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Home My WebLink AboutPermit Building 1976-04-1927s'1'( lt q3'7'l pERI,rrr +-6i% NOTE: NO PERMIT WILL ,d ISSI]ED I,NTIL THIS APPLIC,ATION .-TS BEEN APPROVED d CONSTRUCTION MOBILE }IOME APPLICATION FOR: PLAN REVIEW Address CHAI{GE OF OCCUPANCY E$6 3OWNER Name Clty CONTRACTOR o.s. REG. il 8e-*.< s 24J /?ectlon l- ACCESS T0 PROPERIY (Road Exlsting Structures on Property: Property Location - Address/Directlons: SEWAGE DISP Slte lrspect lon /l Tax Lot,o L'+sts nf cUY ExlsEl-ng Sewage Dlsposal tem Public Comuni ures Clty Census Tract roperty Name S ftrp 0 ( WATER SUPPLY Well B1dg. Plunblng 3Z Surcharge WaEte D13p. Plan Revlery Moblle Hone TOTAL Sprlng Trrc PL :- Naue of Connunlty or Publlc Systen * Naoe Sewage Connectlon PI.A,NS EURNISHED YES w NO Signature of Applicant: Fee Recelved By:C, Use Classifica Water Connection FACILITY PERMIT YES Date: fEl-p6 Septlc Tank Capacl lYpe of Constructl Maximuo rh Use Sq. Ft by Owner FEES: of ield Bldg Froat Setbacks of Road Right of Way: t {Side Exterior 4 D Rear { c55- l2 { LAI{E COI]NTY DEPARII,IENT ENVIRONI'{ENTAL MANAGM{ENT DATE:DATE:DATE:BUII.DING: otner I Be,/ 7T I Owner LANE COUNTY PERMIT FOR:PERI\1IT NO CONSTRUCTION [ ] TVIOBILE HOTVIE [ ] PLAN REVIEW [ ] CHANGE OF OCCUPANCY [ ] NAIVIE ADD R ESS CITY ZIP CODE PHONE I Contractor NAME ADD R ESS C ITY ZIP CODE O.S. Reg. +t Twp- Range-- Section-Tax Lot- Code- Census Tract Subd ivision Lot B lock Acreage -=-Width DepthAccess to Property (Road Name) Existing Structures on Property: PHONE Directions to Property - Address: STRUCTURE (# BEDROOIVIS}SO. FT VALUATION SEWAGE DISPOSAL: PUBLIC [ ] SEPTICTANK [ ] OTHER [ ] PLUIVIBI NG INSTALLED BY: OWNER[] OTHER[] NAIVI E- BUILDING PLUIVIB ING 3% SURCHARGE MOBILE HOIVIE WASTE D ISPOSA L PLAN REVIEW TOTAL WATER SUPPLY: PROPOSED t EX ISTING t PUB LI C COTVIIVIUNITY- NAIVIE PRIVATE WELL OTHER .SPECIFY CONSTRUCTION PERMITS & INSPECTIONS AND WATER POLLUTION CONTROL SPECIFICATIONS IVIIN. SEPTIC TANK CAPACITY GALS.I\ilIN. DRAINFIELD LIN. FT IVIAX. TRENCH DEPTH I NCHES STAY 1OO' FROIVI ALL WELLS TYPE OF CONSTRUCTION GROUP FIRE ZON USE CLASSIFF SETBACKS FT. FROIVI CTR. OF rAN FRONT SIDE EXT FT FROIVI PROP. LINE: SIDE INT. - REAR ZON E AUTHORIZED SIGNATURES lsl ISSUANCE DATE BLDG. PEBMIT - WHITE OFFICE COPY _ WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENBOO IMPORTANT (POST THIS PERMIT ON MAIN BLDG. AT SITE) LANE COUNTY, DEPT. OF ENVIRONMENTAL MANAGEMENT COUBTHOUSE ANNEX. 135 EAST 6th, EUGENE, OHEGON 97401 Call 687-4065 to schedule all required construction inspections. Call 687-4061 to schedule all required septic system inspections. All construction shall comply with the State Buidling Code, D.E.O. standards lor subiurface sewage disposal and the State Plumbing Code. All buildings require a certificate of occupancy before being occupied. (See Details on Reverse Side) c55-l 3 ;;,ffi" - r" -'t', '.' ,;,.'ii Arnusr 25, l9]o l.in. Lte Hrlten, SacngtrnY Lrrt- Couxry LArlD. Sor+trrrrc CouRrxousg Eucrxr, Oneoor . c.P. KlpPF, R.S. Srr rrrn I rx I I A]:c'rl, h DJor /'ot N ",, -t 2.) HARALD D, LYl,{AN, }tD.1 0rnscton T. ..1 S H iift, f' t",t:",:tt Bv tra ., CPK Rrl 50 - BRIDGE PARK ESTATES - Zxo Aoorrrox17-?-19 lwecttgAtroil or jrxE ABovE pto?tn?y tlrotclttr rHA? tr cAr Hor !E otvf,H lilol v touAL AllD ?63?, Bg GIVEil T 2 cougrNgo Vr\ I LAOLE TO JOHN C. STCHER, R,S.e DrnEcron Eutt orNG Ar{o Srrrtratrou DtvIsto}l 'RTLI}IIXARY A?PROVAL AY ?}IIS OEPAR?IITN' FOR ?HE U3T Or sEyAot otspos^L' sysrErs oil Lor-s ll_a.r1o _l!_Blocx \r Lorrxo Lorg I s 2t ] rruo l+ Blocx 6. ilovivcrinppnovrL cAN?!, ??r 2l-aN6 lll Buocx I nrro Lors lJ rruo 16 or Ruocxl4 lro l) tsr-ocx 2, cousr{f,o, pnovtDED punltc U,rrER ts ^ cc t Wrsttnil Erc I tetx t rrq tIh5 wrr.r.^irETrc Srnsrr Errerxe, Onroou r,,l // t?z? Alr,. af€lh),1 {n o8-i-',,', :'r 2€.v 2b ,.1 .u,l^.lr! q. Lrt f:1..I I -,,.0 ,iJ\ t 7,,, l.t,r"'n '-''' "(V( IRD /At \. Lor s , '. -i ' :'.'I i .: .',, I ) BUILOING S ITE EVALUATION-r.+ BUILDING PERHIT APPLICATION NO. PLANNING DIVISION Zon i ng 0rd i nance Cornp I iance: Zone Subdivision 0rdinance Compl iance G/4tr t7 - 07s s[E6liiiSr-t,*,-LOT ()LOT:BLOCK: 1[ r,rr rNspEcnoN b *7 - 7 L APPL I CANT DATE Not licable CKID BY: Setbacks /9 74 I 2 3 4 5 No Yes( ) (D 6. ( ) (,) []il]( ) l' ) ) ( ( ( ( rom Requi red Access Building Site (Area, Width, Frontage) Other (see cornments ) Front Side Exterior Setbacks from inter or nes: Side Rear COil}tENTS: Plans Submitted Soil Stabil ity (footings) Flood Plain 0ther (see conrnents) Not I icable 7I 9 0 ) ) ) YesNor)() () () T'I() () ()CKID BY: DATE COHMENTS: ITATER P0LUTION CONTR0L Not ll. l{eets Department of Environmental Qual i ty Standards. 12. Other (see comments)cK'D BY, A,)-2.*, 4- fi-ZG Aool icable----(l'-No Yesr) IQ () ()() E COI4HENTS: TO APPLICANT: You() () () r Building / Site lnspection: Can be approved. Cannot be approved at this time Questions and further informati C0UNTY PLANNING 0lVlSl0N. Ques as indicated on item N0" on on items I through 5 contict the LANE- tions and further information on items 7 above. *d t h rough l2 contact the LANE CoU U DING AND SANITAT 0N Dlvlsl0N. Will be held in this office unt you can reso vet Pr c55-28 Your buildin 135 Sixth Avenue East Eugene Oregon 97 PHONE. 687_4065 LANE COUNTY PLANNING DlVlSlON PHONE:. 687 ems nd i cated. ) ls ueing returned. rmi t li fee is RONM 4ot -41 85 lr -t ltr I I PLANNING DlVlSlON ACTION PENDING: YES( ) N0( )APPL!CAT!ON# BUILDING INSPECTION DIVISION I PERI!1IT NO CONSTRUCTION [ ] IVIOBILE HOME [ ] PLAN REVIEW [ ] CHANGE OF OCCUPANCY [ ] n Owner NAIVIE ADD R ESS CITY ZIP CODE PHONE I Contractor NAIVIE O.S. Reg. + Twp- Range- Sectio Subd ivision Lot Tax Lot- Code B lock Acreage ADD R ESS CITY ZIP CODE Census Tract PHO NE Width Access to Property (Road Name): Depth Existing Structures on Property: Directions to Property - Address: STRUCTURE (# BEDROOIVIS)SO. FT VALUATION SEWAGE D ISPOSAL: PUBLIC [ ] SEPTICTANK L ] OTHEB [ ] PLUMBING INSTALLED BY: OWNER[]OTHER[] NAIVI tr P LU IVIB ING BUILD ING 3% SURCHARGE IVIOBILE HOt\4E- WASTE DISPOSAL PLAN REVIEW TOTAL WATER SUPPLY: PBOPOSED t EX ISTING t PUB LIC COIVINIUNITY . NAIVIE PRIVATE WELL OTHER - SPECIFY CONSTRUCTION PERMITS & INSPECTIONS AND WATER POLLUTION CONTROL SPECIFICATIONS IVIIN. SEPTIC TANK CAPACITY: GALS. t\4IN. DRAINFIELD LIN. FT IVIAX TRENCH DEPT I NCHES TYPE OF CONSTRUCTION--.- GROUP F IB E ZONE USE CLASSIF SETBACKS- FT. FROIVI CTR. OF r,Afl FRONT SIDE EXT FT. FBOIVI PROP. LINE: SIDE INT. - REAR ZON E AUTHORIZED SIGNATURES lsl ISSUANCE DATE BLDG. PEHMIT - WHITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENROD IMPORTANT Call 687-4065 lo schedule all required construclion inspections. Call 687-4061 lo schedule all required septic system inspections. All construction shall comply with the State Buidling Code, D.E.Q. standards for subsurface sewage disposal and the State Plumbing Code. All buildings require a certificate of occupancy before being occupied. (See Details on Reverse Side) (POST TH!S PERMIT ON MAIN BLDG. AT SITE) LANE COUNTY, DEPT. OF ENVIHONMENTAL MANAGEMENT COUBTHOUSE ANNEX, 135 EAST 6th, EUGENE, OREGON 97401 c5s-l 3 l/// LANE COUNTY PERMIT FOR: STAY 1OO' FROIVI ALL WELLS SITE INSPICTION Ap pnov e o RrptaRx s Dr slppRovro Dare I ruspecron FOUNDATION INSPECTION AppRoveo REuanxs Dr srppnoveo Dar e I ruspEcron FRAMI NG AppRov e o Re uanx s I NSPECT I ON Dr slppnoveo Dar E I xspecroR LATH OR SHEETROCK Ap pRov r o RrManx s I NSPECT I ON D r slppRoveo Dar E I rspecron FINAL INSPECTION Ap pRov r o Reuaaxs D I sAPPRovEo Dare I rsprcroR CERTIFICATE OF OCCUPANCY REaov ro I ssuE Reulnx s D Nor REAoY ro lssuE D Drre INSPEcTOR D n D lo-Job Location (Street, mile post J Subdivision FOR SANITARIAN'S USE ON LY: I\4r-'system Approved COMMENTS: FOR INSTALLER'S USE: Trench DePth T Manufactu well from tank 3 /h 77n 1T5S, T PIot Plan B lock fJ System Disapproved fl Needs Correction oate:S- ) L/ Filler Depth Be Tile from drainf ield lkl tLl \s l0 NI \l\l d 0 I trUJF o \N a\ t \- \ \ f\ I + o-m oo G) g, =(It o) E(I,Z J' c(o .9ao- N N h UJEfF z(, 6 o I I Sca le 0,qrt,.tA INSTALLATlON RECORD AND CERTIFICATE OF SATISFACTORY COMPLETlON When signed by the County Sanitarian, this certificate is evidence as per ORS 454.665 of sat- isfactory completion of a subsurface sewage disposal system at the above location. Return this form to: Permit Processing Section, Department of Environmental Management, Public Service Building, 125 East 8th Avenue, Eugene 97401 g (o oc co \l \s{* $, h) DT c55-t 1 Signature -g-/.-? Pi,) \' o {,I IL s \i \ 'N I Ar" -TroNAt INTCRMATI-O! BEQITIRED submlt tlc follortng ltens to the Bulldlng Officlal at lead -L -:ku ryl:ito lnstallatlon. Retr:rn this form rlth two coples of a]1 reqiiffi lnforratlono tAANlFftcTuReRS 7(u,,sS PEstc^t FoR EAcrl .T-(tJsS sYfLE + sP+N us€ D si gnedr ZA- Butlding Fernrlt No.9v -7 Appllcant , F8€eQoUt, PofvUe> t.NL-. Jo,b Locatlon 2V? O ?7 '(H sf8. ,l,lBuilctl ng rnspector J t fn I RIAP - U UWNET LANE COUNTY PERMIT FOR:PERIVIIT NO CONSTRUCTION [ ] IV1OBILE HOTVIE [ ] PLAN REVIEW [ ] CHANGE OF OCCUPANCY I ] NAIVIE ADDRESS ZIP CODECITY PHONE n Contractor NAME ADD R ESS CITY Acreage-=-.-- ZIP CODE Census Tract PHONE O.S. Reg. + Twp- Range- Section-Tax Lot- Code Subd ivision Lot B lock Access to Property (Road Name) Width Depth Existing Structures on Property: Directions to Property - Address STRUCTURE (# BEDROOTVIS)SO. FT VALUATION SEWAGE DISPOSAL: PUBLIC[] SEPTICTANK[]oTHER [ ] PLUIVIBING INSTALLED BY: OWNER[] OTHER[] NAIVI F BUILD ING PLUIVIB ING 3% SURCHARGE MOBILE HOIVIE WASTE DISPOSAL PLAN REVIEW TOTAL WATER SUPPLY: PROPOSED I EX ISTING t PUB LIC COIVIMIUNITY. NAIVIE CONSTRUCTION PERMlTS & INSPECTIONS AND WATER POLLUTION CONTROL SPECIFICATIONS IVIIN. SEPTIC TANK CAPACITY GALS.IVI IN. DRAINF IELD-LIN. FT MAX. TRENCH DEPTH I NCHES STAY 1OO' FROIVI ALL WELLS TYPE OF CONSTRUCTION GROUP FIRE ZONE- USE CLASSIF SETBACKS- FT. FROIVI CTR. OF rA,{/ FRONT SIDE EXT FT. FROIVI PROP. LINE SIDE INT R EAB ZON E AUTHORIZED SIGNATURES lsl ISSUANCE DATE BLDG. PERMIT _ WHITE OFFICE COPY - WHITE COUNTY TAX _ PINK PLUMBING _ CANAHY BUILDING _ GREEN SANITATION _ GOLDENROD IMPORTANT Call 687-4065 to schedule all required construction inspections. Call 687-4061 to schedule all required septic system inspeclions. All construction shall comply with the State Buidling Code, D.E.O. standards for subsurface sewage disposal and the State Plumbing Code. All buildings require a certiticate ol occupancy before being rccupied. (See Details on Reverse Side) POST THIS PERMIT ON MAIN BLDG. AT SITE LANE COUNTY. DEPT. OF ENVIBONMENTAL MANAGEMENT COUBTHOUSE ANNEX, -I35 EAST 6th, EUGENE, OREGON 97401 c5s.l 3 a PR IVATE WE LL OTHER-SPECIFY:-