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Home My WebLink AboutPermit Building 1974-01-04--'1 LANE COUNTY BUII 'G PERMIT OR MOBILE HOME US .PPLICATION OWNER PERMII TYPE _ BUILDING MOBILE HOME OSC REG. # MAII.ING ADDRESS MAITING ADDRESS PERMIT 33-./3 PHONE PHONE sJrS PROPERTY TOCATION _ INCTUDE POST OFF PROPERTY TEGAL DESCRIPTION TOT_BI"OCK_SUBDIV TWP r METES&BOUNDSEYES ATTACHED NO TAX LOT #CODE CENSUS TRACT DESCRIBE EXISTING STRUCIURES ON PROPERTY IF ANY ao APPi.ICANT NAAAE AND MAITING ADDRESS a5 PROPERTY - ROAD NAA,IE OR tha-,/?HgI.EGAT ACCESS TO PROPERTY SIZE-WIDTH DEPTH AREA FOR MOBILE HOME PERMIT ONLY Number of Bedrooms TO BE BUITT THIS PERMIT Connect to Existi Sewoge m TYPE CONSTRUCTION SQ. FT or New m Req. ! BEDROOMS VATUATION 5o SEWAGE DISPOSAT PI.UMBING INSTATI,ED BY PUBLIC BLDG. WASTE DIS. PTUMBING PIAN REVIEW PARK TRLR. SEPTIC TANK OTHER FEES WATER SUPPLYS a' PUBTIC OTHER . tto F IXTU RES CASH ! 5syyEp d, ?vCHECK E CONNECTION FEE OWNER OTHER NAME FURN ISHED BY FACILITY PERMIT NO OF YES YES NO -42 3DATE DATE 4<J TOTAT MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GAI. TYPE OF STRUCTURE BI.DG. SETBACKS _ FT,rROM CTR, OF ROAD RIGHT OF WAY SIDE INT,SIDE EXT D s to Find Property; PUBI.IC WATER CONNECTION FEE PERMIT # COUNTY BUITDING & SANITATION SPECIFICATIONS DRAIN FIETD REQUIRED TIN. FT TRENCH WIDTH FT OCCUPANCY ZONE t7OR SQUARE FEET REAR YARD PUBI.IC UTIL. EASEMENT BLDG. INSPNDole PLA REAR USE CTASSIFI Doie COPY 1 _ OFFICE :OPY 2 _ JOURNAI. OPY 3 _ AUDIT 'm # css- rz wfd.-4r I PROPERTY OWNEP CONTRACTOR PROPERTY TOCATION _ INCLUDE POST OFFICE IANE COUNTY B )ING PERMIT OR BUILDING I MH tr MAILING ADDRESS MAII-ING ADDRESS ILE HOME J PERMIT PERMII NO. PHONE PHONE PROPERTY tEGAt DESCRIPTION _ METES, BOUNDS RANG E SECTION TAX LOT NO CODE CENSUS TRACT EXISTING STRUCTURES ON PROPERTY APPt. NAME & MAITING ADDRESS I"EGAT 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 STRUCTURES TO BE BUILT THIS PERMIT TYPE CONSTRUCTION SQ. FT. # BDRMS VALUATION SEWAGE DISPOSAI. PUBUC n sEPTlc TANK n OTHERE PTUMBING INSTALLED BY OWNER n OTHER: NAME BUII.DING WASTE DISPOSAT PTUMBING PLAN REVIEW PARK TRAIIER F EES WATER SUPPTY PUBr.tC D tr OTHER TOTAT COUNTY BUILDING & SANITATION SPECIFICAIIONS MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GA[. DRAIN FIETD REQUIRED tIN. FT TRENCH WIDTH FT.OR SQ. FT TYPE OF STRUCTURE OCCUPANCY ZONE PUBI.IC UTIT. EASEMENT BLDG. SETBACKS FRONT FT. FROM CTR. OF ROAD RIGHT OF WAY SIDE INT. SIDE EXT. USE CI,ASSIFICATION REAR AUTHORIZED SIGNATURE - DATE DATE BLDG. PERMIT _ WH ITE OFFICE COPY _ WHITE COUNTY TAX _ PINK PTUMBING _ CANARY BUII.DING - GREEN SANITATION _ GOTDENROD Conslruclion to comply with uniform building code ond counly regulotions covering plumbing ond sewoge disposol. All buildings require o certificote of occuponcy before being occupied. (See Stotemenl on Reverse Side) (posT THIS PERMTT ON MAIN BIDG. AT SITE) LANE COUNTY, BLDG. & SAN. DIV., COURT HOUSE, EUGENE, OREGON 9740I ronu it655-13 \ BU I LD ING S ITE EVALUAT ION "8/t fl 54g'to'ffi^#'%rAx Lor-E-- APPL I NA}IE ADD RES PHONE DATE x Building Permit Appticat ion no,3/3f,- ZJ S i te lnspect ion Pre-Permit lnvest igat ion a ) () L/INE C0UNTY PLANNING DEPART|IENT NOT appl icable Zoning 0rdinance Compl iance (Zone M^{ ) (() Subdivision Ordinance ComilTince ( ) ( ) RequiredAccess () () NO YES )(a (+ (r ({ Ar)r-T--r 2 ') 4 5 Building Site (Area, Width, Frontage, Setback) 0ther (see comments) ()() () ()) COHMENTS: BUILDING INSPECTION SECTION 6. Plans Submitted 7. Soil Stability (footings) 8. Flood Pl a in 9. 0ther (see Connnents) NOT NO !fr'! icable - YES ()e{ NAI4E DATE () () (l () ) ) () ( COHHENTS: /-q lq SANITATION SECTION 10. Sewage Disposal I l. Usable Area 12. Water Supply ]r3. 0ther (see Comments) aool icable---r)-(') (/ )6 ) (-/ NOT NO YES T 7 (( ( (()( COMMENTS TO APPL I CANT: Your Buildinq Permit / Site lnsoect ion: M can be Ipp,o,.a. / -4 -71- €y'' (9 Cannot be approved at this t inre as indicated on iten, N0. above. Quest ions and further infornrat ion on itenrs I through S coiIrEt-tf,E-Lane- COUNTY PLANNING DEPARTMENT. Q.uest ions and turther informat ion on it;;; 5 t hroug h l3 contact the Lane CotirrI y Building arrd 5anitation Division. Will be held in this of icc unt i I yori can res,o I ve t lre p rob lenrs ind i cated ls being returned. Your buildinq pernrit appl it.at ion fee is being returned under separatc cur'€r. ( ( ( LANI: C0tlN'lY I'l i\NN ING DEPARTMENT I lt 5 i.x f lr Av(.)nue I as t , Eugerre , 0r egtrn 97q0 I l'ntrNE 3tr2. l,ilt Exl. 231 II\N[ COUN]Y t]tJIIDING & S/\NlTATION DIVISION 135 S ixth Avqrrurr East, Eutlettr', 0reqon 9740 I l'llr)Nl | 142-lllt [Xr. qll 1.{55 -1B NAI'1E DriTE "ld ) () Dote Permit No CURB CUT PERMIT IN THE BOARD OF COUNTY COMMISSIONERS OF LANE COUNTY WHEREAS, the ottoched opplicotion hos been fully considered by the Boord of County Com- missioners of Lone County, ond it is the opinion ond iudgment of the Boord thot the soid opplicotion should be gronted, ond thot o permit should be issued, now, therefore, it is hereby. ORDERED, thot o permit be ond is hereby issued to for plocing, building or constructing the following focility: upon the right-of-woy of County Rood }.lo. --, Mile Post in strict conformity to the exhibits ottoched hereto, ond subiect to oll terms, co ond permit, the Rulessfipulofions ond provisions contoined in the o erning Focilities to be Permitted upon County uol 50.190(2) ony qmendments thereto, ond nditions, ogreements, pplicotion ond Regulotions Gov- Rood Rights-of-Woy, os set forth by the Lone Mon- ony other opplicoble regulotions, low or ordinonce. Speciol Provisions: I. Drivewoy will be constructed in occordonce with the ottoched drivewoy opprooch specifico- tions (Drowing M98-50). 2. Permittee will be responsible for the immediote removol of oll mud, dirt ond debris from the roodwoy ond right of woy coused by his operotion, leoving the roodwoyond oreo in o neot, occeptoble condition. This permit is revocoble ot ony time, ond will be strictly odhered to ond no work other thon thot specificolly mentioned obove is hereby outhorized. This permit sholl be void unless the work herein contemploted sholl hove been completed be- fore 19_.Expires 19__. lnspected ond Approved Approved by Boord of County Commissioners By Dote By WHITE - OFFICE FII-E GREEN - RESIDENT ENGINEER PINK _ PERMITTEE BtUE _ ROAD SUPERVISOR ORANGE _ BUII,DING & SANITATION DEPT, YELTOW - REAI ESTATE Director of Public Works c98-7 9 l.^ Building Permit t, APPLICATION FOR FACILITY PERMIT (Applicont's Nome) hereby moke opplicotion under Rules ond Regulotions Governing Focilities to be Permitted Upon County Rights-of-W(Jy, Io construct the following focility' Upon the right-of-woy of County Rood No ot mile post on the side of the rood, or - os shown on the exhibits which ore ottoched hereto' in st rict conformity to the stotements of the exoct noture ond omount of work to be done, ond to the description of the focilities contoined in soid exhibits. The opplicont will be the principle owner of the focility os constructed, or other- wise primorily lioble ond responsible to members of the public for its proPer mointenonce' repoir' operotion ond use. The opplicont occepts oll terms, conditions, ogreements' stipulotions ond pro- visions, in Rures ond Regurotions Governing Focirities to be permitted Upon county Rood Rights- of-Woy, os set forth by the Lone Monuol 50.'l9O(2), ony omendments thereto' ond ony other op- plicoble regulotion, low or ordinonce' Sig nolure Add ress WHITE _ OFFICE FII.E GREEN - RESIDENT ENGINEER PINK _ PERMITTEE c98 -7 8 BIUE _ ROAD SUPV. ORANGE-BLDG. & SANIT YEI.LOW - REAI ESTATE wE.No.So. To Permits Processing Noted Dqle Noted Direclor Principol Engineer Subdivision Engineer Permit En r neer Weighmoster Zone No Phone No I-BE FHA No. I ffiffi.:t--{^fi'd'.-r KINNETT, Leon L. e Wl I Addsesa: 2573 North lTth Sprlngf ield, 0regon ot Sponeor: i-Ue=-* SECOND ADDITION TO DEL ROSE Lot No. lock 7 Mortgagee - Name, Addresg and Zlp Code I Flrst l{atlonal tsank of 0regon Real Estate Loan Dlvlslon P. O. Box 1786 Eugene, 0rcgon 97402 _l L R BASEMENT f! New Installation fl ves El No CanAttic or otherAreabe made into additional bedrooms? (Il yes, how many?)| 314 fl ves E NoI3 SYSTEM DESIGNED FOR No. of Bedroom Garbase Disposal WATER SUPPLY BY: Public System |-l Individual 3 I ves [] No.l-l Community System FXI Individual SEWAGE DISPOSAL BY: Public System PART II. - TO BE COMPLETED BY HEALTH DEPARTMENT HEALTH DEPARTMENT INSPECTOR'S SKETCH It v County [f Local Departmert of Health that this individual sewage-disposal system fi C.n be expected to function satisfactorily, and is not likely to create agri\sanitary condition f] Cannot be expected to function satisfactorily It is the opinion of the with proper maintenance f--l State TITLEDATE 4l t0tt 7 4 SI GNA P.H., NOTE: The heolth outhority should complete the oppropriote opnion slolement obove ond offix dore, signolure ond title in the spoces provided. Use of rhe obove grid for Heolth Deportment lnspeclor's sketch os well os use of fhe bock of this form is ot the opinion of the heolth outhority. PART iltr -FOR USE OF FHA OFFICE TO T}E CHIEF UNDERWRITER: I have reviewed the foregoing and the pertinent FHA Compliance Inspection Report, and recommend that the Individual water-supply system be considered f] Acceptable f] Not Acceptable Sewage disposal be considered f] Acceptable t] Not Acceptable. DATE SIGNATUR E CHIEF ARCHI'TECT D EP UTY FO R CHI EF ARCHI TE CT el 3?7a FHA FORM NO.2573 Rqv. I0l/0 rrrb4:/ D .1 t+n".*7f,fiJrro U.S. DEPA**NENT OF HOUSING AND URBAN DEVELOPMENT FEDE RAL HOUSING ADMINISTRATION HEALTH AUTHORITY APPROVAL L }VATER SUPPLY AND SETVAGE DISPOSAL SYS FHA FORM NO.2573 Rev. 10,//0 HEALTH AUTHORlTY APPROVAL INDIVIDUAL }VATER SUPPLY AND SEWAGE DISPOSAL SYSTEM Form Approved Budgct Bureou No' 63-R0296 EM ltl t J [_l Community System t/ REPORT OF IN SPECTION-INDIVIDUAT SEWAGE. DI SPOSAL SYSIE'TT PllfAIY TttAtmENf consists ()f E SePtic tank. I Cessgxnl. 3.ptk fonl3 Distarrce from well,_feet. Material,_ -JrlC[€l-c Numbcr of compartments Total liquid capaciry 1000 gallons.Capacityinletcompartment,-gallons. Inside length Coropool: Distance from: Vell, feet; f<rundation,--feet; nearest lot line at ! front, fl side, I rear,---fcct, tnside diameter, - fe('t. Depth,-fcet. Liqui,J capacity gallons. Lining material sfColtlDAIYrl:Arm:Nrc<lnsistsrlf@Ti!edisposaltieId-[Seepagepits.()ther tnside wid(h, 4i fber. Liquid depth, 5 fcet. Disrance from: Well,- feet; foundation, Total length of tile lines 220 fect. Number of lines, 4 Distance between lines, 10 air 66st Trench witlth, 2 -inches. Total effective absorption area in bottom qf 11sn6hs3, 440 square fcet. kngth of cach line,Depth, top of tile to finish grade,-inches. r)feet; nearcst lot line at I front,:Q[side,ff rear,- 1(J fect Tygr of tilter material: f] Gravel. Depth <>f 6lter material beneath ti l-l Broken stone. Other 6 inches. Depth of 6lter material over tile, I ' -.. --: 2 inches. 3oopogo Dlrr: Number of pits--. . Outside diameter feet. I)epth f*t Lining material f)isunce from: \7ell,---feet; building foundation,-feet; oearest lot line at D front, I side, f] rear,-feet. ln.p.ctlorl modo by: ! State. fi Grunty. D Local Health Authority Inspected by /s/ .j.ri. :,hook Date of inspe<titxr 3lL2l74 tg 7+lleqlstered Sanltarian (TlrL[) REPORT OF INSPECTION-INDIYIDUAL WATER.SUPPLY SYSTEiI Distance to nearest public water main,---feet. Size of main,-inches. Intlivi.lual wells ! arc I are n()t custornary in neighbgrhcxd. Give most recent rct().d of failure of wclls in immediate vicinrty to furnish adequate supply of watcr- Properties in neighborhrnd ! are I are not being developed with both individual water-supply and sewage-disposal systems. L()tsize:-feetwide'----feetdeep.DweIlingsetbackfromfr<lntproPertyline'-feet' lndividual water supply trom: fl Drillcd well. ! Driven well. fl Dug well. ! Bored well. Dlatonca cl woll from: Ruildingf<rundarion,--feet;nearestlotlineat!front,[side,[re.t,- casr iron sewcr,--feet; tile sewer,scptic tank,---feet; disposal 6eld, scepage pit,--feet; cesspool,-feet; other sources oi possible pollution,-ieet. Woll conrlrucdon: Diameter,-inches. Total depth, -feet. Type of iasing,- Depth of casing, -fe6. Approximate depth to pumping level of water in well Sealed watenight to depth of -feet. Approximate yield, -galloos per minutc. Exterior space around casing sealed with: f| Cement grout. ! Fuddled clay. I Ordinary backfll. Well cover: ! C-oncrete. D W""d. fl Maal. Openings in well cover watertight: I Yes. D No. Purnp: ! Shallow well. I Deep well. Lengh of drop feet. hrmp capacity,lons per minute. Located in: I Basement. ! hrmproom off basement. ! Pumphousc above ground. I h.rmp pit. Rrmproom properly drained: D Yes. D No. hrmp mounting watenight: I Yes. D No. Type of storage: I Pressure. f] Gravity. Capacity,-gallons. Hasbacteriologicalexaminationofwaterbeenmade?f|Yes.DNo.If.answer.is..yes'.'givedate-, Quality of wrter E is D is not satisfactory for human consumption. lnstallation ! does ! docs not comply with approved exhibits, if any. Inspection made by: I State. I County. ! lo<al Health Authority. Inspected by Date of inspection r9_ (rrrlE) G P O 900-68 2 feet, feet; 19- IANE COUNTY E BUTLDTNG E ,DING PERMIT OR MOBITE HOME MHE E PERMIT PERMIT NO.'13 PROPERTY OWNER MAILING ADDRESS PHONE $ii, CONTRACTOR MAITING ADDRESS PHONE PROPERTY TOCATION _ INCI.UDE POST OFFICE PROPERTY LEGAT DESCRIPTION _METES, BOUNDS RANG E SECTION TAX LOT NO CODE CENSUS TRACT EXISTING STRUCTURES ON PROPERTYAPPt. NAME & MAITING ADDRESS LEGAT 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 STRUCTURES TO BE BUILT THIS PERMIT TYPE CONSTRUCTION se. FT. # BDRMS VALUATIoN SEWAGE DISPOSAI. PUBTIC N SEPTIC TANK tr oTHERfl PTUMBING INSTATTED BY OWNER E OTHERI NAME BUILDING WASTE DISPOSAT PTUMBING PTAN REVIEW PARK TRAIIER TOTAT (FEES WATER SUPPTY PUBUC !tr oTHER COUNTY BUILDING & SANITATION SPECIFICATIONS MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GA[. DRAIN FIETD REQUIRED TIN. FT TRENCH WIDTH FT.OR SQ. FT TYPE OF STRUCTURE OCCUPANCY ZONE PUBTIC UTIT. EASEMENT BTDG. SETBACKS FRONT FT. FROM CTR. OF ROAD RIGHT OF WAY SIDE INT. SIDE EXT. USE CI.ASSIFICATION REAR AUTHORIZED SIGNATURE _ DATE DATE (posT THIS PERMIT ON MAIN BLDG. AT SITE) TANE COUNTY, BLDG. & SAN. DIV,, COURT HOUSE, EUGENE, OREGON 9740I ronv d 955- 13 BIDG. PERMIT - WHITE OFFICE COPY _ WHITE COUNTY TAX - PINK PTUMBING _ CANARY BUILDING _ GREEN SANITATION _ GOLDENROD Construction to comply with uniform building code ond counly regulotions covering plumbing ond sewoge disposol. All buildings require o certificote of occuponcy before being occupied. (See Stotement on Reverse Side) hr*.< s@rloon PLUMBING GROUND/ORK Ap pnov E o Rrurnr s &Drsappnovro I ruspecroRoor. )* l3-74 GAS PIPING GROUND/ORK Ap pnov r o Reua Rx s D r sappnovro D Dare I ruspecron ROUGH PLUMBING AppRoveo & Drsappnoveo ReuaRrs oare 3 -2t-7l lNsercron ROUGH GAS PIPING Ap pnov E o RruaRx s DrsappRovro Drre I Nsprcron F I NAL PLUMB I NG AppRoveo N DrsappRovEo RE tqa nr s oortfil!'21 I rusprcroR I ruspEcton CERTIFICATE OT OCCUPANCY Rraoy ro lssuE ReuaRx s / / Nor Rraoy ro lssuE f ,-7 Dare I rspecron FINAL GAS PIPING AppRoveo D DrsappRovED D Dore_ Reua nx s \ IANE COUNTY B--OING PERMIT OR MOBILE HOME . E PERMIT BUTLDTNG E MH n PERMIT NO. PROPERTY OWNi'r LL.i 1:'vt,t:!_5lu_!at*ui CONTRACTOR ER MAITING ADDRESS PHONE MAILING ADDRESS PHONE PROPERTY TOCATION _ INCTUDE POST OFFICE PROPERTY TEGAT DESCRIPTION _METES, BOUNDS RANG E SECTION TAX LOT NO.CODE CENSUS TRACT EXISTING STRUCTURES ON PROPERTY APP[. NAME & MAITING ADDRESS tEGAt ACCESS TO PROPERTY rN \r ,r PROPERTY WIDTH DEPTH AREA FOR MOBILE HOME PERMITS ONLY No. of Bedrooms Connecl to Existing Sewoge System I New System ! STRUCTURES TO BE BUILT THIS PERMIT TYPE CONSTRUCTION sQ, FT. # BDRMS VALUATIoN SEWAGE DISPOSAT PUBTIC ! SEPTIC TANK tr OTHERE PTUMBING INSTATTED BY OWNER N OTHER: NAME BUII.DING WASTE DISPOSAT PTUMBING PTAN REVIEW PARK TRAITER q F EES WATER SUPPTY PU BL IC OTHER TOTAL COUNTY BUILDING & SANITATION SPECIFICATIONS MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GAt. DRAIN FIETD REQUIRED tIN. FT TRENCH WIDTH FT.OR SO. FT. TYPE OF STRUCTURE OCCUPANCY ZONE PUBTIC UTIL. EASEMENT BLDG. SETBACKS FT. FROM CTR. OF ROAD RIGHT OF WAY TRONT SIDE INT. SIDE EXT. USE CTASSIFICATION REAR AUTHORIZED SIGNATURE _ DATE DATE BLDG. PERA4IT - WHITE OFFICE COPY - WHITE COUNTY TAX - PINK PI.UMBING - CANARY BUII,DING - GREEN SANITATION - GOTDENROD Conslruclion lo comply with uniform building code ond county regulotions covering plumbing ond sewoge disposol. All buildings require o certificote of occuponcy before being occupied. (See Stotement on Reverse Side) (posT THls PERMIT oN MAIN BLDG. AT SITE) ronu5655-13 TANE COUNTY, BIDG, & SAN. DIV., COURT HOUSE, EUGENE, OREGON 9740I .4 Drre I rusprcron Rr maRx s ,; (ii,''\ r- L.t- FOUNDATION INSPECT ON Ap pnov E o D r s appnoveo Oor, ?I Hspecron &,_ REul nx s I-7-7 FRAMTNG tNSPECTt0N AppRovEo Reulnx s IA DrsAPPRovE, D Dnre -H I Hsprcr e/ LATH OR SHTET Ap pnov E o RrxlRt<s 'INSPECTION Dr sappRoveo l/ ,*r"rrro^/Drr r FINAL INSPECTION Ap pRov e o Reuanxs Dt sappnovso o^r,64/'a/I NSPEcT t/" -.2 .? I CERTIFICATE OF OCCUPANCY Rrlov ro lssue Rruanx s Nor REaov ro I ssur Drrr 2(a t-?7 2'f ?3 7, 12 I NSPEcToR \r SITE INSPECTION AppeovEo D DrsappRovrc D D D / a INDIVIDUAL SEWAGE DISPOSAL C.-STEM RECORD Installer: Complece top pa _ of form to signature and return both copies to Lane County Building Sanitation Department. -t < =-. s Name -f Becfrooms ? Baths ) Basement Yes No f-l-''il SS ir.std./?4J/, No.L v upply Public [f Other-List Ft. from well Steel[ Concrete ff' No. Compartments .1 Caf. Capacity. ./,/.r?-t.t I Leneth g widrh y'2o Diameter TDepth S"-Distribution Box:Yes EF No fl rD str on- Fee!: from F tionLot Line below Applican Name M ailing Address Length oft.{iz d{z .5,I4 ,. {(. Lines t f '.!F*"n lrotal sq.{rt.b-etweenl width e l*./{o lrines 7,,r i rype/ Ayo7.,-, Fill-er Filler depthabove .tile 2- in-Sketch See instructi-ons r6 IllAtrn potlurtot{ c0Nrn0L Drvrsrct{ T 0F ENVIB0NME|ItAL MANAGEiTTENT LAIIE COUIITY 195 E. SIXTH AYEI{UE IUGEHE onEcoil e74olI cl c(IVEDHA$], * r:rq ts. r: -FY o d r\55 5s' o \Z |c, N to st v . 3i sEil c( 5.LlP Y 2-O.O \€< 3 \o o llo,7 Date For *7 S ture ian Use OnIy: Approved: System Installation Conforms to Current Standards Date: ! Oisapproved: Does Not Conform to Current Standards Remarks: tlte/rr ture Lane County Building & Sanitation Dept. ianrs S cs5 - rr 6. q I rr'i-++