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HomeMy WebLinkAboutPermit Building 1980-6-10 , , JOB ADDRESS , , ~ POST THIS PERMIT ON MAIN BUILDING AT SITE 4617 Jasper Road, Sprlngfle1d, uregon CONSTRUCTION PERMIT # LC-821-80- TMH TRS, TL 18-02-05 TLN 2201 SubdiVISion na This permit for the referenced property IS hereby Approved Setbacks and other conditions of approval must be strictly observed Violation can result In revocation of this permit, citation under provIsions of Lane County's I nfractlon Ordinance, and/or other remedies allowed by law Applicant/Address Owner/Address Contractor/Address Contractor's OS # Jean Woolery, Same as above na na na Total Construction Value na na na ConstructIon approved by this permit later Supply we 11 PLANNING DIVISION WATER POLLUTION CONTROL DIVISION . Setbacks Inteflor property lines Edge of road rlght-ot.way 8utldlng foundation Wells, other watel sou,-ces CONSTRUCTION PE RMITS/INSPECTION DiVISION D'rectlons to Site Date Issued C5513 Zoning AGT Partltlonrng # na Parcel # Minimum required structural setbacks, from centerline of road, front 65' side exterior na ' interior property lines 15' ,rear property line 20' Special Instructions ThlS permlt va11d untl1 12-31-81 or untl1 hardshlp ceases, \ihlChever Telephone Telephone Telephone na Renewal of LC-873-79 Temporary Mobl~Home Slng1e Wlde Mobl1e Home Structures now on property- MH, AG BU11dlng-2 mobl1e homes # Bedrooms 2 # Plumbing Fixtures na "" Employees na na Parcel Size ,centerline of road, 3.57 acres For information call 6B7.4394, Candl comes fl rs t. Site Inspection # na Installation ~peclflcatrons na lineal feet of dralnfleld required, max depth ot trenche, Special I nstruct,on5 The ex 1 s 1 tng Septic Tank 10' -- 11)' ;j' I)t)' gal mln septic tank capacity, Dralnfleld -10',--- 10' 10' 100 shows no slgn of surface ma1functlon. FOI Information cell 687-3960 bctwl'gn 8 00 u 00 an, Kathl M. Wlederho1d Tvre of Con,tructlon I nstn.!ctlons na na GroulJ Fire Zone na use Classltlcatron na na For plans information call 687 -4394 between 8 00 R m and 9 00 am, Susan For inSpections (see back of thiS permit) call 687-4065 between 8 00 a m and 5 00 p m na 6-10-80 Susan Ke11erjRLH )/ klne county ~ DEPARTMENT OF ENVIRONMENTAL MANAGEMENT COURTHOUSE I PUBLIC SERVICE BUILDING 125 EAST 8TH AVENUE, EUGENE. OREGON 97401 By . ..1.1 I , ....! 4 , . . , i 10 " 14 16 IB f1 , J J 20 " 24 " " " .l. lJ II ~ 38 rlO U,H f:; '')0'1 ~ '1 I 1 IJrJ [1 llf.\ T!: (V 09H(J ~f'\;'HHY[FLn, OF~ IOf III K Nil S I 11I'I ES I'll) 131 l)l,S ,)') I CO:: 1 V('!.1I,~ 1 J (1N 1 1:1 !)A '( <, " L (WI.. L(llJrll '" ril'f'\ I ,{IN 1 l,mOLl' fiY, ,II.. t\N fl ~ ! BC,',)()~)()(102::')O~ ~'U[lD] \l ,'El,j BLDt, fYl'\: I JSE f: NO Irj)RI'l~ 00 el)\)!.. M'}'I_ riG (Ie. 1 TeHl TH. ,XI:l f': [il~,' BI' Dr' H' ./ BF 21" lJr 1- r I,N nG I I~l CLl f' f ~~ [l;J, Gel ~0nk ~f17 JA:pr~ RD., 34 40 42 Le I U, 44 PI:' 46 1-"_ NO, 1'17'1lml:-' NO rOlP11: ';1 ORS ;1[[ f!('II'IH M. I L r Sl () 1 r SlIF~1 'HI)(;''!:L r'l (it' CHI t;l< I r I 'j .u() E,iCH . .. i"lt_CH \'1 II, 1'('11 - , 1\% O/" so 111-; 5'LJS I C b:2 'I 8o'i i r>l-I,' SIJS',/ '1').00 :2';.\00 (1 (, - o " 56 5'11' 0 ('1"1 f AI< [I~ In' ell v.lF' r: I'LHI~ t LE V ,"11)1\1': Lorll'l I' f I j) bY rl' I..I'JVH 101111 I FC.p:)f (, ~ l v " " o 12 ~;; " LI...1 00 l'Vll : 10 , , ~ 8L-_~ o w , ~ 'I L " I --1 " " 4 o . o ~ e .. Date lane county - 3- 30- 80 K L, Ho01ery 4617 Jasper Road Sprlngfle1d, Oregon 97477 Re Temporary Moblle Home Permlt # 873-79 Map and Tax Lot 18-02-05 TLN 2201 The referenced perml t wlll expl re on 4-03-80 On Janua ry 21, 1980, new regulatlons became effectlve that affect your renewal procedures The only Clrcumstance for WhlCh a temporary permlt may now be granted lS to accommodate a famlly member sufferlng some type of dlsablllty The dlsablllty must be substantlated by a wrltten letter from a physlclan, theraplst or counselor Inltlal renewals for famlly member dlsablllty wlll be granted for an amortlzed peflod, to explre December 31, 1981 If the use ceases before then, the moblle home must be dlsconnected or removed Also under new regulatlOns, permlts for famlly members wlll be granted for a 2-year perlod after the flrst explratlon date, rather than the fonner l-year perlod Nelghbors wlll be notlfled of pendlng permlt lssuance b) mall, rather than by postlng In the future, lt wlll be lI.:c-:ssary to apply ln person Please bflng a sketch of your property dravm ln ll1r~ lnk on 8;''' x 11" paper, showlng all structures, wells and septlc s\lste IS on t'12 property and the dlstances between them OfflCe hours are ~ jJ '1 11 ',0 l 30 P m Ot~er tiDes OC lIlS;;allil1.l'HlS lor WhlCh a temporary permlt was granted, e 9 , caretakers OJ' fam help, r,ldY be able to rema1n subject to obta1n1ng approval of a ConJ11.10nal Jsc ?erm1t from the Plannlng D1V1S10n (687-4186) At least three months lS r0n~lrQU for process1ng A separate sept1c system wlll be necessary 1f the r,lol.Jlie nOI,re 1S to be used for more than a 2-year peflod (max1mum) If further clar1f1cat1on lS needed, please call me at 687-3966 Very truly yours, ~~ He 1 en ElllOtt Perm1t Processlng Superv1sor HElls ENVIRONMENTAL MANAGEMENT DEPARTMENT AOMINISTRATIVE DIVISION I 125 EAST 8TH AVENUE I EUGENE, OREGON 97401 I (503)687-4394 OR 1-800-452-6379 . LEE H TURK, M 0 PHYSICIAN INTERNAL MEDICINE 1110 NORTH 18TH STREET SPRINGFIELD. OREGON 97477 OFFICE PHONE 726-1315 Apnl 2,1980 Lane County Helen Elliot, permit supervisor RE: John Butterf1ela John Butterf1eld 1S totally d1sabled from Coronary Artery Disease '. If you have any further questions please fe~l free to contact me. Sincerely, f ~ v1e~ Lee Turk ~1.D. . OEPARHIENT OF ENV I RONI~ElnAL 11ANAGEI~ENT PSB, 125 EAST 8TH AVENUE EUGENE, OREGON 97401 ob Address~&/? ~~..// @ __ _ Nv. S'P6f1'l't,'eLd. ~~~llf!,.>>R?nqe;S~t'6ntFaCloe /0 ~U,i7<-o~ ~ hld/J ! SubdfvUlo" L:7 -,- - -V l.ct MoCk App1,cat,on for "'\ ,/ / /j/! ''/: " ~ - - /'- - _,_ / Stru~tures no~ on the proper~ /1!!' ~~~-a/~ ~7 ~#/'V l'~$a4,p$e <;if .w.", l4'1 LI ~fidlmtiil.l g ,C_,,,,,,,aT CI ~u.t"'lll LI NbHe Aff,dav,t 1, ,J-P/1 V1 W()(')/..-PVIA , hereby cert,fy that th,s ,nformatlOn '5 true and accurate {please print! .../ If t~lS ap lcatlon 15 for an agrlcultural bUlldlng ,t wll1 be used for purposes allowed by the State BUlldlng Code and Lane C y Code Chapter 10 (Z0010g) and for no other purpose I have the followlng legal lnterest 1" the property owner of record, contract purchaser, lessee. holder of an~XC1USl e optlOn to purchase. duly auth~ act for t~r. who '5 knowledgeable ~t~ appl';.;at,on S,gnature/Address .~ ~ ~/ tJ'r~...t.L ~ ~ ~/t1ft:-'f ~ (ll01 Telephone or Date When perm,t '5 ready not,fy CI App1,cant CI Owner CI Contractor Q.t CI mall C/ phone Owner (z, 0) Phone Contractor (z, p' Phone P!!;t~/-&D A~slgned tlumber$ Contractor's OSR# P1umblng by If Commerclal ReSldentul #"of $wr1d~ # "t' bedrooms _~ SI test holes ready UU NUT WRIlt B~W THIS LINE # of employees ~ It 01' untts' $05:, I~'st'ng, CI Proposed, BP # SI # (~ '30 --?...?> Fee Code lle$crioUo" Sq. r,t, 'or, II of SIts"" !~it Cost ValuatIon Fee Subtota 1 $ $ $ $ $ each $ each $ $ $ $ $ $f?) (}!t) ~~-~~~~~ ,!L~:k~aJ /(JW-- t9'P'-' -, ".... , . o Cu~ {} 'C~c1r. * Rece1Ved by Total Valuat,on $ :lllIIlllMn~rflx~ijre$ at $ ,$loWtIr{ltAtllf ,11ollll. at $ Wa ter Supp 1 y Proposed Year Installed da/ Ex,st,ng ~ 4% State surcharge Plans check fee Change of Occupancy TOTAL PERMIT PROCESSING zon(/Y.;r-" Ii. fr<<il< I ~Cl <. .E,art # , Ii, s,de Parcel # ~1 Parcel SlZe...$:,) 7ff Ie:;- . rear ~ J M,nlmum setbacks . lot Comments ~~~-~~~ ~_ /.k, ~ ~' To be typed ;n perm v 't!--, ,t2L-H??A~ ~;V /74~ ~~/~{.h~Ak"7" (}Lb'-'-,' /- 7~/?~ /,/~..Y- By.;';; /.. I~ - 'W Date '!- 'f CP&I Type Group F,re Zone Use ClasSlflcatlon ( To be typed on permlt d By~ Date {, ~( { ..--11 () Phone For plans lnformatlon call (area ,1nspector) Dlrectlons to slte ~7;0 I~ C/ Plannlng CI Pub1,c Works CI ElevatlOn CI n/a I;! Address ',,- / / Facll1ty Permlt L I~/ ~'.",ronmental Healt~ Pl ans to CP& I WPC setls) setls) Date Requ1red Hold Sl,p to PCC Date Comp 1 eted Da te to PCC FOR INFOR~~TION about progress of your appllcatlon call C74-171 Permlt Control Center 6B7.HELP (687-4357) . lane county ~ PERMIT #~~~'-~ NOTIFICATION OF INTENT TO ISSUE A TEMPORARY MOBILE HOME PERMIT Dat~ 8:J / ' onll~A--,~,/7.J6, a 2-year temporary mob11e home penTllt w1ll be lssufd prenewer;r to accommodate a fam11y member d1sab111ty sltuatlOn for ~4~- - 7.r~ 1f.t' If you have reason to be11eve t (1) the fam11y member d1sab111ty c1a1med lS not va11d, or (2) 1f you have eV1dence that the sept1c system lS fa111ng and creat1ng a health hazard, you may appeal lssuance of th1S perm1t 1n wr1t1ng by subm1tt1ng your letter to the unders1gned Appeals must be rece1ved by 5 00 p.m. of the lssuance date noted above Please be adv1sed that 1t w111 be up to you to prove the va11d1ty of your obJect1on. If your appeal lS accepted, an appeal hear1ng w111 be scheduled before the Board of County Comm1ss1oners and all property owners w1th1n 300' of the subJect property w111 be not1f1ed of the date and place. Very truly yours, O~ OF ENVlRO~NAGEMENT p,i{~ s""iJ 6B7-4394 ENVIRONMENTAL MANAGEMENT DEPARTMENT ADMINISTRATIVE DIVISION I 125 EAST 8TH AVENUE I EUGENE. OREGON 97401 I (503)687-4394 OR 1.800-452-6379 ., / cY- -02- --C7 S- -#- /~?!V _ P;<3oo _ _ _ ~ ..zL~ _ __ -,if- C;:::?3o / _ ....___ _ __!!: yc:::t 3 _ _ _ _~ d0'?!f:? __ ..-- _ ..# ~r:'d?-_ _ ___~ J~Z'- __ _ _ #.... ,q c:?t:!~_ ___ ~ c?. ~ / ~:' __ __. _YF. //M I ~C/-5~/-?O /c:r-z:;72z::;'...s-P ~P<c::J/ -- /F- a~Oz;> (( ?>6_~ _ _ __ _ __ _ _ ,~ _~.;:? O;?..._ _ _ ___ _ _ _ _ JL _ ~;? /..6 *cR~ ~ . -Lc. r?~ /-5a TP # MAILOUT NOTIFICATION On ~2Z-?O , Notlflcatlon of Intent to Issue was mal led to property owners wlthln 300' of the property on WhlCh thlS temporary moblle home wlll be located A copy of the malllng labels lS attached Perm4t rocesslng SectlOn Dept of Envlronmental Management "L r:> (;..';'.--Jp/o/)Pa Mall1ng Date T-C?-"O L~' C--C/ _ Appealed Issuance Date . /J-~~-c::/~# #~ ~7~~~/ C ~ /7~ ~~ / ~ ~7Y/? /cr-~~pS-# ~vv ~~~ 4~ ~~ 6;: ~ / ~ 7'7Y77 /cr-c:::7 c;::;2 - c:::7 S- # cd c? ~ / ~~)&~ ~~- YA?:? ~ I / ~ ;97?7/ /J:- 'b? - ?7s-- ~ c:??;: ~c::/ ~ ~ ~c::;::? ~ ~7.s-7 ~~ ~::7- ~ ~ r7~~ '//-z::/~z::;/o~ c:;iP~ ~~~ ~ C ~g-2./-6 ""~ ~c::7/~ ~~C:;:/S- ~ ~c::/ ~~,~~ 7~ ~. 9/~~ f?ff" ~ '4C ~.h . c:::;;;:> -?......-L...-;;7' '7 t://...~.. / //7// /~c::/c?-c::?..s- ;F-~~~ ~~~ \1---~D~ -:y () \ \ ~ \' eX II'\ e__\s ~ Y\ k l~ sc, d- _ ::r C}.\\~ c:...J-t< c..o......0 01'1 Y\ C\d---/ S J-(l)h st, 5qt\\1\").f. Q..\ ell I O~ - ~1"1ll /p-c:/'~-V~~ ~~ J~d/~~~~ ?7~ ~~:f/ ~ /7 ~~ ~/777 /?az~;::/S~ ~~C::/3 ~~/9b~ ~ //?-..5 ~ 4~;;;~~ /7tf/77 :/J':-vv:<-vs- # /~/.s- ~ II Ii /~~,:;7<-??6d ~S2/c/ " ~JLJ~ ,.:fLc???/ ~ r~ ~ ;?7fY77 I' /cC-~-~..s-~dbVV ~~ /PJ ~ :,~6; :Y I :' . I . L C - 6G--/ -gC II :1 /// /./:-~v2 :.....c;::is~ "/~~~or <~~V~~~- /~, ~ ~r . ~ - ~ -, " -.. .- , '. "- -, \ . .~ ~ , f ~- ...-- , , -' l" .. .... ... " ~?Y77 '. -. -........ , ~ ... , '. , , , , . . , . Jdne Harle Welthcr Leona Mclnghtlm 61113 We~L 80Lh Los Angeles, Callfornla 90045 M1Tlnm J MeVlcknr !o J(,deigh ~l & B J 941 SOULh 47th Sprlngfleld, Oregon I iBobble Wught :R J & ~llJgreL \'rlghL 4821 Jdsper Road Sprlngfleld, Oregon 97477 I UgU1L C ell lbe J: & Lldon W II lIb <.r L 4681 Jasper ROdd Sprlngfleld, Oregon 97477 97477 ~1LlLI LchJ c.y Nlelsen L Pollard Carolyn Janecek 927 South 47th Street Sprlngfleld. Oregon 97477 Isaac W & Mora L Johnson 1,724 Jasper Road 5prlngfleld, Oregon 97477 Larry D. & Shell a J: Johns 1105 Clearwater Lane Sprlngfleld, Oregon 97477 Harry C Maron 170 South 42nd Street Sprlngfleld, Oregon 97477 Elmer V & Margaret Gardner 541 North 6th 5prlngfleld, Oregon 97477 Rondld N & Shlrley A Scott 4709 Jabper Road Sprlngfleld, Oregon 97477 Harold M & L A Macau] ey 4757 Jasper Road Sprlngfleld, Oregon 97477 Howard R & Idella Hlnshaw 4801 Jasper ROdd Sprlngfleld, Oregon 97477 Kenneth L & Jean M Woolery 4637 Jasper Road Sprlngfleld, Oregon 97477 Orvl11e S & Mdrle W Headlce 4579 Jabper Road Sprlngflcld, Oregon 97477 \ ~\\j Att;~ /7 il/J':-'2-i7.L.-! If?/! _~.__ I 'f" , M"r - 'r ./v ::-f I. ~ -:J' _/ /...... Townshlp, Range, Se5-t"lOn, .:Tax/L2! L/L:7'" f./-.J - Subdlvlslon /1 f/ ~H' ~~ .- APP11catlOnpf6( /-,//7YV _ " Structures no)o'n the pr~per,tyll H .6",/'.......,...<: ~~/ ~~ ....:;,.< / //::?'/V Proposed use of property /~/ Res'd~ntlal~' I~/ Commerclal 0(~1 Industnal LI PublIc Affldavlt ~IJ::.?~1_.~ f./J/\t")/..aVIA . hereby cert,fy that thlS lnformatlon lS true and accurate r' (please-pnntl/ If thlS applucatlon lS for an agrlcultural bUlldlng It wlll be used for purposes allowed by the State BUlldlng Code and Lane~County Code Chapter 10 (zon1n9) and for no other purpose I have the followlng legal lrlterest In the property ~ owner of record" contract purchaser, lessee, holder of an exclu51ve optlon to purchase, duly author.lzed'fo act for the owner, whO 1$ knowledgeable of thlS apPllcatlo~~ J Slgnature/Address!J _ 1 _ ~L..A J)//./L- .~~~G-..{'//": -~ '~/cf'-~ - Teleptone I Zr Date ~hen perml tl. lS ready l10tlfy I~/ Appllcant () O\..rner /~/ Contractor Ql C/ ma 1 1 Owner '. (Z1D) Contractor (Z1D) -. DEPARHIENT OF EIIV I ROI,11EIITAI I1ANAGEI'IE PSB, 125 EAST 8TH AVEIIUE EUGEJiE, OREGOn 97401 C1 '5 j7Yirc-{ Ie L-d ,~~() ( Lot ~;:&'-&D Asslgned Numbers Block I ...,1 1~'t::i')~;\.~ ( . . ',I I Zl D) C/ phDne Phone Phone Contractor's OSRE Plumblng by If Commerclal Resldentlal ~ # of stones ~ of bedrooms~~ SI test hol~ ready DO NOT WRITE 8ELOW THIS LINt # of employee~ fr of umts " SOS ---() EXlSt1ng. r13::,f/'30 ~ .=1:(' /~/ Proposed, SI # Fee Code OeSCrlptlon Sq' Ft or # of Sltes Umt Co<:'t Valuatlon Fee Subtota I $ $ $ $ $ each $ each $ $ $ $ $ y{11'..f2/) /1 1)./ UA"IP'/d /~t' ~_A'1' X~-) Lf " ' 56,-, .....''''''~-....;....t'~;T) __/,,/1 .L-.L. . '_-1:>_ .". /C(' I ;F/ /7\./ "r 1_ / ~ .v-r _ --r-Y;'-4~rT/j...-r;;f~J./--75-j.r;:~ -..... //-j,/ //j Y Y '--;.- , '-iF - I' ~ ~ v:7~~~"'" f ' C/ Cash C/ Check' Recel ved by Water sUPPJ~(' / Pro po s ed Ex 1 S t 1..o.g'-==-- Year Installed Total Valuatlon $ Plumblng_flx~ures at $ Sewer/water conn at $ 4% State surcharge Plans check fee Change of Occupancy TOTAL A PERMIT PROCESSING Mlnlmum setbacks df~er- '~1f~ont( /? <;; Pa rt # Parcel # Parcel s:J; S ;/.?7'- , 1~(<:> . rea.b?'-::> tt., slde commefPu ~r ,P, .... -:- ;),~e ... .. -' / __ /' /' J To {. typed on pewfJ':..... -1'7/;......_-'~ h..,/~.(://'h/~1/.?:7S//.f"!t'.f'Y..~C.~~c<'1'-~S.J {lfA_L I /_J/.. A' -:../ ~(M->>r/..._ ..//..k,::/- ,ltlilt/../ /4<_ -[P:fth urr? WATER POLLUTION CONTROL /' InstallatlOn speclflcatlOns "-- gal tank, ft of dralnfleld, max depth of trenches . To be t,yped on perm1t ~O 'PJ( l~ !;'lI.Ja11t<. SU.~M _~.r I'ttl ':..Jill" .1- ~II.II""H "'..Ht,....J-..,I\. 4;"',1..., II..... 1'-' .",.... ..r 1.1...,....1 I. " ...' f>\Ir '''-" MlU\Jl u,'JJlt.I\U't(] 'un_ __. ........."...;. .."m.l "'!'..... -'-"--. __ _ "~'hU......'iJ.J,.fJ (Jln..rlll't I '\l\In1An.~".""-:'" \U...__-_........../}n/..f,J..,,'I'" nrT.\"'!~t..,/.A,. "-~ "Y1P~..II"'II'.~' t/I'V\W "i', -, _ l~ 0", .r-T-T:l ~.~J..,~ ~_ .~. _ ....f~ nl'J ~-ll'- jl _.LA.AJ~l -A"-'.,\....L-OV . t"':, .. 1\ ' - .. ~." I' ,.~., - t \ to. Telephone I..nR'l-~OMrl By IIfJ;1Mlvn.W'llaIAAI1(\i;.(oate 1/, !tI\11A. ~.m - , .~ '" Olrectlons to slte SIFO Pl ans to CP&I wpe setls) setls) Date Requlled Hold Sl,p to pec Date Comp 1 e ted Da te to pee ;:/ &../ vU o o ep&1 v,IPC ." PlannIng Publ1C Wor~s () ElevatIon C-/ n/a I~/ Address C/ Facll1tj Permlt /~/ Envlronmental Health FOR INFOP,lATlON about progress of your appllcatlon call Permlt Control Center 687-HELP (687-4357) Y' .... - bne county jy ;vol ea ~/V l z/ 0 --- to '1 PERMIT # 2548-81 NOTIFICATION OF INTENT TO ISSUE A TEMPORARY MOBILE HOME PERMIT Oate Jan, 28, 1982 On Feb. 8, 1982 , a 2-year temporary mob1le home perm1t w1ll be 1ssued or renewed to accommodate a fam1ly member d1sab1l1ty sltuatlon for Jean Woolery 4617 Jasper Rd" Spf1d, OR 97477 If you have reason to belleve that (1) the fam1ly member dlsabl1lty cla1med 1S not valld, or (2) If you have eVldence tnat the septlc system IS fal11ng and creatlng a health hazard, you may appeal Issuance of thlS perm1t 1n wr1t1ng by subm1tt1ng your letter to the unders1gned Appeals must be rece1ved by 5 00 p m. of the 1ssuance date noted above Please be adv1sed that 1t w1ll be up to you to prove the val1d1ty of your obJect1on If your appeal 1S accepted, an appeal hear1ng w1ll be scheduled before the Board of County Comm1SS1oners and all property owners w1th1n 300' of the subject property w1ll be not1f1ed of the date and place Very truly yours, DEPARTMENT OF ENVIRONMENTAL MANAGEMENT ~/.-? ~<./ ~ Lane County P1annlng 687-4186 ENVIRONMENTAL MANAGEMENT DEPARTMENT AUr~INISTRATIVE UIVISION / 125 EAST 8TH AVENUE / EUGENE. OREGON 97401 / (503)687-4394 OR 1-800-452-6379 / MEMORANDUM bnecounty TO t~//t1rnv A-I'&nu ~ FROM vt~70' !s:fI/(,--, - /~"W}I' "(j ~L~ SUBJEC10'_.1'''" / ~ ';177 'Ii ,-Ii" /~"J(L DATE d2 - / J' 1.:>- ~c/ tl-1!..'dt/?------,~ /-i'c<-c-:t-C2.<2-----;J!:;..{{/)J ,/:(;-;?,~~!...tJl--;:c2~ /?r~ Y247Ju!....-- ,A..ffJ1 LIt: (/'(!..A!,'/ ;f-i/$ /') ~ (.C I <=c) /--?7-et ~~ _#/.l/-?~L p-nv..:__//?z-<--:?ud 2_) ,..2/1/'7:/ .......;;:,- ,....G :/'....d~.-Zz c:U-c/U ~~, t~;t(.ZZ~fL~c'-(Fe--?fi 0.....<> . r:~C(~( :'-0 ?l--C 6P?- tj I f0 (J.4/ ,&J..-6iih-c..-, c:-l--.:Y rct,4..,C;Lc;~t. c/ c-;;tA r- Yl/f; ~--u/. .ii, ' " ~",~ :t. ~. .... !: ~.. ~, .:" '. '~<'''''~' .;.:. 'f"" J"" ... _.f'';,: . '''. . '.. "f ., -'''' .. > . >" . . . IN RE MATTER OF JEAN VVCOLE2.~ 4~ 11 JA5PE.R Ro. le,02.05 'It 220/ JOURNAL NO P>2 1- €:>D Assessor's Map and Tax Lot Numbers _(e,.Q2.'05 I I I "'- l!lao "''''''''' \1'a ~ ~ ol\ \" 'n- \ ~ \ &0" l}\"') ~ ~ q hD'-1S Il()D .\-b~i\~;J.krnJ\lO" L\~\'.l:, 'S+'\:i Z 2~D a.~, <I.'l ,+ 1'<\0 ^ J ,'""" "'~ ~o" \'-IS>> Qi^~ "Q,\ \;i- 221~ ~"~~~+-~n+ ~l~~,,~\~~w:=)A,,~ Rd. \~ 1202. );;;\- \;,Q6-~~"\)'~*\Ul()9.A2r~)JQA \~ 2 2./5 I&n~"_'l~ ~o,\)o. C\t\'C\r\\\\f) -\-iJ, ~(\\~ 2. ~OO h~: .\)~Q~~>Q..~ c::aN\fD.Ol\\'-\l sCJo1\1)oAOA)s.p- loO L ~\)Y\(l ()'\...L ~~', ,_~(), \ ~vM-V..l/[)q G-l. ~o\l p~\~1'\ 2400 +\Q~(},~.'R..... ~ 0. ~Yn (\ (,\n\)Ou \U/S~C~^f'()-^ (7J \Sf 3000 '\\"0 ld?,roJ 0 1J \ -, . , '2500 _fullnl\r\ ,*~Ao\)~(,_-L\\f\roi:\~u)\4'6rrl\ (\~~'\~ 2foDD (;).~, ct- lY'D"aoJ\1l ~1'::il\^U~'~-\~N..\ i~.f\fO^ ~ 402 r,.\\~n a.{\ ~ "- ~~ d~"'(\C'ffi\ \ J'7 dL\~~OA \ ~r 4o~ ~Jh . ~*}.1'0f\ 407\ () ~ ~Q.~ ,+ ~ C ' fYt Q9.o-m~Q~\\'C Hl \ " l\ 1'6 \ ~O _ rV'- (j I U . - \ I I I M14-01 . lane county . ,. .~ RE Renewal of Temporary MOQ1le Home Placement Permlt TRS/TL~-()7.{!'6 ':tt220 I A Temporary Moblle Home Permlt lS valld for two years only, renewed after that tlme The above llsted Temporary Moblle wlll explre on December 31, 1983 c:lS/fg -<31 #~ A~ and must be Home Use Permlt !i you wisn to renew this permlt, please slgn thlS form and return to Lane County Dept of PubllC Works/Land Management D1V. by December 29, 1983 Renewal requlres '" ", 1 . Payment of the $85 00 renewa 1 fee The purpose for thlS fee amount lS to recover the expense to the County resultlng from processlng the permlt WhlCh lncludes a check of the adequacy of your on-slte sewage dlsposal system and malllng notlce to property owners Wl thl n 300' of your property Thl s fee covers renella 1 for a two-year perlod_ 2 Substantlatlon of the famlly member, medlcal hardshlp. A letter from your doctor or theraplst wlll be requlred to renew the permlt lf such a letter was not submltted when the permlt was lnltlally obtalned. If a letter from your doctor or theraplst was submltted when the permlt was lnltlally obtalned, then you need only submlt a wrltten statement indlcatlng that the orlglnal medlcal hardshlp stlll eXlsts and lndlcatlng the nature of the medlcal hardshlp You may use the other slde of thlS form for your wrltten statement 3 Substantlatlon of the famlly member relatlonshlp between the person ,1vlnq In '(he 1:em~,orary rnoPlle r,OOle dnd tne person jlvlnq 1n "rre prlnc,- pie dwelllnq on the same property You need only submlt a wntten statement ldentlfY1ng thlS fannly members relatlonshlp You may use the other slde of thlS form for thlS purpose To asslst you wlth the renewal of your temporary moblle home placement permlt, you may complete wrltten answers to the questlons on the reverse slde of thlS form and remlt thlS form, together wlth the appl1catlon fee, to thlS offlce " ~ LAND MANAGEMENT DIVISION / Publ1C Works Dept / 125 E 8th Ave, Eug OR 97401 (503)687-4061 I ~ , OJ #- INFORMATION PROVIOED BY THE APPLICANT 1 a ~as a letter from your doctor or theraplst submltted when you first obtalned the permlt? Yes ~ No b. If a letter from your doctor or theraplst was submltted, does the same medlcal hardshlp stlll eXlst? Yes ,/ No C If a letter from your doctor or theraplst has not been submitted, please obtaln ancj' attach the doctor's letter to tnlS letter wnen renewlng your permlt ",---2 Please ldentlfy the name of the person who has the medlcal hardshlp /'".:\J' 1/1'21.< d thlS person's famlly relatlOnshlp to the other person(s) who ",v .4 -<JIJ e on the same property ~!' ~ i ~8)(~ 2::: ~-,..:d-L.LlJ p1 / -I ~ ~ '''is''' ,-I / # \ 't:8 ..., ~i58Fanr1y elatlOnshlp ~r..J1..p.A..) \\ -\ ~ ,e:: 3~),';! 17 /J ,/\ .... "''''~ t/ \ ,..-~'\ .0 (Jj -V ;.), ~, " : ~;;'TT-;] .';/ENCLOSE THE $85 00 4 Slgnature / /)} :Jf~, TildllK -YUU 'v, Juur <-uuperdt-,On I, yuu nave any que"tlon~ rEogdl"I.IlIlY 1.nl~ letter or need asslstance, please contact Carol Dyal or Marsha Mlller, Land Management Dlvlslon, PubllC Servlce Bldg , 125 E. 8th Ave, Eugene, Oregon 97401 Kenneth L Woolery Jean M. Woolery 4637 Jasper Road Sprlngfleld, OR 97477 LAND MANAGEMENT DIVISION I PubllC Works Dept I 125 East 8th Aqe ,Eug OR 97401 (503)687-4061 Lot > I . 1 : j \ 1 ~ \ I Plan Block Vicinity Map Job Location 1/ ,PCnDlt _ : Permit ", Pen-at D ~ ~ , _.JP~ --< <2 (' J J OvS f(Zci... \,'t' Ii \ i \ \ c'- f I J 1 'I ,i " (Ada ress) For For For Permit # . /I Pennit Permit D .~ ~, ~ "" .;, ,<' ~, " ^ ... '" i I 10..... II j i I i . 1'/ ~";';'l~ LJ I :; ~ ~ -tA.LvCv. ~ 1~c;.1 .jJ)~1 : --1 ~ p,~[17--~_ -- 5fr',fi<:.. v ---------- ! I! ~ II' , '" '" , Fer For For .;} V r, . 7Z/J!j/ CLuf (j/I..J.!/........ ..- . LEE H TURK. M D PHYSICIAN INTERNAL MEDICINE 1110 NORTH 18TH STREET SPRINGFIELD. OREGON 97477 OFFICE PHONE 726-1315 Apnl 2,1980 Lane County Helen Ell1ot, permit supervisor RE: John Butterf1eld John Butterfield 18 totally d1sabled from Coronary Artery D1sease. If you have any furUler questions please feel free to contact me. 5incerel~_!_ 1/ ;I-I. (:/ vlef / {fJ-/ Lee Turk M.D.