HomeMy WebLinkAboutPermit Building 1977-6-30
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JOB LOCATION
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Acreage or Lot Si7P -, .......... Ie, '..J Partitioning #
Contractor's O,S, # f'
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APPLICANT'S NAME AND ADDRES~' - ~~ :..;..0 I!-:;: f~ /,~,. VY' / ;J ".{ f.
OWNER'S NAME AND ADDRESS f":~~, '" ,; ,(},)' 'J.. [ :'d E ,N,.;;: '] _,0" r~.-t. L
CONTRACTOR'S NAME AND ADDRESS~",LI e:. / (.../.' )"} '~+-. '
Mail permit to (L-plIPplicant ( ) Owner ( ) Contractor, ) Prefer to pick up, Call
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STRUCTURES NOW ON THE PROPERTY -,;;,) ;::- i..J
THIS PERMIT IS FOR ,CUiA./ Qto.'O~
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WATER SUPPLY ,j,' ,,' ,JZ...LC
LANE COUNTY PERMIT
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Subdivision
Lot
# BED ROOMe;
SEWAGE DISPOSAL
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.. PLUMBING BY
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THIS PROPERTY IS WITHIN ONE MILE OF THE CITY OF
I hereby certify that the above statements are true and accurate, and that I have the following legal interest in the property: ~wner of record;
contract purchaser; ~ potential buyer; _ realtor or agent', I further certify that (jf not the owner) I am authorized t9Jabt;for the owner of
record, and that,said owner,is ~ware and approves of this,action, I'hereby agree to comply with all applicable Codes relating to this per.'n\i.t,
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Fee Paid $ ':,/'" I ;" ,::-":': ~.. ~', Y, ". Signature y,... {, . c;.- Datp Ii /- /9/_77
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) NEW ADDRESS (. ) FA'CILlTYPERMIT TO TRANSP0HTATION DEPT '() SPECIAL PMT-. AREA, MIN, ELE:{,,i};TION:
SANITATION BUI19.ING ~..J'-'J
- Minimum Septic Tank Capacity (Gallons) #, It/ Type of Construction './ Group ;1 Fire Zone
Drainfield Required, Lineal Feet ,"1' ,,," ,? A"d ...:~'.lJse Classification
'Maximum Depth Comments: :/1'" : (~
Comments: ~ <', .... L
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!,.,6!PI:-ANNING REQUIREMEN'r'S SATISFIED, Bv: J /.J' ,'I-' ,;.' Date:X' ).:J- ) 1 Date Issued: O.b!c-...:30-77
"8 ZONE: :fr4?!' r SETBACKS: FRONT----,,:' I SIDE FACING STREET (FROfv'!...C/U INT, SIDE YARD I. '.' REAR ~J '(FROM P/L)
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LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, '125\EAST 8TH AVE" EUGENE, OREGON 97401 PI7l0NE: 687-4394
, P;ST THIS PERMIT ON MAIr:i BUILDING AT SITE \
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BLDG. PERMIT - WHITE;"SUILDING - GREEN; PLUMBING - CANARY; SANITATION - GOLDENROD' OFFICE COPY - WHITE
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JOB LOCATION
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Acreage or Lot S,ZP
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LANE COUNTY PERMIT
{ ) Compieted SubdlVISlor'
. ' 'Lot
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APPLICANT'S NAME AND ADDRESS-...!'-/t', -- ~ c;..{J/' S-'T: (l S/,'b, -1(1 UA ~r~b
OWNER'S NAME AND ADDRESS 1......17,.., ,{ / )U-~ {: !1AA / / /L. ::> I ",a...-> ,K)-(/L. Je...-J/.
CONTRACTOR'S NAME AND ADDR'ESS~7...1 ("., r ~'YI ~+-: ~ .
Mail permit to ( Ll,"APplicant ( ) Owner ( ) Contractor ( ) Prefer to pick up Call
STRUCTURES NOW ON THE PROPERTY S,,e- D
THIS PERMIT IS FOR .aIM / q & O.L2f'
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WATER SUPPLY '-"'~
Partitioning #
Block
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Phono.{ 1, , I
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Phonp
(owner, etc) when ready
SEWAGE DISPOSAl
# BEDROOMS_# PLUMBING CONNECTION~
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PLUMBING BY
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THIS PROPERTY IS WITHIN ONE MI LE OF\THE CITY OF
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I hereby certlfv that the above statements ar,e,true and accurate, and that I have the following legallnt~rest In the property _owner of record,
contract purchaser, _ potential buver,l_ realtor or agent I further certlfv that (If not the owner) I am authorized to act for the owner of
record, and t':~ said owner I(aware ~n.9,approv:,'iof thiS action I'hereby agree to :omply with all applicable <;:odes relating to thiS permit
Fee Paid <to " -,l)' 1l5l. ( (!O' /, I...'~~ C,'-/:I1!;C-V) Slgnatur;)'7 (1..,,0 I Ie:. ';~C(j..{ 0_ Date Y. /:" /-77
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( ) NEW ADDRESS ( ) FACILITY PERMIT TO TRANSP0RTATION DEPT ( ) SPECIAL PMT AREA MIN ELEVATION
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SANITATION
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Minimum Septic Tank Capacity (Gallons)
Dralnfleld Required, Lineal Feet
_ MaXimum Depth
Comments k,':', _ ,n,.... _ _ = M, /1 -..... ~,"
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BUILDING
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Comments - d"-
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Fire Zone
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PLANNING ,REQUIREMEN:rS SATISFIED By \.... ~f:/_ 'vorl''', F' Date X -,):;)-77 ' Date Issued In(:;.:30 "'(-I
ZONE fir-:-;;, ~ETBACKS FRONT_<,<I SIDE FACING STREET (FROM C/L) INT SIDE YARD L"" REAR 1"""1-?'(FROM PILi
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LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE, EUGENE, OREGON 97401
PHONE 687-4394
POST THIS PERMIT ON MAIN BUILDING AT SITE
C5513
SLOG PERMIT-WHITE BUILDING-GREEN PLUMBING-CANARY SANITATION-GOLDENROD OFFICECOPY-WHITE
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SITE INSPECTION/
ApPROVED ~ DISAPPROVED ~
DATE .9.. 7-7?
INSPEC~~
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REMARKS
FOUNDATION INSPECTION
ApPROVED L....c:J --;, SAPPROVED 1---1 DATE.2 - ;!. - 751 I NSPECTOR ~
REMARKSj-k Akk ~ '7'-7- 7'/ (1A"f
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FRAMING INSPECTION
ApPROVED /~'SAPPROVED / / DATE 2 - 2--7J? INSPECTOR
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REMARKS
LATH OR SHEETROCK INSPECTION
ApPROVED 1---1 DISAPPROVED L-.,I DATE
INSPECTOR
REMARKS
Mp))"J!
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FINAL INSPECTION
ApPROVED ~SAPPROVED ~ DATE 2 - 2---;7 i INSPECTOR c;)1",<rt!!-
REMARK 5
CERTIFICATE OF OCCUPANCY
READY TO ISSUE ;---y NOT READY TO ISSUf ;---y DATE
INSPECTOR
REMARKS
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~P(2II0(-n~i/i3-77
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INFORMATION SHEET
~Buildlng Permit
3 64 6c.1?i=-. c.,
( ) Completed
( ) Pending
APPLICANT'S NAME AND ADDRESS l.\. \ . e. ~.-1'Y\-=.--\Y<Lr Ai fVl I lPJL! (~ p....o (OJ" /.... c;\(
OWNER'S NAME AND ADDRESS, If different from applicant's '\Cf"h Il)"""",,(pvf) 4f.,2,7...Jr;"",.."
CONTRACTOR'S NAME AND ADDRESS U J ,'- ~~+n y -h ~f'\-. 0
Mail permit or results of site feasibility study to J><J Applicant ( ) Owner ( ) Contractor
'( ) Prefer to pick up Call (owner, etc ) when ready
STRUCTURES NOW ON THE PROPERTY ~(J\ \ c.J? ~
PROPOSED USE (this permit), G, f.1 "-(1 () P ./
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WATER SUPPLY fALOt1n,,,\ 111010_ ~ nm.lCLQ
SEWAGE DISPOSAl ::-X lD-t',;;~ LQ riTL- ~II'Y hl11)',Q.,Q,
PLUMBING BY ~ f.nA l -'
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Acreage or Lot Size
Partitioning #.
) Site Feasibility Study for Septic Tank
) Would like to meet on site Call
Test holes will be ready
SubdivIsion
Number of sites
(owner, etc)
Lot
Bloc~
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PhoneA9,4 qqqq
Phone 74-(., - 06(.1
Phone
{existing or proposed well, etc If publiC, name of system)
(existing or proposed septic tank, etc) S I #
Address.
) PROPERTY IS WITHIN ONE MILE OF CITY (
*** **** ******** ** ****** ************ ** ** **** 0 FF ICE USE ON L Y BE LOW TH IS LI N E *** ****** **** ****** ** ****** ** ** * *' ** ** **** **
( ) New Address Necessary ) Facility Permit Necessary
ZON~ SETBACKS Front Side FaCing Street
(FROM CENTERLINE OF ROAD)
) Special Permit Area
Minimum Elevation
Intenor Side Yard Rear
(FROM PROPERTY LINES)
To Planning/BUilding Inspector ISanltananlSurveyor
This applicant appears to have a problem With
Your assistance will be appreciated
By
Permit Processing Section
Response
C5512
By
DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
Permit Processing Section
125 East 8th Avenue
687-4394
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