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Home My WebLink AboutPermit Septic Tank 1975-9-24 ~ '- (-,J ", . . ,. .'''\. ,. \ \ ( r --~ -__, .' r.",' ". .". -.. . ' . ~ /1)1/1-(00:' 75 LANE COUNTY BUILDING 0 BUILDING PERMIT MH OXX. MAILING ADDRESS P.O. Box 2qq MAIliNG ADDRESS OR MOBILE HOME USE PERMIT PERMIT NO. r PROPERTY OWNER JlAN R'NnT CONTRACTOR ,: S.&.~F' PROPERTY lOCATION -INCLUDE POST OFFICE ?()~ I "ll ~l'm. \,JOV PROPERTY LEGAL DESCRIPTION - METES, BOUNDS SUTHERLIN OREGON MH 480- 75 PHONE 4"iC)-~8q2 PHONE .j' , - o;T" TWP - 18 AnnJTI~M Tn rlt R~RT ~B~VF, RANGE SECTION I ()T 'lO RI <)~K 6 TAX LOT NO. CODE CENSUS TRACT 03 11 APPl. NAME & MAILING ADDRESS FOR MOBILE HOME PERMITS ONLY No. of B~drooms BE NIIIT EXISTING'STRUCTURES ON PROPERTY NONE SAME LEGAL ACCESS TO PROPERTY 2068 I NLAND WAY PROPERTY. SIZE - FT. WIDTH DEPTH AREA STRUCTURES TO BE BUILT THIS PERMIT Connect to Existing TYPE CO,NSTRUCTION Sewage System 0 SQ. FT t:: BDRMS New System 0 VALUATION PERMIT TO PARK MOBILE HOME 2 PERMIT TO INSTALL SEWAGE DISPOSAL SYSTEM PRIOR SEWAGE DISPOSAL PUBLIC D BUilDING ,WASTE DISPOSAL IPlUMBING PLAN REVIEW PARK TRAilER SURCHARGE , FEES PLUMBING INSTAllED BY OWNER D OTHER: NAME WATER SUPPLY SEPTIC TANK D OTHERD l(J(l.ClCl hoo PUBLIC D D OTH ER MIN. SEPTIC TANK CAPACITY ..n 00 1:> ,.,It '''' COUNTY BUILDING & SANITATION SPECIFICA nONS DRAIN FIELD REQUIRED 'TOTAL WITH DIST. BOX: GAl. 7"i0 UN. FT 100 TRENCH WIDTH FT. OR SQ. FT. 200 ORAIN.lrLn TO Br A MINtMUM OF TEN FEET FROM PROPERTY LINES ANn I='UTUIU. Ru Ii [) I NG TYPE OF STRUCTURE OCCUPANCY ZONE PUBLIC UTIl. EASEMENT BLDG. SETBACKS u FT. FROM CTR. OF ROAD RIGHT OF WAY FRONT h~' SIDE INT. "SIDE EXT. REAR AUTHORIZED~ SIGNATURE - DATE /S/ J. E. Boss BY SHiPP/PLUMB USE ClASSIFICATION 0; CRUICKSHANK/SANITARIAN DATE 9/24/75 DLM BlDG, PERMIT - WHITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENROD Call 687.4065 to schedule all required inspections. Allconstruc- lion shall comply with Uniform Building Code, D.E.Q. standards IMPORTANT: for subsurface sewage disposal and county regulations covering plumbing. All buildings require a certificate of occupancy before being occupied. (See Details on Reverse Side) ,rOR~l.= C55-13 '_.. (POST. THIS PERMIT ON MAIN BLDG. AT SITE) LANE COUNTY, DEPT. OF ENVIRONMENTAL MANAGEMENT COURTHOUSE ANNEX, 135 EAST 6th, EUGENE, OREGON 97-401 . ' ~,'L..,'. ~. ....".... J , . :. ~ .,.-r:- ., .~.~ 'l~~', "-' .".... ;" y,' '.- .... "' PROPERTY OWNER .. ' " . fl~CJ /"1.~rll>? CONTRAqOR '9.^,,~ PROPERTY LOCATION - INCLUDE POST OFFICE f . () LANE COUNTY BUILDING 0 .... MOBILE OME , JJ.' I '-/ C' / i'~ .l .m - ~f .....r.t.&..~;~~ ." ::,"- 1 \ .. .~, i BUILDING PERMIT OR MH Dl()( MAILING ADDRESS ", 1='.0. SOlI t~'}C) ~ MAILING ADDRESS l)SE PERMIT PERMIT NO. [f.l-! I!80.. 73 PHONE 4qC]-';\&32 PHONE II \) 'SUTlfllll..lN Ollll:GCltJ \ , ~ 1;.n(,f1 1'''A"'n 1~1I'" PROPERTY LEGAL DESCRIPTION - METES, BOUNDS ': -< ~ t\VH TWP - 18 ^nnJ~t~~ vn Wlftn~QT ~nn"p RANGE SECTION I nT ~ I'll. a"" 6 TAX LOT NO. "; CODE CENSUS TRACT 03 11 '. " APPl. &>>OT NAME & SA~~ '\. MAILING ADDRESS EXISTING STRUCTURES ON PROPERTY !'10m! LEGAL ACCESS TO PROPERTY -\. _~o .... cu= IIJLAlW U!I T PROPERTY SIZE - FT. WIDTH DEPTH AREA .FOR MOBILE HOME PERMITS ONLY No. of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT :.i Connect to Existing Sewage System 0 TYPE CONSTRUCTION SQ. FT. :;:: BDRMS New System 0 VALUATION Pcr~IT TO PARK ~WOILIl: HO~~ a Pti;Rt-1I'i' TO INSTAl.L Sfl\:IAGlt DlGPOOAL SVGTeel PRle::! SEWAGE DISPOSAL PUBLIC 0 BUILDING WASTE DISPOSAL PLUMBING PLAN REVIEW PARK TRAILER OUflCI';ArJ(\l! . FEES PLUMBING INSTALLED BY OWNER 0 OTHER: NAME WATER SUPPLY SEPTIC TANK 0 OTHERO IM.on IU~(j PUBLIC 0 o OTHER TOTAL . m.M _11' 1':l~.1::> COUNTY BUILDING & SANITATION SPECIFICATIONS DRAIN FiElD REQUIRED' , . lIN. FT lCO TRENCH WIDTH FT. OR SQ. FT. 200 MIN. SEPTIC TANK CAPACITY WITH DIST. BOX, GAL. 1"iQ DnAI~~I~LD vo G~ A MI~I~~~ O~ Tc~ vttev ~~c~ PQOPERTV Llrorro AND rUVlmr. CUILnl~Q " TYPE OF STRUCTURE OCCUPANCY ZONE PUBLIC UTll. EASEMENT BLDG. SETBACKS __ FT. FROM CTR. OF ROAD RIGHT OF WAY I FRONT hc:;:' SIDE INT. 'i SIDE EXT. . REAR AUTHORIZED~ SIGNATURE - DATE /5/ J. E. Go~s Cy UJi,pp/Ft.u::.., , USE CLASSIFICATION <; CllUI CllSHAUR/OIHII TAR I Al1 DATE 9/2b/T; c!.~ BLDG. PERMIT - WHITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUMBING - CANARY . BUILDING - GREEN SANITATION - GOLDENROD ., Coli 687.4065 to schedule 011 required inspections. All construe. tion sholl comply with Uniform Building Code, D.E.Q. standards' IMPORTANT: for subsurface sewage disposal and county regulations covering. plumbing. All buildings require a certificate of occupancy before being occupied. ~. _ (See Detoils on Reverse Side) \, (POST THIS PERMIT ON MAIN BLDG. AT SITE) LANE COUNTY, DEPT. OF ENVIRONMENTAL MANAGEMENT COURTHOUSE ANNEX, 135 EAST 6th, EUGENE. OREGON 97401 .- . FOR~_':=' C55- 13 ., , SLAB FLOOR PLUMBING GROUNDWORK ApPROVED ;---? DISAPPROVED ~ DATE INSPECTOR REMARKS GAS PIPING GROUNDWORK ApPROVED / / DISAPPROVED ~ DATE INSPECTOR REMARKS ROUGH PLUMBING ApPROVED / / DISAPPROVED ~ DATE INSPECTOR REMARKS ROUGH GAS PIPING ApPROVED ~ DISAPPROVED ~ DATE INSPECTOR REMARK 5 FINAL PLUMBING D~T/2.,...;t-7) INSPECTOR~j ./ . t l/<J ApPROVED j>/ / 01 SAPPRDVED ~ REMARKS FINAL GAS PIPING ApPROVED ,C1 DISAPPROVED / / DATE INSPECTOR REMARK 5 .CERTiFICATE OF OCCUPANCY READY TO ISSUE ;---? NOT READY TO ISSUE ;---? DATE INSPECTOR REMARKS l ! '~( ",' "1- __..r~...._ ,',,,, ') ..\ l ~ LANE COUIiITY BUILDING 0 ~/,""\ J BUILDING PERMIT OR MOBILE 'hclME MH D~:~( MAILING ADDRESS USE PERMIT PERMIT NO. f>~' , ~:(~. 'l'~j ..... PHONE ~f.:O~ ~Qr~ ~~ PHONE ! PROeERTY OWNER n." ':l~1\IaY CONTRACTOR t'..O.. lIC<': t::-"'; MAILING ADDRESS f.u'pn>~(~ H' ~':--'i:CON: . ~i.4Mt' PROPERTY LOCATION - INCLUDE POST OFFICE (",' pjj., < , I,,, '''''' H..,.. PROPERTY LEGAL DESCRIPTION - METES, BOUNDS qTli ,~rl'qjT~e.. TO r;IUlr:~r r;;~~_ll:t' t~T -=to tU.C1Ci-', ~~ TWP RANGE SECTrON TAX LOT NO. CODE CENSUS TRACT :f. 03 11 APPl. Cn::~"':" EXISTING STRUCTURES ON PROPERTY 'ik~it NAME & S{tf;tt LEGAL ACCESS TO PROPERTY ~!O(e hlLAND 'oI~'f MAILING ADDRESS FOR MOBILE HOME PERMITS ONLY No. of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT PROPERTY SIZE - FT. WIDTH DEPTH AREA Connect to Existing Sewage System 0 TYPE CONSTRUCTION SQ. FT, :;; BDRMS New System D VALUATION p",,\!('C TO PA',11 r~:J!lI~:' : ,01>1;: 2. f::~~~ \" 'fe ':<!1TA;"~. 3t~~!A':;~~ OlOf:':;Sli. :';'J~T1H ., ...;' . FEES PLUMBING INSTALLED BY ,,:. OWNER 0 OTHER: NAME WATER SUPPLY SEWAGE DISPOSAL PUBLIC D. BUIlDING WASTE DISPOSAL PLUMBING PLAN REVIEW PARK TRAILER t'I.,;~-;:,1S\.'=;~ SEPTIC TANK 0 OTHERD ~fjJ..1 ~tJ h~~:tJ PUBLIC D o OTHER "?n... .; TOTAL $ \. ~ -;.: * {,' MIN. SEPTIC TANK CAPACITY COUNTY BUILDING & SANITATION SPECIFICATIONS DRAIN FiElD REQUIRED WITH DIST. BOX: GAl. "I<<'" ,-J..' UN. FT lCO TRENCH WIDTH FT. OR SQ. FT. 2f'O I)Sh\INrltLtl tu !it A lIt.n'~1UM C? jl'rtr. n~tT fHDM r:.:~>::~(~~";1 i_ ,i:,~l; j\!,n nJTUI<f. iJU'tlllloc. :.., \ t' \ " .~.. ~ \.. ',) , \ \" It. '. \ ~.\>. ~~'. ! . , TYPE OF STRUCTURE OCCUPANCY ZONE PUBLIC UTll. EASEMENT BlDG. SETBACKS.. FT. FRONT t:(.-i' FROM CTR. OF ROAD RIGHT OF WAY USE ClASSIFICATION I~ I "I SIDE INT. AUTHORIZED J. F:. I ~q~l~ !.r: SIDE EXT. SIGNATURE - DATE ,....,'.../1.... .~" ..' I' ....\,11"1.. REAR q C}.UH f:";;'J~"'..~ltl/!AH' 'rAP I A'4 DATE ., (,.,.). /" ". ')fr..i'l !:r ",' . BlDG. PERMIT - WHITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENROD Call 6B7.4065 to schedule all required inspections. All construe. tion shall comply with Uniform Building Code, D.E.Q. standards IMPORTANT: for subsurface sewage disposal and county regulations covering plumbing. All buildings require a certificate of occupancy before being occupied. , . " '." (S~e"\:-Details.on Rev'e~se Siae) .... \ '.' '\ ..: . ): .~~ ''-'' (POST; THIS PERMIT. ON MAIN :BtDG. AT SITE) LANE COUNTY, DEPT. OF ENVIRONMENTAL 'MANAGEMENT. COURTHOUSE ANNEX, 135 EAST 6th, EUGENE, OREGON 97.401 1'_9RM = C55-13 'i SITE I NSPECTI ON ApPROVED Cl DISAPPROVED Cl DATE INSPECTOR REMARKS FOUNDATION INSPECTION ApPROVED / / DISAPPROVEO L-I DATE INSPECTOR REMARKS FRAMING INSPECTION ApPROVEO I I D,SAPPROVEO I I DATE INSPECTOR REMARKS LATH OR SHEETROCK INSPECTION ApPROVED L-I DISAPPROVEO r=7 DATE INSPECTOR REMARKS FINAL INSPECTION ApPROVED Cl DISAPPROVED .Ol DATE _ INSPECTOR REMARKS M ~..iA I'~ J I-IA _t/~.(Yt. CERTIFICATE OF OCCUPANCY READY TO ISSUE / / NOT READY TO ISSUE Cl DATE INSPECTOR REMARK 5 M//f./'i/ti..-7.F- j;1J.eJ/ ot30 rJ3~ y:{("'(~8 ~J '. :3- tLf t#"K-E/~fIk-t1~ ACrIVITY INFORMATI01~ SHEET , lane coumy ('I \ ' COMPLETE THIS SECTION, INCOMPLETE FORMS WILL BE REJECTED! j , l' 1 . .i I U;""v"\. ~. ~~"I\\i2l PERSON MAKING REQUEST -?hUib ':rto \"'~I"rl l.<>c-.~ MAILING'.ADDRESS ~ ~.g PROP'ERTY OWNER ~M€. MAILING ADDRESS ~~ CITY e>~ll> STATE <=1[4- n ZIP CODE 'SA-M\Z.. CITY STATE zip CODE io~(" - "i41 ~ BUSINESS TELEPHONE # '741- /4-1"2..- HOME'TELEPHONE # '6JtMJ7.- BUSINESS TELEPHONE # <rAM'!; HOME TELEPHONE # 2... PROPERTY ADDRESS (IF DIFFERENT FROM MAILING ADDRESS) . 3 MAP & PARCEL NUMBER (R~OUIRED INFORMATIONJ ~ ARDMoi.~J l.N--()JJQ /t1ODoLIIJt TO'~HIP tKI' r J1~j 2~ ,,1..7, X -fff-I/8B ,/OWNSHIP ~b~ a i}j. kGoM, TOWNSH I P (from tax maps in Departm~ent of As~m nt and Taxation. or from tax statement) \.L / 1". '1-0 .r 03 II . olfobO .il.4U,- RANGE SECTION TAX LOT(S) OR PARCEL # ~, RANGE SECTION TAX LOT(S) OR PARCEL # ZONING RANGE SECTION TAX LOT(S) 1/4 LOT 30 ern IP OR PARCEL # ZONING 4 SUBDIVISION (if applicable) t:ll "R..~ t r=..UM' J..... ACRES BLOCK UJ MQRli:"" TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP: 5 REQUEST (state exactly what you plan to do) tlil'f'k,..... -iJ.,.,""'+.: ~.,,'t'h 1JFU,J })88 l/1 /VIne-d,t:. Jhf.o1P. I" .' f 6 DIRECTIONS TO SITE: -=12n?<' ./-,,.. ~... 1;>,..,..... Hlh"i8lU?, ~ S,.,~b. (O/"/\ rtc.tJ. efA - ~- .... V "f'Vlllii, """,,..n~J. /T'/k,!.) ro..lI-e.mn;f 72> ~v..tf'"P/k-"f- J').)/"n) I..''!:'l.. E"...if <t-~: , -. "'(.,,,,,,er' '.1 ** FOR STAFF USE ONLY ** NUMBER ;:j ., V> " ZONE/LAND USE: BY: DATE: DATE -i.' _"'_.r-; TIME IN: OUT: '\ \1 .; LAND MANAGEMENT DIVISION / 125 E. 8th AVE., EUGENE, OR 97401 / 687-4061 INSTALLER: PROPO.'-'l SEWAGE DISPOSAL SYSTEM RECORD' " > ._.. t~ Complete 'top part of L.l to signature and submit both .copies with appl ication-. . PERM IT NO .MH 480- 75 INSTALLER.' S NAME BIiC' 40V Units Be~ooms PROPERTY AOORE~~ .--:-- . ,\ \ ""'- No. Livin9 2068 JC INLAND WAY Inside Leng..th OWNER NAME. Dimensions: . Width Steel 0 Ft. Diameter . Baths 'Basement WaterSul1pl'i,;./ . Yes No Pubfic l---'other-List Concret:: ~ compartments' / Gal., Capacity /&0 &' Tile Disposal rreld: 'J ~ Depth Distribution Box: Yes ~No Other Distribution-Type . Septic Tank: Ft. from well DAN BENOT Tota I' Sq. F t.2 eN:? Feet from WEll Lot Li ne Front 1Ft. Between lines //7 Foundation MAILING ADDRESS P.O. Box 299 SUTHERLIN OREGON Length of Lines-Ft. [TrenCh_I .16'"C92~113. 4. 5. 6. WidthL/ 'lot Plan (see instructions): Side IFille'ikIFille~ Del'th Type r:7_ Above T i 1 e2 Rear . IF~ 11er Jl~low InJr,le 1'/ ,n. 1- lofl V; LiFr /.1 f.I ~ 41. -==- l' /9F1 lOfT l' ~" lifT ? /0 fT-7 " v). .J . D'!;"';! ~ .t, '" ." If .1-" ~ --.l RECEIVEfl 8y \. SE! 291975 .' . :..,. LANE COUNTY ENVIRONMENTAL MGMT. - - "'. ( ~ ~ r M H r I - - ~ ~ -\ 5/1F -- - l 7 N i j j./ L .4.x/ I? IM,q i 7~" S i Qnature "L-i----z r<\~--e:~ . CERTIFICATE OF S;iTISFACTnw COMPLETION ~..,< For Sanitarian Use Only: .' (j'i'" . Date: /O-j- /v In accordance with 1973 Oregon Laws Chapter 835. Section 214.this certificate is issued 'as evidence of satisfactory completion 'of a subsurface. sewage disposal system at the above location. . ,roo Approved: System. Installation conforms to current standards 1:=1 Disapproved: .Does not conform to current standards Remarks: Date f4_ :/4''' C55 -11 Qw,,7'-)J1~_____ Sa~tarian's Sign~ure LANE COUNTY STATE OF OREGON OEPARTMENT OF ENVIRONMENTAL QUALITY '. "'VUlE COUNTY ENVIRONMENTAL. HANAGEMENT PLOT PLAN Name and Address of Owner Telephone: The building being constructed under thois penllit will be used for" Date this ~roperty was purchased Do you now, or did you ever own proper ty adj acen t to thi.s tax lot? If so, please list those tax lot numbers br draw those properties orr .the plot plan belo~. Indicate on your drawing the location of all homes (including mobile homes) the property, as well as the locatioI'l of the new buildin'5.. - --.' ".1" ....1 . fit). ----- ~ -=\~~j=~il;~-~~---~ ... ,\'- T:.-~~':~.~~ /' ... --=j-=~~L:-~~~i~~~-==~ . '~~~1tl '.. , . I ... .' Ii:: .'1.~(~~ r Jk .. ';~;\: '. \ '.___ ;- -- ~+ -- ~ =: l.t ;IS ~- -- --" '\ S ~ ~ ~ - - ---- .. - - 7' I / :'.I/,t~ -/..::--- ii1;/~t f^ L- nor,..,T on '1' r .. ') .,.. 6_~ __,,_ ~, t .... ,. , . . '::-:} , ,. . . -) I ( '" ~ I .1 I "1-' I 1 -,_._~.. ......I--..~ ": .1 J. I .T --1- '~I 'i2 -") I. __,- . f<~?'i<.6 (;.'1-11.. j' )C Je j'-' . 1, ,L' ' 'j 1 ~:~Pr, ( . .q, '~, ,L. 1 , ' I I .. ._Iu I' .. . . I -----+~-- I _I '1 :(\ ~) ., 11 I IJ' ,1------ . f- . _~L-~_ r~ \) I \ Name of Applicant (if Address Telephone . Appl.JcilJ1r'S Interest: Ruy'c'~ 0 'I - - [;),~ different from owner) : ----- ----J , "T I I I -,. I. -, Map Tax La t Seller lJ Agent [i Permit 11)1J/i.-:Y.~u~2Q TRS, IT 'Plot Plan Subdivision :f\tp.,,,_~,"\ tz;12r>\/f1. Lot '00 Block (&, \ ~'\, ~. V-S. '~<[- -l.L !2-\VG \,..:l\\~""...\\V .' /0' - ~t5h-e" 5tH) . ~ . " ft1fW /d IIV 'tv.~ , HoT 70 15! I t;;...,eVl (,/OlVicinity Map } C74: 150 f/OflrIi ~ . Job Location (Address) tJ.bbo .Dv/un.--/ Permit # For Permit #. For Permit # For Ii ~ ]7f.ilAlV~ W""~-7 'i2.oov~ 1!t4- . ,"I~ ~'w)' f:2<J IIf).:> ~\ /VY)f)/.8 . J Jf()rt}8' ,.- .. --..- -':N1! ~ ~ . 't.'.. I .12 I wc..-<., u Permit II Permit II Permit II 1\ . '\ '. . ~ ,,~~T" \" . - '~R.\\}!;." I For For For , .(: ., -.c#:;{f'1J "'_~-==<' . 1"""- /nofWc ;r;,M~ --- U . 70 13e- J?crJov-t;J . 1'" '~,-,-" .' :; . ~ ("f~/",~r' , ;, -7_/,-1 - ~\o :r:s I t'I.l5\ . '1 ~. r~ i'- S <LJl ~ \) . 'f ~ ~~ 'f.)"'- ~~ T' 1. II/.] I d -1 '_L 1 '. I' / - .. I '10 "- ~ f 15 ' ~ , {J~PPROVtD MTE 1- f-Fcj' "y.' 4~J- ~ - . r1 :rtD~ y~~ _. - . I ~ ~t f 'I =- ?b ~o