HomeMy WebLinkAboutPermit Building 1975-4-20
~:",5/~ e-t<MJ'~ tA, ~E COU', '~':"B~ILDING PE~MIT OR MOBILE I-It"\ME
ri' 'F d! ?UllDING ~~L) MH 0 " ./
PRQPEkfY OWN...R MAILING -ADDRESS
. Donald R: Sidener 204,3 Inland Way SDrifIQffeld
~CONTRAGTOR '. MAI~ING ADDRESS
, '95::3-1S-.
USE PERMIT
PERMIT NO, 953-75
PHONE
746~0132
PHONE
SAME
PROPERTY LOCATION - INCLUDE POST OFFICE
PROPERTY LEGAL DESCRIPTION - METES, BOUNDS .
" ,_ ,,1A 4- tiel ' A '/ he,.. i-
TWP RANGE. SEc~rON
r-irove
TAX LOT NO.
,-,,-I- Jl9
r CODE
8At c.t ~
CENSUS TRACT
18
3
111
17-186
EXISTING STRUCTURES ON PROPERTY
'APPL.
NAME
i.
SAME
Mobil Home
LEGAL ACCESS TO PROPERTY
MAILING
ADDRESS
Inland Way
PROPERTY SIZE - FT.
WIDTH
DEPTH
AREA
FOR MOBilE HOME PERMITS ONLY
No. of Bedrooms
STRUCTURES TO BE BUILT THIS PERMIT
Connect to Existing Sewage System 0
TYPE CONSTRUCTION SQ. FT. 1; BDRMS
New System 0
VALUATION
Private aaraae
24)(24
5761a5,30
3052,1':0
<
OTHERD
?R no fEES
PLUMBING INSTALLED BY
OWNER 0 OTHER: NAME
WATER SUPPLY.
SEWAGE DISPOSAL
PUBLIC n
BUILDING
WASTE DISPOSAL
PLUMBING
PLAN REVIEW
PARK TRAILER
SEPTIC TANK 0
PUBLIC [J
o OTHER
\
TOTAL
$~
18
----3A ?~'
COUNTY BUilDING &
"~~
, ;T
~,,::"~
~
SANIT A nON SPECIFICA nONS"
MIN. SEPTIC TANK CAPACITY
WITH DIST. BOX; GAL
. DRAIN FiElD REQUIRED
lIN. FT
TRENCH WIDTH FT.
OR SQ. FT.
",'
TYPE OF STRUCTURE
OCCUPANCY
ZONE
PUBLIC UTIl, EASEMENT
5NJ
BLDG. SETBACKS'n FT. FROM CTR. OF ROAD RIGHT OF W.AY
USE ClASSIFICATION
FRONT
45
Is/
SIDE INT. PUE SIDE EXT. 40
AUTHORIZED SIGNATURE - DATE
REAR
l)
J. E. Boss BY ,C. HARBAUOlH
JOHN SHOOK /SAN 'TAR' AN,
DATE
41':m hr;
nt e1
BLDG. PERMIT - WHITE
OFFICE COPY - WHITE
COUNTY TAX - PINK
PLUMBING - CANARY '.:, "."'''~i'; ;"J.'.
BUILDING - GREEN -
SANlTATlON - GOLDENROD
IMPORTANT:
Call 687-4065 to schedule all required inspections, All, construc-
lion shall comply with' Uniform Building Code, O,E,Q. standards
for subsurface sewage disposal ~~d ,"c;9unty regulations covering
plumbing. All buildings require a certificate of occupancy before
being occupied.
(See Details on Reverse Side)
FORM:!::; (55-1}
(POSTTI:IIS PERMIT ON MAIN BLDG. AT SITE)
, LANE COUNTY, DEPT, OF ENVIRONMENTAL MANAGEMENT
COURTH.OUSE'iNNEX, 135 EAST 6th, EUGENE,. OREGON 97401
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BUILDING SITE EVALUATION
~~H
( ) l'BUILOiNG PERM-IT APPLICATION NO..9S-3-7_"-
( )S ITE INSPECTION,
,
1.
2.
3.
4.
5.
-' " Not
ADDl icable
Zoning Ordinance Compl lance: ZoneoPA-N1H( ) -
Sub,dlvislon Ordinance Compl lance -( )
Requ j red 'Access ( ) ,
Building Site (Area, Wi<;lth, Frontage) ,()
, ,
Other (see comments) ( )
, ,
PLANNING DIVISION
COMMENTS:
"
PLANNING DIVISION ACJION PENDING: VESt
BUILDING INSPECTION DIVISION
7. Plans Submitted
8. Soil Stablltty (footings)'
9. Flood Plain '
10. Other (see c~ents)
COMMENTS:
WATER POLUTION CONTROL
Not
ADDI ;c;>ble
,('j
(~
"
II. Meets Department'of Environmental
Quality Stand;>rds.
12. Other (see, comments)
COMMENTS:
"
T' /1;_R o'S S 1/
SUBDI, .ION:-
LOT:
APPL'I CANT
DATE
No 'Yes
T') TI 6.
(,) ~ R
( ) ( )
( ) ~/:)
( ) If')
No Xll
r) ()
( ) ( ) \..
TAX LOT
BLOCK:
CK'D BY: ~ y-c?-:r-7.s-'
Setbacks 'from cfl of road:
Front)" r
Side Exterior' '70
Setbacks: from inter I or I I nes:
Side cO //G'
Rear ~
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-' DATE
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TO.APPLICANT:
, Yo~r Building I Site Inspection:
_'1l: )><rCan be app roved; .. .. ' .
,\. ~ / ( ) Cannot, be approved at th IS ,t .me as I nd I cate,d on Item NO. ' above.
--(-;;,p' ' Quest ions and' furt,h,er i nformat lon' on .i terns I, through, 6, contact the LANE~
~\ COUNTY PLANNING DIVISION. Questions and further \nformation on items 7
through 12 contact the LANE COUNTY BUILDING AND SANITATION DIVISION.
( ) Will be'held In this office until you can resolve the problems indicated.
( ) Is being returned. '
( ) Your bu i 1 ding perm I t ap.ili.s!!.!_LQ.'lJe~ L5:_~eln,9-':E1t~.l:D,!l.d under seoarate cover
DEPARTMENT OF ENVIRONM~NiRL MRNA~~M~NI
135 Sixth Avenue East Eugen~ Oregon 97401
PHONE: 687~4065
LA~E COUNTY PLANNING DIVISION PHONE: 687-4186
) NO( ) APPLlCATlON#
,Not J '
ADD 1'; cab 1 e No ~
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T ,( ) (
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C55-28
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, 'APR 2;:' 1975
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LANE COI
BUILDING lQj
'V BUILDING PERMIT
MH D
MAIliNG ADDRESS t'
;;\-:';'11 ln~~nr. WH
MAILING ADDRESS
OR MOBILE ME
,
USE PERMIT
PERMIT NO,
'-,,~.-,,:I'1
PROPERTY OWNER
'in-:J"~ ?, ~i..~~2;'\r
CONTRACTOR
S'lr1l"1'Jf10'i,1
1
~
PHONE
7".,.::1-:-.,
PHONE
tj;:,r.:::
PROPERTY LOCATION - INCLUDE POST OFFICE
I
~ROPERTY LEGAL DESCRIPT~~ M:TES, BOUNDS
,;:/' f:tf---vvr ,~' a . L I
TWP RANGE SECTION
L/C/ ,J!. L
I ~("
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TAX LOT NO.
CODE
CENSUS TRACT
<-,
. I
"
.,
n
l1~lPb
EXISTING STRUCTURES ON PROPERTY
APPl.
NAME
'-:&','.'7
t >~.". ....
'~:'lb11 ~n
LEGAL ACCESS TO PROPERTY
i~ian;; ';':\\1
~~ ~\ . \ROP~~T\SIZ~ f~T.
....} 1\ ,
&
MAILING
\ .
ADDRESS
FOR MOBILE HOME PERMITS ONLY
No. of Bedrooms
STRUCTURES TO BE BUILT THIS PERMIT
WIDTH
DEPTH
AREA
Connect to Existing Sewage System D
TYPE CONSTRUCTION SQ. FT. +F BDRMS
New System D
VALUATION
, ,"ill: t"i Ilal"a~
2~.!i'-~'~
!;7f$". 30
I'W"'"n"., ..,
.~ -~;"~;,~.. .
"
,. '
SEWAGE DISPOSAL
PUBLIC 0
BUILDING
WASTE DISPOSAL
PLUMBING
PLAN REVIEW
PARK TRAILER
SEPTIC TANK 0
$
OTHERD
E3.no FEES
PLUMBING INSTALLED BY
OWNER 0 OTHER: NAME
WATER SUPPLY
PUBLIC 0
o OTHER
TOTAL
$
.J!8
~ft..~:J
COUNTY BUILDING & SANITATION SPECIFICATIONS
MIN. SEPTIC TANK CAPACITY, '"
WITH D1ST. BOX: GAL \, \
~\\
DRAIN FIELD REQUIRED
.
UN. FT
y;,
" '
,
TRENCH WIDTH FT.
OR SQ. FT.
,
...' '"
"
"
'-'
"
TYPE OF STRUCTURE
OCCUPANCY
ZONE
PUBLIC UTIl. EASEMENT
FRONT
5N
BLDG. SETBACKS __ FT.
~5
/sl J. t. 6oS8 BY r..
J
FROM CTR. OF ROAD RIGHT OF WAY
SIDE INT. itt..~;;; SIDE EXT.
AUTHORIZED SIGNATURE - DATE
USE CLASSIFICATION
ljo
REAR
';I
'M:!jAUlfI
.)om., FITVr.;/:""III'fAI!I!\N
DATE
~/~:~' {}:,
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 subs~rface_\ sewage disposal. and. county regulations covering
plumbing. ' All, buildings' require a c~rtificate of occupancy before
being occupied.
(See Details on Reverse Side)' ~ '
" ~.
\..:. .
FOR~l = C55-13
(POST THIS PERMIT ON MAIN BLDG. AT SITE)
LANE COUNTY, DEPT. OF ENVIRONMENTAL MANAGEMENT
COURTHOUSE ANNEX, 135 EAST 6th, EUGENE, OREGON 97401
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SITE INSPECTION
ApPROVED ~ DISAPPROVED ~ DATE
INSPECTOR
REMARKS
FOUNDATION INSP~TION '
ApPROVED ~ ~'SAPP~OVED ~/ DjjTjp, -2 ~/~ ,~YlCTOR
REMARKS 0;( ~ ,jIJIur/ 4/-it.i!Ak, (I; .f! l!J/;l
I IoU-<
,
~
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C'/r. ,"
FRAMING INSPECTION
:::::::D;d~'~#;)J~ ~;(Jt ~S':;:i~A"2&~
, 'j'tI7.M . f 7 .....""C! , L
.
LATH OR SHEETROCK INSPECTION
ApPROVED /
/ D'SAPPROVED ;----? DATE
INSPECTOR
REMARKS
/
FINAL I NSP;~~
ApPROVED ,DISAPPROVED
~ DATE
p" ,',
rU-lJ,""",{#
REMARK 5
",
CERTIFICATE OF OCCUPANCY
READY. TO ISSUE / / NOT READY TO ISSUE / I DATE
INSPECTOR
REMARK 5
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V4' "
.Y\II"4//~"__
?'&S--76-exl~cV' cRGJtjJ~'
,
NOTE: NO PERMIT
;'L, BE ISSUED UNTIL THIS APPLICl
Lttr3-/fS
PERMI'r "1- ,
IN HAS BEEN APPROVED
.
A~PLICATION FOR:
OWNER
'7),
MOBILE. HOME
CJ
PLAN REVIEW
c:::8
"ClIAi'GE OF OCCUPANCY c=J, ' '
"'s/-' rZ;i'pJ'V'1f .-
~ Phone",
70'-(' i 3 -:J---
CONSTRUCTION
~'
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Name
f. :S'.'d"";(I)"r-;2tl.~3
, . .' Address
LI"/"'".,1 ~,
_ ~. ~City: I
"
CONTRACTOR
1.
Name
Address
. .fCity.
Zip
Phone.
. 0.5, REG. II
.4;-'
'-,.
Block
Code
'., .:..r-d b:.(~j,
.;- Proper~~ Acreage.
Census Tract
17~ /'If,
Twp. /9> Range~' Section
SubdiviSi~n h/ ht',,~ tJ(("~ .j 1:._'
/N/t'I-;"J
/h" I. ,'I
II
Tax Lot
Lot
:.
4C;
" I
. WiW.~DePth~
ACCESS TO PROP.ERTY. (Road Nam~)
t,/J.t._ ...1
, i
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Existing Structures on Property:
Property Location -,Address/Directions:"
"
Below fo r Off ice
Us e -Onl vXXXXXXXXxx.XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXxxxxxxxxxxxX
Sq. Ft" > _ 'n /IBedrooms. Valuation-
~t.jy..:J<j,S1{"', (P/ .:c5.3o ?'ns::J.'xn
,
fA~(l1e,tj4/l()JI-f )
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SEWAGE OISPOSAL,
Site Inspection C
, E~dsting Sewage Disposal s;stem d"" or New~ System Requ"ired .CJ
Public C:J " .,
Other ~ Community ~~e" ~f _Co~unity or PUbl~C Sys-tem
WATER SUPPLY:
'Well Spring
Bldg.
Waste Disp.
Plum'l:!ing
Plan Review
)){oo
PLUMBING:
Installed by Owner
CA/~~
'/ V. ,. T
Name'
FEES,
if of Fixtures
Water
Connection
PLUMBING YEES:
Mobile !lame
1% Surcharge
'.
<
, PLANS
FACILITY PERMIT
...:7~
'c=:] CASH
~~,
ES c:=J N~ t7 g .t?ES cg--Nc)
, nat~re 'Of' A:gat'~' /if11;(:? ~dJ '_
ee Received B' W{-: Date' ';;J:::J<:;--J '\
,
TOTAL
,.;) R .;) fL>
Min. Septic Tank Capacity
,Drainfield
- Lineal 'Feet
"}iaximum Depth
Type of Construction
r
611
,~
Gro~p~1
Fire Zone
Use Cla~~ification
"
Bldg Setbacks - from Cente;r of Road Right o~ Way:
Front '-/ g Side Int. ~.p //.z;j. Side Exterior ~t?"~ ~
Rear
s
,Zone ,$:leA - /U;I/
C55-12
DATE:
Y~-G<r-::> r-
LANE COUNTY'
'~~~ If Iid'Jr:-#::,~ ~27-?j
DEPA~ENT OF ENVIRO~ENT4I MANAGEMEN; I" . "
PIA~
-