HomeMy WebLinkAboutBuilding Mechanical 1980-05-25t,{ 1-25 DEPARTI1ENT OF ENVIRONI,IENTAL TIANAG' -\T
PSB, I25 EAST 8TH AVENUE
EUGENI, OREGON 9740I
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Appl ication for
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R^ttU/<,he reby certify that this information is true and accurate.ffitricultural building it will be used for purposes allowed by the State Building Code and
ing) and for no other purpose. I have the following iegal interest in the property:
tract purchaser;lessee; holder of an
['nowTE?'[eable of $r-il app] ication.
exclusive option to purchase;
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Affidavit: r, BbEf-
If this application is for an ag
Lane County Code Chapter l0 (zon
owner of record;---7(-dut y au thori zed t<-ic-or
S i gna tu relAdd res s
Tel ephone
l,,lhen permi t .i s ready noti fy
0urner
Con trac Lor
Contractor's 0SR#
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Da te
Appl icant Owner
Plumbinq by
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Phone
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DO NOT WRITE BELOI^I THIS LINE
If Conrnercial
Res idential :
: f of $torlei
# of bedroom
# of employees ,*. ,of ,,'U6,1i1,,'
,$$5!r.ri l-U Existing, Bp #
/_/ Proposed, SI #SI test holes ready
tee
code Dtt &[l*iit:l.ftt,,iJ*:l il}ni.tli of tltas- Eoat Valuation
Tota l Va.l uati on: $(
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TOTAL
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4% State surcharge
Plans check fee
Change of 0ccupancy
PERMiT PROCESSING Zone Part. #Parcel #Parcel Siz
l'linimum setbacks r t, f.ont t, side ; int rea r
Ctxlne n t s
To be type.J on permi t
CP& I Type
By Da te
Gro trre lone _ Use Classification
To be typed on permit
Da te
Phone
For plans information cail (area inspector)
Directions to site
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PU RCHASER SALESM,AN:
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I.ANE COUNI-. BUILDING pERMr_lone ccunty
POST THIS PERMIT ON MAIN BUiLDING AT SITE
CONSTRUCTION PERMIT # LC'2680.80
JOB ADDRESS: 2790 N. 23rd St., Springfield, 0R 97477
TRS, TL: l7-03-24,4.2, 2745
SUBDIVISI0N: Third Addition to El Bon'ita Gardens, Lot 2], Block I
CONSTRUCTI0N APPR0VED BY THiS PERl4iT: l4asonry fireplace.
Val uat'ion : $2 ,500.
C0NDITIONS 0F APPR0VAL: N/A
PERMITTEE: Bert Cornick
DATE ISSUED: 0ctober I, 1980
BY: Hans Etti i n/Susan Kel I er
Setbaqks - Subsurface Seyracle Di s posal Existing or new SDS
specificat'ions:Se tic Tank Drainfield
'l 0'
l0'
l0'
I 00'
max. depth of****************Jr******************************)k************* tfenChgs
SETBACKS AND OTHTR CONDITIONS OF APPROVAL MUST BE STRICILY OBSERVTD. VIOLAIION
CAN RESULT IN REVOCATION OF THIS PERIIiT, CITATION UNDER PROVISIONS OF LANE COUIITY'S
INFRACTION ORDINANCE, AND/OR OTHER REMEDIES ALLOI,JED BY LAI{.
From: Interior property lines
Edge of road right-of-way
Building foundation
I,iel I s, other water sources
l0'
5'
50'
ga1 . mi n. tank;
feet of drainfield;
I^IHEN READY FOR INSPECTI0N (see reverse sjde) call 687-ready: Perrn'it number, job address, type of inspection
and phone number, and any special directions to s.ite.
4065. Have the followjnq information, when jt will be ready, your name
Envi ronmental l.lanagement Department
]25 East Bth Avenue / Euqene, 0reqon 97401 (