HomeMy WebLinkAboutPermit Septic Tank 1978-7-28
'TRS~TI 18-03-;2.-33
/f 4300
JOB LOCATION
I YO'71
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LANE COUNTY PERMIT
Acreage or Lot Si7~
Contractor's O.S. #
Less 1
Partitioning it
) Completed
Subdivision
Lot
Filbert Groves 3rd addition
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Block
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APPLICANT'S NAME AND ADDRE""
OWNER'S NAME AND ADDRES"
CONTRACTOR'S NAME AND ADDRES"
Mail permit to I ) Applicant ( ) Owner
Jean Adel1'Vantuge, 1875 Mohawk
Ii 79, Spritlgfield, Oregon
97/'.77 74~/-8Q~O
'Phonp, - ~~
Phon~^'
Phonp
(owner, etc.) when ready. .-
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) Contractor.
) Prefer to pick up. Call.
STRUCTURES NOW ON THE PROPERTY
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THIS PERMIT IS FOR Carport)
5 ~e- d'/.2'",?-7J'"
. WATER SUPPLY
none
Install SDS, Mobile Home Singlewide
# BEDROOMS~# PLUMBING CONNECTION~
01:-"
public
SEWAGE DISPOSAL proposed.
S.I. #
78-714
THIS PROPERTY IS WITHIN ONE MILE OF THE CITY OF
PLUMBING BY
.,
I hereby certify that the above statements 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 certify that (if not the owner) I am authorized to act for the owner of
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.
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Fee Paid 50. 99.06 Signature /s/ Jean Adell Vantugeq Date 7/12/78
)NEWADDRESS ( )FACILlTy'PERMITTOTRANSPORTATIONDEPT. (){)SPECIALPMT.AREA. MIN. ELEVATION: fl//f
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SANt:8'. :[;:.0',1)0. N BUJLDjlNG . -17 ;? "7
/~ Minimum Septic Tank Capacity (Gallons) o/k f . Type of Construction !::--7 Group
. C':) u. Drainfield Required - Lineal Feet . M-H -::::r-D, Ilse Classification
""... MaXimum~DePth 1:>:'" ".8 ~_ Comments:7!t'tJq-~; 'i'H~ ~-M.1T -p--~ I-A.c:.tZ:it_ ~
Co~ments: ~ . ~'~ e::::;l\.Ll~'~;e;t..\..~IlOV p-. '-">Z..i2:<ef!:der .:'
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Date: 7/2 7/7( B~L.vty~.~ULLJ..~ ~ate: 7~.z8-18
Date: 7/12/78 Date Issued: 7/..:2-!?7'7Y
(FROM CILI INT. SIDE YARD 5' REAR ,,'{"(FROM P.I.LI
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PLANNING REQUIREMENTS SATISFIED. By: Roger HoUis
ZONE: SETBACKS: FRONT 45' SIDE FACING STREET
LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE., EUGENE, OREGON 97401
PHONE: 687-4394
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POST THIS PERMIT ON MAIN BUILDING AT SITE
BLDG. PERrvlI"T": WHITE; BUILDI~G - GREEN; PLUMBING - CANARY; SANITATION --= GO'LOENROD: OFFICE COPY - WHITE
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~LANNINC DIVISION.
PaFtltlonlng. ,
Parcel No.
LANE COUNTY -<;PARTMENT OF ENVIRONMEI':-JTAL MANAGEMENT
125 EAc.. dTH AVENUE, EUGENE. OFiEG~N L ,1
Current Zoning
[]pendf~q []C~mpleted
fEr
AVERAGE PROCESSING
TIHE
PartitionlnQ. Reoulred
Other I
$
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$
~. WATER POLLUTION CONTROL
New Site, In8pect1~sl
'SD~ ConstructIon ~ New
Number otBedroomsi
of Sites
O,~lr
$
$
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Commercial/Industrial - . o~ fmployees
Other '7/f- 7/ Y-
$
~. 'CONSTn.UCTION PEiUUTS AND INSPECTION
l....6.J ... (See above tor t of bedrooms!' ot employees)
,n :~Obi~ H~roe'. .. . . $
~ Permanent
o Temporary
'0 Renewal
Structure
FEE
3/, SO
Sq. Ft.
valuation.
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$
$ __"J~,
$
$
$
Eac.h $
r.ach $
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~otal V,lu~tion S
Plumbing fixtures at S
Sewer,IWilter Conn. Ilt ,')
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4\ State Surcharge
Plans Check Fee
Change of Occupancy
$
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$ 7..20
$
TOTAL BUILDING P~RHIT fEE
$
99 () ~.
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Suntotal
HlnimWll 8tructural setbacks:
From centerline ot street:- Front
Exterior Side
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Roar S-'
Address
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From interior lot lin~s:
o C04t!'! plans sheet' to
side
applicant
o
Curb cut t~ applicant
~ PUBLIC U_NDS 0 Address J4 MiniThum Elcv,),tion
0 PUBLIC WORXS 0 r^'C i 1 i'ty Perr:1it
0 E1JV I RO:,~''.f:::IT,'L IlEALTII $
Cal!lh Check: I d5'.3- flcc'd hy ~. TOT^!, $ '790(,
JMini~um Elevation
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AFf'IDA'JIT: If this permit is"for an"agricultural buildin'J, I hereby declare ~hat this buildinq
will be used for agriculturaL pu,rposes ;JS allo.....ed by zoning and/or the State Building Code, and
for no other purpose. I further certify t:h,l.t the statements and other .in,form:ition submitted on
thi~ Bpplication are true and accurate, and that I have lh~ follo.....ing legal interest in the
propert.y: o.....ner of record; contr,'lct purchasen l(~ssee;' hol[lL~r, of an exclu~ive option
to purchasc;-__duly auth(1ri~ea--:[o ,let (Ot' a person .....h~ohas the IOIlowinq ,leqal int(!rcst~
: Or that the UWTl€'r of record is knowlr!d'le<lble of this
not tlH~ o....ner, .1, furthC?Z.., to comply with all 'PPlk~tinq
A~Plicant'S. S"ln"ture_~~~~~ d ~_
.V"
appllCation, if 1 '-lffi
to this permit.
Dote 7-/,;(- 7 X
~n~ county.
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THIS I~ YOUR RECEIPT, P.ND DOES ~OT GIVE YOU PERMISSION TO BUILD.
FOR INFOR"1ATION ABOUT THE PROGRESS Of YOl)R APPLIC^TtrJ~l. CALL P)';RMIT COt~TROL. 667-4)':17 (6S7-HELP)
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Plea.!'e Pririt - Return Arplicatioo 1.-
Recf>ptionjsl \,'hf'n Cr-mrleu.d
Appolnrnltflt Dlllt'.
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Office Use Only
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APIPLICATIO N
APPLICANT-X-PCl~ J1r1 o. J \..,Vt:Wd,t,L
ADDRESS -l ) 1;7\~/~ .AA
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OWNER (IF DIFFERE~T)
PHONE
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ZIP
-X9"hL{
PHONE
City
2.
DESCRIBE STRUCTURES NOW.ON 111.E PROPERTY.
NOTE ANY STH\lCTURES TO BE DEHOLlSHED.
3(v\~Oh;:r~ F~R
APPLICATION) ARE l/)n2:.+nli '2LD. ~ - (2" ~)
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4.
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FUTURE PLANS:
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PLOT PLAN. Sketch (a) 311 ronds (b) boundAries of property (e) eXisting/proposed buildings (d) existingl
proposed sewage disposal areas (e) pxisting/proposed wells (f) existing/proposed driveways
(g) easements (h) drainageways, streams, creeks, any other pertinent .features. If commercial
_ or ind~"'.~_~~.~., 5ho,,; free~t.an~ing' sigr;s,_ p~~k:~e- ~':~_~~_'._.._E'mIC~'!_'.~!!.~IONS. ~_=.
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3. METHOD OF SEI.'AGE DISPOSAL Oh"t'Y)t=)Ori \
g. PROPOSED WATER SUPPLY WELL_. Sl'~;NG_ STREA" LAKE PUBLIc,~r-l- (;::;@ tP.;.((~1'lL
la. ELECTRICIT1' FUR:HSllED BY
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13. SCHOOL DISTRICT
]4. PLWlBING BY
******************************** DO NOT \,'RITE BELow TillS LINE *******~***'********************
BEfORE YOUR APPLIC\TIOi-l CAi-l BE PROCF.SSEll YOU MUST FURNISH:
8'p:ll PLOT 'PLANS LEGAL DESCRIPTION
(DlMENSIO::;W)
BY
D;\TE
LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
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l'lAP I ~ - ~'.t..:t. 3 T.L. 4300
TO:
PLAlm IiIG
PERMIT PROCESSING
OTHER
FROI1:
FLOOD PLAIIJ tWlAGEt1EIH
DEPARTMENT OF PUBLIC WORKS
PHONE - 687-4195
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SUBJECT :
BUILDING PER~lIT NUI-1BER 27..34-78
SUBDIVISION
OTHER
SITE IN FLOOD HAZARD AREA. YES
DETAILED STUDY
NOT A SUBSTANTIAL IMPROVEMENT
MINIMUM FLOOR ELEVATION REQUIRED
SITE IN DESIGNATED FLOOD HAZARD AREA
EXTRA PRECAUTIONS MAY BE APPROPRIATE,
RECOMMENDATIONS:
PARTITION NUMBER
NO )<
APPROX II1AT-E STUDY
DATE
/ /11
BY (jf3
) Site Feasibility Study for Septic Tank. Number of sites
~ M- ar..ltP.- \ Test~les :viii be ready
) Completed Subdivisi;::::' LK?E?KI ~,(?O(/-e-.
( ) Pending
APPLICANT'S NAME AND ADDRESS J~ Ad-e..iI /)AIV7t-6t/~ .
OWNER'S NAME AND ADDRESS, if diffe t from al) licant'c /X=-7_~ J1Z6'd'At.UH ~ 79
'NTRACTOR'S NAME AND ADDRES I' }ill" /'lL}- ( J..p .
.iil permit or results of site feasibility study to ( Applicant ( ) Owner ( ) Contractor.
) Prefer to pick up. Call (owner, etc.) when ready.
STRUCTUR"ESNOWONTHEPROPERTY ~~ .. . _':
PROPOSED USE (this permit) ~~cLl.L 5,0.";2,. (Z 61:0.) N..o'&I.LZ- )1o~~uJ~,..r'''r''''i.2. ~
WATER SUPPLY Ih\::..@vfjU ~OV'C.... C-oAAAJ... ." ~xisting or proposed well, etc. If public, name of system)
. ,()
SEWAGE D'SPOSAL~~d 'd-, D, 'S , (existing or proposed septic tank, etc.) s.(I;;--
PLUMBING BY_ ~~y Address
( ) PROPERTY IS WITHIN ONE MILE OF CITY ( '1"f6-
TRS, Ti
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,~i<~. /?- 0 3 -';;,,33'
<(3.. 00
Job Location
/~(
Written Directions
( ~ing Permit
Acreage or Lot Size t a Sg
Partitioning # .
INFORMATION SHEET
5C+J /-IA-4JD
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WA--V)
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Lot
iUo Jllocl< 4
Phonp 7<17-R'?sq.
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Phonp
Phonp
S;P/i'lIY9~1 e..lci
Contractors O. s. #
-If '*.. ** -If * **** 'If-lf ** -IHHf--/l-***** *** '* ** "'" '* ~HHt ** ** ***... OFFICE USE ON L Y BE LOW TH IS LIN E ** -If * **.."*...... *.* ** '* '* **"*.. '*"* ** '* '* ** *.,.....,
'* *.... 't * '* '*......
) Special Permit Area.
) New Address Necessary
ZON"
) Facility Permit Necessary
SETBACKS: Front Side 'Facing Street
(FROM CENTERLINE OF ROAD)
I nterior Side Yard Rear
. (FROM PROPERT'( LINES)
To: Planning/Building Inspector/Sanitarian/Surveyor.
This applicant appears to have a problem with.
Your assistance will be appreciated.
By.
ResponsP'
C55,12
By
DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
Permit Processing Section
125 East 8th Avenue
687-4394
Minimum Elevation:
Permit Processing Section
nivision
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TRS. TI
JOB LOCATION
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LANE COUNTY PERMIT
Acreage or Lot Sizo
Contractor's O.S. #
::n=-:J 1
Partitioning #
(. ) Completed
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APPLICANT'S NAME AND ADD RF<:<:
OWNER'S NAME AND ADDRES<:
CONTRACTOR'S NAME AND ADDRE<:<:
Mail permit to ( ) Applicant ( ) Owner
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Phone
Phono
.' (owner, etc.) when ready.
1(~ ,'.:';:';:;
) Contractor. (
) Prefer to pick up. Call
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$TRUCTURES NOW ON THE PROPERTY
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T~IS PERMIT IS FnR~:~" ~,._t:....
f> .:tt ~ ee.- ,)tt2 7-;' '7,f! <"TCll::.c
WATER SUlh y. ..
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r:'1'~C1:::):l.{'~ DAlc..y # BEDROOMS~# PLUMBING CONNECTIONS-..-
SEWAGE DISPOSAl P=YO;:;CG
S.1. #
i r:;-- 7 ~J.,
THIS PROPERTY IS WITHIN ONE MI LE OF THE' CITY OF.
. PLUMBING BY
I hereby certify that the above statements are tr\le and accurate, and that I haveth~. following 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 of this action. I hereby agree to comply with all applicable Codes relating to this permit.
Fee Paid $ ,;;).::-:~' Signature' lei ,;2.':"':; t.t!:\a 'JGc~~',::,jS(:; Dato 'i1:i.2/;'J
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) NEW ADDRESS ) FACILITY PERMIT TO TRANSPORTATION DEPT. (X) SPECIAL PMT. AREA. MIN. ELEVATION: .'/',
BUI.LD,ING .' ,.
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Minimum Septic Tank Capacity (Gallons) . / .\! , Ty'pe of Construction ~--,. Group
. Drainfield Required, Lineal Feet '. iv\ ~ <<-'T'i.:-'. Use Classification
Ma'm D th . - o:-!'_"'T,..j:'7.~1-'7. ..~..-~~.".J. ..-....,...~, r. ,"",'_d t". ,.-
xl""um ep rl,. 1'1 Ii. Comments:"'t}. 'J~'<'~:-, P' ~~ - ~L_.r..tt, 'I..:..L.:..... " ...." '.'.
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'Comments: it~~-,~ Q....l~~,~:).b.-.- (LL~:J"f.,...ti~~ '~'V::~(~}.~' ~'s.....:-1!:\;'!.;.;~";.i-"r_t'''';'-L::t . " -L":"'" . r:~..;..~, ~;:.~-
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PLANNING REQUIREMENTS SATISFIED. Bv: '.~::'~" ~':>}.;!.~.O
ZONE: SETBACKS: FRONT (l~' SIDE FACING STREET
Date: 7.28-175
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Date: 1I...1./1t Date Issued:
(FROM CIL) INT. SIDE YARD :.if REAR :3'
(FROM PILI
LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE., EUGENE, OREGON 97401
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PHONE: 687-4394
POST THIS PERMIT ON MAIN BUILDING AT SITE
BLDG. PERMIT - WHITE; BUILDING - GREEN; PLUMBING - CANARY; SANITATION - GOLDENROD; OFFICE'COPY - WHITE
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