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Home My WebLink AboutPermit Building 1973-7-23 r~ ').. I ~, . .~ .. I ' \ '. . . PROPERTY OWNER ~:;.1;i:'rt CONTRACTOR --::-:-~ ! l ,. , . ~ , ';'~" ",1 ~A~E -&TY BUILDING B 1 ~_':iJ-i':; BUILDING 'PERMITOR MOBI.OME MH D MAILING ADDRESS ~():;O ;;OUtil 11,'-.11 ~)pr:ncriuldt UruJ~m J :/.;-;- ./..- ~).... - USE PERMIT PERMIT NO. PHONE i"~:,P':I':,?:. :J"j luers MAILING ADDRESS PHONE PROPERTY LOCATION - INCLUDE POST OFFICE i '::":.:~ :Jc 1 ros:J .~v~nu~ PROPERTY LEGAL DESCRIPTION - METES. BOUNDS 'J.ro 00110 Jlocl\ 1 I.ot 6 TWP 1 j' APPl. NAME & MAILING ADDRESS RANGE CENSUS TRACT SECTION ?1~.3.3 ;;x r;1'bo CODE J3 20-::Dl:3J 1{~p;lord 3l! i 1 dors EXISTING STRUCTURES ON PROPERTY [lone -lEGAL ACCESS TO PROPERTY De 1 ro~o Avu:,uo PROPERTY SIZE - FT. 16:;0 Saueh lit'." ~prL'I:]yl~ld, (resen DEPTH AREA WIDTH FOR MOBILE HOME PERMITS ONLY No. of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT Ct"!;.::11 ;,1:1 Connect to Existing TYPE CONSTRUCTION Frc:::o Sewage System D SQ. FT. # BDRMS 1011 0 I? ~;;) New System 0 VALUATION i;~, ~ ~2 ";':;.:;J 1..; :J --_!..'_\:' ~- : 3, ~! ~l u(.ru--.....J Lt,.LLli;.;iH.';U u.n.,...;. 'wu . i1::J t.(,., I I .)\..~.i~u;,.! (..i I :::>:"\J~U I .oJy;:) 1.~1U G iJ I :'::7'':' i n~ (' btturcs ~ - . I ..H.:U....:. 1"VIIIII.:J\oI.IUII 1 P~Jllc ~ctcr systc~ SEWAGE DISPOSAL PUBLIC 0 BUILDING WASTE DISPOSAL PLUMBING PLAN REVIEW PARK TRAILER TOTAL SEPTIC TANK r'D PLUMBING INSTALLED BY OWNER 0 OTHER: NAME WATER SUPPLY J.. ,!CC~~flC;; OTHERD ~\).UU 20.0U 2t50 $ FEES PUBLIC 0 o OTHER $- '::7.50 COUNTY BUILDING & SANITATION SPECIFICATIONS DRAIN FIELD REQUIRED UN. FT 150 OR SQ. FT. 300 WITH DIST. BOX: GAl. MIN. SEPTIC TANK CAPACITY 7;;0 2 TRENCH WIDTH FT. :l~of C:rolns to street. TYPE OF STRUCTURE .' iJ OCCUPANCY I & J ZONE PUBLIC UTIl. EASEMENT BLDG. SETBACKS _ FT. FROM CTR. OF ROAD RIGHT OF WAY FRONT 43 I SIDE INT. !.) I SIDE EXT. AUTHORIZED SIGNATURE - DATE IsI J.r:. Bess by 11cr')ctlcl1 USE CLASSIFICATION REAR 5' John Cn,lcltshcnk, R.S. DATE 7-?~- ;'3 BLDG. PERMIT - WHITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENROD ~, FORM':: r ~~ - q Construction to comply with uniform building code and county regulations covering plumbing and sewage disposal. All buildings require 0 certificate of occupancy before being occupied. (See Statement on Reverse Side) (POST THIS PERMIT ON MAIN BLDG. AT SITE) LANE COUNTY, BLDG. & SAN, DIV., COURT HOUSE, EUGENE, OREGON 97401 , BUILDING SITE EVALUATION 5C" '..' . " .(~ Building Permit Application No._/'?SS--7.,j> () Site Inspection () Pre-Permit Investigation LANE COUNTY PLANNING DEPARTMENT NOT NO app'icable I. Zoning Ordinance Compl i~~ ( ) ( ) (Zone ) 2, Subdivision Ordinance Compl iance ( ) ( ) 3, Requ ired Access ( ) ( ) 4. Bui Iding Site (Area, Width, ( ) ( ) Frontage, Setback) 5. Other (see comments) ( ) ( ) T 17 R 03 S o?q. TAX'1.0T .CQi,S;l!S TRACT j/~~ ~ ..6'-/ ~/ APPLICANT:. / Ni\ME ~/7~/ L?.::P./-1-<./ ADDRESS / r--- PHONE DATE 7-/7 - YES NAME O.HE (~ ~ (~ (j)/ ( ) VJD {./7-7~ COMMENTS: BUILDING INSPECTION SECTION NOT NO YES NAME DATE aDDl icable ~ 6. Plans Subm i tted ( ) ( ) 7, Soil Stabil ity (footings) t/J ( ) ( ) 8. Flood Plain f> ( ) ( ) 73fi~ ~ u -'I' 9. Other (see Convnent s) I) ( ) ( ) " ( COMMENTS: - SANITATION SECTION NOT NO YES NAME DATE app I icab I e 10. Sewage Disposal ( ) ( ) ~ iNtI73 II. Usable Area ( ) ( ) Y2 ~~/~ , 2. Water Supply ( ) ( ) W- 13. Other (see Comments) ( , ( ) ( ) - - COMMENTS: TO APPLI CANT: Your Building Permit / Site Inspection~\ (~ be approved. 7~;2o-7d~l/J () Cannot be approved at this time as indicated on item NO. above. Questions and further information on items' through 5 contact the Lane- COUNTY PLANN ING DEPARTMENT. Ques t ions and further i nformat ion on items 6 through 13 contact the Lane Countv Building and Sanitation Division. () Wil I 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 cuver. LANE COUNTY Pl/INN I NG DEPARTMENT 135' ~l)<rh ^vcni.., EdOt, Eugene, llrl!9"n !i7ljol rHONE:' 3111..1311 EXI.231 . . -'-' ~-. .._~.. ~ . . . . ... . . ... ".,.--.- .'.. " LANE COUNTY BUILDING & SANITATION DIVISION 135' Sixth Ilvenue East, ElI(lene, Oregon 97/101 PHONl: JlI2-1 J I' EJH. lj" MC\Ci_')R IJ '-' Datf' . . Permit No ., CURB CUT 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 Lone County, and it is the opinion ond judgment of the Board that the said opplication should be gronted, and that 0 permit should be issued, now, therefore, it is hereby. ORDERED, thot a permit be and is hereby issued to or constructing the following facility: for placing, building , , . ,\ '-{,.' , ~ ...... , '.' 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 M98-50). 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. 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 ".,'.; ,19~. Expires ,19_, Inspected and Approved Approved by Board of County Commissioners By Oat" 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 . " ,Date . . ~ APPLICATION FOR FACILITY PERMIT IN THE BOARD OF COUNTY COMMISSIONERS OF LANE COUNTY Your applicant, hereby makes application under Rules and Regulations Governing Facilities to be Per- mitted Upon County Road Rights-of-Way. to construct the following facility: Upon the right-of-way of County Road No. i ; at the following location: . I .'./ " 1', as shown on the exhibits which are attached hereto. in strict conformity to the state- ments of the exact nature and amount of work to be done. and to the description of the facilities contained in said exhibits. Your applicant will be the beneficial owner of the facility as constructed. or otherwise primarily liable and responsible to members of the public for its proper maintenance. repair. operation and use. Your applicant accepts all terms. conditions. agreements. stipulations and provisions. in Rules and Regulations Governing Facilities to be Permitted Upon County Road Rights-of-Way. dated March 31. 1960. and any amendments thereto. and any other applicable regulation. law or ordinance. /, ," . " ...- . '( WHITE - OFFICE FilE GREEN.. RESIDENT ENGINEER PINK.. PERMITTEE BLUE.. ROAD SUPERVISOR ORANGE.. BUilDING AND SANITATION DEPT. YELLOW .. SURVEYOR Phone No, , . ~-.. .- ~,U,S, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT -rz :J., 71 FEDERAL HOUSING ADMINISTRATION No, _ - ~ HEALTH AUTHORITY APPROVAL I -J~~IVID_UAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM 1"'0, J 3 , .',. PART I-TO BE COMPLETED BY FHA .~ ~ F~A FORM NO. 2573 Rev. 10170 :~~iD /O/.;{?'J , ,,.TI: ._<"? '~ID N.I.'(/ /-1 In.urlni'OH~e I FHA Case No. Eorm Approved !t!B.?dge~8Ureou No. 63-R0296 C! S' '/ rf/P/i'> f1 ! U lE: II r:n _ .\',.._ u 1.7 './" 7 '. N 197':1 ~s/; ~ Mortll8aee - Name, Addr... ond Zip Code I Mortgagor or SpoDsor: I., -'Wlt COIJ/'1Jy f.'f-'!Lr/.J & Margaret Ruth u/:.Or. "I First National Bank of Oregon Springfield Branch P,O. Box 9 Springfield, Oregon 97477 P!l.Ili!!/J~,.A~01s August L .J Subl_ll",ue lrose Avenue, llpr1ngt1e Id, ore'Q~ No. Vera Delle 6 o Yes o No 11 J;J New Installation CaD Attic or other Area be made inw- -additional bedrooms? (If ye~. how many?) T~Q . ""~n~nnu. RAT'" 1 r WATER SUPPLV'!lV, o Public System SEWAGE DISPOSAL BV, o Public System BASEMENT o Yes !;J No SVSTEM DESIGNED FOR ..JJ Community System o Individual No. of Bedrooms Garba2e Disposal o Community System 0 Individual PART II. - TO BE COMPLETED BY HEii TH DEPART~E~T J;J Yes o No. HEALTH DEPARTMENT INSPECTOR'S SKETCH 3...)(' . ~~ - ~. ~RNTl ~'i'i- 71 '~:r- -'-':=-- _:::tt: - - -:-:: ===- ------ - I ~--- - - - - - 1- - - - - - .:: ----=:: ~----- 1-- c::::=- '-- ,-- ,-- ! c= '-- , - -l_ _ _ _ _ , c===_ T_ , ( - - - 1- - - - - L': = = = _ _ _ _ _ _ _ _ _L - - - - -L _ _ _ __ I ______ 1-,=; cti~===:: 11 is the opinionof the 0 State 0 County Local Department 01 Health that this individual water-supp1y system. o is 0 is not satisfactory as a domestic water supply for the subject property. c ::::= L ___ , -,--i:::====C - - - - - - - - - - 1- -+ I~ [ c:: _ L I C- / 11 is the opinion of the D State ~ County 0 Local Department of Health that this individual sewage-disposal system with proper maintenance: p Can be expected to function satisfactorily, and D Cannot be 'expected to function satisfactorily is not likely to creat~ an insanitary condition D::~?_7; ,:'~~,Cl~f~~ ~:~TELRE,;:s:::= :'~:::7~~~:: NOTE: The health authority should complete the appropriate opnion statement above and affix dote, signature and title in the spaces provided. Use of tho above grid for Health Deportment Inspector's sketch os well as use of the back of this form is at the opinion of the health authority. I .I PART III. -FOR USE OF FHA OFFICE TO THE CHIEF UNDERWRITER: I have reviewed the foregoing and the pertinent FHA Compliance Inspection Report, and recommend that the Individual water-supply system he considered 0 Acceptable 0 Not Acceptable Sewage disposal be considered 0 Acceptable 0 Not Acceptable. DATE SIGNATURE D CHIEF ARCHITECT D DEPUTY FOR CHIEF ARCHITECT HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM FHA FORM NO. 2S73 Rev. \0/70 REPORT OF INSPECTION-INDIVIDUAL SEWAGE-DISPOSAL SYSTEM PRIMARY TRIATMENT wnsisls l)~ep(i( tank. 0 Cesspool. hptk Tonk: -' ".: ~, Distance fmm wid!. Total liquid cap~l)'. Inside length, C_'" OisuncC' from: Well. (eet; foundation fed; nearrS1 lot Inside diameter. feet. Depth fee(. LiquiJ'capa(ity. 51CONDARY TRIATMlNT consists of [j Tile disposal field. 0 Seepage pits. Other ",.,1\. '01&)0 Material. fl'e{. Inside width, ~eUCRE:TE Number of companments ~allons. Caflaljry inlet compart~ent 5 feeL liquid depth, fect. ,:,allons. line at 0 front. 0 side, 0 rear, !itallons, lining material r.... T." Dlaposol field: Distance {rom: We,ll. feet; foundation, feet; nea~sl 101 line at 0 fronf. 0 side, 0 u:ar, Total lenl{th of tile2~es 1 ~ feet. Number of lines, . Distance ooween lines Trench width inches. Total effective absorption area in bonom of trenches. 300 ltngth of each lin" (')- (') feet. Depth. top uf tile to finish grade, Type of hher material: [!fGraveL 0 Bruken sCJl"e. Oth'" IXpth of filter material beneath tile,. b inches. Dtopth of fileer material over tile 2 Seepage Ph.: 10 r.... r.... square fCC't. inches. inches. Numhcr of pits__, Distance frum: Wdl . Outside diameter, (eee:. (eet~ building foundation Depth, (CC'I. Lining malerial (eet; nearest lot line at 0 front, 0 side. 0 rear, r.... Inspection made by: 0 State. [j(County. Date of inspenioll SEPTEMBER 24 o Local Heahh Authority. Insp<<ted b: . 19--13 /s/ JOHN CRUICKSHANK, R.S. SANITARIAN (TIn!) REPORT OF INSPECTION-INDIVIDUAL WATER-SUPPLY SYSTEM Di!Har.a: (Q nearesl puhlic water main, feet. Silt: of main inches. IndiviJual wdls 0 art. 0 are not ,:ustornary in neighborhood. Give most r<<ent fl"Cord of failure of wells in immediate vicinity to furnish a~uate supply of water Properties in neiKhhorhood 0 are 0 are not bt-ing develo~d wilh both individual water-supply and sewage-disposal systems. Lit size:: feet wide, _feet deep. Dwelling Set back from front property line, feet. Individual water sUf'ply (rom: 0 Drilled well. 0 Driven well. 0 DUK well. 0 Bored well. Dbtance af well 'rom: Building foundation (ast iron sewer, Sttpage pit, Well COftl Diameter. inches, TOlal depth, feet. . Type of casinr Deplh of casing, feet. Approximate dt:pth [0 pumping level of water in well feel. Approximate yield, :allons per minute. Scaled watenight to depth of (eet. Exterior spa(e around casing sealed with: 0 Cement grout. 0 Puddled clay. 0 Ordinary backfill. Well covt'r: 0 Conaete. 0 Wood_ 0 Metal. ~nings in well cover watertight: 0 Yes. 0 No. Pump: 0 Shallow well. 0 Dttp well. Length of drop pipe feet. Pump capacity, ~allons per minute. Located in: 0 B.uement. 0 Pumproom off basement. 0 Pumphousr above ground. 0 Pump pit. Pumproom properly drained: 0 Yes. 0 No. Pump mounting watenight: 0 Yes. 0 No. Type of storage: 0 Pressure. 0 Graviry. Capacity, gallons. Has bacteriological examination of water ~en ma~? 0 Yes. 0 No. (fanswer -is "yes," give datI" 19_ Quality of water 0 is 0 is not sarisfactory for human consumption, Installation 0 does 0 does not comply with approved exhibits, if any. Insp<<rion made by: 0 State. 0 County. 0 Loul Health Authority. Inspected by fCC't; tile sewer, feet; cesspool, fttt; nearest lot line ar 0 (ront, 0 side, 0 rear fet't; srptic tank, feet; disposal field, feet; ocher sources oi possible pollution, feet:. r.... (cct~ Date of inspection .19_ (TITlE) GPO 900.6e2 . -. -. . , ~....~-.......~..:~,- ,. " LANE ctINTY BUILDING 0 BUILDING'PERMIT OR MOB_HOME USE PERMIT MH 0 PERMIT NO. MAILING ADDRESS PHONE PROPERTY OWNER ..'" ." CONTRACTOR MAILING ADDRESS PHONE PROPERTY LOCATION -INCLUDE POST OFFICE PROPERTY LEGAL DESCRIPTION - METES, BOUNDS TWP RANGE SECTION TAX LOT NO, CODE CENSUS TRACT ,. , .j to'. APPL NAME & MAILING ADDRESS EXISTING STRUCTURES ON PROPERTY :::..,; , LEGAL ACCESS TO PROPERTY ""II PROPERTY SIZE - FT. ., , WIDTH DEPTH AREA FOR MOBILE HOME PERMITS ONLY No. of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT Connect to Existing Sewage TYPE CONSTRUCTION SQ. ,('". .. ~ " ..' .\. " .J\,: System 0 FT. :;+ BDRMS l~ ~ \ ~ :! New System 0 VALUATION .. ." ",,'.C " ",') t , "', .'-, .. .I '" ~.. _ SEWAGE DISPOSAL PUBLIC 0 BUILDING WASTE DISPOSAL PLUMBING PLAN REVIEW PARK TRAILER . .' ,,' FEES PLUMBING INSTALLED BY OWNER n OTHER: NAME WATER SUPPLY SEPTIC TANK '0 OTHERD PUBLIC 0 o OTHER . '. .. ;;0 , TOTAL $--' " MIN. SEPTIC TANK CAPACITY WITH DIS1. BOX: GAL COUNTY BUILDING & SANITATION SPECIFICATIONS DRAIN FIELD REQUIRED ., L1N. FT I, TRENCH WIDTH FT. ,. OR SQ. FT. . , " ,~ . , ., TYPE OF STRUCTURE OCCUPANCY : ;',. J ZONE PUBLIC UTlL EASEMENT BLDG. SETBACKS __ FT, FROM CTR. OF ROAD RIGHT OF WAY :'.,It I FRONT SIDE INT. SIDE EXT. AUTHORIZED SIGNATURE - DATE USE CLASSIFICATION REAR ,1,:; ~,.' '. DATE . i .~._,.","-,. c..-..... ,,~. u., ~ ".' - . .,. " ~ ..,. 'oJ. ... .' , . ~, ("'. I/o~,\/.t , BLDG, PERMIT - WHITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENROD Construction to comply with uniform building code and county regulations covering plumbing and sewage disposal. All buildings require a certificate of occupancy before being occupied. (See Statement on Reverse Side) (POST THIS PERMIT ON MAIN BLDG. AT SITE) LANE COUNTY, BLDG. & SAN. DIY., COURT HOUSE, EUGENE, OREGON 97401 FORM == C55 -13 . . .' SLAB FLOOR PLUMBING GROUNDWORK ApPROVED rt DISAPPROVED .C1 DATE INSPECTOR REMARK 5 GAS PIPING GROUNDWORK ApPROVED rt DISAPPROVED .C1 DATE INSPECTOR REMARKS ROUGH PLUMB I NG D'SAPPROVEO .C1 DATE 0_ J?-I'L INSPECTOR~~ .L..Z - J' ApPROVED ~ REMARKS ROUGH GAS PIP I NG ApPROVED .C1 DISAPPROVED .C1 DATE INS~ECTOR REMARK 5 FINAL PLUMBING ApPROVEO W D'SAPPROVEO .C1 DATr/H?-'J' REMARKS ..I/o .p'V.JI"''''''~ JI-.;..-...~'I ~....I..qtI '// INSPECTOR ...x/# v FINAL GAS PIPING ApPROVED Cl DJ $APPRQVED / / DATE INSPECTOR REMARKS CERTIFICATE OF OCCUPANCY READY TO ISSUE Cl NOT READY TO ISSUE rt DATE INSPECTOR REMARKS , . . INDIVIDUAL SEWAGE DISPOS~YSTEM RECORD Installer: Complete ~op JIrt of form to signature and return both copies to Lane County Building Sanitation Department. I bt:' . I .' .. . '. . f1~i&uL ,~alier's Name ;;; No.LivingUnits IBedroomslBaths septJ.c TanK: Ft. from well Steel 0 Ins~ae uJ.m.enSl.ons: r''C. Length 5f Width () Applicant" Name KeDhart Builders Mailing I Property Address 1449 Del rose Avenue I Basement I Water Supply Yes 0 No 0 Public 0 Other-List P..MIT Nn 1~;5-73 Cruickshank Diameter Depth (p L Gal. Capacity, /tP~O Tile Disposal Field: Distribution Box:YeS~ No 0 Other DistributJ.on- Type Concrete ~ No. Compartments 1"90 ~(,\llf'h "A" Feet from Well Foundation Lot Line . Front Side Rear ITotal Sq1Ft.betweenIFiller;; IF~ller decthlFiller depth f.-? . I / alJOve ., below t, 7P (J hnes tJ Type :1 ti le ..... in, ti 1" /, in, Yddress ~~rjnnfi~lrl Orponn Length of Lines - Ft. I Trench 1. @ 3. 4. 5. 6. Width :1 Sketch (See instructions): - IV i J r ~~ I rl - '1' If. ~-~ -15:-, - ~- ~', I :-iPf ___-J I :___ .7S~ _ _ _ --- --,- i , l ~ , f' r r - , , h ". - " \\ '~I ~ 'I , :1 I: I / \ ., 1qn LA;:: ,..- '1 '~I ,,_..-.. ,. , ;~:r; Date q - J 4 - 1 ') . - Signature ~~/p~j7 ~~~ For Sanitarian Use Only: ~pproved: System Installation Conforms to Current Standards o Disapproved: Does Not Conform to Current Standards Remarks: Date: qj"24}73 " Lane County Building & Sanitation \),J/hI~~ature Depf~ ' ~'-~ . ~. '. LANE _NTY BUILDING 0 BUILDING PERMIT OR MOB_HOME MH 0 MAILING ADDRESS USE PERMIT PERMIT NO. PROPERTY OWNER PHONE CONTRACTOR MAILING ADDRESS PHONE PROPERTY LOCATION - INCLUDE POST OFFICE PROPERTY LEGAL DESCRIPTION - METES, BOUNDS TWP RANGE SECTION TAX LOT NO, CODE CENSUS TRACT APPl. NAME & MAILING . ADDRESS EXISTING STRUCTURES ON PROPERTY \, , ',\) " ~', s ~'1 LEGAL ACCESS TO PROPERTY ~, , PROPERTY SIZE - FT. , WIDTH DEPTH AREA FOR MOBILE HOME PERMITS ONLY No, of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT Connect to Existing Sewage System 0 TYPE CONSTRUCTION SQ, FT, :;:t BDRMS New System 0 VALUATION " \ SEWAGE DISPOSAL PUBLIC 0 BUILDING WASTE DISPOSAL PLUMBING PLAN REVIEW PARK TRAILER r~ -. So\ ~~ \.~;\.It"" "'.;\( --'0 "'l ,~~~,\,~\~~~~~,,:.., PLUMBING INSTALLED BY SEPTIC TANK 0 OTHERD . o FEES OWNER 0 OTHER: NAME WATER SUPPLY . 0 ,. , . PUBLIC 0 o OTHER .) TOTAL .' o MIN, SEPTIC TANK CAPACITY COUNTY BUILDING & SANITATION SPECIFICATIONS DRAIN FIELD REQUIRED WITH DIS1. BOX: GAl. L1N. FT TRENCH WIDTH FT. OR SQ. FT, '\ , ...~. " , \ 7 ,,''>...\ l\ '-~\.\ '" \ "\s)~ \ ~. \\~~,~ \:\-N\' , I', TYPE OF STRUCTURE OCCUPANCY ZONE PUBLIC UTIl. EASEMENT BLDG. SETBACKS._ FT. FROM CTR, OF ROAD RIGHT OF WAY ~ USE ClASSIFICATION FRONT SIDE INT, SIDE EXT, AUTHORIZED SIGNATURE - DATE REAR , C , DATE o v . . BLDG. PERMIT - WHITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENROD Construction to comply with uniform building code and county regulations covering plumbing and sewage disposal. All buildings require a certificate of occupancy before being occupied. (See Statement on Reverse Side) (POST THIS PERMIT ON MAIN BLDG. AT SITE) LANE COUNTY, BLDG. & SAN, DIV" COURT HOUSE, EUGENE, OREGON 97401 J FORM == r.ss-n . . SITE INSPECTION ApPROVED Cl 01SAPPROVED Cl DATE INSPECTOR REMARK 5 FOUNDATION INSPECTION )j-;! '2- ' 711 NSPECTOR rt;J ApPROVED ~ DISAPPROVED ~/ DATE REMARKS FRAMING INSPECTION ApPROVEO / / DISAPPROVEO /7 DATE INSPECTOR REMARKS-x. p~ tf'-/Z-,.I'l7 erJ/~~d ~A;.f~/O",If)';'17 r LATH OR SHEETROCK INSPECTION ApPROVED L--/ DISAPPROVED / / DA TE INSPECTOR REMARK 5 ,.-- FINAL INSPECTION '."0'" ''''..'O''p OM' l;l-Ilf-r" REMARKS . . ~ ~;i J I vJ{[- 73 ..Lf'L^7' '. if v v f INSPECTOR ~ ./ CERTIFICATE OF OCCUPANCY READY TO ISSUE / / NOT READY TO ISSUE /7 DATE INSPECTOR REMARKS I JJ S"-'1J } .J / /ti"lJ~ ~o-/.ro l . --.:, .. PERMIT PROPERTY OWNER LANE COYMI.V BUILDING PERMIT OR MOBILE J/IjfIIE USE APPLICATION TYPE - BUI_G ~ MOBILE HOME Dose REG.. PERMIT:#: /35 5-7 ~ , MAILING ADDRESS PHONE . CO~CTO~uJ 1- ~~dd;;;o ADi~?) () PROPE~CAiioN~ iNCLUDE POST OFFICE /-sL~9 LI.L~'A ~~/"_ PROPERTY LEGAL DESCRIPTION ,/7 111. A /J /? _ / -/ ..L / LOT - BLOCK - SUBOIV. .oM: -' ~ f ---P ./ 0 I7C Ii-<:.. (0 TWP RANGE SEC. TAX lOT # /'7 ~.3.-:z;/- APPLICANT II J-rb771L/ /~ NAME AND MAILING ADDRESS FOR MOBILE HOME PERMIT ONLY Number of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT /~A./f/./~o - c7 an.A JLaL~ -1'1;t:;/L ~ tl -1l~ d./j)~ SEWAGE DISPOSAL ~li 11/1'/, ~~lHONE 7~b - ~t/'.;L? CODE _____ METES & BOUNDS 0 YES ATTACHED 0 NO CENSUS TRACT ~o -eo /5D DESCRIBE EXISTING STRUCTURES ON PROPERTY IF ANY ~ LEGAL 1t~ADtt:::. PROPERTY SIZE-WIDTH DEPTH . AREA Connect to Existing Sewage TYP7CON RUCTION ~ '~--L- ~ ' PUBLIC WATER CONNECTION 'EE / .<.CJ COUNTY BUILDING & SANITATION SPECIFICATIONS DRAIN FIELD REQUIRED L1N. FT. J Sl) TRENCH WIOTH FT. 2.. -~-e'- . PUBLIC 0 BLDG. WASTE olS. PLUMBING PLAN REVIEW PARK TRLR. SEPTIC TANK hi( ..,-", _ o-t.> ---'_ iJ. ~ ;:z (. So OTHER 0 FEES WATER SUPPLY PUBLIC 0 OTHER PLZBING 'EESe. J. J-i) FIXTURES / "'. v.-J CASH 0 S~ CHECK f'9I"'""C'ONNECTION fEE $ ...J. LJJ TOTAL 97. "0 MIN. SEPTIC TANK CAPACITY 15() ~J?rJ cfralh<=. n 5VP,o"f,. WITH 0151. BOX: GAt. System D or New System Req. D )f;'; ) 11 i~07~ r/3i 3.;:J. / , 4CJSt!. J /11-3'5 /;;2,.&.1 rj -} PLUMBING INSTALLED BY n (\ / , OWNER n OTHER D NAM I . ~~ PLANS FURNISHED T JAdi.iri PERMIT YES II( YES G;!\ . NO [] SIGNAl ANT - /y- DATE ~--f 7-/17- ']] DATE 7 -/'7-V I' # /3SS-"T3 OR SQUARE FEET .?no , , / ZONE REAR YARD PUBLIC lUTIl'1EMENT J USE CLASSIFICATION V REAR S ... /'J Oat. BLOG. INS"J-.tJ ~ tfR' IJ.,- ;;. v-- 7.) (j I TYPE 0' STRUCTURE c5 AI' OCCUPA7"t:t-:{' BLDG. SETBACKS - FT. FROM eTR. OF ROAD RIGHT OF WAY 'RONT 4 S' ' SIDE INT. S; 1 SlOE EXT. \. ';//~TAftk.. - 0 ,() ~1 PLA~NGIl\ ~ J;.~/<<[f117J1~ \~ 7-/7-73 Directions to Find Property: COPY 1 - OFFICE COPY 2 - JOURNAL COPY 3 - AUDIT form # CSS-IZ