstal lation conforms to current standards I-I 0isapproved: Does not conform to current standards Remarks: r an s LANE COUNTY c55-1I STATE OF OREGON DEPARTMENT OF ENVIRONI{ENTAL QUALITY ure l ';1 :'{:rP iS TO ASSIST LCCATll'lG - ) ii' i l'i[ col,\i]ANY Assu'\iES ..ir-rriliiiTY rcR li'iAccLtRAclES'MA--{J_p,.A€J! _ SlXTH ADD|TION TO YOLANDA PARK SECTION 24, LAITE rt7s, 60ufitr fr,W, of,Eooil w. N. 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I :d ,1rC! ,? 'iOf,l * .?t 2.U.&ra€a ffip€,pc4fr eerc &40 ac7 AGD. AFftOAWT , t '!. ).-,I I I I I I l I I I I I I I I -T.t- ! Spr'i:i l.:L i9 2C FART ,wr.a ,t Il -- t LANE COUNTY BUILDING Il BUTLDING PERMIT MHN N\AILING ADDRESS OR MOBILE HON\E USE PERMII PERNA\T NO PHONEPROPERIY OWNER CONTRACTOR MAILING ADDRESS PHONE PROPERTY LOCATION _ INCIUDE POST OFFICE PROPERTY TEGAL DESCRIPTION _ METES, BOUNDS RANG E SECTION TAX LOT NO CODE CENSUS TRACT EXISTING STRUCTURES ON PROPERTYAPPL. NAME & MAITING ADDRESS tEGAt ACCESS TO PROPERTY PROPERTY SIZE - FT. WIDTH DEPTH AREAFOR MOBILE HOME PERMITS ONLY No. of Bedrooms Connect to Existing Sewoge System tr New System !STR UCTU RES TO BE BUILT THIS PERMIT TYPE CONSTRUCTION SQ. FT. # BDRMS VALUATION SEWAGE DISPOSAI PUBTIC T] SEPTIC TANK fl oTHERn PLUMBING INSTATTED BY OWNER E OTHER: NAAAE BUITDING WASTE DISPOSAT PTUMBING PTAN REVIEW PARK TRAILER (FEES WATER SUPPLY PUBLIC tr OTHER TOTAT cou NTY BUILDING & SANITATION SPECIFICATIONS MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GAL. DRAIN FIELD REQUIRED I-IN. FT TRENCH WIDTH FT OR SQ. FT. TYPE OF STRUCTURE OCCUPANCY ZONE PUBI.IC UTII.. EASEMENT BLDG. SETBACKS FRONT FT. FROM CTR. OF ROAD RIGHT OF WAY USE CI.ASSIFICATION SIDE INT.SIDE EXT REAR AUTHORIZED SIGNATURE _ DATE DATE BI.DG. PERMIT _ WHITE OFFICE COPY _ WHITE COUNTY TAX _ PINK PTUMBING _ CANARY BUILDING _ GREEN SANITATION _ GOLDENROD coll 687-4065 ro schedule oll required inspections. All consfruc- tM p .RTA N r, i;'i, iH 1."""I tly! lj ! jl [::i : ;x, ::" "ff *; j;1.,3;,':T** plumbing. All buildings require o cerrificore of-o..uponcy-u"ro..being occupied. (See Detoils on Reverse Side) (POST THIS PERMIT ON MA|N BrDG. AT S|TE) IANE COUNTY, DEPT. OF ENVIRONMENTAT MANAGEMENT COURTHOUSE I,NNEX, I35 E,AST 6Ih, EUGENE, oREGoN 9740Ironu #655-13 5tID - Lane County authori zation for, SS S'L'I'IY ZIP ) PTION OF PROPOSED WORK - BE SPECIFIC 1 IS NAME OSR I HAVE CAREFULLY EXAI4INED THE COMPLETED APPLICATION !-OR PERMIT, ar,d Llo herelry certify t-hat aII j.nfomation hereon is true and correct, and that I rave the following Legat interest in the property, !or... of record; I cc,ntra.:t plrrchaseri Iauthorized agent. I frrther certify that any and all work perfomed shal1 be done in ccoldail.:,r wiih the ordrnances of Lane Couty and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY wi1l" he nade of aLi strructure wlthout the pemission of the Building Division. f fur- ther cerLify that registralion with the Builderrs Board is in full force and effect as required by oRS 701.055, that if exempt the basis for e is noted hereon, and that only subcontractors ed employees who are in compliance with ORS 701.055 wj"II be used on this project. I IIAVE READ AND :HECKED THIS APPLICATION THOROUGHLY. /- tlaltr (please'print)SIGNATURE DATE FOR OFFICE USE ONLY Application/Permit # RANGE SECTION TAX LOT nour or --EL BLOCK PROPOSED USE OF PROPERTY Residential Commercial [-l rndustrial Pub I ic a ROF2OF EI'IPLOYEES Proposed Exi s ti NUMBER u READ THIS SECTION CAREFULLY. YOUR AUTHORIZATION IIAS BEEN BASED ON THE FOLLOWING CONDITIONS: fl pnxnrnc,zZoNrNG:zone_ Partition #- Parcel #- Parcel Siz.- Minimum Setbacks, "", frort-c",.id..interlor rear COMIIENTS: trDate Installation GaIIon Specifications: _ Tank # rnstallation Record rssued? n v"= [-l HolJ t_.1 Lineal Eeet of Dr:ainfield Maximum Depth of Trenches COM}IENTS: Date: fl pr,ens EXAMTNATToN: COM}IENTS: Use trDate PERI{IT APPROVED BY BUILDING OFFICIAL,/DESIGNEE (oer oRS 456.805 (1) )DATF LANE COUNTY DEPARTMENT OF PUBLIC WORKS LAND MANAGEMENT DlVlSloN, 687,4061, J . ,- l2sEASrSTHAVENUE, EUGENE,oREGoNgT4olb5SEE REVERSE FOR INSPECTION INE'ORMATION cL4-25 R* I saurtatrow: s. r. *_ B. P. t