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Home My WebLink AboutPermit Building 1975-12-15 <. ~;. '.., , -, . . , . . LANE COUNTY PERMIT. PERMIT NO, 320:'-7) . CONSTRUCTION (1( ] DOwner ~(rp~l.arj qU11 nro NAME MOBILE HOME [J PLAN REVIEW [J CHANGE OF OCCUPANCY [ ] 1600 C;OIlTH A ~PR I NGF' I rLD OR!!GO,j .,:;,6- 41..2<:> ADDRESS CITY ZIP CODE PHON!! o Contractor ~4;~r- NAME ADDRESS CITY ZIP CODE PHONE O,S. Reg. # ~,l^ Twn '"7 . 0 Range " FlnsT ADDITIOfJ Subdivision '.':~' ^ ~'':I I ~ Lot ~'I33 ,,\ Section ;~ Tax LDt..J//()()U Code Census Tract II) Block Acreage Width Access to Property (Road Name): DrLlOsr t,vnlUE Depth Existing Structures on Property: NON' Directions to Property. Address: 14Q< ~"~OS' AV'NU. SPR I tJGFI no OREGO!' q7477 STRUCTURE (# BEDROOMS) 1,*<'1:"1 I I ~H"!; SQ, FT, 1410 sO.FT. 0;06 "",'T. VALUATION Mo. ;'18.00 2. :iol.00 ':'/1. ,^...,C" It"'~"'^11 ATln", nr. q;.;",,-,II e'," nl~pnC:AI ~ynT~:~ \>,,\3, ':', '....(] SEWAGE DISPOSAL: PUBLIC [J SEPTIC TANK [ OTHER [ PRlon PLUMBING INSTALLED BY: OWNER r) OTHER r I NA.ME WATER SUPPLY: PROPOSED [ ] EXISTING [] [ J PUBLIC [ ) COMMUNITY. NAME: [ ] PRIVATE WELL [ ] OTHER. SPECIFY: BUILDING PLUMBING 3% SURCHARGF MOBILE HOM" WASTE DISPOSAL PLAN REVIEW I<Q.nn ... <7 hO. on PL UMO : 7,.00 TOTAL 2'59.17 CONSTRUCTION PERMITS & INSPECTIONS AND WATER POLLUTION CONTROL SPECIFICATIONS MIN, SEPTIC TANK CAPACITY: GALS, onn MIN,DRAINFIELD 1"0 L1N. FT, MAX, TRENCH DEPTH C':,TI..Y 10 I:"C''''' C';1P:.4 to4:nn~::" 6::\lO PRO?rnTV LINF' WITH.ALL I9ARTS Of" T..IE. ORAI~;f"Ii!LO ,6 INCHES ~''''~~,",He" Il.M AO~ lI. ~n~ nC"OI AI"C"YC"l'IIT n.:" ~Vl"':.Tr.-l\t IIIJ t"IITIII~H" ~ TYPE OF CONSTRUCTION '" ;< GROUP I~..I FIREZON" STAY 100' FROM ALL WELLS USE CLASSIF, SETBACKS. FT. FROM CTR, OF r/W: FRONT 4"i' SIDE EXT. " FT. FROM PROP. LINE: SIDE INT. REAR 7' ?UE ZON" AUTHORIZED SIGNATURES: /s/ .1 ~ nt'"",",: nv I-iM~)n^lIr.:'" ~nJ\v /qhM I TAQ I ~t. ISSUANCE DATE: 1211"/71.:, no ,., BLDG. PERMIT - WHITE OFFICE COpy - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENROD IMPORTANT: Call 687-4065 10 schedule all required construction inspections. Call 687-4061 to schedule all required septic system inspections. All construction shall comply with the State BuidJing Code, D.E.Q. standards tor subsurface sewage disposal and the State Plumbing Code. All buildings require a certificate 01 occupancy before being occupied. (See Details on Reverse Side) ~ " . ,,:::::::,V,< \t \ (POST THIS PEF,lMIT ON MAIN BLDG. AT SITE) C55-13 LANE COUNTY, DEPT. OF ENVIRONMENTAL MANAGEMENT COURTHOUSE ANNEX, 135 EAST 6th, EUGENE, OREGON 97401 LOT 10.13LOCK I LANE ee,,) O~~F~GON REr' ' i'Ef\II--:- CiOR- '., ~I u , ,-.t~____I"~,__._ M[~S; '--'-~-------~'-'-'~'~ , .. ",-,- . ',", , ':'., ':'~'~" ", ,'\ ',' ~ " .\ Mr\ l h. -,,:... ,',' " . 13U I LDER --~---_.._._- 'f.>I.:.\-.O'. . r'.," ..... I.!;!', \) c'\ DONALD --.-.- - . _2ETERSON JAC~< KEPHART PLjjtL..J~ 14 10. ~ .7' f'uBLIC/I'T"U''! EA~~Mf!"'T , . ' ': 'I~' ;hJ. ~~f~'J;~;"f:',[~;~'~~:"&~:",:~,:" '.-'_"'>fio",,",t"'~'" I " ,i;.~~~I!!P)M~. . .<~ .. '. ','_wr .." ,- -," . .~.' "7' -', ~ .~~._~.._- --....- " I- .:.J. t-:'i I i i I I j , I I " I , ,:~'.:t' . - .--:~'> 0"0- ....:. . ., . :~Y.~;,: t'{'J/.'" ,', J~'1.4!}':::' """.'h .\ . ";';Wi~: I .:~ :t.; -,'" ,'.. ~ -"l~~!';...' .," ,?'t"a;;i'-. l:.l 1.,,,,;,'.;.,:: l'~I~'.':;"'. I '~1:.~ ~:i' J j.ji';'" \" . I. J~...:' / J .~".:tJ.,~. . :.- '~.I"""" +~!.~~~~;~;,,>,:;<:, , .. :t::t.'l'~"" .., '. 't~~':"..;. , ::\lJ',~,,"r:' " '}' J,~~:~.~.~;" :.... 'lY .\ . . ..rit:"!." .; ",d; ~!~ \. '., . ... .. ' ~".-i~.' .~...,. r1: 1 .. ,r ..;.... "1(':,'t ( .~f.".tf. ~,. ~ Of'!. r '\11~ .~. ' ,.. ~'~~'i.~J,j:." . . !: ,.;{&'<t.:" .' , "f.t~' .. ,,', ' .. .X~:~:;,:;<:.: ~ ...":.'::':.,,' --,-_1. 1493 ,,- ....-.. ~8r J;UNC,' DR. , ). . ~.-;. f'.L, 'to. 'lr.. . ".":.' " ,'~.'" I -,-. .~~ ';~. P,L. 91), '1:(,' CONe. . APPf(()Il~I.' \ ,ASSOMe:D EL ;-y', DELROSE AVE, ';",: ..,.~.;~'..;...r5. .'1:', '.. ~ :. .:..jl.... ni' '.... '.' . ...., rtM:, .E:Lk:v..laI,.o! . '. .' .::',:';; ..~,.: ':~";:,..~.~..' :":Y:~.::. " . 2'\- ~."" '\o@; -1;i1i,V< -, ,~.,;' ,'. I'..;:, ...~~r.$~;;: , ' . - '" '>.; . ~.:. ~ ...... <<.: () l.. \ "'. \ ''j " ,'. ~ I,' ,_ N'l' , . I:.~-. , '-';~:':j;,:~< ': '. .; ,,~ .1 .,.,'~ ~:;f~~;:;l~' /__.E .G_:_E;L~~_l9Q,f..:':':' . ;~ ,--' ' :~ '---~'.'-'~~'~~.A:-' ,(r CO~B ,'/I::'O,o''''y "' ';",". . '.. ',~:::: : ' "),,-:,;':: ", ',t....' ~ .:.,-,;::., .' . ~. ," 'l. . . ~",':- , .' , "', -'.'. . :;..... ',;', " '-~: ',' ':"'/J \BUILDtNG SHE EVALUATION. ~BUiLDING PERMIT APPLICATION NO. () SITE INSPECTION " ~ &,V ~C Pr T -/7 R~S t.'?+TAXt: .J.2~-7.s-- S~N: LOT: . 0 BLOCK: / J . APPLI CANT DATE PLANNING DIVISION Not I.~() " ~ ApplLcable No Yes CK'D BY: fIIIF'? ~(../et.,7~ Zoning Ordinance Compl iance: Zone~ q:::.. () () W 6. Setbacks from cll of road._;., Subdivision Ordinance Compl iance r''"' ('\.Y" ( ) ( ) Front 4.5 Required Access () ( ) (~, .sJ,~. e,,"_, I.;, . Building Site (Area, Width, Frontage) () () (~ Setbacks from interior lines: Other (see comments) () () (), Side .S' ( fI<. A- __ t<J.VI ~f4) ~ Rear .4#'''' ~ ~ r) '/~~ ~M~-m~ I I. 2. 3. 4. 5. COMMENTS: PLANNING DIVISION ACTION PENDING: YESl } NDl } APPLICATION# BUILDING INSPECTION DIVISION Not Applicable (I) ( ) ( ) ( ) 7. Plans Submitted 8. Soil Stability (footings) 9. Flood Plain 10. Other (see comments) COMMENTS: WATER POLUTION CONTROL Not Applicable ( ) ( ) 11. Meets Department of Environmental Quality Standards. 12. Other (see comments) COMMENTS: No ~ () .J!'J ( ) ( ) ( ) ( ) ( ) ( ) CK'D By/3jJj;~~ /,. --It) .fI~'" f/DATE No Yes ()~ ( ) ( ) CK'D BY~. k,. I j,Z-9.7S" OATE / TO APPLI CANT'~ ,~Yo Building I Site Inspection: C h' f\i~ I Can be approved. ~~'r1~ ( ) Cannot be approved at this time as indicated on item NO. above. ~q ~ Questions and further information on items I through 6 contact the LANE- t 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 aeplic~!jE~_fee is beinQ retur~~d und~ seoarate cover. DEPARTMENT OF ENVIRONMENTAL MANAGEM~NI 135 Sixth Avenue East Eugene Oregon 97401 PHONE: 687-4065 LANE COUNTY PLANNING DIVISION PHONE: 687-4186 C55-28 \ /(, , , ,-", I 2/1? ;- ;.-- ,. j/ /-' .,,1 , T. /' RV.') ./""", S VISION: ,oJ LOT: TO APPL I CANT: /;.;7' " jYouf Building I Site Inspection: ,.' J~ 'j (if) Can be approved. . //{ c,''''; ( ) Cannot be approved at this time as indicated on item NO. above. t~ 'I ; Questions and further information on items 1 through 6 contact the LANE- :' COUNTY PLANNING OIVISION. Questions and further information on items 7 through 12 contact the LANE COUNTY BUILOING AND SANITATION DIVISION. ( ) Will be held in this office until you can resolve the problems indicated. ( ) Is being returned. ( ) Your building permit aepl ication fee is bein,q r~tur:.n.~d und~ seoarate cnv"r_ DEPARTMENT OF ENVIRONMENTAL HANA~EMtNI 135 Sixth Avenue East Eugene Oregon 97401 PHONE: 687-4065 LANE COUNTY PLANNING DIVISION PHONE: 687-4186 - . . BtH Loi NG S lolE EVALUAT ION. ,. ,. (;):,'BUILDING PERMIT APPLICATION NO. () SITE INSPECTION .' APPLI CANT DATE 1. 2. 3. 4. 5. Not ADD I i.cab I e No Yes Zoning Ordinance Compl iance: Zone tl/ 'I - () () Tij> 6. Subdivision Ordinance Cempl iance jf" (~)? () ( ) Requ i red Access () ( ) (c,)<:':' Building Site (Area, Width, Frontage) (), () (+"'" Other (see comments) () () ( ) ( I( A ,. (ut '/'v"- .J.J I" l( l,.~; PLANNING DIVISION COMMENTS: r r \ I ~ /f::/' ,,// ~ --- ,'/. ',~ ~,' PLANNING DIVISION ACTION PENDING: YES~ ) NO( ) APPLICATION# BUILDING INSPECTION DIVISION Not ADDI icable ( I) ( ) (I) ( ) No Yes () -pJ ( ) ( ) ( ) ( ) ( ) ( ) 7. Plans Submitted 8. Soil Stability (footings) 9. Flood Plain 10. Other (see comments) COMMENTS: WATER POLUTION CONTROL Not ADDI icable ( ) ( ) No Yes () liJJ ( ) ( ) 11. Meets Department of Environmental Quality Standards. 12. Other (see comments) COMMENTS: A // , ., ii l " C55-28 S ( ". ~ {~', TAX LOT , , BLOCK: ; (/ CK'D BY: IJ//'.tj. Setbacks from ell Front ,SI,de 'Exter i or" Setbacks from interior Side Rear Ij. /)1'; ( , / of road:. ;I .' .c"f' .1 lines: ::.' d' > /j I r' /- , CK'D BY: .1:~;;'V't., I ' '/. ,': DATE CK'D BY:~, ~_ /..2 - 'i - 7.5' DATE ;' . Datf. ;1 . DECEMBER 1~. lq7~ . Permit No '120')-7') 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 lane County, and it is the opinion and 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 is hereby issued to K < PIURT Au I LOERS 1690 SOUTH A STREET SPRINGFIELD OREGON 97477 or constructing the following facility: for placing, building FIRST AOOITION TO VERA DELLE LOT 10 BLOCK 1 1493 DELROSE AVENUE SPRINGFIELD 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, Specia I 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, 3. SIDEWALKS WILL BE CONSTRUCTED IN ACCOROANCE WITH THE ATTACHEO SIDEWALK SPECIFICATIONS AND DRAWING M98-49. THE STANDARO CURB TYPE SHALL BE CONSTRUCTEO UNLESS OTHERWISE SPECIFIEO: that This permit is revocable at any time, and will be strictly adhered specifically mentioned above is hereby authorized, to and no work other than This permit shall be void unless the work herein contemplated shall have been completed be. fore nrc<MBER ,19.1L, Expires ,19_, Inspected and Approved Approved by Board of County Commissioners By at. 41"A~<. ,:<... Director of Public Works Dato By WHITE - OFfiCE FilE GREEN - RESIDENT ENGINEER PINK - PERMITTEE BLUE - ROAD SUPERVISOR ORANGE - BUILDING & SANITATION DEPT. YELLOW - REAL ESTATE C98-79 .....;. '\- '. . LANE COUNTY PERMIT .: PERMIT NO, . , . ~ ~ , .' CONSTRUCTION [] MOBILE HOME [] PLAN REVIEW CHANGE OF OCCUPANCY [ ] DOwner -- .." "l ""; ~ \'" NAME ADDRESS CITY ZIP CODE PHONE o Contractor NAME ADD R ESS CITY ZIP CODE PHONE O.S. Reg. # Tw~, ~ Range Section Tax Lot Codp Census Tract '.'." ,. " ~ ~~. Sulidivision \1 Lot Block Acreagp Width Access to Property (Road Name): 1.. .-'., Depth Existing Structures on .Property)." '" " .\.., . Directions to Property - .Address: ,- , -. ,~ ,/\.. ~ ~ ,.- ,"'," ....--< . :r. I, .... " ',~ . ,..~... STRUCTURE (# BEDROOMS) SQ, FT. ;.:~r, ':_:0. .0 VALUATION , , ". .0 "i\' 'l......:rv ('f . ", '" ..-. ~ .. " SEWAGE DISPOSAL: PUBLIC [I SEPTIC TANK [ " c , ".---- ':' . ." '" ~ '" PLUMBING INSTALLED BY: OWNER I] OTHER I 1 ~IL\MF WATER SUPPLY: PROPOSED [ J EXISTING [] [ ] PUBLIC [ ] COMMUNITY. NAME: [ J PRIVATE WELL [ ] OTHER. SPECIFY: OTHER [ BUILDING PLUMBING 3% SURCHARGe MOBILE HOM" WASTE DISPOSAL PLAN REVIEW ". ,0." p'j .., .-'~' (, TOTAL G.-r,/'). . CONSTRUCTION PERMITS & INSPECTIONS AND WATER POLLUTION CONTROL SPECIFICATIONS MIN. SEPTIC TANK CAPACITY: ,.. GALS. MIN,DRAINFIELD L1N, FT. MAX, TRENCH DEPTH INCHES ',' ,....~ r. "',:";::. ... ."'/w. TYPE OF CONSTRUCTION GROUP FIRE ZON" STAY 100' FROM ALL WELLS _ USE CLASSIF. SETBACKS. FT.. FROM CTR, OF r!W: FRONT SIDE EXT, FT. FROM PROP. LINE: SIDE INT. REAR ,,/J ZONF AUTHORIZED SIGNATURES: Isl ISSUANCE DATE: .,~ ,. ,,~ l. .. .-' BLDG. PERMIT - WHITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENROD IMPORTANT: Call 68t:~4065 to schedule all required construction inspections. Call 687~4061 to schedule all required septic system inspections, All construction shall comply with the State Buidling Code, D.E.a. standards for subsurface sewage disposal and the State Plumbing Code, All buildings require a certificate of occupancy before being occupied. ... \ . '. -- , " (S~ De!ailS On Reverse Side) , (POST THIS PERMIT ON MAIN BLDG, AT SITE) C55.13 LANE COUNTY. DEPT. OF ENVIRONMENTAL MANAGEMENT COURTHOUSE ANNEX. 135 EAST 6th, EUGENE, OREGON 97401 ...." ..... . . c. SITE INSPECTION ApPROVED Cl 01 SAPPROVED Cl DATE INSPECTOR REMARKS FOUNDATION INSPECTION . ApPROVED 1--1 DI SA:?OVEo,1--1 . DATE INSPECTOR;' . REMARK 5 . () ;( ft, 4i j{tt~,_P-~..v~rI.tJ..1L /- (" I 7" .Ju U1'>1./tt. A/;;i2 (J') / _ . / rI A I.' . y/ (-'1/ ~ //': . /J" . - c/ /t:U1 ~~asY,/7"'V~,"I' ~/~2/?>7/./.u '.': . , J.~ " FRAMING IN~P;7" ApPROVED DISAPPROVED Cl DATE;2. u Pb""/lJ /], .~ INSPECTOR' ~~ ~/ REMARKS LATH OR SHEETROCK INSPECTION ApPROVED 1--1 01 SAPPROVEO 1--1 DATE INSPECTOR REMARKS FINAL INSPECTION Cl DATE #~/~7~ I INSPECTOR /' ~~! ApPROVED $ DISAPPROVED REMARKS CERTIFICATE OF OCCUPANCY READY TO ISSUE / / NOT READY TO ISSUE Cl DATE INSPECTOR REMARK S , - ,/ ,. / ,/; df /',,,,'/f//O~'" ./', / . ,-.,,,,,,- ,-- : 11 3,1.0<S:J:r /~-4~ it/V;; I .D.d~ , . - LANE COUNTY PERMIT. PERMIT NO. ::;:J:j-/2 ,.' . CONSTRUCTION [:1] MOBILE HOME [] PLAN REVIEW [] CHANGE OF OCCUPANCY [ ] DOwner n,:~~~:,"'~7 j)~,o..r.110 NAME I(-;,~ GC:J1i'IJ Ci ADDRESS [}j)(.J OCX7. Cc..O O~JCQ,:'J CITY ZIP COOE -',t: ""r:> Vi..."....~~(...;; PHONE o Contractor nf~1 NAME ADDRESS CITY ZIP CODE PHONE O.S, Reg, # t'l Twp.J.:! Range ~ Section P.0 Tax Lot 171(;1)11 ~G:)I1i'Oc::J Subdivision \1:'f'/\ r'"afT Lot W Block I Codo Census Tract Acreage Width Access to Property (Road Name): Dll/,.f;C0R tl\;C~UG Depth Existing Structures on Property: c~::;::c Directions to Property, Address: ~t~~ O~~nCJc Avcr~u: S~n;C7IGI!.O CnECC:J 97~77 'STRUCTURE (# BEDROOMS) i~I?\U....r-::l (\'\DM'"! 1 nllJ'I"tJ\JI? 1(;:,; r'f' ;~r."wN::\ I~H1:\.J8nol J'.1S\i"r.C1 SQ. FT. i 1.) i 0 CCM''i'. ~'~ C8.17'U'. VALUATION OJ:OD1~D.CJ -2..,~~cw ^ ' V;aj; ,.:,,:;.{. .,J SEWAGE DISPOSAL: PUBLIC [J SEPTIC TANK [] OTHER [ ] vC! IC:J BUILDING '''Voce) PLUMBINr. ~o;\i' 3% SURCHARGE 1.::;).0 PM.!::;) I MOBILE HOM" WASTE DISPOSAl lj.C':J PLAN REVIEW PLUMBING INSTALLED BY: OWNER [I OTHER [] NAMF WATER SUPPLY: PROPOSED [ ] EXISTING [J [ ] PUBLIC [ ] COMMUNITY. NAME: [ ] PRIVATE WELL [ ] OTHER, SPECIFY: TOTAL '<';-;';)0';;)( CONSTRUCTION PERMITS & INSPECTIONS AND WATER POLLUTION CONTROL SPECIFICATIONS MIN. SEPTIC TANK CAPACITY: GALS, <;~ MIN.DRAINFIELD ar,:Jl L1N, FT, MAX. TRENCH DEPTH i6 INCHES ::76V ~O !7acr~. O'~~CJ ~~UJ:1 n:'::J r;;;O~:WVV ~ tr~u t1 OVC:~~~Q. pa,aVD 07 7t:a c:JClIC7IC~O :,'?Qr:n\1[; r::J ~,!rll\ V'C.:l cr:C::I.I\G!lC:C:wr C;" G'ii'O'il'r:cJ to t7fJ'i"l::U I TYPE OF CONSTRUCTION--':I:J GROUP W.q FIRE ZONF STAY 100' FROM ALL WELLS USE CLASSIF. SETBACKS - I;T" fROM CTR. OF r/W: FRONT "';;I SIDE EXT, :i' FT. FROM PROP. LINE: SIDE INT. REAR j" r.:u: ZON" AUTHORIZED SIGNATURES: /s/ " D [-;0 r~ ov l'lClf~Ol\0J~l C:lI!.7/CCl':lIW.r:1OClf;j ISSUANCE DATE: 12/FJl7.i ,:~~M BLDG. PERMIT - WHITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENROD IMPORTANT: Call 687-4065 to schedule all required construction inspections. Call 687.4061 to schedule all required septic system Inspections. All construction shall comply with the Slale Buidling Code, D,E.a, standards fOr subsurface sewage disposal and the Slate 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) . , \ \ , C55.13 LANE COUNTY, DEPT. OF ENVIRONMENTAL MANAGEMENT COURTHOUSE ANNEX, 135 EAST 6th, EUGENE, OREGON 97401 r SLAB FLOOR PLUMBING GROUNDWORK . ApPROVED / / DISAPPROVED ~ DATE REMARKS GAS PIPING GROUNDWORK ApPROVED ~ DISAPPROVED ~ DATE REMARKS ROUGH PLUMBING . INSPECTOR INSPECTOR DISAPPROVEO C1 DATr2-9-?t.. ~O- <:!, , ' ';+!!1...iIA~~rJ." INSPECTO~~~ (";) 211 ''';:7'// j, '/."M ~ , , .... '2- - G - 7 t; --7"'.#--r r// ApPROVED Jg1 REMARKS....,L'JP -. '1'a// C>l,Je.-- S-' ROUGH GAS PIPING ApPROVED C1 DISAPPROVED C1 DATE REMARKS FINAL PLUMBING ApPROVEO ~ DI SAPPROVEO ~ DATE.r- r"}- '} L. REMARKS FINAL GAS PIPING ApPROVED C1 DISAPPROVED C1 DATE REMARKS CERTIFICATE OF OCCUPANCY READY TO ISSUE C1 NOT READY TO ISSUE ;---? DATE REMARKS INSPECTOR INSPEC~~~ INSPECTOR INSPECTOR . " . PROPOS~EWAGE DISPOSAL SYSTEM RECORD ~ . " , I NSTALLEIfR' Complehe top part of form to signature and submit both copies with appl ication,.' '+ ' . or,?? ,(f /{ &-"oy PERMIT NO 3205-1' . . ~ INSTALLER'S NAME PROPERTY AOORESS 1493 DELROSE AVENUE GRAY No. Living Units Bedrooms Baths Basement Yes No Water Supply Public I~her-List Septic Tank: Ft. from well Inside Len9.):h OWNER NAME Dimensions: Width Steel 0 Ft. Diameter Concrete ~o. Compartments / Gal. Capaci ty /t?' t?' OJ Tile Disposal Field: , _____ DeDth Distribution Box: Yes ~ No Other Distribution-Type KEPHART SUlLO: MAILING ADDRESS 1690 SOUTH A STREET Feet from WEll Lot Li ne Front 1Ft. Between Li nes /d Foundation SPRINGFIELD OREGON Le~th~f Lines-Ft. I Trench I Tot~l Sq. ~o 20 3. 4. 5. 6. Widtht. Ft.J",tJ :'lot Plan (see instructionsl: ~ Pet... fZt95p Side Rear IFi lle~ IFi Iler Depth IFi II er ,~,Iow TVDeI':e.... Above TileLin.ITlle/f"in. I --?" r ( 'N /\ I~ "- , " I'-. I~ Ifo ""~ {; ~ ~~ \;-..\. '" ~, ( ~ ~ "Cl- ~ f ( , /d'IY;'7 11l'(-1~- . J f \Y' . 1/ 1'. 1/'",9 1 ''''' ~ 'f,df) -='~ 1-eJrt -' 1- ( 10(1 { \/I " { ~ ~ ~ lJ ~ "'- lrf/j//VE \V ( Signature \~')- ift JfS /---/ .''''' CERTIFICATE OF SATlSFACTOR COM dTION ~ '7-117'1 Date: ."J -)- is issued at the above OateAl::J - r- 1'07 For Sanitarian Use Only: In accordance with 1973 Oregon Laws Chapter 835. Section 214 this certificate as evidence of satisfactory completion of a subsurface sewage disposal system 1 ocat ion./' ~ Approved: System Installation conforms to current standards c=:J Disapproved: Does not conform to current standards Remarks: C55-11 sani~~~ture LANE COUNTY {J'" STATE OF OREGON DEPARTMENT OF ENVIRONMENTAL QUALITY ) 'L- v a . PERMIT iF 'NOTE: NO PE~LL BE ISSUED UNTIL THIS APP ION HAS BEEN APPROVED 3 .::loS- -7f APPLICATION FOR: -. _:7:;;z~1 i:';Z, ! '\.--' Name YJ r:::=J CONTRACTOR <;aA"_-<> /...... Name O.S, REG, U '7- Twp, II Range ~ Section 2- <f . Tax Lot Code SUbdiVisionj}Vl.a 1Y~~AtI4-t I n Block I Property Acreage X ACCESS TO PROPERTY (Road Name)-LJ.J:>~lf:.fJ < e ~.-U~ / )\ Existing Structures on Property: 111' GJ ;X ~2~ r'~"""""W_' I"-? ~ (b hd>/ 4",,-- Below for Office Use Onlvxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxixxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx 1)weLli VVI 14-ID O;t Sq, Ft) (~r\oms qo~a~a~i~nq) ('1"~ Q... I f'l{)f" ~ / -' 2 "g I ~i:L S<f'I<Z. OJ. III~) J /'d-11'rY'\ / "> ""2.<.L.1 q, Cj( 0 ~ / SEWAGE DISPOSAL: ~ ' Site Inspection {J n C11 ~ WATER SUPPLY: Well Spring ______ FEES: l.~q .00 Bldg, Waste Disp:75:,-C_. _' -.- ~'g. 'fO.DO Plumbing Plan Review Mobile Home Y Surcharge ,t)o ~7 ,~. ---r ~<id"':=;-_ . J ~.Q~1,31 TOTAL C=:J PLAN REVIEW C=:J CHANGE OF OCCUPANCY C=:J 1'70 SOLtL.A ~AI'A. 9'/<I/!/} /lc.,('b ~VL7 Address "7 Ii zIp ~one Address City Zip Phone Census Tract Width______Depth s;..?~k-)~O /1 Existing Sewage Dis:j:osa System Public ~ Other Commun y C=:J r:::=J or New System Required c===J Name of Community or Public System ~~w PLUMBING FEES: ~ :).-'U \ V o CASH ~ CHECK :J.. Water ~. Connection ~ PLUMBING: Installed by Owner Other ~Name ~ :s:b...c1c. (b-r\ Sewage Connection PLANS FURNISHED / LLL1 YES C=:J FACILITY PERMIT ~r~ ate: ii..-4~ Fee Received By: ~: Tank Capac~y 91=(>. Drainf17Jd Required - Lineal Feet _/ =-t""'(t Ma~imum Depth"?L _ bf I,1H'A.n.. ../?_"""D,..<-/?.J/~ L;,~--, -~~, ~ 7:~J(, ~ . , ,'-'-----7; , , I. --- dl I V ' ..A.....,.-,,. t:".""A f {....../ . AAr-<:rf~_.t?..A--( ~ S'.!,.<:::: ....;-_ " ,. Type of Construction <5 Xi/ ~ Groun H7\"T Use Classification Fire Zone Bldg Setbacks -;;om Center of Road 71gh of Way: ~ Front. . It. Side Int. Side Ex ior Rear.,5' pjLJ.:t . Zone 1~ _ PIANN~. llUv 1fE: ~jIT~~ /.:z~~7r- J?1~~;A:;:p.. If" CIS. 11 LANE COUN~ DEPAR~;Ni1o'F ENVIRONMENTAL4:~~~ENT 7''-'"'' l ~