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HomeMy WebLinkAboutPermit Building 1978-6-30 I>~ f'. J DEPARHIENT OF ErlVIRO~11ElnAL r1ANAGEI ~ . J PSB, 125 EAST 8TH AVErIUE EUGENE, OREGON 97401 Jo tress' Y/..../'7 I/"""'A";/./) P:!/ Clty LUALu Townsh,p. Rang~. SeCtlO~. Tax1L;;r7/Z-A~'~;"';""'- d ?5'h7-;?>>- -- ,fA (/ ,- -on-~ SubdlV1S10n #?~/~ _ Appl1catlOn fOr Y:____/~Jt? J./ ~ Structures now o~ {t;;'""pr;p;;-t-y--- '1 ~ r .r'"'''' / - Proposed use of property I_I ReSldentlal - ~-" ( AppllcatlOn i/ CC - cf,'73 -7,~ ~ Asslgned Numbers " Lot Block () Commerclal c/ Industnal () PubllC Affldavlt I. J/ J //)/JA / ~~ V , hereby cert,fy that thlS lnformatlOn 1S true and accurate ,- yt 151 e"aseFpflnt) - . If thlS appllcatlOn 1S for an agncultural bUl1dwg It ~1111 be used for purposes allowed by the State BUlldlng Code and lane County Code Chapter 10 (zon1ng) and for no other purpose I have the followlng legal lnterest 10 the property owner of record, contract purchaser. lessee, holder of an exclus1ve optlon to purchase. duly author1ze~to~act for the own~~7who 1S knowledgeable~o~thls appllcat10n Slgnature/Address ~,~/j;/ / ~ ,/)& (Z10) ~~.. /" ./~-t ./ r I - -y----" , ~ /" q ~Telep~~e ./' ,/ or Date 7"-'-::-:" ,"7",-' When penTIlt lS ready notlfy L/ Appllcant () Owner C/ Contractor ill. C/ mall C/ phone Owner (Z1P) Phone Contractor (Z1P) Phone Contractor's OSR# Plumblng by If Commerc1al Resldent1al # of stones of bedrooms ~ SI test holes ready DU NUr WRITE BELUW # of employees THIS LINE # of SOS Unl ts C/ EXlstlng. C/ Proposed. BP # SI # Fee Code Descnpt10n Sq Ft or if of S1tes Unlt Co<'"t Va1uatlon Fee $ /.// ~ - /~ $ $ $ $ .$ $ $ \ \ \ $ .#J ~ ,- ...-7 ./ d/"'_.d'/d'A'P' _/ Y::::?/ff _/._</J_ "7P }" j....-v'... ....-r/VY-V-( -~ I ...,...... , ,. (,.P' -- , ~ () Cash -, /./ Check # " RecelVed by v? . .J / ot'L. /1 ' /""~ , , Water Supply / Q 7.:r" .J Total Valuatlon $ Plumblng flxtures at $ each Sewer/water conn at $ edch SUbtota 1 4% State surcharge Pl ans check fee Change of Occupancy TOTAL Part , Parcel # Pa rce 1 SHe Il, slde , lnt rear Proposed Year Installed EXlstmg PERMIT PROCESSING M1nlmum setbacks Zone Il. front Comments To be typed on perml t By Ddte WATER POLLUTION CONTROL Insta11at1on speclflcatlons To be ~.".~ V typed J-J) gal tank, . . foOt (Jof dralflfleld, max depth of t!~>>ches on permlt , Jl.t s Il S: .a.1CkAll ~ a..... ~...t'", ar..M.;..i' 0 k- ~ /1~A_ :dt.-...._~;t~ dZ~-;", ~~~ . /TP- U I t7 i 1/ Telephone BY~ ~ j/_- ~- '1- 7( --""~- --- -- --- Date Dlrectlons to slte ----,,~-- r------ -_...--.-------.---- - D SI!:"Q Pl ans to CP&I setls) Date Hold 511 p \.0,1 PC - sells) Requ 1 red \ - to PlC 0/ CP&I .4h"7 , ~ WPC Viii ~ U Plannlng -//'~ 0 PubllC Works 0 El eva tlOn U n/a /~/ Address - . C/ Facll1t/ Perm1t L/ Envlronmental Health Ddte COIllpleced Oa ce to PCC FOR INFOPltATION about progress of your appllcat10n call Permlt Control Center 687-HELP (687-43S7) ('t.. ~ . .: ,- ~ (. DEPART/lENT OF ENVIRONI1ENTAL 11ANAGEI~EI ~ '(J PSB. 125 EAST 8TH AVENUE fit ~~r-S EUGENE. OREGON 974~Or fA 0 Job Addr~J 4I~/7!t?d../P) p C1t,r' U~"".A~ ,11lWll~~tP. ll~nge.,SpJl(>n, T~<!t //rf'-t:J2 -/J.-S- ~...:<'. I?/ d# SlIbdf\lHfon It.// h' .,- Lot lIlock Appl,catlon for- ~__'/""-'.u?f ~ ~# .. / I Structures now on the property Pr,opo$ed U$J1 "f I'rol'<tr1;y, Cf It<tsldentta1' Cf COIlll1e~taJ' K I U//?/?/'c,e y- . -{P1e~se print) If thlS appllcatlon lS for an agrlcultural bUl1dlng ,t wlll be used for purposes allowed by the State BUlldlng Code and Lane County Code Chapter 10 (zonlng) and for no other purpose I have the followlng legal lnterest In the property owner of record, contract purchaser, lessee. # holder of an exclu51ve optlon to purchase, duly authorlz~t ,for__Stl;,~.mej;'77h~ r~dgea~le~0h-'S appllcatlOn SlgnaturefAddress ~./,-'/ ~./y /' k~./..//~ - (ZlP) 0elePh~pt - - / / or . Date ~-~ 7Y When permlt lS ready notlfy Cf Appllcant Cf Owner Cf Contractor h C/ mall Cf phone Owner (z, p) Phone Contractor (Z1 D) Phone "IIIl Appl H,at ion # J.C - ~7:? -7f-77JlIl- l\$Slgn~d Number. Cf 'IndU$tl'ial ' o l'yb1W , hereby cert,fy that thlS lnformatlon 1$ true and accurate Affldavlt I. Contractor's OSR# Plumblng by If Commerclal ReSldentlal It of .wri~ It (>f wd."OOIIlS c::z SI test holes ready DO NOT WRITE BELOW THIS LINE # of employees It of untts 50S: f~f EXlstlng, BP # f~f Proposed. SI # Fee S.v Ft: 0" COde lle.crlotlon , of Sites ~-#'~LU?-t"~~.~A'/-~.54- ?,f I Ul>lt CO$..t Valuatlon VC::k" ij 7~.. / Recelved' bY~P'~./A'~ // / Water Supply Proposed EXlstlng Year Installed Total Valuatlon $ 1'1~tng flxtUTe$,at $ each SeWer/w~t~1' Conn"at $ each Subtotal 4% State surcharge Plans check fee Change of Occupancy TOTAL Part # Parce 1 # Pa ree 1 SlZe t, slde . lnt rear PERMIT PROCESSING Mlnlmum setbacks Zone t, front Comments To be typed on permlt By Date CP&I Type To be typed on permlt Group F1re Zone Use ClasSlflcatlon For plans lnformatlon call (area lnspector) Dlrectlons to slte BG4/Jf:;J) U Date Phone '--1-;;2...</-17 Sf/cd) Pl ans to set(s) set(s) Date Completed CP&I WPC Date 4?1red 4ff1- Hold Sllp to PCC Cf SIFO ~CP&I I)f' WPC C/ Plannlng C/ Publ1C Works /~/ Elevatlon C/ nfa Cf Address I~I Fac 111 ty Perm1 t ~I Envlronmental Health FOR INFOP~~TION about progress of your appllcatlon call C74-171 Perm1t Control Center 68l.HELP (687-4357) Fee A? $ /b? - , $ $ $ $ $ $ $ $ $ $ $A ~ Da te to PCC