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Home My WebLink AboutPermit Building 1974-7-8 ''',Ii~. lI"r ,,','eo _....-.._~.r..... .,r, ~".-. .......--.~ .,.,.r:o:..,.,.... .,~.~. -_.~....:;.:-..:-t. ;\'.o:1:--;L:",'-:_~'--::"'-...'''''''l't< ~_'''''''''''''f:_.\..''''''''' ~ o' 0# t1I' .~, '. ;;- 0, LANE COUNTY.ILDING PERMIT OR MOBILE BUILDING []I MH 0 MAILING ADDRESS t'lCl) "t)" 5t~I',..:r. Sndnr;'?i..H. nr. MAILING ADDRESS Ho4sE PERMIT PERMIT NO. 1/;'.7-7(/ 1~t'jO_/~i PHONE 747.':O;~~ PHONE PROPERTY OWNER 'J1NG. J,l',' II. CONTRACTOR ~)i'lfrC PROPERTY LOCATION - INClUDE POST OFFICE H:-vlli!I' nr :"f'~ Rd. t~ 1\. 16th to :l0] rose. PROPERTY LEGAL DESCRIPTION - METES, BOUNDS <end. I'.dd. Cd rl;se Lo~ 13 fl n:. ::; TWP RANGE SECTION rlq~t on r.elrose. Last lot. 17 h 0'" ront: I'l ~3 'ik 3. L/ .JJ; L;T~ CODE CENSUS TRACT EXISTING STRUCTURES ON PROPERTY APPL. NAME & MAILING ADDRESS FOR MOBILE HOME PERMITS ONLY No, of Bedrooms t~uovc 11 '0 Hone ~AL ACCESS TO PROPERTY h Del ro~c PROPERTY SIZE - FT. WIDTH DEPTH AREA STRUCTURES TO BE BUILT THIS PERMIT Connect to Existing Sewage System D TYPE CONSTRUCTION SQ. FT. :;+ BDRMS 1J\':elllnn ~-N 163G (:12 C3) New System 0 VALUATION 19.5JG i,l,' rllqc-:.~tL' c::c6.Unc. 4:<5 (" 3 1.27:" 2C.()~ I SEWAGE DISPOSAL . OTHERO n.te 30.0C 37.00 FEES PlUMBING INSTALLED BY OWNER 0 OTHER, NAME WATER SUPPLY PUBLIC f] BUILDING WASTE DISPOSAL PLUMBING PLAN REVIEW PARK TRAILER SEPTIC TANK ~ PUBLIC 8 o OTHER TOTAL $ 1!:4.tO COUNTY BUILDING & SANITATION SPECIFICATIONS MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GAL. 9CO DRAIN FIELD REQUIRED 150 UN, FT TRENCH WIDTH FT. ? OR SQ. FT, "'"..1' ;$~~ TYPE OF STRUCTURE ':;Qr~ BLDG. SETBACKS __ FT. FRONT t.J1 OCCUPANCY (,. J FROM CTR. OF ROAD RIGHT OF WAY SIDE INT. ::;' SIDE EXT. -- AUTHORIZED SIGNATURE - DATE ZONE I.GT PUBLIC UTIL. EASEMENT USE CLASSIFICATION REAR !) I Is/J.~.D~SS, [lV, C. It'ICl::::.UGIl J. SHJOII, S2ClitcrL:n DATE 7-fJ-ii BLDG. PERMIT - WHITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENROD Call 6B7-4065 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 plumbing. 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 6th. EUGENE. OREGON 97401 FORM == cSS.lJ ,- -- - TUR O'ZS 2lj TAX LOT CENSUS TRACT XV\d. De/IDS'e.. IS-b L-'6 APPLI CANT: / NAME l-OnCP ADORES S '..J ,BUILD INQ: SITE EVALUATION .: () Building Permit Appl ication No. () Site Inspection () Pre-Permit Investigation PHONE DATE t. -;< /-71/ ; PLANNING DIVISION NOT NO aDDI icable I. Zoning Ordinance Comp 1 i ance ( ) ( ) (Zone A&-r) 2. 'Subdivision Ordinance Compl iance ( ) ( ) 3. Required Access ( ) ( ) 4. Bui Iding Site (Area, Width, ( ) ( ) Frontage, Setback) 5. Other (see comments) ( ) ( ) YES NAME t~ I ) (( ; DATE /'~- /~s-7 <L , ) COMMENTS: , -' BUILDING INSPECTION DIVISION NOT NO YES NAME DATE ~pl icable ~d~,_ -~~~ /- ~-~ ? Y 6. Plans Subm i tted () ( ) (0 7. Soil Stability (foot i ngs) ( ) ( ) ('7 ) ) 8. Flood Plain (~ ( ) ( ) f (see Comments) ( ) ( ) ( ) J I 9. Other COMMENTS: TO APPLICANT:' ':KrYour , /' ~.1 - ( , LY ~., ( ) ( ) ( ) Building Permit / 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 5 contact the Lane- COUNTY PLANNING OEPARTMrNT. Questions and further information on items 6 through 13 contact the Lane Countv Buildinq 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 cover. .---- - .-- DEPARTMENT OF ENVIRONMENTAL MANAGEMENT 135 Sixth Avenue East Eugene Oregon 97401 PHONE: 687-4065 LANE COUNTY PLANNING DIVISION PHONE: 687-4186 C55-28 r' .' Dotp . ,,-8-74 . . Permit No 1127-74 CURB CUT & Sidewalk 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 ond 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 1391 "N" Street, Springfield, Or. or constructing the following facility: Owe 11 i ng JAY B. LONG for placing, building 2nd. Add. Oelrose Lot 8 Blk. 6 1715 Oelrose Av.e 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 appl ication 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 neot, acceptable condition. 3. Sidewalks will be constructed in accordance with the attached sidewalk specifications and drawing M98-49. The standard curb type shall be constructed uniess otherwise specified. 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 Julv 8 , 19.1.L. Expires ,19_. Inspected and Approved Approved by Board of County Commissioners By d:./:J /tJ~ -. f. Djre~to~ 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 " '7 fe(!.",~ (. Dat~'. - . . . Permit No. " CURB CUT PER M I T' 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 for placing, building or constructing the following facility: 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 (Drowing M98-50). 2. Permittee will be responsible for the immediate removal of all mud, dirt ond debris from the roadwoy 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- forI" ,19_. Expires ,19_. Inspected and Approved Approved by Board of County Commissioners By Date 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 cOUNT.ILDING PERMIT OR MOBILE HO.SE PERMIT BUILDING [j;] MH D PERMIT NO, MAILING ADDRESS ~ ; ,~in."..:, PHONE PROPERTY OWNER 1 :.'lr1: .o~l\) r, CONTlfACTOR 1',1:)1 -- U;~lI '~{'ot.l"''''.c. MAILING ADDRESS' r.:~,... t,~O(dl ;-.1..-1. , r:. .'!,:,1.'t;J\;J PHONE :)."'r'(": PROPERTY lOCATION - INCLUDE POST OFFICE !:,_!tI~-.ln P!ri1:::';,,: r>J.. t::::l r:. *(th t-.~' l\:l";;:in. r'~;h~ 0:1 Drir.:sr. f'-..c:G~ lot. PROPERTY lEGAL DESCRIPTION - METES, BOUNDS "ulr; l;'-:'lli~:in TWP ,:,'d. ~..i....,~,!'l ''"It rIll".. (, RANGE SECTION TAX LOT NO. CODE CENSUS TRACT 0.,,," A',",.,. 17 0'1 ::11 APPL. NAME & MAILING ADDRESS FOR MOBILE HOME PERMITS ONLY No. of Bedrooms EXISTING STRUCTURES ON PROPERTY ,;tftttn N"'nZ"'l LEGAL ACCESS TO PROPERTY 01"\1 f.7i'\!Ilrt PROPERTY SIZE - FT. WIDTH DEPTH AREA STRUCTURES TO BE BUILT THIS PERMIT Connect to Existing Sewage System D TYPE CONSTRUCTION SQ. FT. :;; BDRMS New System 0 VALUATION 0'_;~D! Ifln C;.:J i(',,[] c: I. Cl~ I'; .r::; r:-:r~ ~{1~!\ r.Qr:c.~~..:~~r.. 11~'i (; 'J ~ .. i ',,' ,i ~ 'n.J)'~ i SEWAGE DISPOSAL PUBLIC rJ BUILDING WASTE DISPOSAL PLUMBING PLAN REVIEW PARK TRAILER . OTHERO 'i7 .OU sc.ra "1.00 FEES PLUMBING INSTALLED BY OWNER 0 OTHER: NAME WATER SUPPLY SEPTIC TANK [!] PUBLIC (;] o OTHER TOTAL !- 1(4.00 COUNTY MIN. SEPTIC TANK CAPACITY WITH OIST. BOX: GAL. 90;) BUILDING & SANITATION SPECIFICATIONS DRAIN FielD REQUIRED L1N. FT I~O TRENCH WIDTH FT. :1 OR SQ. FT. ~~J TYPE OF STRUCTURE 'jwtJ BLDG. SETBACKS u FT. FRONT l~!j 0 OCCUPANCY I C. J FROM CTR. OF ROAD RIGHT OF WAY SIDE INT. J I SIDE EXT. B_ AUTHORIZED SIGNATURE - DATE ZONE . 1ST USE CLASSIFICATION PUBLIC UTIL. EASEMENT REAR 5' lolJ.E1.G15J. BY. C. HAR5.-'\UGIl J. SHOOK. 3Gnltorlc~ DATE 7-0-1/;' jll BLDG. PERMIT - WHITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENROD Call 687.4065 to schedule all required inspections. All construc- tion shall comply with Uniform Building Code, D.E.Q. standards IMPORTANT: for subsurface sewage disposal and county regulations covering plumbing. All buildings require a certificate of occupancy before being occupied, " ;7 (See Details an Reverse Side) ~ FORM =- C5S.!3 (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 ApPROVED ;---? DISAPPROVED ~ DATE INSPECTOR REMARKS GAS PIPING GROUNDWORK ApPROVED ~ DISAPPROVED ~ DATE INSPECTOR REMARKS ROUGH PLUMB I NG ApPROVED !Xl REMARKS DISAPPROVED CJ DATEt::..jJ~J'L- INSPECTO~~ J ROUGH GAS PIPING ApPROVED ~ DISAPPROVED ~ DATE INSPECTOR REMARKS FINAL PLUMBING ApPROVED /E1 D'SAPPROVEO CJ DATE -;:'::J Q-? J"., NSPEcrO'll REMARKS FINAL GAS PIPING, ApPROVED ~ DISAPPROVED ;---? DATE INSPECTOR REMARKS CERTIFICATE OF OCCUPANCY READY TO ISSUE ~ NOT READY TO ISSUE / / DATE REMARKS --/~ // INSPECTOR . '. .. .4 ~, . " . LANE cOUNnelLDING PERMfT' OR MOBILE HO.SE PERMIT BUILDING n MH D . PERMIT NO. MAILING ADDRESS " PROPERTY OWNER ~ CONTRACTOR ~ , '!' ~ t,- MAtllNt1 ADDRESS . 1(' ~ _)i PROPERTY lOCATION - INCLUDE POST OFFICE , r~~' " . ~~. . PROPERTY LEGAL DESCRIPTION - METES. BOUNDS ~. , , TWP RANGE SECTION TAX LOT NO. CODE CENSUS TRACT APPL. NAME EXISTING STRUCTURES ON PROPERTY LEGAL ACCESS TO PROPERTY & .-.:) '" 'A. ~\.; " I, " MAILING ADDRESS s.. \PR'3\fR,TL~I{~~fU' i.\ WIDTl;-l ,DEPTH " . c FOR MOBILE HOME PERMITS ONLY No. of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT AREA .., , ... " \', \"/ Connect to Existing Sewage System D TYPE CONSTRUCTION SQ. FT. :;:; BDRMS " i New System 0 VALUATION \) \' ."'~. - ~ ,", "~''o ~ \\~~ g \.' \:~,<:;\, ',.....-, . \' \'. V\. C' V""';,,'\\-\ " ,~...... \ ,~~.~~~ ~}'; \ ~,~.. ',' " SEWAGE DISPOSAL PUBLIC 0 BUILDING WASTE DISPOSAL \. PLUMBING PLAN REVIEW PARK TRAILER SEPTIC T A~K 0 \ .~ J\ < OTHERO .'. FEES PlUMBING INSTALLED BY OWNER 0 OTHER: NAME WATER SUPPLY "~~. ... \ -',< PUBLIC EJ o OTHER TOTAL \ Ii - " , '.- < I COUNTY BUILDING & SANITATION SPECIFICATIONS - ' .' .' MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GAl. DRAIN FIELD REQUIRED L1N. FT TRENCH WIDTH FT. OR SQ. FT. " 1,:, , J'r "~,\\\ L :... ,\~~.~>:,-~\ ~~~~~. ~,\-. t>*-z,i~.,-.\' \. . \ '. '~\I", . . ~~X '\t-l'.':-o', "\'~\S.:)'5>'-I>\_ " ,.' :" ,.'.\1"'" ',' .J\.:'\tl>0\',';' OCCUPANCY'\' I. J:\ ,lONe' -! 1. \' ,. PUBI.lICiLfnL.'EASEMENT \,j .), -'\, ....,,:-- \.",\ TYPE OF STRUCTURE' _1 ... FRONT BLDG. SETBACKS. FT. FROM CTR. OF ROAD RIGHT OF WAY . SlOE INT. SIDE EXT. L AUTHORIZED SIGNATURE - DATE USE CLASSIFICATION REAR " r I DATE , '". o BLDG. PERMIT - WHITE OFFICE COpy - WHITE COUNTY TAX - PINK PlUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENROD \ Crill 687-4065 to schedule all required inspections. All construe. tion shall comply with U"iform Building Code. D.E.Q. standards for subs,,!.rface sewage disposal and county regulations covering plumbing. All buildings require a certificate of occupancy before being occupied. (See Details"on Reverse Side) IMPORTANT: iORM = C55-13 (POST THIS PERMIT ON MAIN BLDG. AT SITE) LANE COUNTY. DEPT. Of ENVIRONMENTAL MANAGEMENT COURTHOUSE ANNEX, 13S EAST 6th, EUGENE. OREGON 97401 J !r' \ I . . . SITE I NSPECTI ON ApPROVED ~ DISAPPROVED ~ DATE '/ REMARKS / INSPECTOR t FOUNDATION IN~N ApPROVED L:-! DISAPPROVED! ! DATE %.::.1'1.' 7l( INSPECTOR REMARKS--f!../5;,~~r '/-1lz.--'11/R rI &i (0,7 7' . ( FRAMING INSPECTION ~ ApPROVED ! ;: .01 SAPPROVED 0, DA;E..J' ~t!J/', 11( . ~ /,/CTO[;:?C ~ REMARKS_~t!f- r~..L~.I(h~ r;'-j"Jo '~'I;U ~A.i:U;1'- -1jf4.ll:t,t1>fU'tt~'U, f'.~d.>I tt,'--ICJ .'1" ~ ~A7 fI. t./ /J 1'1_ ~:J f~'" 1"'- L4l/' --t ./7( JJ# Aid ~ ~ C7'- l,i -7 ~/0' t../ - I . -- LATH OR SHEETROCK INSPECTION ~~ 17 '"""'" LLI 0, :~'~"a ~ Om ~.~ '"':"'"' { ~ (f/ J. REMARKS~~P)!.~~ ,.~-.:.._ ,~c===---.?-;;;7~ I / / . '- I)ir'i;)l~ q-Il;'-'11I fA &": . ' ~~ /' DATE'1"11'- J~(I~SPECTa ApPROVEO &i1V-"'ji) .~- ...4.e~ jl~J/.1.{ A ~2;;:"1{ft- ,,u .L. ."fo.. CERTIFICATE OF OCCUPANCY READY TO ISSUE / / NOT READY TO ISSUE ~ DATE INSPE:CTOR REMARKS l, A 4} 4' //, /1 / _.a/J/~ 11~7-7'f ~ /7N:J' Z;~4<1Ic:e- .. INSTALLER: % OSEO SEWAGE DISPOSAL SYSTEM R D ~ Complete top part4llrform to signature and submit ~ copies with plic~~;:~-:~~ PERMIT NO. ~ii(''1''. I PROPERTY ADDRESS . ItjSTALLER'S NAME d J, i/I BACKHOE SERVICE NofM! ;vil~\pIJ" i'tU. ~s It:.\y r- , HAILING 139/ /II ADDRESS () l' Sp'\'\.~.'t c{ Len!!th of Li nes-Ft. I Trench'l 1.752.7.53. 4. 5. 6. Widt~ 'lot Plan (see instructions): Lf'lY\o 'Sf- Ou 17 I 5 \:)~L R,,~\-:= Baths Baseme~ ~Supp'y Yes (N~ ~e Other-List Concrete ~. Compartments Gal. Capacity I Tile Disposal Field)""'\ Depth" Oistribution Box: (Ye~ No Other Distribution-Type ~ Septic Tank: Ft. from well Steel D Inside Dimensions: Ft. Lenllth )1' Width..:s Diameter OWNER NAME /()()() Total Sq. Ft. ~Cb Feet from WEll Lot Line.-J Front ;QV 1Ft. Between Li nes / ~ ' Foundation ~I Side /eJ Rear It) IFi Iler //IFlller Depth IFlller Below Type I~Above Tile),/lnlrlle~ in. '. / ::;; ~ ~ ~12 ". (to. ~ ~ II) ~' - , - I <::), ..../ .... "1 I LIp , 'T <:) C'1 '?-:' r , I ~I I $()~ ,II, rJ) ! s (0ll R n \\17 i'>], ' w'iiib\Dl!..UVG lV JULI.; 1974 I.ANE COUNTY ENVIRONMENTAL MGMT. 'h \ I ...... ~O L' < f/'Of eI" "J ) I '>-G ~o/ I / ~~ ~l d Date /1//t::'1 ~ Si!l!'ature ~~/1/i?'~xV'- CERTIFICATE OF SATISFACTORY COMPLEi'1-6i( - - 'f /';j For Sanitarian Use Only: Date: 7;f6 7tt In accordance with 1973 Oregon Laws Chapter 835. Section 214 this certificate is issued as evidence of satisfactory completion of a subsurface sewage disposal system at the above loca~i . Approved: System Installation conforms to current standards Disapproved: Does not conform to current standards Remarks: STATE OF OREGON DEPARTMENT OF ~~~ ~~ iJ;ian s Signature E COUNTY ENVIRONMENTAL QUALITY C55-11 PERMIT TYPE - PROPERTY OWNER ~. /].'1'-(/ ~C/ (/. PERMIT # II 21.;;..7 f 7;:L7- :3tJSO ; PHONE a.~/4sf PR PERTY l'd;;'-,'Ng; P,OST;?) _ ~7J, /fLd ~dd/)/hU /4d~j- ;~j, PROPER LEGAL DESCRIPTION c::r, / /) /-:7 /1 ,,-.1_ #) A /J. - - ~ _ / /' _ ro:./ , METES & BOUNDS 0 YES LOT - BLOCK - SURDIV, (?'/l.I..v ~c:r 1iJ tL:/~ rJ (p -"- <r . ATTACHED n NO TWP RANGE SEe. TAX LOT # CODE CENSUS TRACT ~ZANT ~ ,/ DESCRIBE EXISTING STRUCTURES ON PROPERTY IF ANY NAME _/??.......~~ AND LEGAla:hR~RO~i7/S~' MAILING PROPE'RTY SIZE-WIDTH DEPTH --'..~..,...... ''''''1''''1 '...Jr.t In"'CILt;. rlVl'OlI; U;U: 1.\I'f'I,.ILH.IIUN .! BUILDING [l MOBilE HOME Dose REG, It .a&1L~G ADDRESS . tJ/ ./ _ A1 ..w?'/ l( '77 ~ 4/-. <J.:dJ ~' MAILING ADDRESS / / ./f_ AREA ADDRESS FOR MOBilE HOME PERMIT ONLY Number of Bedrooms STRUCTURES TO BE BUJP .THIS PERMIT . /)/ / I~../ f!//7C-Sl' ~~ -. J ~,~.~~. (/ . . Connect to Existing TYPE CONSTRUCTION Sewage System 0 or New System Req. 0 )~Fq ~lzED"7fSJ AtZSk C/;;2S@ -3 /275 ~ 1I?)L ~ SEWAGE DISPOSAL PUBLIC n SEPTIC TANK A BlDG, LL'L-'/,p 0 ' WASTE 015. ~ 0 .00 ....... '?7c CJ 0 PLUMBING INSTALLED BY MIN. SEPTIC TANK CAPACITY WITH OIST. BOX: GAl. qo (') OTHER 0 OWNER 0 OTHER 0 NAME FEES WATER SUPPLY PLANS FURNISHED PUBliC if...?3-~ YES i'I E'!2 YES ;JL1:::::s ~ '~~33'D~~"J\~~?\."r; ,," O FEE C B~// CASH 0 SEWER " { () , (/ CHECK I' CONNECTION FEE ~ '---I. ~ ;:J JO\ PERMIT # V.Z/. V PUBLIC WATER {)(.,./ J 7 7 CONNECTION FEE t /1 . ......: - -~-,_. ----.'-...--' COUNTY BUilDING & SANITATION SPECIFIC~TioNS DRAIN FIELD REQUIRED / lIN. FT. J(S(J TRENCH WIDTH FT. /2 / / / / / _~OD / DATE ra-;)/-7Y DATE' PLUMBING PLAN REVIEW PARK TRLR. TOTAL //? /.-1, 6 a . OR SQUARE FEET .360 J / TYPE OF ~RET4t7:I . / .A; .lii~CKS-:'FT' FROM CTR.OF'DAD RIGHT/d;'"fAJe... -- ---/' --.~ 'RONT + S SIDE INT. ~)F3-~ ' REAR ~IJF:.. ~~t~... ri?lljr Y/7r>b c..-~~-~i INS~~~ C': 4 I ,J .' I . , . ections to find Properly: ~/ I REAR YARD PUBLIC UTIl. EASEMENT USE CLASSIFICATION f.L.... Date -1 - t>'d..L;:ft/ .?-S,-?r/ COPY I - OFFICE COPY 2 - JOURNAL COPY 3 - AUDIT Form # CH'll . .., . -~'....,;.".:' .'~'.. ..,."". _', _.n. . ;-..._p...........,..-; h _; _~._. ..-.- ----- ..--. .. '.. .....-.'1' --"".-. . '" .