HomeMy WebLinkAboutPermit Building 1978-3-14
\\V( . PERMIT ;;;;//I-(-30-/tj' '"
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;'.\~~" 1[.-<. LANE COUNTY PERMIT ,-f/.<-!iviz: .:CiP<t!tJ P-u/ A;--Y/~
Acreage or Lot SI70 ,-::?.-5""? 4 Partitioning # /Y /t- () Completed SubdivIsion /J/ A-
Contractor's 0 S # /)/ 4- - "O;?/ Lot Blocl<
APPlICANT'S NAME AND ADDRESS-=,I-!, ,/; ti/,&-t9-I;U4~ 37 a~..?--/ 6;! ~~~ Phone?.?i.0'- 76b7
OWNER'S NAME AND ADDRESS ~Y-/ ,7 - .;:! ' / // .. Phono
CONTRACTOR'S NAME AND ADDRES" //./t'/?-r//7 ./'7~...-zVA/(./e~?U'_d./ Phone~.?-
Mall permit to ( ) Applicant ( ) Owner ( ) Contractor (v(Prefer to pick up Call 'i't:/? -c:;7~&;7_ (owner, etc) when ready
STRUCTURES NOW ON JHE PROPERTY )1i260/;../~-??Z-C/>-'- );'J:?C-<#; &-j:Pt<'-:7_"- &~-</L~
'THIS PERMIT IS FOR i~J~i' ./I/lut~ :1Jk-'~/If9?J{.f!.,. -~-U-U.-l # BED ROO MS...;::L'f PLUMB~ CONNECTIONsA:It-
.. 1 "7 t/ ~ .'7"-' /)(
WATER SUPPLY t-I..v!/A...-; .. SEWAGE DISPOSAL../~~O 0, t1--:0' S I # /VA-
THIS PROPERTY IS WITHIN ONE MI LE OF THE CITY OF PLUMBING BY .. ~/]-<../ )~~^---
I hereby certify that the above stateTT'ents are true and accurate, and that I have the follOWing legal Interest In the oroperty _owner of record,
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 t~at ~? owner IS aware and approves of thos action I hereby agree to ~omPIY With a~_afP"cable Codes relating to this per~t
Fee Paid $41, 'I () slgnaturf;;l/..A.. ,C' jJr,:'~... f'~ /< -:/../ . DatL/) ;,1..' ,'" -/7' ;-5-'
(vJNEW ADDRESS ( ) FACILITY PERMIT TO TRANSPORTATION DEPT"/ () SPECIAL PMT' AREA MIN ELEVATION '""-...
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Drall1fleld ReqUired Lineal Feet
MaXimum Depth
Group
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SANITATION
Comments
<;.eE:. A"T\""A..CJ.-tE.D
By Date Date
.. .
PLANNING REQUIREMENTS SATISFIED Bv Date Date Issued
~ONE ~.f71 SETBACKS FRONT (S::-~/ SIDE FACING STREET (FROM CIL) INT SIDE YARD,,(S'l REAR~&I'(FROM PILl
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LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE, EUGENE, OREGON 97401 PHONE 6874394
POST THIS PERMIT ON MAIN BUILDING AT SITE
C5513
BLOG PERMIT _ WHITE BUILDING - GREEN PLUMBING - CANARY SANITATION - GOLDENROD OFFICE COpy - V\.HITE
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'irlE ABOVE SUBJECT lS Jh A SPEC1AL PEPI:n AREA_
THE ABOVE SUBJECT lS INCLUDED IN T~E H U D FLOOD INSURJ.NCE APEP
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Environmental ~[dnagement Department
Division of Construct1on Permits & ,Inspection
125 - 8th Avenue East
Eugene, Oregon 97401
Gentlemen
Re Temporary Mobile Home Permit Applicat~on
Th1S request for a temporary mob1le home permit ~b made under the
general provis1ons of LC 11.100-10(4).
l( (a) A personal, but not necessarily
whereby 1t 1S necessary to have
premlses
(b) The mob1le home will be used for the applicant's personal use
during the t~me a conventional dwelling is being constructed
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on the prem1ses, after which it will be removed; "
(c) The mob1le home will be used b7 an employee o~ this applicant
for bona fide agricultural, forestry management, or ~ineral
extraction purposes;
(d) The mobile home will be
a watchman or caretaker,
industr1al use.
f1nanc1al, hardsh1p exists
someone living on the s~e
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used for residential purposes for
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in conJunc~ion with a commereial or
The specif1c circumstances necess1tat1ng this request are Ii Id t'I ~ II.(
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I understand that th1s perm1t 1S valid for one year only, and is subject
to reevaluat10n and renewal at the exp1ration of that time. "
Mdress
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M74-152
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INFORMATION SHEET
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ex) Building Permit
(X) Site Feasibility Study for Septic Tank
IJ-est holes will be ready
SubdiVIsion
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Number 01 sites
a-8EWAGE DISPOSAl
vPlUMBING BY <A-L~'E.J
"1l.creage or Lot SI.70 7{, _<)".,. tLCYe e 5
'Partitioning # ( ) Completed
( ) Pending
-1I:PPlICANT'S NAME AND ADDRESS !{, h, {;)Dol e leu q".t,3.,. Sa < D f'..P Rri ~<; o-f' /rI
I.{)WNER'S NAME AND ADDRESS, If dlffe~ from applrcant'< ~, ~.$, a..hE'19f", '.'
'-C"ONTRACTOR'S NAME AND ADDRESS c- s.u-:s rn H on GrOOV(-(:f:)-!ifi,.".. V-"'" OA.I ~!'A. '^'" r> _ ~
lIifall permit or results 01 site feaslbllrt't study to ( ) Applicant (X) Owner ( ) Contractor -,(b /I F/l-4.A.--L-~ ~
L-rPrefer to pick up Call 71ft. - ,9~';;7 (owner, etc ) when ready -tj: t. b' -. '!. Contractors O. S. #
t$-TRUCTURESNOWONTHEPR~ERTY f'/jl')bl\l~ h()'Yvlta_ ~I Ntt1ITI-~tl?P()s.€. b~1 Idl'V\('
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PROPOSED USE (this permit) P-~ moeJ/ f-IO"mg ~/;/e~l~~!' (.'-u(d,?/C Oil """"r~'i -t;N1)
"'WA TER SUPPLY e x.. I c:::. T, Yl C, \ 1.) 1"". II (existing or proposed well, etc II publiC, name 01 system)
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(existing or proposed septic tank, etc) S I #<
_ Address
\..{"") PROPERTY IS WITHIN ONE MILE OF CITY (
qUA
*************** ********************** ****** OFFicE USE ON L Y BE LOW THIS LINE *** ********** ** **** ** ** **** *-It *** * *'t **..., * *-'0-"''''
) New Address Necessary
~ON~
) Facility Permit Necessary
SETBACKS Front Side FaCing Street
(FROM CENTERLINE OF ROAD)
) Special Permit Area
Minimum Elevation
Interior Side Yard Rear
(FROM PROPERTY LINES)
To Planning/Building Inspector/Sanitarian/Surveyor
This applrcant appears to have a problem with
Your assistance will be appreciated
By
Permit Processing Section
Responsp
C5512
By
DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
Permit Processing Section
125 East 8th A venue
687-4394
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