HomeMy WebLinkAboutPermit Building 1978-04-20Sto ilr1 U e?BfsPR
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TRS, TL JOB LOCATIO
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Acreage or Lot S Partitioning
Contractor's O.S. *
APPLICANT'S NAME AND ADDR trqq
OWNER'S NAME AND ADDRES s
CONTRACTOR'S NAME AND ADDR
Fee Paid $- Signature
() NEW ADDRESS () FACILITY PERIVIIT TO TRANSPORTATION DEPT
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LANE COUNTY PERMIT L-2r-s5 Ap*
) Completed Subdivision
Lot- Block-
Phone
Phone
Phone
Mail permitto ( )Applicant ( )Owner ( )Contractor. ( )prefertopickup. Call_(owner, etc.) when ready.
STRUCTURES NOW ON THE PROPERTY
|.HIS PERVIIT IS FOR # BEDBOOMS-# PLUI\4BING CONNECTIONL
\IJATER SUPPLY SEWAGE DISPOSAL-s.t. #
THlSPRoPERTYtSWlTHlNoNEMlLEoFTHEclTYoF.PLUMBlNGBY
I hereby certify that the above statements are true and accurate, and that I have the following legal interest in the property:
-owner
oI record;
-contradt
purchaser;
-
potential buyer;
-
realtor or agent. I lurther certify that (il not the owner) I am authorized to acl for the owner of
record, and that said owner is aware and approves oI this action. I hereby agree to comply with all applicable Codes relating to this permit.
Date
sANtrATtoN BU tLD tNG
Minimum Septic Tank Capacity (Gallons)Type of Construction roup
-Fire
Zone
Drainfield Required - Lineal Feet
Maximum Depth
Comments
c.r,n."*
Use classification
c'd Date
PLANNING REOU I REMENTS SATISFI ED. Bv Date Date lssued
ZONE SETBACKS: FRONT SIDE FACING STREET (FROIVI C/L) INT. SIDE YARD REAR (FROrvr P/L)
LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE., EUGENE, OREGON 97401
POST THIS PERMIT ON MAIN BUILOING AT SITE
BLDG. PERMIT -WHITE; BUILDING - GREEN; PLUMBING - CANARY; SANITATION - GoLDENROD; OFFTCE Coplr - WHTTEc55-13
PHONE:687-4394
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Date:
SITE INSPECTION
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CERTIFICATE OF OCCUPANCY
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JOB LOCATIO
Partition ing
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"1TRS, T
LANE coUNTY PERMIT t -Yl- f {
) Completed Subdivision
Lot- Block-
APPLICANT'S NAME AND ADDRE ss
Acreage or Lot Si
Contractor's O.S. +
Comments
Phon
Phon
Phone-
s.l. #
CONTRACTOR'S NAME AND ADDR
Mail permitto ( )Applicant ( )Owner ( )Contractor. ( )Prefertopickup. Call-(owner, etc.) when ready.
THIS PEBMIT IS FO # B ED ROOIVIS-# PLUIVI B I NG CO NNECT IONS
STRUCTURES NOW ON THE PROPEBTY
OWNER'S NAME AND ADDRESS '
WATER SUPPLY SEWAGE DISPOSA
THlSPRoPERTYlSWlTHlNoNEMlLEoFTHEclTYoF.PLUl\4BlNGBY
I hereby certify that the above rtatements are true and accurate, and that I have the following legal interest in the property:
-owner
of record;
-contract
purchaser;
-
potential buyer;
-
realtor or agent. I further certily that (if not the owner) I am authorized to act for the owner oI
record, and that said owner is awire and approves ol this action. I hereby agree to comply with all applicable Codes relating to this permit.
Fee Paid $-Signature
{ )NEWADDRESS ( ) FAC|LtTy pERMtT TO TRANSPO RTATTON DEPT.- ( )SPECIALPI/T. AREA. MIN,ELEVATION:-
-
sANlrATloN BU ILD ING
Date
-
Minimum Septic Tank Capacity (Gallons)
Drainfield Required - Lineal Feet
Maximum Depth
Type of Construction
a"-r""*
Use classification
By:
roup Fire Zone
By Date:Date
PLANNING REOU IREMENTS SATISFIED. Bv:Date:Date lssued: ;
ZONE SETBACKS: FRONT SIDE FACING STREET (FROIVI C/L) INT. SIDE YARD REAR (FRONN P/L)
LANE COUNTY DEPARTMENT OF ENVIRONMENTAL I\4ANAGEMENT, 125 EAST 8TH AVE., EUGENE, OREGON 97401
POST THIS PERMIT ON MAIN BUILOING AT SITE
C55-1 3 BLDG,PERMIT-WHITE; BUILDING-GREEN; PLUMBING-CANARY; SANITATION-GOLDENROD; OFFICECOPY-WHITE
PHONE:687-4394
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PLUMBING GROUNU/ORK
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