HomeMy WebLinkAboutPermit Septic Tank 1978-9-22
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LANE COUNTY PERMIT
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Acreage or Lot SI70
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APPLlCANT'SNAMEANDADDR'="" \""''1'--. _\,...\.,." \.ol', -\ c_, \1:>""-, \.,1 2~...A. q,'40S
OWNER'S NAME AND ADDRES" y.", 1->..\--.', \..J,J \, """,0\\"....' "\-\010, .)r, 0-<" 7'
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Marl permit to ( ) Applicant ( ) Owner ()<) Contractor ) Prefer to pick up Call...:c<:, :1-,,,,,,,~C~.
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Phono
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,(owner, etc) when ready
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STRUCTURES NOW ON THE PROPERTY
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THIS PROPERTY IS WITHIN ONE MILE OF THE CITY OF
THIS PERMIT IS FOR
WATER SUPPLY
SEWAGE DISPOSAl
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Minimum Septic Tank Capacity (Gallons)
Dralnfleld Required - Lineal Feet
MaXimum Depth
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ByG.~.r^, .', :'-::O:/lI";r;';,.-'.-__ Date,,?/~(/I../- t By 1'/ _' ~-?/'.}/l.;:r--- Date 41-22 -::4(:'
PLANNINGREQUIREM'ENTS1SATIS'FIED By',,- ,IV. \\'" \ ,_ "1 Date '-' '>19) Date Issued q__~,\ _-':.
ZONE ';'\..\1:'J SETBACKS FRONT '-,.: SIDE FACING STREET -. (FROMC/L) INT SIDE YARD\S'REAR'20(FROM PILI'
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LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE, EUGENE, OREGON 97401
I hereby certify that the above statements are true and accurate, and that J have the following legal Interest In thp oroperty _owner of record,
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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 th.s action I hereby agree to comply With all applicable Codes relating to thiS permit
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Fee Paid s:' '\'. . Signature.' .. \ " Date n- -n- _,,- J
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) SPECIAL PMT AREA MIN ELEVATION
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Si' AI Type of Construction (,-';:;" Group
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) NEW ADDRESS (
) FACILITY PERMIT TO TRANSPORTATION DEPT
SANITATION
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Fire Zone
;! Comments
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PHONE 687-4394
C5513
POST THIS PERMIT ON MAIN BUILDING AT SITE
SLOG PERMIT-WHITE BUILDING-GREEN PLUMBING-CANARY SANITATION-GOLDENROD QFFICECOPY-WHITE
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SITE INSPECTION
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ApPROVED Cl DISAPPROVED C/ DATE
INSPECTOR
REMARKS
FOUNDATION INSPECTION
ApPROVEO L-I DISAPPROVEO L-I DATE
INSPECTOR
REMARKS
FRAMING INSPECTION
ApPROVED / I DISAPPROVED 17 DATE
INSPECTOR
REMARKS
LATH OR SHEETROCK INSPECTION
ApPROVEO L-I 01 SAPPROVEO L-I DATE
INSPECTOR
REMARKS
F\~ECTION n~J /
~pn8'E. Cl DISAPPROVEO 17 DATE ,Z;::-z-.ti-~1INSPECTOR )i:.~
RE:ARKS-R'''' 'T ..iS~...'t-1 / )LtE-,' ,~/.2 9 /'7~ ;;4(L,., . "
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)1(l'" ;: ~ b 'i - 17'!> r-"'-'" A 2:, 'Jt ,r-C ../
CERTI F I CATE OF OCCUPANCY V -
READY TO ISSUE 17 NOT READY TO ISSUE ,1 / DATE
INSPECTOR
REMARKS