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Home My WebLink AboutPermit Building 1974-6-21 I, . /UI't' , ,- y "\ "~::~:"I' PROPERTY OWNER ~ KeDhart. Jac:t CONTRACTOR ilPJ CK.. '? LANE CO. BUILDING PERMIT OR MOBILE .ME BUilDING me MH D MAILING ADDRESS IGS;O S. "A" Street MAILING ADDRESS USE PERMIT PERMIT NO, ICS8-74 10 0 ~- 7<../ Sprlngflold, Orogoa PHONE 71)6-!lf-l29 PHONE Same PROPERTY LOCATION -INCLUDE POST OffiCE 14th St. to Oolrose. rlQht to Vora 143G Dolroso PROPERTY LEGAL DESCRIPTION - METES. BOUNDS Vera 00110 Lot B Block 3 TWP. RANGE SECTION TAX LOT NO. CODE CENSUS TRACT 17 03 24.5'.3 11" S</ct1J 24-100 EXISTING STRUCTURES ON PROPERTY tlono LEGAL ACCESS TO PROPERTY Dolroso PROPERTY SIZE - FT. APPl. NAME OlMmor & MAILING ADDRESS FOR MOBilE HOME PERMITS ONLY No. of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT WIDTH DEPTH AREA Connect to Existing Sewage System D New System D TYPE CONSTRUCTION SQ. FT. :# BDRMS VALUATION Dwelllna Framo 1545 Q 12 (;1) lB. 540 1.750 500 @l 3.50 G~r~re. attachod. celled - 20.2!;0 Subd I vis I on ('oDrolled oer Stan PotllaSC!( SEWAGE DISPOSAL PLUMBING INSTALLED BY PUBLIC 0 BUILDING WASTE DISPOSAL PLUMBING PLAN REVIEW PARK TRAILER SEPTIC TANK XlI OTHERD $~7 _00 '>0,00 l4_00 FEES OWNER 0 OTHER: NAME WATER SUPPLY PUBLIC l!J'< 0 OTHER TOTAL I 161,00 COUNTY BUilDING & SANITATION SPECIFICATIONS MIN. SEPTIC TANK CAPACITY WITH DIST, BOX, GAL 900 DRAIN fiELD REQUIRED lIN, FT ISO TRENCH WIDTH FT. 2 OR SQ. FT. 300 TYPE OF STRUCTURE OCCUPANCY ';Sl BLDG. SETBACKS u FT. FROM CTR. OF ROAD RIGHT OF WAY & J lONE RA PUBLIC UTIL. EASEMENT USE CLASSIFICATION FRONT 45 SIDE INT. 7' PUE SIDE EXT, 40 AUTHORIZED SIGNATURE - DATE 151 J_E_ Doss bv C. Ilorbauqh REAR 5 John Shoolt DATE 6-21-71) sf BLDG. PERMIT - WHITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GReEN SANITATION - GOLDENROD Call 6B7-4065 ta schedule all required inspectioos, All construc- tian shall comply with Uoifarm Building Cade, D,E.Q, standards IMPORTANT: for subsurface sewage disposal and county regulations covering plumbing, All buildings require a certificate af occupancy before being occupied. (See Details on Reverse Side) FORM =- C55-13 (POST THIS PERMIT ON MAIN BLDG. AT SITE) LANE COUNTY, DEPT, OF ENVIRONMENTAL MANAGEMENT COURTHOUSE ANNEX, 135' EAST 6th, EUGENE, OREGON 97401 . JS/cl-/- 106:1- :I T!R 03 S :2 rj TAX LOT C US TRACT Pat Drlle.. L- "6 e.5 APPLI CANT: h-: / --.;.::. NAME (If'OI1Qr / ADDRESS ~ BUlLDING'SITE EvALUATION ~ ( ) ( ) ( ) Building Permit Appl ication No. Site Inspection PHONE DATE 6-/'-!-7V Pre-Permit Investigation - 0- ..... ._~ - - -.. ...- ,~ , I. Zoning Ordinance Compliance (Zone R4 ) Subdivision Ordinance Compliance NOT ;1 icable I) ( ) ( ) ( ) ( ) ( ) NO YES NAME OATE LANE COUNTY PLANNING DEPARTMENT 3. 4. Required Access ( ) ( ) ( ) ( ) ( ( ( ) r\~ ~ -g;",." , ;(.,-/7 -:?l/ 2. Building Site (Area, Width, Frontage, Setback) Other (see comments) 5. '- COHJolENTS: - BU I LD ING INSPECTION SECTION NOT NO YES NAME ? ~ DATE aDDl icab 1 e (lh~tI~~ e" khp 6. Plans Submitted ( ) ( ) fX) ;- / 7. Soil Stabil ity (foot i ngs) I~ ( ) ( ) B. F1 ood Plain ( ) ( ) 9. Other (see COIMlents) L ( ) ( ) - COMMENTS: SANITATION SECTION NOT NO YES 1~m~ DATE app I i cab' e t/2 0/7 L-I 10. Sewage Disposal I) ( ) ( ) \J" .' ; II. Usable Area ( ) ( ) ( ) 12. Water Supply ( ) ( ) ( ) 13. Other (see Comments) ( ) ( ) (/ ) COMMENTS: TO APP LI CANT: Your Building Permit / Site Inspection: ):'1Ir<~can be approved. V'?/ .n() Cannot be approved at this time as indicated on item NO. above. ~ (b~ Questions and further information on items I through 5 contact the Lane- COUNTY PLANNING DEPARTMENT. Questions and further information on items 6 through '3 contact the Lane Countv Buildino and Sanitation Division. () Will be held in this office until you can resolve the problems indicated. () Is being returned. () Your building permit appl ication fee is being returned under separate cover, LANE COUNTY PLANNING DIVISION 135 Sixth Avenue East, Eugene, Oregon 97401 Phone (503) 687-4186 LANE COUNTY ENVIRONMENTAL MANAGEMENT 135 Sixth Avenue East, Eugene, Oregon 97401 Phone (503) 687-4065 C55-28 . . . Permit No 1068-74 CURB CUT .., . . Dm!' 6-24- 74 S 10EWALK PERMIT IN THE BOARD OF COUNTY COMMISSIONERS OF LANE COUNTY WHEREAS, the attached application has been fully considered by the Board of County Com- missioners of lane County, and it is the opinion a nd judgment of the Board that the said application should be granted, and that a permit should be issued, now, therefore, it is hereby, ORDERED, that a permit be and 1690 SOUTH "A" ST., SPRINGFIELD, or constructing the following facility: VER~ DELLE LOT 8 BLK, 3 is hereby issued to OR. JACK KEPHART for placing, building DwELLING 1436 DEL ROSE upon the right-of-way of County Road No, Mile Post in strict conformity to the exhibits attached hereto, and subject to all terms, conditions, agreements, stipulations and provisions contained in the application and permit, the Rules and Regulations Gov- erning Facilities to be Permitted upon County Road Rights-of-Way, as set forth by the lane Man- ual 50,190(2) any amendments thereto, and any other applicable regulations, law or ordinance. Special Provisions: 1. Driveway will be constructed in accordance with the attached driveway approach specifica- tions (Drawing M9B-50), Permittee will be responsible for the immediate removal of all mud, dirt and debris from the roadway and right of way caused by his operation, leaving the roadway and area in a neat, acceptable condition, 2, 3. SIDEWALKS WILL BE CONSTRUCTEO IN ACCORDANCE WITH THE ATTACHEO SIDEWALK SPECIFICATIONS ANO ORIWING M 98-49. THE STANDARD CURB TYPE SHALL BE CONSTRUCTEO UNLESS OTHERWAISE SPSECIFIEO. This permit is revocable at any time, and will be strictly adhered to and no work other than that specifically mentioned above is hereby authorized, This permit shall be void unless the work herein contemplated shall have been completed be- fore JUNE 24 ,19-15-. Expires ,19_. Inspected and Approved Approved by Board of County Commissioners By C-~recto ~7rk ~ BLUE - ROAD SUPERVISOR ORANGE - BUILDINC & SANITATION DEPT YELLOW-REAl ESTATE C98-79 Data By WHITE - OFFICE FilE GREEN - RESIDENT ENGINEER PINK - PERMITTEE , , . . .' .' ' Dot" Permit No CURB CUT PERMIT IN THE BOARD OF COUNTY COMMISSIONERS OF LANE COUNTY WHEREAS, the attached application has been fully considered by the Boord of County Com- missioners of lone County, and it is the opinion and judgment of the Boord that the said application should be granted, and that a permit should be issu'ed, now, therefore, it is hereby, ORDERED, that a permit be and is hereby issued to for placing, building or constructing the following facility: upon the right-of-way of County Rood No, Mile Post in strict conformity to the exhibits attached hereto, and subject to 011 terms, conditions, agreements, stipulations and provisions contained in the application and permit, the Rules and Regulations Gov- erning Facilities to be Permitted upon County Road Rights-of-Way, as set forth by the lane Man- ual 50,190(2) any amendments thereto, and any other applicable regulations, law or ordinance, Specia I Provisions: 1, Driveway will be constructed in accordance with the attached driveway approach specifica- tions (Drawing M9B-50), 2, Permittee will be responsible for the immediate removal of all mud, dirt and debris from the roadway and right of way caused by his operation, leaving the roadway and area in a neat, acceptable condition, .f':: !)' '-1~/ 0 ~1t/ This PC~it is revocable at any time, and will be strictly adhered specifically mentioned above is hereby authorized. to and no work other than that This permit sholl be void unless the work herein contemplated sholl hove been completed be- fore ,19_, Expires ,19_, Inspected and Approved Approved by Boord of County Commissioners By , Dat.. By Director of Public Works WHITE - OFFICE FILE GREEN - RESIDENT ENGINEER PINK - PERMITTEE BLUE - ROAD SUPERVISOR ORANGE - BUILDING & SANITATION DEPT. YEllOW - REAL ESTATE C98-79 '. LANE aNTY BUiLOING [Q( _ /1n~/ PERMIT OR MOB. HOME USE PERMIT PERMIT NO. 1'/" PROPERTY OWNER BUILDING MH D MAILING ADDRESS ~L ~~ :nj'"~" P:':,.:--: 'J.:~:-~.: ~)\~~~::-:C~ (;:~/I~'/:-~;)S~JI ~';tC';~~~ r,. . ,,..~ )0" CONTRACTOR MAILING ADDRESS '," --:" PROPERTY LOCATION -INCLUDE POST OFFICE r::;~~ :;:'. C:J .:,Jr'::-:". '-'~(,~t \:0 \:~~.C ~:;:;) C;,~?C:}::: PROPERTY LEGAL DESCRIPTION - METES. BOUNDS ':-.:'!"Cl ['J ~(; ~C?,~ [)~C:.:t D TWP RANGE SECTION TAX LOT NO. CODE CENSUS TRACT 2~~Q~~) EXISTING STRUCTURES ON PROPERTY l:~8 LEGAL ACCESS TO PROPERTY C'Jh'Q:) PROPERTY SIZE - FT. .." ,-~ v/} 20 APPl. NAME C:~'S~~:8Y & . MAILING ADDRESS FOR MOBILE HOME PERMITS ONLY No. of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT WIDTH DEPTH AREA Connect to Existing TYPE CONSTRUCTION Sewoge System D SQ. FT. tt BDRMS .' ...' <) ''1 f' ) V:,,:I, ".' t. ~-J :~_,:lOk:' 91' <';':::J Cc,7(V'~. c~C:::::~::1. cclle(1 :.;C:! ~-: ~1 c/, J..4....J ()...~:;avIGI~::1 :"';~)~C~~ C:i:;, 5tc) r:e~e.:::)t.~!.. SEWAGE DISPOSAL PLUMBING INSTALLED BY OWNER 0 OTHER: NAME WATER SUPPLY PUBLIC lli1 0 OTHER PUBLIC 0 BUILDING WASTE DISPOSAL PLUMBING PLAN REVIEW PARK TRAILER SEPTIC TANK l-n OTHERD n.CJ r,:;.OJ ;::"J..:};.l FEES , TOTAL , K,LGJ COUNTY BUILDING & SANITATiON SPECIFICATiONS DRAIN FiElD REQUIRED I~O OR SQ. FT. MIN. SEPTIC TANK CAPACITY WITH CISl. BOX; GAl. ~~'JG 11 UN. FT TRENCH WIDTH FT. TYPE OF STRUCTURE OCCUPANCY I (', J lONE M PUBLIC UTIL. EASEMENT f3~j BLDG. SETBACKS n FT. FROM eTR. OF ROAD RIGHT OF WAY FRONT ~~:; SIDE INT. I' v~r:! SIDE EXT. !k"1 AUTHORIZED SIGNATURE - DATE USE ClASSIFICATION REAR s 101 J.l!. D~S[) f;y C. ;!arblrJgh Jc.'l;'l m".ook BLDG. PERMIT - WHITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENROD ..~ PHONE . . ' ~ PHONE New System D VALUATION ~ ,- ".,,, _ '.J'" ...,.:,..../;... , r-:;, r:. I (. '0(, ,,~., iJ"'V DATE ~2~Eo',,'''' ~f Coli 6B7-4065 to schedule 011 required inspeclioos, All construc, tion sholl comply with Uniform Building Code, D,E,Q, stondords IMPORTANT: for subsurface sewage disposal and county regulations covering plumbing. All buildings require a certificate of occup'ancy before being occupied. ........' ~ (See Detoils on Reverse Side) ,ORM =..cSS-lJ (POST THIS PERMIT ON MAIN BLDG, AT SITE) LANE COUNTY, DEPT, OF ENVIRONMENTAL MANAGEMENT COURTHOUSE ANNEX, 135 EAST 6th, EUGENE, OREGON 97401 , . . ~ SLAB FLOOR PLUMBING GROUNDWORK .1 ApPROVED ;---? DISAPPROVED ~ DATE INSPECTOR REMARKS GAS PIPING GROUNDWORK ApPROVED / / 01 $APPRDVED ~ DATE INSPECTOR REMARKS I, ROUGH PLUMB I NG ApPROVED ~ 01 SAPPROVED ~ DAT~~./ IJI REMARKS INS):.l>,._t'-'~ ROUGH GAS PIPING ApPROVED ~ DISAPPROVED ~ DATE INSPECTOR REMARK 5 FINAL PLUMBING DISAPPROVED ~ DATE 1-/~-;1fINSPE~4 ApPROVED W REMARKS FINAL GAS PIPING ApPROVED Cl DISAPPROVED ;---? DATE INSPECTOR REMARK S CERTIFICATE OF OCCUPANCY READY TO ISSUE ~ NOT READY TO ISSUE / / DATE INSPECTOR REMARKS , " "",,~,'"' ~ -..~ "" J"'i:l (..."-........1 LANE cotTY BUILDING PERMIT OR MOBILE_ME BUILOING m MH 0 MAILING ADDRESS ~e/J jo 1ft. )CG'~:~ MAIUNGIADDRESS USE PERMIT PERMIT NO, ~::~;'1-,;~'~ --- . . " PROPERTY OWNER CONTRACTOR ~;7~~'::J~ :()~~~p . f'.......,..-.." \ ~',-, / ." PHONE ....~.' '.' 0-/ '-:-:....)= -.~) PHONE ,"r ~, PROPERTY LOCATION - INCLUDE POST OFFICE ,-' _ ~:~~:~ ~)Co C~J ~L;~~\;,:;QO ~a:):, CO e:~~'\"';:,~':;~~S;.,-}':"CJ? PROPERTY LEGAL DESCRIPTION - METES, BOUNDS ~.7C ':~)~ 1.10 ~',\::; "( on(.':_:~:~ TWP RANGE SECTION TAX LOT NO. "~' Ji,\ ~. .,'"\ t I ',- \ ' , ~. ,',',' \' .......,.. ..."... \", CODE " CENSUS TRACT r-'\ '", ( .~-.l Ji APPl. NAME & MAILING ADDRESS FOR MOBILE HOME PERMITS ONLY No. of Bedrooms '< f"r" ~ ') ....-".,. ~. EXISTING STRUCTURES ON PROPERTY l__~:) LEGAL ACCESS TO PROPERTY ~:..; ~ rc-:~ PROPERTY SIZE - FT. WIDTH DEPTH AREA STRUCTURES TO BE BUILT THIS PERMIT Connect to Existing TYPE CONSTRUCTION .c, '00 Cc r"'C::l Sewage System 0 SQ. FT. ~ BDRMS ~.,~, /" " () Cr'- " ~d'-') , ' .fl..:' ~,),1 New System 0 VALUATION "'1'\ ,,/ ,::'.'C'\';:) -:'.C;C "~:':'."i. C'-U L.': , , , '... , .")~!- . . /"'1 / ';'t :," ). <\' ,~ .~. , ."'; ^ , , , ,,~,' \.'I'.'h~'0 """\-.l . , .~'\JU,I:';::"_~ r.',./~~_....;;,: [.~:.r ,. V'" I... n~r/-""- j ~ . OTHERO illo:""J \ ,~~" "(\ ' PLUMBI~G INSTALLED BY OWNER 0 OTHER: NAME WATER SUPPLY PUBLIC Oi 0 OTHER " SEWAGE DISPOSAL PUBLIC 0 BUILDING WASTE DISPOSAL PLUMBING \ . PLAN REVIEW . PARK TRAILER SEPTIC TANK '8 FEES , . ',\..."" , ).' -,.'_.'" \ ;~'- ~'Jo( ':) \" - ,', ..... TOTAL $ .~'- ~ o~,J COUNTY BUILDING & SANITATION SPECIFICATIONS DRAIN FIELD REQ,~IRED MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GAL. ,'~ L1N. FT ...~ -' TRENCH WIDTH FT. OR SQ. FT. u < I,' \ \ , " '\'" ,~-~~~ \.. JY ~ ,^,,:\ .(,~' "'~~,>) ~'\..~':~~ II 'I; TYPE OF STRUCTURE ,l.-.l BLDG. SETBACKS OCCUPANCY o ~> ,) ZONE r" PUBLIC UTIL. EASEMENT FRONT , ',~ FT. FROM CTR. OF ROAD RIGHT OF WAY )0 ., SIDE INT. .. '-',' SIDE EXT. AUTHORIZED SIGNATURE - DATE USE CLASSIFICATION REAR " 'I j. '-- . , , ,,' .~v ~;. ,~:C,=)(...~~:) J. ~.:'_) . ,,,,,-~ , DA~E " .. ", L) , ,> '--, 4..', BLDG. PERMIT - WHITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENROD Call 687-4065 to schedule all required inspections, All construe, tion shall comply with Uniform Building Code, D,E,Q, standards IMPORTANT: for subsurface sewage disposal and county regulations covering plumbiog, All buildings require a certificate of occupancy before being occupied. (See Details on Reverse Side) f"ORM =CSS.13 (POST THIS PERMIT ON MAIN BLDG. AT SITE) LANE COUNTY, DEPT. OF ENVIRONMENTAL MANAGEMENT COURTHOUSE ANNEX, 135 EAST 6th, EUGENE, OREGON 97401 . . A <, ,I . SITE I NSPECTI ON ....0." 9 o"i;:~o'l'= om. . ,",,,me REMARKS/r k~~~/~~ ~ -trv;;j<.qt..J JJ. , '~o FOUNDATION INSPECTION -L] ApPROVED / --I---;;,SAPPROVED 1---/ DATE 1""-1~ INSPECTOR0 REMARKS ~flI'C;;k P.MY7~ I~ -.28 .Wg'j'lt, ;r~ I '0 I' ~1. FRAMING INSPECTION ApPROVED 1l/1/DISAPPROVEO Cl OATEL~-' R~MARK#,~~.Ur~ q-/2-;> . i j'4tltJAJt U If .it ~ff / <~ . '" . 0/- Z, 1,- -'/<+- LATH OR SHEETROCK INSPECTION ApPROVED ~DISAPPROVEO ~ DATE ~ -:J6J?l/INSPE~T<< (E'l, REMARKS FINAL INSPECTION C7 ApPROVED ~SAP~"';VED ~ DATE/lr-/8~7t{ INSPECTO(7 REMARKS~A,~.LJ1{~ (tJ-j54I/CI(., ~ II-It{ /711 f// . --" 7 e,l CERTIFICATE OF OCCUPANCY READY TO ISSUE Cl NOT READY TO ISSUE Cl -DATE INSPECTOR REMARK 5 lOr; ~~. f:/. ~ . 'Y 8-}'y 7(~/"JI, #~ , IN top PROP<A SEWAGE DISPOSAL SYSTEM RECORD. . . ", .,~. part of _ to signature and submit both copies with application.i'. .\ PERMIT NO. 1068-74 PROPERTY ADDRESS JS 1416 DELROSE Basement Water ~Pply Yes No rPub Ii c Other-Li st Baths IN No. Living Units Bedrooms Septic Tank: Ft. from well Steel c=J Inside Dimensions: Ft. Len~h q Width,J( Diameter OWNER NAME dACK KFPHART Concrete ttrNO. Compartments ( Gal. Capacity Tile Disposal Fiel~ DePth.~ Distribution Box: lJest No Other Distribution-Type /60 0' MAILING ADDRESS 1600 C;OIJTIoI IlAII .c:;,T_ Feet from WEll Lot Li ne Front I 't. Between Lines It) Foundation SPRINGrIELD, OR. 97477 Length of Llnes-Ft.;r~ (TrenCh I Total Sq. '. in 3. 4. 5. 6, Width'- Ft. :?tf>t) 'lot Plan lsee instructions): Side IFiller IFiller Depth Tvpe it Above Ti Ie 'J Rear Iof6'<p7 IFi Iler Below in.ITile 1'1 in. ~[:Vtb" 0 01 . JUL 08 1974 . weter Pollution 'f ~contrdl Division ... Lane county, ,!<i . " "'oJ () tC J. K 6',<;E - I fJ6t< ~, , I \ L - - - -- , I , I../!;::. ,... h...,. _.....- - - Date 7-7~].ff Sl nature CERTIFICATE OF-SATISFACTORY ~at7: 711/7'1' IS Issued at the above For Sanitarian Use Only: In accordance with '973 Oregon Laws Chapter 835. Section 214 this certificate as evidence of satisfactory completion of a subsurface sewage disposal system 1ocaf~' Approved: System Installation conforms to current standards Disapproved: Does not conform to current standards Remarks: C55-11 s~~~~~~u~ L~ COUNTY STATE OF OREGON DEPARTMENT OF ENVIRONMENTAL QUALITY LANE COU. BUILDING PERMIT OR MOBILE ~USE PERMIT TYPE - BUILDING [1 MOBILE HOME Dose REG, # PROPERTY OWNER MAILING ADDRESS k'e.oroa-r ,TACK. )(oCj'() ~.Il A'I 8~FL..D CONT~ACTOR MAILING ADDRESS APPLICATION :"O;rI ,I PERMIT:#: . ~.$' -; 'f PHONE 74ta-442.C1 SonLll- PROPERTY LOCATION - INCLUDE POST OFFICE , 411+ c::::;,-tcQc2;t -ID ~Ql..roSQ..) '1\5hi" -I-D l.)sl,Q.. iJe.ro. 'PJLLte.... kOT SEe, TAX LOT # ~Lj PHONE I 4 3(0 D.lLL\ DSQ... PROPERTY LEGAL DESCRIPTION LOT - BLOCK - SUBDIV. TWP RANGE APPLICANT NAME AND MAILING ADDRESS FOR MOBILE HOME PERMIT ONLY Number of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT ~1.u.LlGtlL'J Go.rctJ'- . at\-, ~CQ-\~ i-r ~ ~L.- 3 METES & BOUNDS 0 YES ATTACHED 0 NO CODe CENSUS TRACT .:1Y-/oo tr"?" ~ DESCRIBE EXISTING STRUCTURES ON PROPERTY IF ANY '}\~- LEGAL ACCESS TO PROPERTY - ROAD NAME OR # PROP~~~ DEPTH AREA Connect to Existing Sewage TYPE CONSTRUCTION System D or New System Req, D SQ. FT. @ # BEDROOMS VALUATION t <;"4:"; \~ ~) 1 ~ /5LJ.D ~oo@..?So /, ,So ~ D.dq (') , SEWAGE DISPOSAL (su.e;l:)\\:llsl'l:ly) o.'pproo~ ~ ~ ~a.~~) /, PUBLIC 0 BLDG. WASTE 015. PLUMBING PLAN REVIEW PARK TRLR. TOTAL PLUMBING INSTALLED BY / SEPTIC TANK 0 $.:IJ, Of) 5:; f) ,nn ,.. \.\.,Q{J OTHER D WATER SUPPLY OWNER 0 OTHER 0 NAME PLANS FU~HED YES~ NOD SIGNATURE OF APPLICANT FEES PUBLIC 0 PLUMBING FEES --1..Q FIXTURES OTHER DATE G-J 4- -7-f DATE h -\4-' 'f lel/Dt-,K'l-7i COUNTY BUILDING & SANITATION SPECIFICATIONS I DRAIN FielD REQUIRED I UN, FT, / ,.c;--o TRENCH WIDTH FT, 2. tR SQUARE FEET J c> () / \ / R)./ ~33f),Do CASH 0 ~R CHECK f""1i"""CON-NECTION FEE FEE~ PERMI ({,., L(")D PUBLIC WATER CONNECTION FEE d. ,oz:, .;;,),00 MIN. SEPTIC TANK CAPACITY WITH DISI. BOX: GAL TYPE OF STRUCTURE .:IZ N' ClOD r OCCUPANCY /+:T REAR Y ARC PUBLIC UTIl. EASEMENT BLDG. SETBACKS - FT. FROM eTR. OF ROAD RIGHT OF WAY USE CLASSIFICATION SIDE INT. '7 I PIJl7 SIDE EltT, yo REAR .s- t(~77;~ /- -1;7 - ;r~ BLDGft - v5th..A. - C! ,)1, Find Property: COpy 1 - OFFICE COPY 2 - JOURNAL COpy 3 - AUDIT Form # CSS-12 Date (....~f:j -~ ../