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Home My WebLink AboutPermit Building 1976-3-9 P' ", , .,' e LANE COUNTY PERM IT Fee PERMIT NO. 'j) " ~. 0[" , ... ....' I ! ,,___\ . ,\ . ..' ,. . I. 'CONSTRUCTION [X~J MOBI LE HOME [] PLAN REVIEW [] CHANGE OF OCCUPANCY [ ] o Contractor ~aul r.1oser NAME lH)il 'Ii p 01 son NAME 202 1132 Cottonwood Street ADDRESS CITY Route 1 Sm\ ;57 ADDRESS CITY "'I'\r~~r.f:i':l'" ,1 '")r~t1(y! ~L'""' ~ d~j I \.; U I<.! \.v ~t~'J'..H ZIP CODE r. .: .c . ~ :'\ ~pri~~L1C. ~JrC10n ZIP CODE '1" r I 'i.>i; ~,., ',"."il. .. jt', I ::; DOwner PHONE ,.,,~ .-:: "... ("'... .. J' :~'i.; -\) ..;: . ~". PHONE 0.5. Reg. # " Twr ': " Range ~)1 Su~a?Ji~io~ark 1 st add Section.:(1~3?JTax Lot iF ?, Ot}COdP Census Tract Lot ? ~ Block (" Acreage Width Access to Property (Road Name): r~t~~n~~~~ S~r~~~ Depth Existing Structures on Property: ~~OH~H ...-.....-- Directions to Property - Address: ., "i ':I:) . ..._'i,;i f',.."+~.,,,.,...!,A S+_"'1)"+ ~:,...,l.,r:.(,:; ,,'; ,; f'll!'f""""'- -,.........._".~'~-...."''-' -"". __..... -~. ~..~.... '~II....~ l;;7' ....;)~.. STRUCTURE (# BEDROOMS) SQ. FT. VALUATION ,),w>: .lr. ~~~.. A~~~'~~~~ !'=~~i ~ .~' ~~t::n :: !!~ ~ ~ i t~o ::)~\<.~,?~4 l~f '~~_R~.~_."!.~_ .f__ ,_"_" 11._ ~ _. r....' _ __ ~ _ _ q ". _. r ~;lO H~ J,~ ~,v .,CfJ~"t. w; .!J-.:na;i~ ..i I ;:)~,tJ:lQ I ';;3;) l,~~J~l SEWAGE DISPOSAL: PUBLIC [] SEPTICTANK [ OTHER [ ] PLUMBING INSTALLED BY: OWNER [] OTHER [] NAMI= WATER SUPPLY: PROPOSED [ ] EXISTING [] [ ] PUBLIC [ ] COMMUNITY - NAME: [ ] PR IVATE WELL [ ] OTHER - SPECIFY: BUILDING PLUMBING 3% SURCHARGF MOBILE HOME WASTE DISPOSAl PLAN REVIEW "'." Aft. ",,'V . ~J~J f:o. I'.~r<- ...;le 'Ju ~ ","l D .~~ ('If: ,,,,\J?il. ....,J1.~~ TOTAL 77. .;;<~ CONSTRUCTION PERMITS & INSPECTIONS AND WATER POLLUTION CONTROL SPECIFICATIONS MIN. SEPTIC TANK CAPACITY: GALS. 'jWlf) MIN. DRAINFIELD ~~.~ I.IN. FT. MAX. TRENCH DEPTH 11:;1: INCHES :'~;;)~: f') Tnn'" 4'rolll ?lab' t."'rW"~~ltof'I!"'O 'ali';~~ ~1l: ~~M+'" "",.t~~ ~n""."A ~~nl. .....-..1 ,r-:. .J:.....C"-.r~ .c...:'"\__ ~.~l}::: (':~'ff'I'rf'~ J'n ,:./ t7'j i1~;~:( arai ill ines "." -Stay ~lt.. feet"" frapl ~roii~r~v Hiles "'~IIHh "a Tr" c:i ;;;t~ "n~ 'l:h~,.J~lr;3'l~~'i <,,"1 . ':"fl~ ''1'',':: -:f' ,;1'::::1 for re::ll,),cofllent of Sewaop. )is~!',,~l ~\I"t;'r.I~ . STAY 100' FROM ALL WELLS TYPE OF CONSTRUCTION GROUP FIRE ZONF USE CLASSIF. SETBACKS - FT. FROM CTR. OF r!W: FRONT iVo SIDE EXT. .\..; c ... FT. FROM PROP. LINE: ,.., PI'" SIDE INT.:'J REAR 1...1 ..r:, ZONF .""'1.. .t. AUTHORIZED SIGNATURES: /s/ c"Hi'I.rb;:;pt ~/Lv.;';g ISSUANCE DATE: <;V'H vI "I'm i ,;-;, ""I ,,\'I .,~}",!t:' f!!~ -. ~. ~ ~ - "" ,... ~ In BLDG. PERMIT - WHITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENROD IMPORTANT: Call 687-4065 to schedule all required construction inspections. Call 687-4061 to schedule all required septic system inspections. All construction shall comply with the State Buidling Code, D.E.a. standards for subsurface sewage disposal and the State Plumbing Code. All buildings require a certificate of ' occupancy before being occupied, (See Detai Is on Reverse Side) (POST THIS PERMIT ON MAIN BLDG. AT SITE) \"-, \. .~\-.",..~ " , C55.13 LANE COUNTY, DEPT. OF ENVIRONMENTAL MANAGEMENT COURTHOUSE ANNEX, 135 EAST 6th, EUGENE, OREGON 97401 - ~cl" 3~i- Z; .au ij LD~ ~~ S rTE EVALUAn ON e I v .') ~,.BUijLlHNG PERMn APPUCATWN NO. () SijTE ijNSPECT~ON PlANNijNG DiVijSijON Not - - ~ App i icab] e 1. Zoning Ordinance Compliance: Zone~( ) 2. Subdivision Ordinance Compliance ( ) 3. Required Access ( ) 4. Building Site (Areap Widthp Frontage) () 5. Other (see comments) ( ) COMMENTS: C~~v7s'0:t3 LOT: S CJ. 7 TAl( LOT BLOCK: APPLijCANT DATE No Ve () ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) CKOD BV: fAI~g f ~0110.7~ Setbacks from -c/lef -ro~~: Front 90 Si~lf"- ~- --~-~~ Setbacks from inter iorr-l i nas: Side ~ Rear -~t1Ir.5., 6. - -~~ PLANNiNG DijViSijON ACTiON PENDiNG: VES( ) NO( ) APPLiCAliON# BUOLDiNG iNSPECliON Di\l~SiON Not App 1 icab 1 e - - -( T- ( ) ( ) ([> 7. Plans Submitted 8. Soil Stability (footings) 9. Flood Plain 10. Other (see comments) COMMENTS: WATER POLUliON CONTROL Not App 1 icab 1 e ( ) ( ) 11. Meets Department of Quality Standards. 12. Other (see comments) Environmental COMMENTS: .. --~ - - - - - No Yes r) (Ja ( ) ( ) ( ) ( ) ( ) ( ) CKOD BV{!, )~__ ~ "'"tf = 7& -DAlr~- ---- --- --- - ---- --- No Yes T")9Q ( ) ( ) CK'/DJ B~~-~i[- 2L ~ n ------~ _.~_. - ------ TO APPLiCANT: Yo~~Building I Site Inspection: I _ ~ Can be approved. ~:/~ ( f Cannot be approved at this time as indicated on item NO. above. ~ ~v ~~ Questions and further information on items 1 through 6 contact the LANE~ r)~ COUNTY PlANN~NG DiViSiON. Questions and further information 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 bunding permit application fee is being ret_ur:n~d_.!:J.mIer se!?at'~te cove.r__ __ ____uu, ----- - - -DEPA~TMENT OF ENViRONMENTAL MANAGEMEN"f ... ~- ------- 135 Sixth Avenue East Eugene Oregon 97401 PHONE: 687-4065 LANE COUNTY PLANNiMG DiViSiON PHONE: 687-4186 C55-28 ,:\-, .aUILD"l~~, SITE EVALUATION e ," .") ( r .BUILDING PERMIT APPliCATiON NO. ~, () SITE INSPECT~ON PLANNING DIVISION Not Applicable ( ) ( ) ( ) (') ( ) 1. 2. 3. 4. 5. Zoning Ordinance Compliance: Zone Subdivision Ordinance Compliance Required Access Building Site (Area, Width, Frontage) Other (see comments) COMMENTS: T. R sU'B'm'v I S I ON : LOT: S TAX LOT BLOCK :1 APPLICANT DATE No Yes () ( ) ( ) ( ) ( ) ( ) () ( ) ( ) ( ) CKDD BY: Setbacks from ell of road: Front Side Exterior Setbacks from interior lines: Side Rear 6. - PLANNING-lllvfsTI>N ACTiON PENDING: YESl-,-mfl ) APPUCATiON# BUnLDING INSPECTION DIV~SION Not App 1 icab 1 e ( ) () ( ) ( ) 7. Plans Submitted 8. Soil Stability (footings) 9. Flood Plain 10. Other (see comments) COMMENTS: WATER POLUTION CONTROL Not App 1 icab 1 e ( ) ( ) 11. Meets Department of Environmental Quality Standards. 12. Other (see comments) COMMENTS: TO APPLICANT: Your Building I Site Inspection: ( ) ( ) - No Yes () t) ( ) (.) ( ) ( ) ( ) ( ) CKDD BY: DATE No Yes () ( ) ( ) ( ) CKID BY: DATE Can be approved. Cannot be approved at this time as indicated on item NO. above. Questions and further information on items 1 through 6 contact the LANE- COUNTY PLANNING DIVISION. Questions and further information 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 building permit application fee is beinq retu~n~d under seoarate cov~ DEPARTMENT OF ENVIRONMENTAL MANAGEMENT 135 Sixth Avenue East Eugene Oregon 97401 PHONE: 687-4065 LANE COUNTY PLANNING DIVISION PHONE: 687-4186 ( ) ( ) ( ) C55-28 ~ \~ \: ' ~\!; ,'. ./ " i e LANE COUNTY PERMIT Fe PERMIT NO. :;:;"1;, CONSTRUCTION [?i;,] MOBILE HOME [ ] PLAN REVIEW [ ] CHANGE OF OCCUPANCY [ ] DOwner ". <::,:..r, ,1f',,1 . ~"t,~"O ..J ',_:~,-~ U <. .,,,;;,,0,,-, ~ '.] (1 " ~ i )"1 '1/" \lUG........) ~ {'''' "(rt'l.. "; /). I~( ,"/v~~~~"',-,~,I ....' ')r:;'::'''lr),' ) \A V L,,/~ "",,\..y>;..,r.....:J (J \Jl) \__t) L' C:G1c""~' v {,'It(," /\ ,', ..',.'"N....) ,;"'tr/a \H .'L J '~ '.-~; 'l...) \Vlt\-.J~', ~'J ~;/\(;. ,",',/'" -, ~f:! ~ o Contractor NAME t''' 'I t)....." ~ IJ , y., '11. <y) , {,.} b II \ ,,' g, (:1'~ ~_ c: ~'J ADDRESS .' ,,",,'1 'iI " 1,_\>< ~ CITY ZIP CODE PHONE "...,,, I) " ':7 ~,..,y) d~)11 NAME ADD RESS CITY {~r-'~'I\T '( (~(fn.q (.._~~,....,-",-v, <"V1'1-< :,)l HI.LI ....,'; U',,,,,'I ZIP CODE ")f ,', _ r ~ l" '. , , ,;', PHONE 0.5. Reg. # ~'~) ,',..'-....Ll (I~ " .Twr 11/ , . "':"1"n :-:;.,\';C' . ,_J,), "_ \. 'll,.l ,,' Subdivision Rangp "n ",'I Section .' '/ ~'II Tax Lot Codp Census Tract )10()f-1(;/J' lJ<,,)U '-.....:;\.;:.... Lot ':"(' II Block n . \ Acreage Width Access to Property (Road Name): (',~"'~~t)(":''''A,~/v~r i Cr~i~)..-'t"J) Depth .. Existing Structures on Property: ~"" r ~,((... Directions to Property - Address: ',1 <I ("\( ) I; If' c :(~~' \,~('::;'-'" ~~'--" 'j (,~ \. ~r;1;0"~: ;"" C~rlf,~'/i8<.;:]11() 11 (":~' ,;:0F'r,",V""\ " - ~.'..../ - - --.' q.. -...........'~.- 'STRUCTURE (# BEDROOMS) SO. FT. VALUATION I--\,\~ ,-I.. , , ";\ : {~>-~f' \,...J\,.~:'1l("'10"1 "I I.. f ,1:11.. J' r .\, _ '1 1 -,\[ 'II 1] iP;v;' 1 ii [.'(,;' ':l <10'? \.' (" ,.,.,"1:' :" ",.-., , " 'f ~ I' I , . ... I ~ t, \, I ;"-,,,,,", ,-,;(, t',.'-'. \,,-, .,&r..... (.'''-''' -~/ .,''''' ,'//-',.'1,,,-',......\1 ~,)(\,-\...,,(...~, '_/J, d.,) ,~'--) ".....,/'._)~(J -.......:,.J'.,;".;!, ,l.. .-lV.";,,,..../0,,)V '--,J~/.)\..)"... SEWAGE DISPOSAL: PUBLIC [] SEPTIC TANK OTHER [ ] PLUMBING INSTALLED BY: OWNER [] OTHER [] NAMF WATER SUPPLY: PROPOSED [ ] EXISTING [] [ ] PUBLIC [ ] COMMUNITY - NAME: [ ] PRIVATE WELL [ ] OTHER - SPECIFY: BUILDING PLUMBING' 3% SURCHARGI= MOBILE HOME WASTE DISPOSAl PLAN REVIEW ~.'~, ......."'. (i', ,-".i',/,--I (\ i";--' /t' ',f' I )i (:.'.) i,.I U'IV"tJ' ~)~~ '''''./i i TOTAL --, > ".(... 'f; .: U I n,/{I CONSTRUCTION PERMITS & INSPECTIONS AND WATER POLLUTION CONTROL SPECIFICATIONS MIN. SEPTIC TANK CAPACITY: ('1 r';-"-,,'\ (\ '.'''' ~,r,~ GALS J",,:i MIN. DRAINFIELD !:(j L1N. FT. MAX. TRENCH DEPTH ,.' INCHES /" "--,,' 'f, /".(\.I";'" ..' " .. '-j \' ,;' ~'(' l!~' L ; /" ';'~-~'f, ~........\i;nt-!,-~ ,..,t' \_ ..,j , ~ \j~j~,),: WI..;k',! ;" '~ ~~,...., .. ,..., ,.. ^ " " ", J"'l f) (' "'1'-:-"')" ~''''''''''''''~j\'. (-:-------.,. ,l.'~'~'1 '"',)~~,,"'-' -r.llk'""''l ['1.1' f\' I "~}",,r~(,\, r-t (..'.r......'.'>.'"",,., 0,,_:.),":",.... ,(\-,/.'") ',',:',, ,.'" ',.^'. (' '." '! I .j:",. \. ." rC. i I.<;,t.'. .; ":-"'!i"" ~ \.' .:.1:1.'" .1 ~ \ ' ! I 1:' Ii"" !I"-j .... I '; iJI. "I.. 1. '. . ~\I'_-' 'I"'." I ~:'-'-\'I \)!(.r,~-"~~ \;"'-)'V'-' \1)'j1 <.,./""...~". ":;r-__:~" -, :.....::'?.....\~'--:'A.~)...,f\.f) '{(i'll,"/'), ,.r~Llr>,-.-.\';f\; ~-,..., f~~" '-I:'~() \:/11.,,~J \,v:"J~1 ".,',.:J0~iJu'lJ,.....~.J{)U ,1\/..\'/ UI.../ V\..~~--"\.) ~I,;~h~ j:J{lliJ:>....~U~\:,:..;~/ ('\;L4'__~J ~.j\lJl1l:J ~JIJ ',,>-.U'L)(} \',L; ~;;'.>1 '. ",,:" '...:~.'\'i;~~)0".~;..~-".':;' ,,,</ ~)(~'J'")r'>:,' :,'''.'(~--'...;-~r;J.,u ~':~.~~<\"y.---" , \/"" ",I L, -"--"';. ~^._.;., ,) IJ" "''''''''''6_._ J~ i" ...../ J C.-: ,.... ....,-..!J c,__'. V""l \'1".....:..; I I '.:, Ii ~I TYPE OF CONSTRUCTION GROUP FIRE ZONF STAY 100' FROM ALL WELLS USE CLASSIF. SETBACKS - FT. FROM CTR. OF r/W: FRONT ;, I SIDE EXT. ". L, FT, FROM PROP. LINE: (. :' j (" ;".' SIDE INT.:) REAR ,) nL, ZONI= , " .~~jj:' AUTHORIZED SIGNATURES: /s/ ;', r,""i",(,1"'n""r;. ~/!: "/~,C'(' \, _>'/,j"", '" L.........."',..:: 'IV;"/' '--'....1(;..) ISSUANCE DATE: :'\c"~'1l,p,~ ~'nr>)I"'" \...tf C\ '(I! 0.....)\1 ~ l:<:>~J U,- ,Ld ;~}; ~ lill:; ~('., , :,Ii " BLDG. PERMIT - WHITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENROD IMPORTANT: Call 687-4065 to schedule all required construction inspections. Call 687-4061 to schedule all required septic system inspections. All construction shall comply with the State Buidling Code, D.E.a. standards for subsurface sewage disposal and the State Plumbing Code. All buildings require a certificate of' occupancy before being occupied. . (See Details on Reverse Side) (POST THIS PERMIT ON MAIN BLDG. AT SITE) " \. .;\ " C5S.13 LANE COUNTY. DEPT. OF ENVIRONMENTAL MANAGEMENT COURTHOUSE ANNEX, 135 EAST 6th, EUGENE, OREGON 97401 ,__~_".. " "'",, , L e SLAB FLOOR PLUMBING GROUNDWORK ApPROVED / / DISAPPROVED / REMARKS GAS PIPING GROUNDWORK ApPROVED / / DISAPPROVED / REMARKS ROUGH PLUMBING ApPROVED / / DISAPPROVED / REMARKS ROUGH GAS PIPING ApPROVED .I / DISAPPROVED / REMARKS FINAL PLUMBING ApPROVED /- j 01 SAPPROVED .I REMARK S -1JtJ ;:::-, /If ..,.L FINAL GAS PIPING ApPROVED / / DISAPPROVED / REMARKS CERTIFICATE OF OCCUPANCY / DATE / DATE / DATE / DATE I DA TE <)"-/1=..9& / DATE READY TO ISSUE I I NOT READY TO ISSUE / REMARKS / DA TE e INSPECTOR INSPECTOR INSPECTOR INSPECTOR I NSPEC1;.oR~~ INSPECTOR INSPECTOR -J n . .' 4 . PROPOS.SEWAGE DISPOSAL SYSTEM RECORD . ~ INSTALLER: Complete top part of fo to signature and submit both co s with appl ication'~', " '.~ PERM IT NO. 328-76." INSTALLER'S NAME \ PROPERTY ADDRESS rvn~ Gve..~ ? 5e'1""-g Cottonwood Street No. Living Units Bedrooms Baths Basement Water Supply Yes No Public~Other-List Gray Septic Tank: Ft. from well Steel o Concrete [Z) No. Compartments Inside Len'1th OWNER NAME Dimensions: Width Ft. Diameter Depth . Tile Disposal Field: Distribution Box: Yes Other Distribution-Type Gal. Capacity If; PI? No P;:llll ~nC::j;)r Total SCI. Ft. t./An Feet from , WEll Lot Li ne Front Ft. Between Lines iu Foundation MAILING ADDRESS ~r~;~~r Length of Lines-F't.---- Trer'\'ch lta52. 3L/JJ4. 5. 6. Width~ Plot Plan (see instructions): ll~~'nnrl ~+~oo+ Side Rear Fille~) Filler Depth Fille~Below Type/ v..,_ Above Ti le 7_in. Ti le IG.' in. , - ------- -, - - { ~E(GE]VEll ~ --------.--- -, ....- - ~--~-- -ViR'cycSEd lVE~Iv' 8",; Id 1\' 9 t~AR 2 G 1976 - - .- .- - - - k4Hg cgU:NTY f;twl~~MgNfA( MGMT. - \ \ \ I .3D - - I -- - - I ,-/0 -I I '. bDI I "0' f '0 \ ! t 1- I D-I I I - \ Llo -:::- - - - I \ 5~1 '-.-1 I.:) - -:;- - Date J I ..; /' 2~ /7lL.;) Signature f)1rl'1.<?~1"- I't'2 <?///-----. CERTIFICATE OF SATISFACTORY COMr fl~ " For Sanitarian Use Only: ,!) ate: 3-.Jo-~ In accordance with 1973 Oregon Laws Chapter 835. Section 21 this certificate is issued as evidence of satisfactory completion of a subsurface sewage disposal system at the-above locatjon. ~ Approved: System Installation conforms to current standards c::J Disapproved: Does not conform to current standards Remarks: 1:'. ., C55-11 ~~ Sanitarian's Signat~ LANE COUNTY V STATE OF OREGON DEPARTMENT OF ENVIRONMENTAL QUALITY \ .r :\ ~\~ ~ . '\\~ . ~ CONSTRUCTION [] MOBI LE HOME [] PLAN REVIEW [] CHANGE OF OCCUPANCY [ ] ~ e LANE COUNTY PERMIT FOe PERMIT NO. DOwner NAME ADDRESS CITY ZIP CODE PHONE o Contractor NAME ADDRESS CITY ZIP CODE PHONE 0.5. Reg. # Twr Range Section Tax Lot Codp Census Tract Subdivision Lot B locI< Acreagp Width Access to Property (Road Name): Depth Existing Structures on Property: Directions to Property - Address: STRUCTURE (# BEDROOMS) SO. FT. VALUATION .' SEWAGE DISPOSAL: PUBLIC [] SEPTIC TANK [ BUILDING PLUMBING 3% SURCHARGF MOBILE HOME WASTE DISPOSAl PLAN REVIEW OTHER [ ] PLUMBING INSTALLED BY: OWNER [] OTHER [] NAMF WATER SUPPLY: PROPOSED [ ] EXISTING [] [ ] PUBLIC [ ] COMMUNITY - NAME: [ ] PR IVATE WELL [ ] OTHER - SPECIFY: TOTAL CONSTRUCTION PERMITS & INSPECTIONS AND WATER POLLUTION CONTROL SPECIFICATIONS MIN. SEPTIC TANK CAPACITY: GALS MIN.DRAINFIELD I.IN. FT. MAX. TRENCH DEPTH INCHES TYPE OF CONSTRUCTION GROUP FIRE ZONF STAY 100' FROM ALL WELLS USE C LASSI F . SETBACKS - FT. FROM CTR. OF r/W: FRONT SIDE EXT. FT. FROM PROP. LINE: SIDE INT. REAR ZONF AUTHORIZED SIGNATURES: /s/ ISSUANCE DATE: BLDG, PERMIT - WHITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENROD IMPORTANT: Call 687-4065 to schedule all required construction inspections, Call 687-4061 to schedule all required septic system inspections, All construction shall comply with the State Buidling Code, D.E.O. standards for subsurface sewage disposal and the State Plumbing Code. All buildings require a certificate of occupancy before being occupied. . (See Details on Reverse Side) (POST THIS PERMIT ON MAIN BLDG. AT SITE) C55.13 LANE COUNTY, DEPT. OF ENVIRONMENTAL MANAGEMENT . COURTHOUSE ANNEX, 135 EAST 6th, EUGENE, OREGON 97401 r /<~.. i!J'~') .' , ,I) ./ t" ,f ,I . ,/ e SITE INSPECTION ApPROVED / / DISAPPROVED / / DATE INSPECTOR REMARKS FOUNDATION INSPECTION ApPROVED / / DISAPPROVED / ,./ i! to /r ,!;,I /.. fj~lIt:t / ./"-j 1'(". /" f\.........:./' / .PATE .' 1,~2 - ,~~ j;.lZ..~ J t. J -r.. .....(,. "~:J ,,71,-n II . l I INSPECTOR .'_' ,1 - j'c.} , -7~'(<{ REMARKS FRAMING INSPECTIQ~ /' ApPROVED /4' i DISAPPROVED / {) /~ /, '~' I" :J ' I NSPECTOiJL:;;.p-; (.) ,;: / DATE ,I".A/J//i I REMARKS LATH OR SHEETROCK INSPECTION ApPROVED / / DISAPPROVED / INSPECTOR / DATE REMARKS /'1 FINAL INSPECT '7 ApPROVED /,. / DISAPPROVED / / DATE 6/ 'i,;). / J 71t1 NSPECT R REMARKS CERTIFICATE OF OCCUPANCY READY TO ISSUE / / NOT READY TO ISSUE / / DATE INSPECTOR REMARKS ~. --I I) r\. Y . // //1"1 ,~;1 l.';1i(r~ kf . II [AI v " l ~. , ~ \ r, \'Jff"7trlP~ 11:;2~~ . ~ . .. <r ....' OWNER ~ - ~ 3.:2r-'~lk PERMIT if BEEN APPROVED NO PERMI~LL BE ISSUED UNTIL THIS APPLI~ON HAS APPLICATION FOR: NOTE: CONSTRUCTION I X. I cO A /) L Name CONTRACTOR ?/I I L '- I P Name PLAN REVIEW I I CffE OF OCCUPANCY I e. 0 n- ~,,/ Id ~(/ {) ~i:::- , S P /f'1/V G r"~( D . 7 L/ ~ c. 3.4 I 9 City,,' Zip Phone OL 36 IiI. /?i.', f3 t! I( uS-? j''lPKIN6 F/tS'~j;) '/ ~,-- ~ ~7 3 . Address . 'ghy Zip Phone 1/1 ! / ,I ' /1 . lCode .../'/ Block (;j.l Property Acreage II l 6 rTtJJ.r" W b( P r-')r, ..',1 , I , I c c r-I () i',r f4,) /) J D rl L FE FTC (1/ t!., 7 T 6 /-r tAJ' € p /tr~ Below for Office Use OnlyXXXXXXXXXXXXXXXXXXXXXXXXXXXX~XXXXXXXXXXXXXXXXXX fi fi~4=--:J ) It Sq. F~ ~ I ~jr;Or () a 1'1/1>>...11 r !" ..!j;;;' (1.0/ /0. {O,: ij - ~ / ...,.;!..,-. /' - I . i I /' ,I) .'vrYt <AJ ,.1>./1 lJ77:J rl t'A ( ~ 7(1' / " it/JOa" /l ~ -~ ;1 SEWAGE D OSAL: . ...--- Site Inspection # Existing Sewfge Disposal System I~l or New System Required I WATER SUP~ j Public I I Well Spring Other:1 COImnunity I I /1 PLUMBING :' Installe by Owner O.S. REG. II TwP,-.rJ ;::;; f) -:; -# MOBILE HOME IV! IJ SF: R /132 Address Range - 0 ~Section ;; I Census Tract Tax Lot Subdivision-^1cNLo Pi1RK. 1ST "'~i)Lot ACCESS TO PROPERTY (Road Name) , Existing Structures on Property: 13 Width 7 B' Depth J 70 J-I.oU's~, I' ~'1 2 (}l.LJ"D, S?R/N t>}=/.E'~ n Property Location - Address/Directions: t) F' ;:: FEES: Bldg. Plumbing 3 % Surcharge Waste Disp. Plan Review Mobile Home TOTAL sr,.. , e /?/.rrEN/V;A- L $cHt:dJL:, C E' NrE NII//A. L .", \1 \ dAb 6'7 , -, .3 ,Of) J <; ~'. , , . , \ ~..r; .{7 O. 'LjrJCASH '~I INO L \ YES rLINO 00}. .S3 ~ Signature of AP~nt~J?~~ . @&~~, c ;?S.C 0 , :b)ek('~ Fee Received By~p~YI,f~ Datei3~r9~r:~ . ~ 7.S-3' ',.. V Septic Tank cafacyy (1ft> 0 D,rainfield Required ~}lfal Feet ;;:2 L( 0 Maximum Depth ..J C?- . . .~~~)*~~/Ah~~ ~_~ ~/V (J ~ ~ if-7N~...&JY") ?-zU4) ._~ -'. .~/ ~~_k~ <>--:uH~ 4 /~7A I~--- ~ dlVLv ~""r7 of ( WJ'_ Type of Constructio (J) GroupLtff '.1 Fire Zone J XXXXXXXXXXXXXXXXXXXXXX Valuation 7'3/_1 Name of Community or Public System Other I I Name I PLUMBI, FEEI2iJ 3 l / II of Fixtures /' Sewage Connection Water Connection PLANS FURNISHED FACILITY PERMIT Use Classification Bldg Setbacks - from Center of Road R~of Way: Front If 0 Side Int. !::> Side Exterior I 5' Rear {A ((J U.6zone f<-fd- -- PlANNING: {)A 1lo -\tJfA' ,i1f\ C55.12 DATE: LANE ~. SAN;TAT;9Jr DATE: ./L1/~ 2:Y7.h' COUN~E;ARTMENT ~ ENVIRONMENTA ..BUILDING: /1/' ~DATE: ..' tI .' <7;:'./ / . 'j -<'So C t. o . /; 7 ," L-t"J' .,,' ~.: ,_ (~/ . ' . . a.- t ;"-C.., ;,c. " Y--J ('. (,,:/ 'i'/ c,. {'/; _~ v ' MANAGEMENT