HomeMy WebLinkAboutPermit Building 1977-1-24 (2)
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PERMIT # JCj/- -71
LANE COUNTY PERMIT
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Phono . .ill'
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(owner. etc.) when ready.
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Acreage or Lot Si?O
Contractor's O.S. #
Partitioning #
( I Completed
APPLICANT'S NAME AND ADD R""" 1
OWNER'S NAME AND ADD RES"
CONTRACTOR'S NAME AND ADDRES"
Mail permit to ( ) Applicant ( I Owner
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) Contractor.
) Prefer to pick up. Call
STRUCTURES NOW ON THE PROPERTY
.THIS PERMIT IS FOR ' ~
WATER SUPPLY'" '.'
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# BEDROOMS_# PLUMBING CONNECTIONS--
SEWAGE DISPOSAl
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, PLUMBING BY
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THIS PROPERTY IS WITHIN ONE MILE OF THE CITY OF
I hereby certify that the above statements are true and accurate, and that I have the following legal interest in the property: _owner of record;
contract purchaser; _ potential buyer; _ realtor or agent. I further certify that (if not the owner) I am authorized to act for the owner of
'record, and that said owner is aware and approves of this action, I hereby agree to comply with all applicable Codes relating to this permit.
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Fee Paid $ J. / Signature' Date . ./
( ) NEW ADDRESS ( ) FACILITY PERMIT TO TRANSPORTATION DEPT ) SPECIAL PMT, AREA. MIN. ELEVATION:
SANITATION . BUILDING
Minimum Septic Tank Capacity (Gallons) '-A/ Type of Construction _ J Group
Drainfield Required - Lineal Feet --C;",l'..--'''-<./~ Use Classification
Maximum Depth Cor;;;"ents: /
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Fire Zone
. Comments:
By: Date:
PLANNING REQUIREMENTS SATISFIED. Bv:
?ONE: ,1/4 SETBACKS: FRONT
By:
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Date: /.~ ..../
(FROM CILl
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J ._/ Date Issued: /- v
INT. S'IDE YARD REAR
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(FROM PILI
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SIDE FACING STREET
LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE., EUGENE, OREGON 97401
POST THIS PERMIT ON MAIN BUILDING AT SITE
PHONE: 687-4394
C55-'3
BLDG. PERMIT - WHITE; BUILDING - GREEN; PLUMBING - CANARY; SANITATION - GOLDENROD: OFFICE COpy - WHITE
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Job Location lot.! 5
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INFORMATION SHEET
I Site Feasibility Study for Septic Tank.
( ) Would like to meet on site. Call
Acreage or Lot Sizo Test holes will be ready .._
Partitioning # ( ) Completed Subdivision "//.L.~_..P /L.-~
( ) Pending /) J} - . /)
APPLICANT'S NAME AND ADDRESS -V~ C ~ /t'/tI F d/-<<. - ,",.J ~
OWNER'S NAME AND ADDRESS, if different from applicant's~;
CONTRACTOR'S NAME AND ADDRESC:
Mail permit or results of site feasibility study to ()() Applicant ( ) Owner ( ) Contractor.
e( ) Prefer to pick up. Call (owner, etc.) when ready.
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( 'f) Building Permit
Number of sites
(owner, etc.)
Lot S
Bloc~ 2.
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0-_ Phone-.Z..'-' 7 -} r 7.2..
Phono
Phono
STRUCTURES NOW ON THE PROPERTY
PROPOSED USE (this permit)
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WATER SUPPLY
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(existing or proposed well, etc. If public, name of system)
SEWAGE DISPOSAl ~
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(existing or proposed septic tank, etc.) S.1. #
PLUMBING BY
(y) PROPERTY ISWITHIN ONE MILE OF CITY ( ~~
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Address
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******************************************* OFFICE USE ONLY BELOW THIS LINE *******************************************
( ) New Address Necessary
eZONF
) Facility Permit NeCessary
SETBACKS: Front Side Facing Street
(FROM CENTERLINE OF ROAO)
) Specia I Perm it Area.
Minimum Elevation:
I nterior Side Yard. . Rear
(FROM PROPERTY LINES)
To: PlanninglBuilding Inspector/Sanitarian/Surveyor.
This applicant appears to have a problem with
Your assistance will be appreciated.
By
Permit Processing Section
Responsp'
C55-' 2
By
DEPARTMENT OF ENVIRONMENTALMANAGEMENT
Permit Processing Section
125 East 8th Avenue
687.4394
lIivision
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JOB LOCATION
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PERMIT # It/I-II
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LANE COUNTY PERMIT
) Completed Subdivision ~Lfm'J J aA.-e--~
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Contractor's O.S. # Lot ~ Block r-...'
APPLICANT'S NAME AND ADDRF""JJrJ1I.11J j7 r ~/.;, ",,/', /d1Js I k.L)./~--d/1 t:.?'.<:rJ:. ,-:]cl-R Phone/cj7--317~
OWNER'S NAME AND ADDRES" -' f' .. - ( {./ Phone'
CONTRACTOR'S NAME AND ADDR""" Phone
Mail permit to ( ) Applicant ( ) Owner ( ) Contractor. ( ) Prefer to pick up. Call (owner, etc.) when ready.
STRUCTURES NOW ON THE PROPERTyJ.?-l/.<'1..1l. ~
. .THISPERMITISFOR -.aI1A!.I~/ tZaA_~/
WATER SUPPLY ,Aft> ./ I
Acreage or Lot Size
Partitioning #
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THIS PROP'~RT":' IS WITHIN ONE MI LE OF THE CITY OF
# BEDROOMS_# PLUMBING CONNECTIONS--
SEWAGE DISPOSAL_ ,-~Uc..../_~-F S.1. #
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.. PLUMBING BY
I hereby certify. that the above statements are true and accurate, and that I have the following legal interest in the property: _owner of record;
contract purchaser; _ potential buyer; _ realtor or agent. I further certify that (if not the owner I I am authorized to act for the owner of
record, and t,hat said owner is aware and approves of this action. I hereby agree to comply with all applicable Codes relating to this permit. I
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Fee Paid $4--}. d / . - Signature jy~..4' .r ,.4.;,....,..,..... Dato /- ;; ~ -7
( I NEW ADDRESS ( ) FACILITY PERMIT TO TRANSPORTATION DEPT. ( I SPECIAL PMT. AREA. MIN. ELEVATION:
SANITATION
...
,
Minimum Septic Tank Capacity (Gallons)
Drainfield Required. Lineal Feet
Maximum Depth
BUILDING
_ _erA/. Type of Construction J Group
. A>;'-<"..,-!",~llse Classification
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Comments:
":5 Fire Zone
.Comments:
By: vi ~.J/' Jr.~ ~"Date: /- :2-~-71
'-r-r-l/h.A.::r- (/ Date: j-cY4- Y/l Date Issued: 1-,;)'-1- 77
(/ SIDE FACING STREET (FROM C/L) INT. SlDE YARD REAR (FROM PILI
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By: Date:
PLANNING REQUIREMENTS SATISFIED. By:
ZONE: A/A SETBACKS: FRONT
LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE., EUGENE, OREGON 97401
POST THIS PERMIT ON MAIN BUILDING AT SITE
PHONE: 687.4394
C55.' 3
BLDG. PERMIT - WHITE; BUILDING - GREEN: PLUMBING - CANARY; SANITATION - GOLDENROD; OFFICE COPY -WHITE
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SITE INSPECTION
ApPROVED Cl DISAPPROVED Cl DATE
REMARKS
FOUNDATION INSPECTION
ApPROVED ~ DISAPPROVED ~ DATE
REMARKS. & 0
FRAMING INSPECTION
ApPROVEO I V'/ DIS~PPROVED Cl DATE 1-1--1- 17
REMARKS
LATH OR SHEETROCK INSPECTION
ApPROVED t.-I OISAPPROVED L-I DATE
REMARKS
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FINAL INSPECTION
ApPROVED ~DISAPPROVED
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INSPECTOR
INSPECTOR
INSPECTOR ~~
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! 1 NSPECTOR
Cl
DATE!-7-7-?? INSPECTOR ~
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REMARK 5
CERTIFICATE OF OCCUPANCY
READY TO ISSUE L:::7 NOT READY TO ISSUE L:::7 DATE
REMARKS
INSPECTOR