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Home My WebLink AboutPermit Building 1977-02-09PERMIT # TRS, TL .4. z *?fdo JOB LOCATIO Acreage or Lot Size Contractor's O.S. # LANE COUNTY PERMIT Lot- Blo APPLICANT'S NAIV1E AND ADDRE ss OWNER'S NAME AND ADDRESS CONTRACTOR'S NAIVIE AND ADDRESS Phone Phone Phone s.t. # Mail permitto ( )Applicant ( )Owner ( )Contractor. ( )Prefertopickup. Call-(owner, etc.) when ready TRUCTURES NOW ON THE PROPERTY ' THIS PERMIT lS FOR # BEDROOI\4S-# PLUI\,1BING CONNECTIONS- \A/ATER SUPPLY SEWAGE DISPOSAL THlSPRoPERTYlSWlTHlNoNENnlLEoFTHEClTYoF.PLUIVlBlNGBY I hereby certify that the above statements are true and accurate. and that I have the Iollowing legal interest in the property: -owner of record; -contract purchaser; - potential buyer; - realtor or agent, I further certify that (if not the owner) I am authorized to act 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. Fee Paid $-Signatu re Date () NEW ADDRESS () FACILITY PERIVIIT TO TRANSPORTATION DEPT () SPECIAL PIVIT. AREA. IVIIN. ELEVATION SAN ITAT ION Minimum Septic Tank Capacity (Gallons) Drainfield Required - Lineal Feet Maximum Depth BU I LD ING Type of Construction a",n,n""* Use classification rou p ire Zone Comments B Date PLANNING REOUIREIVIENTS SATISFIED. By B Date Date lssuedDate ZONE SETBACKS: FRONT SIDE FACING STREET (F ROIVI C/L) INT. SIDE YARD REAR (F ROIVI P/L) LANE COUNTY DEPARTMENT OF ENVIRONIV1ENTAL TVIANAGEIVIENT, 125 EAST 8TH AVE., EUGENE, OREGON 974O1 POST THIS PERMIT ON MAIN BUILDING AT SITE c55-13 BLDG.pERMtT-WHrrE; BUTLDTNG-GREEN; pLUMBTNG-GANARy; sANrrATroN-coLDENRoD; oFFrcEcoptr-wHrrE PHONE:687-4394 PERMIT # TRS, T Acreage or Lot Size Contractor's O.S. # JOB LOCATION Partition ing LANE COUNTY PERMIT ) Completed Subdivision Lot- Block_ CONTBACTOR'S NAME AND ADDRESS APPLICANT'S NAME AND ADDR FSS Phone- Phone-OWNER'S NAME AND ADDRES q Phone- lVlail permitto ( )Applicant ( )Owner ( )Contractor. ( )Prefertopickup. Call_ i TRUCTURES NOW ON THE PROPERTY WATER SUPPLY SEWAGE DISPOSAL-s.t. # THlSPRoPERTYlSWlTHlNoNEMlLEoFTHEClTYoF.PLUIVIBING BY I hereby certily that the above statements are true and accurate, and that I have the foltowing legal interest in the property: _owner o, record; -contract purchaser; - potential buyer; - realtor or agent. I further certily that (iI not the owner) I am authorized to act for the owner oi record. and that said owner is aware and approves of this action. I hereby agree to comply with all applicable Codes relating to this permit. Fee Paid $Signatu re THlsPERMlTlSFoB#BEDRooML#PLUMBlNGcoNNEcTloNL Date INEWADDRESS ( } FACILITY PERI\4IT TO TRANSPO RTATION D EPT, lSPECIALPMT.AREA. MIN.ELEVATION:- SANITATION lVlinimum Septic Tank Capacity (Gallons) Drainfield Required - Lineal Feet Maximum Depth BUILDING Type of Construction Comments: roup Fire Zone Comments By Date:B Date PLANNING REOUIREMENTS SATISFIED. B Date:Date lssued LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE., EUGENE, OREGON g74O1 POST THIS PERMIT ON MAIN BUILDING AT SITE BLDG.PERMIT-WHITE; BUILDING-GREEN; PLUMBING-CANARY; SAN|TAT|oN-cOLDENROD; oFFtCECoptz-WHtTEcss-1 3 PHONE:687-4394 (owner, etc.) when ready. r I ZONE:SETBACKS: FRONT SIDE FACING STREET ROM C/L) INT. SIDE YARD REAR , (FROlVl P j SITE INSPECTION Appaoveo & DtsrppnovEo R e'anx s 1---o- --2./a-7.-*-- Date ?->7'77 t*rrecro^ FOUNDATION INSPECTION APPRovEo Rrltlnx s M Dr SAPPRovED I ruseecr3 * r'-"? FRAMING INSPECTION APP Rov E o D DrsappnovEo D Dorr-I NSPEcToR RettaRxs LATH OR SHETTROCK INSPECTION AP PROv E O I HspEcron Rruanxs FINAL INSPECTION AP PRov E o ReMaax s M DtSAPPRovED I Nsprcroa CERTIFICATE OF OCCUPANCY Rraov ro I ssue REuanx s Nor Rerov ro lssue D Dorr-lNSPEcroR- D Dare , J fZ DrsappRoveo 77r*',^rr:{'ll ? D oo',r-J'Lfu l[- r ns, rl \\- c>J- tq q)h\b {! eritains Permit Acrease or Lot si." \G f X fCt6 Partitioning#..- ( ) Completed( ) Pending APPLICANT'S NAME AND ADDRESS.)WNER'S NAME AND ADDRESS, if di Job Location INFORMATION SHEET ( ) Site Feasibility Study for Septic Tank. Number of sites-( )Would like to meet on site. Call (owner, etc.) Test holes will be read v Subdivision ?,+pt, EB:D'7Les 4,sz 0-sP 331 \? Lot loc+-yr 7.<, 4$eO u.t,,^*toac app lica Da>tt t'213 7r 3 ne Phone 3ag->zzt.ONTRACTOR'S NATVIE AND ADDRE "railX Prefer to pick up. Cal permit or results of site ti stud yto ( )Applicant ( )Owner ( )Contractor (owner, etc. ) when ready. STRUCTURES NOW ON THE PROPER *91>n'te D/alrA8*) R*,-. *N> 574g.a6, A2*+ 4 C *a- [2oaPROPOSED USE (this permit)l,E".t Frron,a €n;nWATER SUPPLY 8aA)B DrzT SEWAGE DISPOSA existing or proposed well, etc. lf public, name of system) i sta r proposed septic tank, etc.) S.l.! PLUMBING BY "lr ,-".\-r*c I(Sgnt Address //5?0 U42/,r, Ark 9uaer{+ l PROPERTY IS WITHIN ONE MILE OF CITY (SDp;ardfteK ******** oFFtcE usE oNLY BELOW THtS LtNE ********l+r*r Necessary pecial Permit Area. lVlinimum E ton) zoN rupq fi{gssE\.L\: \ ( ) Facility Permit Necessary ( ) S 5O t v-(\ / (FROM CENTERLINE OF ROAD) lnterior Side Yard -5- R."r. (FROIVI PROPERTY LINES} To: Planning/Building lnspector/Sanitarian/Surveyor. This applicanr appears to have a problem with Your assistance will be appreciated. By Permit Processing Section Respon By DEPARTMENT OF ENVI RONMENTAL MANAGEMENT Permit Processing Section 125 East 8th Avenue 687-4394c55-12 tvtston -g ( t