HomeMy WebLinkAboutMiscellaneous Plans 1966-9-22
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Lcne Con:.ty Pl.):1n:ng Commission
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DEPARTMENT OF HEALTH AND SANITATION
LANE COUNTY COURTHOUSE
EUGENE, OREGON
Scptarber 16, 1966
"-SD KINGERY, EdIth
JJ 03 1$ 4500
~r. Frank Hruza, Secretary
Lane County PlannIng Commlss Ion
Courthouse
Eugene, Oregon
RE: KINGERY "I~OR SUBDIVISION
ThQ above described property has been InvestIgated by thIs department
and Is hereby given approval for the Installation of Individual sub-
surface sewage disposal systems.
HAAOLD D. LYMAf~, M.D., DIrector
nichard A. Kirby, n.s.
Sanitarian II
Ml(:sk
(2)
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RECE'I'PT~'Ne~
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REQUEST ~ 2llf INSPECTION
lWP..!1-RANGE..&,.SEC. ,}.1
TAX LOT No.45oo CODE
SER I AL No.
DATE S~tA~h~~6, Iq~;I
R"K.- TEL. No. 7q(,.. .,.JU
\1
BY M~.. I\r" \"'11. .
MAILING ADDRESS ~it'l7 T.........n"
~..,naflfIJldA n"'r"
OwNER or PROPERTY . ill""", SIZE Dr PROP. ., .....~.." LEGAL ACCESS?_n....A""'nd F....ry R....
CONSENT or OwNER? y_"
EXISTING STRUCTURES ON PROPERTY ~..... .,n '....nt p.rt ft' In._
SOURCE OF WATER SUPPLY: PUBLIC
SPRING
WELL: DRILLED XX DRIVEN
DUG
DESCRIPTION OF SITE (DIRECTIONS, LANDMARKS, HOUSE OR BOX 'NO., IF ANY):
GlIIIe Fllrm Rood turn tight on Dclltb:>nd Ferry Road and proceed 10 mile right aide
with brick type sldolng. '
PROPOSED USE OF SITE (E.G., NUMBER or DWELLINGS, COMMERCIAL OR INDUSTRIAL USE, SUBDIVISION):
000 dWelling ( Minor Subdlvllllon) Route 2, Box 255
iii
fi(.
URBANIZING AREA. (Minor Subdivision to be lubmlttod.FEE:N
o. or
SPECIAL PERMIT AREA. No. or
SITES~
ACRES
TOTAL-
$~
~f IOn
leC!:.....t. '
1
RESULTS OF INVESTIGATION:
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BEFORE CONSTRUCTION IS STARTED BRING THIS rORM TO THE BUILDING AND SANITATION DIVISION AND ~
MAKE APPLICATION FOR-; BUILDING PERMIT. IF THE PROPERTY IS A PORTION ONLY OF A TAX LOT, A
METES AND BOUNDS OESCRIPTION OF THE PARCEL MUST BE FURNISHED. EXACT SPEClrlCATIONS FOR THE
SEWAGE DISPOSAL SYSTEM WILL APPEAR ON THE BUILDING PERMIT. Two SETS or THE BUILDING PLANS
AND PLOT PLAN WILL BE REQUIRED.
~
LA~~NTY BUILDING AND SANITATION DIVISION: ~_,
-----,~. ~ cd?z ~.
/ ~ILOING INSPECTOR . - SANITARIAN ..
~ REPORT IS NOT COMPLET~THOUT THE SIGNATUR~S OF THE B~ING
J6~y
INSPECTOR AND SANITARIAN.
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