HomeMy WebLinkAboutPermit Building 1975-2-13
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LANE cof
BUILDING 0
'V BUILDING PERMIT OR MOBILE
MH ~
M'AILlNG ADDRESS__
506 "/EST~ CENTENN'IoALi #l'/i,
-. MAllI~G.ADDRESS
. "1'
"
"ME USE' PERMIT
PERMIT NO,
t>Qi 49~ 75,
PROPERTY OWNER
'~DOIl~"Ill' &, BARBARA'S t DENER
SPRHlGFI ELO OREGON'
PHONE
740-0132
CONTRACTOR
SAME
PHONE
PROPERTY lOCATION -INCLUDE POST OFFICE
2043, INLAND WAY SOUTH' ON '2!ND STREET, 'TO HARBOR eRtvE
, PROPERTY lEGAL DESCRIPTION":"" METES, .BOUNDS
r tLBERT ,GROVE '5TH tOO'1 T lilIN', 'toT:'49 BLOCK 2
AROUND Loop TO, I NLANO, WAY,:
TWP
18
RANGE
"
3
SECTION
11 ,?Z-
T AX LOT NO.
tt:- 400,
CODE
, 19..,0&1,~"
CENSUS TRACT
-35-400
. APPl.
NAME
DONALD & BAR~ARA SIDENER
EXISTING STRU.CTURES ON PROPERTY
NONE
LEGAL' ACCESS TO PROPERTY
, ,:INLAND '\1AY
&
506 WEST CENTENNIAL gl4 '
MAILING
. PROPERTY SI~E,-FT.
ADDRESS SPR t NGF I ELO,' OREGON
FOR MOBILE HOME PERMITS ONLY
No. - of Bedrooms
~TRUCTURES TO BE BUILT THIS PERMIT
PERM I T TO: PARK MOB t'LE HOME
WIDTH
DEPTH_ .
A.REA
Connect'to Existing
TYP~ CONSTRUCTION
Sewage System 0
SQ. FT. :.= BDRMS
New System 0
VALUATION
3
"
PERMIT To'l'NSTALL SEWAGE DISPOSAL,SYSTEM:',
",
SEWAGE DISPOSAL
, 0 '
PU'BLlC 0 R I,OR SEPTIC TANK:. 0
. BUILDING $-
. WASTE DISPOSAL
PLUMBING.
PLAN REVIEW
. PARK TRAILER
OTHERD
NEW' REllUl,RED ,
FEES
PLUMBING INSTALLED BY
OWNER 0 OTHER: NAME
WATER-SUPPLY
'U.W
, '
'1.W
PUBLIC D.
o OTHER
r:t'LBERT GROVE WATER
"
TOTAL
jU.UU
.u4
. ()q,u4
~
MIN. SEPTIC TANK CAPACITY
COUNTY BUILDING & SANITATlON',SPECIFICATIONS
DRAIN fiELD REQUIRED
WITH DIST, BOX, GAl. . 900 ,
" '. '
DRA'I'NF' I EL 0 TO BE' NO CLOSER ,THAN,
lIN. fT
150
. TRENCH WIDTH fT.
OR SQ. fT.
TEN FEET; TO PROPERTY LINES NOR THE F'UTURE 0
BUILOINGS'ANO ,MOBILE HOME'
.'
1":"
TYPE OF STRUCTURE.
I
.' OCCUPANCY
ZONE
PUBLIC UTIl. EASEMENT
.il
BLDG. SETBACKS'__ FT.
'45"'-
FRONT "
FROM CTR. Of ROAD RI.GHT OF W~Y' ,
7'P , 45"
SlOE INT.. UE SIDE EXT. '
AUTHORIZED SIGNATURE - DATE
/S/ J; [" Boss BY:'C. HARBAUGH
REAR
'5'
. USE CLASSIFICATION
JVHN;CRUtllUIlIIPlK/SANtTARIAN
DATE
2/.13/75
DL"I
BLDG. PERMIT - WHITE
OFFICE COPY - WHITE
,COUNTY" TAX - PINK
PLUMBING,- CANARY
BUILDING - GREEN
SANITATION - GOLDENROD
IMPORTANT:
Call 687,4065 to schedule all required inspections, All construc-
tion shall comply with Uniform Building Code, D,E,Q. standards I
for subsurface sewage disposal and county regulations covering
plumbing. 'All buildings require a certificate of occupancy before
being occupied.
(Se~ Details on Reverse Sjde)
rORM == C55-13
(POST THIS PERMIT ON ,MAIN BLDG. A~ SITE)
LANE COUNTY, DEPT, Of ENVIRONMENTAL MANAGEMENT
COURT~OUSE ANNEX, 135 EAST 6th, EUGEN.E, O~EGON 97.401
f',
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~-
~,'-"",,\,,,l.!" LANE COL. ,Y
,r -" .--.dvr.,.. BUILDING D
(I I. , '-
~' -~PROP'EP.TY OWNER
C~001'tALD &lb,1I8l1ttA "SIotNtlt
~.tt~CONTRA~CTOR
"" ,!lAMe;
~~-l
~i"-PROPERTY lOCATI()N - INCLUDE POST OFFICE
1;." 'tolI3 IHLAHll WAV SCUll' ON 2ND 5T"ECY 1'0 HA"OOll ,f)illvt
d ,~ PROPERTY lEGAL, DESCRIPTION - METES, BOUNDS t.
t! !rlLalaV CIIGve 5T" ADDITION LeT ~9 ~oc~ 2
,,:f -, TWP RANGE SECTION ~ 7' TAjj:l-OT'NO.
"I! tt! 3 tl ,c,t.- Il<lO
:1 APPl.
n
I
MAILING
I ADDRESS SPit I NQr IlL.. O/{lteoH
11
, FOR MOBILE HOME PERMITS ONLY
I -1 No. ' of.' BecJ.rooms
.. j ',_ ST~UCTl!R~ST~\BE B~_ILTTHIS PERMIT
1 .,fI'lRIll It TO 'I'AIIII Iolne. u i.,
I .
II",ItM,'!' 'TO ,IHllTM.L SriWAcm 0ISPO$AL SY5Tt.MI
f':
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:t;:t:Sr':'A~~/~~~q~~;., '_, ,-,' ,- , _ . ,,~:, t
."LPUBlIC;I"I)~~;,9.~SEPf'c ,TANK..:.oE7, . ,,'OTHEOO
{ I '''X;~~i~'" "',,,'",,"',
BUILDING...-;o.,al If.''- , "'I' ",~t"r' ,$----=::'- ~ '-
'tA;T'[)i~~;S~L,:,;.,f;t~ '~::'~1' " ,c. ,~~~
,I '.", -I ~~1l,;::.?~, a l(ft I, ".~ "\-~.<fU\1
~, 'P.WMBING~~~" ..~~ J" .; ~ ,',"
~~, ~... ,'" 1 J 4.;4'1 . -
..t 'rL,A~N'~t,iJ~~i~:'r:"t )_ ~ ~
t"PARKiRAllER'~;-';;I~~ ::;: ,,' ,,' >V_'!1t
I il " ',3,,1:' r,:; . ."', .;{."7
.. . f !. ~,'.\'r~..
*, TOTAb, .< .~;1.'\:t.~.:. . ~~'>$
11 ., ',;,~ '~,I"-:~~ ,i"
l iMIN SEP~TANK~CAP.ACIT.Y!~~ ,~rf:~fC. - ,
'l',~ :. ~~,t It, ;>r:'l...~~ . ..1 "~iKlQ(
.::+~.WITH'_'[)ISr:.nBQ~~(Gf..t~... ' . . .;{.
fl.~;;~~l;~s~~l~t'"o:~d,~~ tllAH TEN
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BUILDING PERMIT OR MOBILE . 0ME
MH i19C
MAILING ADDRESS
'0' WEST CeNTENNIAL '14
USE PERMIT
PERMIT NO,
/
,
Mot
49- 'f5
PHONE
1"&"0132
S~"'NGFltLC
ORE.."
MAIL.I~G ADDRESS
PHONE
............
, ~
it" -~
..
ARGUND looP, TO '''U.NI) WAY:'
CODE
I~.I
CENSUS TRACT
35-400
t!
"
., I,
DONALD l BAII''''''A StetllEII
EXISTING STRUCTURES ON PROPERTY.
NolCl
NAME
&
506 WElT CEHT1NHIAL #14
LEGAL ACCESS TO PROPERTY ,
IIIlLAIiD WAY
WIDTH
DEPTH
. 'AREA-
',Ii:
.~
I J:;,
PROPERTY SIZE - FT,
3
,New System
:_,LVAL)JA~ION
,,-,1- .
.,~~..
'"i,~
...."
Connect to Existing
TYPE CONSTRUCTION
S~~age:Syste.rn '0 ,I'
?Q: fT :;:::SDRMS
...~ '
.c.,....
,~~.'..,- :
",,'.i-'\
'..~
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t11j1'lf~!t!~~.
FEES~ -';~:~' 1~>
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.. P~~M~I~c;~j[NSTA_~LED~~,~_r_,_;
,," ...... . """:"..r,,"."
.' O.WN ER :D;.~,~()JHER;.', NAME
WATER S~PPlY>:~-'-:,".,;;if~'\
PU BllC' 0 l::":[~~~:C;T~~-~
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COUNTY
BUIHlING,!8i\i-S;t..NIT AllaN SB,ECIFICATlONS
DRAIN,FI~~<~RE~W~~~' '_-:'! . '_;.'
UN. FT:-~ ~:~J6'>~,>, TRENCH,WIlJTH FT:
<~~
. :0':sJi',1" ",' f;~,:.&~~; ,,<ii'
rtHu.~ i,.' ' ~~1~~;1'flj'<
,:J,..} ''':-di-'c..,,~k-_:U't.; i.
\:,~,',i "';~ ;'i"t""f:iilt.,\'f~
rl..\ :r:"~" '_',-. -1",~,,-<"iD~:~':_.:."', '. ,",
~'--.' _~t-" ,- 1. !'-,f;~,'-'~'.~.'.r\-"..--:":' ..-:
'. ,,',' " ,.J"; ::"':~'1i '!"'),'-'-:t.N\~_,j~:_.-
;-,~";,,.- --~". _..,j~~,~~:...-~. .
of--.' 'I'UBLI<;:;UTIL: EASEMENT - ';" ,;-~c~.~~~' ~~ - t;~
_.d .>t :;1i~~~:-, ~~~~'j"f }~
w"" " ,;;..;.it~
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~~l~m.;:"~::~~ :,ii
, '~~~~~:~~~t~~~'~~t~dUJ~if~~~~;,~I~~i~~if~~I':;d;J~(i;{i>
IMP()IHANT: ~~~~b~~~rfAI7~0~di~;s d::~~~~~':~n~t~*i~~~~5~~~b~~G'9g~t~~~:~~~~t .1,
<,~ -~~~:';~'t~ ,(.it. being occupied, ,.' ' '~lt'j;'C~'; ,
.~.- . ~'"~t~-'~~,;fo. .:::~ \.. \\ {',.,'(See Details\6'n' Reverse?SiCle),\' \\:V~,"~:-~L . ";' 1-
\.:-.:. .,..__ ,~.." -.....~. "\~J''\'';.!',\:~ -;:l--.." .... \' ,'.." <:'~ ',~:'::
""-(POSl',tI:!IS, ,P,ERf:i!1T ;(Q~ M41~,BL, D,G.AT SITE) '\' \ 'l~j
LANE COUNTY, DEPVO')ENVIOONMENTAL MANAGEMENT , '; ,:~
. COURTHOU~ A;NNEX,;'13S~ EAST '6th, EUGENE, OREGON 9.1401 t... _. . ::j,\t~,JJ
",",\." .,~' 1:Z!',_L!~U:~""~,.~;.I&,",~^ l';~ ~ ~~.",. _!.. ~. ~ ~ .~_._,,~!~;hf..:i:':f':...1.;.'.;'....I;'.:'., . ;'h_'"~;,;.lA;."t
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.
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FT: ,FROM, CTR.,OF ROAD ,RIGHT OF WAY.'
<.' 7' PIK: 45'
SIDE [NT. . . SIDE EXT.
AUTHORIZED SIGNATURE - DATE
',f!.'BO.~ .v C. HA,II*.UGH
O,CCU,.p~~~~!.'ff'I: ~.
'-dY~:',f"J_"
."~j."l. ."
";'!Jj,.I,Q.><"
J~.~~lik"R
ZONE .\
,
'lBLDG. SETBA(KS~
I ',: if~'"
i FRONT I-~
"
usE" C;~~SS~FICATION
~~-(:
J~l1l1: Gnu ICllllllt,.(!UM IU" rAU
.'i-:.'," .
fBLDG, ,PERMr.t~~.y.:B,ITE
OFFICE COPY ~'::Wf:lFE:
\oCOUt:-ITY' ,:rAX ~ilf'.(K:.'~
'{, 'I~PllJM;B)N'G''-'::~4'~~ARi Y ;';:.'
,BUIL,I?}_~9('"79,R~IN:Z_._ --:'_
.( f?ANII~TJ.S.~*:-:}t2-~DENROD
;;~;:.tt'~.: ,.:~<.-~,,~.,~,'J>ti. -, -', ~ "\F~,J~
1:!
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1,j~~f:1;:~'oJS'5.:~~::kh;~f;Lj~.c~:_:i~:;~~.i: -;.:d.:J>j".L<:.,:
.' .
.,
SITE INSPECTION
ApPROVED .C1
DISAPPROVED .C1 DATE
INSPECTOR
REMARKS '
FOUNDATION INSPECTION
ApPROVED /
I. 0,15 APPROVED /
/ DATE
INSPECTOR
REMARKS
FRAMING INSPECTION
ApPROVED / / DISAPPROVED 17 DATE
INSPECTOR
REMARKS
LATH OR SHEETROCK INSPECTION
ApPROVED;----? DISAPPROVED ~ DATE
INSPECTOR.
REMARKS
FINAL INSPECTION
ApPROVED .C1
REM~RKS Jm,(-!.
DI SAPPROVEO rn7 DATE /-)
""j A ~u ('/
'./ , s~ r - ,t..",,1 ~
/.:01 I {;~/f. /!~{-il, _. r-j~' j...}:r /0' ,:;-,
INSPECTOR
CERTIFICATE OF OCCUPANCY
READY TO ISSUE 17 NOT READY TO IssUE / F DATE
INSPECTOR
REMARKS
/1 -"
ffA 4Cf~7.5-d~ ~D 'IJ
;( 'tf p 'lJ~,
"J /7 Ii" /?,Il /l
I( ._",/ /., , 1/ -I'/( / n/ ~ /
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Wi> COUNTY ENVIRONMEl>..AL MANAGEMENT
Name and Address of Owner )Ohll\J Ie ~<trbt:l.Y'a.
5'Ol, kJ, C,o_Y\-tPY\"'\Ll\ 7,1,,1.11.: :\:FlU-
PLOT PLAN
S,'JeY\€ X-'
Telephone: 1'+ to -- b I 3 "2-
The building being , constructed under this permit will be used for Mo\.;,\ \+nMe,.
Date this property was purchased ...JCl\'\\<_tcVV 1 'I, s"'
,
Do you now, or did you ever ,own property adjacent to, this' tax lot? If so, please
list those tax lot numbers or draw those properties' on the plot plan below.
Indicate on your drawing the location of all homes (including mobile homes) now on
the property, as well as the location of the new buildin\.
__'~=f====~~=':'-=~'~='~'=:='= -='':''='='-='-='~ -- ," - :='= = -= = : _
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_ ___, ,,' ~ I.~~ \J r-..---- -(..-..'1""" I
, ~ ~, _ L ..:J 0:. . '-1 '[~ ' - S 6 - '_ "Ii"
" '. _ " / "~' " . , _ m . _ , '
}\'- ' . .-' ~ ~ "'d- - - ,- - '{-....
Fr'~1 -,,='.s~ ~-::::>,-~~==~~ ~~'~'j' ,;, _-'.______"-u
,', '-' ',':^','~:fi~11-.3~:'C' '.'
- -, ., - ~-- ': J . ~ ,~~~~d:~;;!~~1- =,~~~.~;~ ~~ ,~:~I~" ' ,j' n
==----=--=-=-=-==;~~::::F~::::::=--~:~~--~::=:=-----
p 1:1U,'(J/'.'hi:t.
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-_---~~______~L~_~____--
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-~~~~~~~~----~-~-----
--
.- - r-- -. -.
Name of Applicant (if,di 'ferent from owner):
Address
Telephone
Applicant's Interest: Buyer
M74-99
D
Seller 0
Agent
o
Map
Tax Lot
Permit II
,-,:6
, Wf/C
2:"'$'-;S- '
( )
".JC ./: crl '
/#' IT_'-';:-R 'O~
SUBDl, .:.ION:
(~BUILDiNG PERMIT APPLICATION NO. M+\ 4-'1-"1< LOT:
I
, fl,o-l-o
, , 1~
~ V S Not
r ' Applicabl~
I. Zoni,ng Ordinarice Compl i'ance: Zone RA-M~ ( )
2. SUbdilii'si,on Ordinance Compl iance ( )
- ' , \
.3. Requ i red Access . , " ( )
4. Bu11dfng Site (Area, 'Width. Frontage) ()
5. ,Other (see c9flll1lents) '( )
BU'llD:fNG SITE EVALUAT ION
"
S 11-'2.. '2I'AX LOT 400
BLOCK:
SITE I,NSPECTlON,
APPL I CANT
DATE
:S;Jp ~IA"
?-&;-7r:::
PLANNING DIVISION
,No Yes
T)N 6.
(') (~
( ) (J,..---,
() (~
( ), ( )
CK'D' 'BYr-J\~ 2.1!:41~
Setbacks from cll 'of road:
Front ~I
Side Exterior ~;
Setbacks from interior lines:
'Side '7' PoE"
Rear ' ts'
-'
COMMENT'S:
r,
, )r
/,
, ,
PLANNING' DIVISION ACTION PENDING: YESl, ) 'NOl ) ,APPLI CAT 10N#
/'
BUILDING INSPECTION DIVISI,ON
,
\
Not
Appl icable, No ~/i J'
() , () 1I..j1:X}1
V)' ,() ( )
() () ( )
) ()', ( ) CK', 0
,. J
,
'].. ,Plans Submitted '
8. Soil Stability (footings)
9.' Flo'od PIa (n,
10. Other (see'commerits)
,
Byd/14''fL~" 'l.-'l(
- DATE
COMMENTS:
, , ,
WATER PDLUTION'CONTROL
,
I
Not
Applicable No Yes
() ,T)~'
(,) () ( )
, CK'D B{]/~,~afJ.A~B.1:J7J1>-'
, t?~'':'''~
-" '.'
11. I Meets Depart~ent of' Enyi ronmental'
, ,Qual ity Standards.' , ) , ,
, ,
12. Other (see comments)
" '
COMMENTS:
"
, ,
. TO APPL leANT:' "',
",',' 'ffur Building, I Site, Inspection:
, - ~ -'. Can be'approved.\ , _
, , S-{) '-( Cannot, be ' approlied at tnis' time as indicated on item 'NO. above.
J/\. ,Questions and further information o,n it!!ms 1 t,hn?ugh 6 cO,ntact the LANE-
,,' COUNTY PLANNING DIVISION. Questions and further information on items 7
through 12 contact ,the LANE COUNTY BU I LD I NG AND SAN ITATlON OW I S ION. '
( ) Will be held in ,this office until you can resolve the problems indicated.
(.> Is' being reti.'-rioed. " , . ,-,
( ) Your buildinq permit application fee is beinSl returned, under seoar"te C:2Y6:-
'vEPARTMENT OF ENVIRONMENTAL MANAGEMENT
~35 Sixth'Averiue East Eugene Oreg~n 97401,
,; , 'PHONE: 687-4065 I
LANE COUNTY PLANNING DIVISION PHONE: 687-4186'
,=...1'
-;f,
. .~
C55-28
'~')' ':o.'.~' -..:...;~..,~c"','~\'..,,:,,/r:""':'~-,:~' C.\:"""~ t-, "
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_.~ ...,-.~_,~......~..,......-..-......,.,..,-c._,..,..-
.
LANE COL
BUILDING n
Y BUILDING PERMIT OR MOBILE
MH II\:I(
MAILING ADDRESS
506 WeST CEnY~~IA~ 014
MAILING ADDRESS
ME USE PERMIT
PERMIT NO, ~.H
PROPERTY OWNER
DONALD & 8ARaA~A SIDENER
S~QlnGrIELD OREGOn
49-75
PHONE
746-0132
CONTRACTOR
SA~l[
PHONE
~~";" r ..-,
,... '~ ~t 1-:., :
PROPERTY LOCATION - INCLUDE POST OFFICE
2643 INLAND WAY SOUTH on 2ND STREET TO HARDOR DRIVE
PROPERTY LEGAL DESCRIPTION - METES, BOUNDS
rl~eER! GROVE 5TH ADDITION LOT 49 BLottt 2
AROUND Loop TO INLAND WAY:
TWP
18
RANGE
SECTION
3
11
TAX LOT NO.
400
CODE
19-(1"
CENSUS TRACT
35- !roo
APPl.
NAME
&
OONA~O ~eARBARA SIDENER
EXISTING STRUCTURES ON PROPERTY
NONE
LEGAL ACCESS TO PROPERTY
IlINLAND WAY
506 WEST CENTENNIAL 014
MAILING
PROPERTY SIZE - FT.
ADDRESS SPR INSF I ELe, OREGON
FOR MOBILE HOME PERMITS ONLY
No. of Bedrooms
STRUCTURES TO BE BUILT THIS PERMIT
WIDTH
DEPTH
AREA
Connect to Existing Sewage System 0
TYPE CONSTRUCTION SQ. FT. # BDRMS
,New System 0
VALUATION'
PERM IT TO PARK "'.celLE Hom.
'I
PERUIT TO INSTALL S~AGE DI~POSAL SVBTEMI
SEW AGE DISPOSAL
PUBLIC OQR lOR SEPTIC TANK 0
BUILDING $
WASTE DISPOSAL
PLUMBING
PLAN REVIEW
PARK TRAILER
OTHERD
,tlEW REQIlIliIEO
FEES
PLUMBING INSTALLED BY
OWNER 0 OTHER: NAME
WATER SUPPLY
'!l'W
't.W
PUBLIC 0
o OTHER F'ILDERT GROV!l: tlAVEO
TOTAL
jU.~
.~
o<l.1J'I
$
MIN. SEPTIC TANK CAPACITY
WITH DIST. BOX: GAL 900
COUNTY BUILDING & SANITATION SPECIFICATIONS
DRAIN FIELD REQUIRED
L1N, FT 150 TRENCH WIDTH FT.
OR SQ. FT.
D~AIWFIELO TO Be UO CL05ER THAN TEN VEET TO PROPERTY LINtS, UOR TME FUTURE: G
Bu ILDIlIG5 ANP lI10GILE HOelli:
TYPE OF STRUCTURE
OCCUPANCY
ZONE
PUBLIC UTlL. EASEMENT
FRONT
BLDG. SETBACKS n FT.
45'
FROM CTR. OF ROAD RIGHT OF WAY
SIDE INT. 7'P\Jt SIDE EXT. 45'
AUTHORIZED SIGNATURE - DATE
USE CLASSIFICATION
REAR
5'
/5/ J. E. 6Os9 OY C. HARBAUGH
Jo:m CRUtC:IISQQN~/eAlltTAflIArI
DATE
2/1113/7:;
OI.t1
BLDG. PERMIT - WHITE
OFFICE COPY - WHITE.
COUNTY TAX - PINK
PLUMBING - CANARY
BUILDING - GREEN
SANITATION - GOLDENROD
Call 687-4065 to schedule all required inspections, All construc-
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.
(See Details on Reverse Side)
FORM::: C55-13
(POST THIS PERMIT ON MAIN BLDG. AT SITE)
LANE COUNTY, DEPT. OF ENVIRONMENTAL 'MANAGEMENT
COURTHOUSE ANNEX, 135 EAST 6th, EUGENE, OREGON 97401
\
SLAB FLOOR'
PLUMB,I NG GROUNOtIORK
ApPROVED ;---? DISAPPROVED / / DATE
REMARKS
GAS PIPING GROUNDWORK
ApPROVED / - / DISAPPROVED 'j / DATE
REMARKS
ROUGH PLUMB I NG
Ap~ROVED / I DISAPPROVED / / DATE
REMARKS
ROUGH GAS PIPING
ApPROVED C1 DISAPPROVED .Cl DATE
REMARK 5
FINAL PLUMBING
l ;'
ApPROVED
i.Jf-/
C1 O-AT{/:j.t/-7~
DIS~PPROVED
REMARKS
FINAL GAS PIPING
ApPROVED C1 DISAPPROVED / / DATE
REMARKS
'CERTIFICATE OF OCCUPANCY
READY TO ISSUE / /, NOT READY TO ISSUE ;---? DAr'E
REMARKS
INSPECTOR
INSPECTOR
INSPECTOR
1 NSPECTOR
,I~SPEC~~
(/
INSPECTOR
INSPECTOR
.'
.
'.
"
.'
. ,PRopr~D SEWAGE'DISPOSAL SYSTEM'RECORD
C~p'l ete top part, of '.,m to' s'ignature and 'submi t both'
. ,
". . '.
....: .
INSTALLER:
, .
INSTALLER'S NAME
, PROPERTY ADDRESS
cvl'ies with appl icatiun..' ,
PERM IT. NO. MH 49-7~
JC
, Tf, D SO P7 &l..f5,AJJ INLAND WAY
No. Living Units Bedrooms Baths "'Basement Water Supply
Yes No' Public 1/ Other-List
Septic Tank:
Ft. from well
Inside
LenQth
OWNER
NAME
Dimensions: '
Width
Steel, 0
Ft.
Diameter
Concre?e~ No.~COmpa~tments Gal. Capacity
Tile Disposal Field: /'
Depth, Distribution, Box: Yes V' No
Other Distrib~tion-Type
Feet from
WEll
Lot Li ne
Front
1Ft. Between
Lines /0
/60Q
,
DONALD SIDENER
MAILING '106 WEST CENTE~NrAL #14
ADDRESS
SPR1NGFIE~D OREGON':,'?7'177
Length of Lines-Ft., lTrench I Total Sq.
'.652~t)3.bD4. 5. 6.,Width1 Ft...-100
:'lot Plan (see instructionsl:
//8',/
, ./
Foundation
/
Side " Rear
IFi lle.:t.;" IFiller Depth' IF.iller Below
Tvpef 1- Above Ti Ie:). inJT'i Ie t. in.
-Cl;,
\...--
\",1'
,,...
~ "
~ "-., '
- s:(. ~
~--l
,55'
-of
;.J/
35'
. ;iJooe ~
,(
r...
If I'
'/0' ,
f- ,I
,
f:P /Zo/JpRf'(),/./HIJ
~~'/'"
<( ~ '
s~."
'l\'
Q, \
<::<.
"t~. "
~~
~J.-
'-
/,/'\0 8/'- Ji /-t- 0 M 13-
It P, F3A
'C>(l
ffr ~~C EO VE Cb
p AUp~!l.r.y /
Lff'/P-
, MAR 1 01975 ,~
Ii I tAf'fE COUNTY
'IlIV/RO{VMErnAL '
., MGMT.
, w~i~vp.i?J :IjbX
JI..JkANt) w/>Y . ,ab ,':, .
Date ,/}, -/0 ---'5 " Signature, f'({I~A;A.P ./"'......n~
, ' ,CERTIFICATE OF SATISFACTORY COMPLETION ' . I '
For Sanitarian ~se Only:' '. " .. '.. ~at7: 3/((.//5
I n accordance WI th 1973 Oregon Laws Chapter 835. Sect l.on 214 th. s cert I f I cate rS Issued,
as evidence of sat i sfac;tory comp 1 et i on of a subsurface, sewagr d i sposa I'sy.stem at the abl?~e '
location. '
.):i(:p. A~'proved:, ,System Installation conforms ,to current standards
-d 0 I sapproved:. Does not conform to current standards '
Remarks: '
...
'-
1'-IDRTH
" .
,. STATE OF OREGON'DEPARTMENT OF
\. TzQ,Jl
~~ . .
i tar i an' s ,S i g~a.tu, re
A ECOUNTY".' .,
ENVIRONMENTAL QUALITY'
C55-11
Uy:?' *"
~ PERMIT if
LL BE ISSUED UNTIL THIS APPLIc. IN HA EN APPROVED
APPLICArrON FOR: .
CONSTRUCTION ,c::J MOBILE '~OME, 00' PLAN REVIEW c::J CHANGE ~F OCCUPiI!'CY "c=J
~WNER ']l6htl'd 8/ BA.r-~i-~' SiAener ,C;t'Jh 1A1. U?V1+-blY\\cJ 4hif. spfJ. Or q71/77 lItb -bi3'J_
, . Name ,Address. _ City. Zip Phone
-" ~~
. Phone
w;/t
r i c-\::
;it 11- ,'t" r- ;o~
.,
NOTE:
NO PERMIT
~ CONTRACTOR
Name
Address
~ity.
Zip
0'.5. REG. II _
Twp" I sr S.Range .'3 Section II ' Tax Lot i.J n ()
Subdivision 1=';,[ ho..l:..t' Gr,,"/f>, .s+.h.~ Lot -::U:- Ll-q
ACCES'S TO PROPERTY (Road Name) _1'....1.... nt:l
Exis~ing. Structures on Property: I\~~ ~~ ~~
'2.(','-1-3 T",\;.,,,,,J 'vt)aj -:
-k, \-\-~"'v "})v.:tvP. - nrh;"V'\~ \fO"p +,.., -r-,^ \ ~
Code
/,?-o I
Census Tract...,3'yt.{O 0
~idthll10ePth~
Blo~k ' 2..
Propert? Acniag.e
\J/A J
Property Location - Address/Directions:
$. n "..+-1.-
\.,~
1>\'\
2,,41 ,sf.
Below .fo r Of f ice -LIse On! vXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXYVVVVyv'OO(XXVVVVy,rvv.xxxXXXXXXXXXXXXXXX
~. /.-?J C) .-/_ 'n . Sq. Ft. i/Bedrooms Valuation-
,L'fr'\ofr:..tL ,A-r ~3,
. . . . . ~-'
.A7d1A""
.-
.-
~~
, , r->~ ..
SEWAGE DISPOSAL: D1..J.rV, '
Site Inspection ~V . -,
WATER' SUPPLY:
Well
Public
C=:J
r ..><I
,
/'
/
~ or New System Required t:><r
L.:......J , ....
, /' FILhBIe.:f'
Name of C7 or Public System.6.f( n 'V ~
CJNae
Existing Sewage Disposal System
Spring
Other
Community
"
FEES:
PLUMBING:
Installed by Owner
c:J
Other
Bldg.
Waste'Disp.
Plumbing
Plan Review
,s7J. 0 0
ij.,;O
PLUMBING FE~S:
II of Fixtures
g).
Water
Connection
~.
1% Surcharge
_7tJ .00
, tJt{
FACILITY PERMIT
Mobile Home
"
<7 l/.tJ'L :;~ . Signature of A~Plicaln;;' ,~YES CJ NO
..., , , 'I Fe~Received BY:-lf)RA-..-.- 'Date:~-.s--70
Min. Sept~c;. Tank, capacity, '100 Drrin}iield R uired - Lineal Feet Jb-eJ Maximum Depth
JJf'q,k(lpJ.-j in ,be ., ,dn~r;.- -0;.._ ' _ +",.P/': to ,~JA,C/1' 'Wr -co -I77(.u..o
.b(.itJJ/~/J;:."". an /?1/JI..f~ h.>nh'> ,
TOTAL
~
TYpe of Construction
Group
Fire Zone
Use Classification
Bldg Setbacks - from Center of Road Right of Way:
Front 4-s' Side Int, 7' I't( C. Sid~ Exterior 4~'
Rear
s'
Zone l2.A--Mti\-
~: ?--{~h<
" ,~'
,C55-12
~ANJ?!:~ ~ j.TFf , '
tYl!. . ,7 7R!>-
/.: ~'I'
LANE CO Y DEPARTMENT OF ENVIRONMENTAL
MANAGEMENT
DATE:
BUILDING:
DATE: