HomeMy WebLinkAboutPermit Building 1975-12-24 (2)
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LANE COUNTY PERMIT FOR:_
PERMIT NO. 3272-75
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CONSTRUCTION bod MOBILE HOME [] PLAN REVIEW [] CHANGE OF OCCUPANCY [ ]
DOwner
.IAf"lt J:\ _4111 RII~
NAME
RR!!10
Rn~ :;>h!l r:lJ(,H~'NI='. O~r.(;orJ 747-C)Q7'1
ADDREoSS CITY ZIP COOE PHONE
rlJ.(.':f'~,'r . O.lu'~nH ffip,-<;;1~
ADDRESS CITY- ZIP COOE PHONE
o Contraetor 7 I Qn M~'?
NAME
~C\t:\ Rltcu,uJc:'1 I
O.S. Reg. #
Twn 17 Range flJ Sect ion III Tax Lot llu-tn Code Census Tract
Subd ivision Lot Block Acreage 0 Width
Access to Property (Road Name): r~ nl!"...,....~.......... t"'t"~ov OI'\An Depth
Existing Structures on Property:
u........... ....,... ...... r.lUI. t<l.1...,,,,,,rr
Directions to Property, Address:
~:.'\-GM()"'':'':" ~~......... ~,:,.._ ~ ....~... c....... . ....~ 't"IIDU "^O"Pt..4
\.:::::-: ::S;;:: S:l :.::-:- ::r.:IE:: EE ~:r.: './: 7:: ::::: ::!.:-l: 7~::
_...n...... ....A......
STRUCTURE (# BEDROOMS)
SQ. FT.
VALUATION
€;:;--;:: EYET::-! :-:::r:..!;:
SEWAGE DISPOSAL:
PUBLIC [J SEPTIC TANK [
BUILDING
PLUMBING
3% SURCHARGC
MOBILE HOMc
WASTE DISPOSAl
PLAN REVIEW
OTHER [ ]
PLUMBING INSTALLED BY:
OWNER I 1 OTHER I 1 NAMF
2').00
WATER SUPPLY: PROPOSED [ J
EXISTING []
[ J PUBLIC
[ J COMMUNITY - NAME:
[ J PRIVATE WELL
[ ] OTHER - SPECIFY:
TOTAL
25.00
CONSTRUCTION PERMITS & INSPECTIONS AND WATER POLLUTION CONTROL SPECIFICATIONS
MIN. SEPTIC TANK CAPACITY:
GALS.~fVI MIN. DRAINFIELD
~ ;::~ /,:'l..
... _u_ ...nrlo'"'........... .,.....
-:>7"
'iV'
L1N. FT.
MAX. TRENCH DEPTH
._.~.. AU....?t"; ~P.""'''' f:OOn..
?h
INCH ES
P."or''l'''''' .....,.....
~nI'\O('" OTV t 11-.It='
~~~:~~~ ~ ~~?~~~:~~:...~
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TYPE OF CONSTRUCTION
GROUP
FIRE ZONC
STAY 100' FROM ALL WELLS
USE CLASSIF.
SETBACKS. FT. FROM CTR. OF rlW:
FRONT SIDE EXT.
FT. FROM PROP. LINE:
SIDE INT. REAR
ZONC
AUTHORIZED SIGNATURES:
/s/ GREG G:1AY/SAtll TAR I AN
\SLDG. PERMIT - WHITE
OFFICE COPY - WHITE IMPORTANT..
COUNTY TAX - PINK
PLUMBING - CANARY
o;WILDING - GREEN
.\ATION - GOLDENROD
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ISSUANCE DATE:
12-24- 7') BP -= 9
Call 687-4065 to schedule all required construction inspections. Call 687-4061 to schedule all ~~'
septic system inspections. All construction shall comply with the State Buidling Code, D.E.O. standards
for subsurface sewage disposal and the State Plumbing Code. All buildings require a certificate of
occupancy before being occupied.
(See Details on Reverse Side)
(POST THIS PERMIT ON MAIN BLDG. AT SITE)
LANE COUNTY, DEPT. OF ENVIRONMENTAL MANAGEMENT
COURTHOUSE ANNEX, 135 EAST 6lh, EUGENE, OREGON 97401
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3d7;2-7S-
T J....R ()3 S 1'/ TAX lOT /~&c)
S~N:
lOT: BLOCK:
!U I lD ~NG SITE EVAlUAT ION .
~llDING PERMIT APPLICATION NO.
() SITE INSPECTION
APPLI CANT
DATE
1.
2.
3.
4.
5.
Not
ADD I icab I e--- No Yes
Zoning Ordinance Compl iance: Zone 14f'1ud,W . () TI 6.
Subdivision Ordinance Compliance (~ ( ) ( )
Requi red Access () ( ) (--r;:::::
Building Site (Area, Width, Frontage) () () ('1
Other (see comnents) () () ( )
PLANNING DIVISION
COMMENTS:
PLANNING DIVISION ACTION PENDING: YES\ } NOl } APPLICATIONH
BUILDING INSPECTION DIVISION
Not
Aoolicable
l )
( )
( )
( )
No Yes
() TI
( ) ( )
( ) ( )
( ) ( )
7. Plans Submitted
8. Soi I Stab ill ty (foot i ngs)
9. Flood Plain
10. Other (see comnents)
COMMENTS:
WATER POLUTION CONTROL
Not
Aoolicable
( )
( )
No Yes
()~
( ) ( )
II. Meets Department of Environmental
Quality Standards.
12. Other (see comments)
COMMENTS:
CK'D BY: /#/!t. ,;;~(,$~ /~-
Setbacks from ell of roa~
Front ~I ~.~
Side Exterior I I -
Setbacks from interior in s:
Side
Rear
CK'D BY:
DATE
CK'D BY:#,l ~_ I~
() DATE
TO APPLICANT:
Wou Building I Site Inspection:
Can be approved.
$( Cannot be approved at this time as indicated on item NO. above.
J('1 Questions and further information on items I through 6 contact the lANE-
~ /: COUNTY PLANNING DIVISION. Questions and further Information on items 7
\~ through 12 contact the LANE COUNTY BUilDING AND SANITATION DIVISION.
\ ( ) Will be held in this office until you can resolve the problems indicated.
( ) Is being returned.
( ) Your building permit ap'plication fee Is beln9 retu~n~d un~ seoarate cnver_
DEPARTMENT OF ENVIRONMENTAL MANAGEMENI
135 Sixth Avenue East Eugene Oregon 97401
PHONE: 687-4065
lANE COUNTY PLANNING DIVISION PHONE: 687-4186
C55-28
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ErO'ILDING SITE EVALUATION
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LV."BUILDING
.
PERMIT APPLICATION NO.
3~7;1- -;5"
()
SITE INSPECTION
PLANNING DIVISION
T JiA.R t>:';; S II/. TAX LOT /~.. .,
SUBDI~N:
LOT: BLOCK:
APPLICANT
DATE
Not
Applicable. No Yes
Zoning Ordinance Compliance: Zone -11;"",,6".(1,.0) T) TI 6.
Subd I vis ion 0 rd i nance Cemp I i ance I' (....)-- ( ) ( )
Required Access () () (-);;;
Building Site (Area, Width, Frontage) () () (...)
Otner (see comments) () ( ) ( )
I
I.
2.
3.
4.
5.
COMMENTS:
I,ru
BUILDING INSPECTION DIVISION
PLANNING DIVISION ACTION PENDING: YE5l } NOl } APPLICATION#
,
7. Plans Submitted
8. Soil Stability (footings)
9. Flood Plain
10. Other (see comments)
Not
Applicable
( )
( )
( )
( )
,
COMMENTS:
WATER PDLUTION CONTROL
Not
Applicable
( )
( )
II. Meets Department of Environmental
Quality Standards.
12. Other (see comments)
,
COMMENTS:
.-.\
No Yes
T)TI
( ) ( )
( ) ( )
( ) ( )
..
;
No Yes
T)~
( ) ( )
CK'D BY: t~'~4~. y,:;." .
Setbacks from cll of road:
Front III ,. .
Side Exterior 1/\/1 /.
Setbacks from interl!lr.llnes:
Side
Rear
CK'D BY:
DATE
CK'D
BY: /-I-IJ) /h' _ I).:J "'1'
... - {iDATE
~
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/
TO APPLI CANT:
Your Building / Site Inspection:
~(<) Can be approved.
( ) Cannot be approved at this time as indicated on item NO. above.
Questions and further information on items I through 6 contact the LANE-
COUNTY PLANNING DIVISION. Questions and further information on items 7
.. / ,\ through 12 contact the LANE COUNTY BUILDING AND SANITATION DIVISION.
( ) Will be held in this office until you can resolve the problems indicated.
( ) Is being returned.
( ) Your building permit ap'plication fee is bein.9..~~t\,.[I)~d under seoarate cover.
~EPARTMENT O~ ENVIRONMENTAL ~~Au~~cNI
135 ,S i x,~h Ayen~!'l, East/.Jugc:ne _ ()regon 97401
PHONE: . -687-4065 ' .. '. j
LANE COUNTY PLANNING DIVISION PHONE: 687-4186
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C55-28
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PiAlriED
INSTAllER: Complete ~ part ~rm
;(~'Sli1/~
No. Livir Units' fft?oms
Septic Tank: t/
Ft. from well Steel c=l
Inside Dime~ions: ft.
lenjlth 7^' Width ~ .<Diameter
OWNER ~.
NAME Z I RO ,..F G.
SEWAGE DISPOSAL SYSTEM REC. ,. ~.
to signature and submit bo pies with application. ·
PERMIT NO. <272-7~ GG
PROPERTY AUURESS
DEADI~ONDS FEBRY ROAD
Baths Basement ~ Water ~upply
/ Yes No Public \( Other-list
,
Concrete IlJ No. Compartments / Gal. Capacl ty
,J '.lile Disposal Field: r).
DePth~.( Distribution Box: Yes /) No
. Other Distribution-Type
/0 (PO
EUGENE, OREGON
l~&t~of J..jnes-Ft. [TrencQ.1
'I' 2 1::13.~t4. 5. 6. Width Pf
:'Iot Ian (see instructions):
/'
Tota.!-Ss(.
FtA "rtJ
Feet from .J'
WEll - Foundation 7-() I
lot l i n(.lbt ~ I
Front r; Side _ Rear ?-.r
I Ft. Between IFiW#;giller Depth IFille~ Below
Li nes /1) TvJ{lJ.u.-..A1\bove Ti I e "Vi n .IT il e ~ in.
- J' .-c;z;u '\
HAiliNG
ADDRESS
355 BUSHNELL
N
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OJo!'~V _
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'0 / '9p / 190
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'''' I /,-:; I~ i~ I S1,"~'"" /2 OJ Irf?~
I . CERTIFICATE OF SATISFACTOI\YjCOMPlETIONA V a
For Sanitarian Use Only: {/ Oat. 1-S;-7~
In aecordance with 1973 Oregon laws Chapter 835. Section 214 this certificate is ued
as evidence of satisfactory completion of a subsurface sewage disposal system at the above
location.
~ Approved: System Installation conforms to current standards
c::J Disapproved: Does not conform to current standards
Remarks:
C55-11
.4-~ff-
Sanitarian s 'gnature
lANE COUNTY
STATE OF OREGON DEPARTMENT OF ENVIRONMENTAL QUALITY