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HomeMy WebLinkAboutPermit Building 1974-1-4 (2) r; - ~. ~.'- .---......-~7.....-....._...--,. ~.-_...---._.-......~._.....r-..,~'--,>Ft.., --'.c ...., _~_-.-......_.._ .,,' I; .K..c~\.' '~. " . I ( (- O. " _ ~ ''';',. .'....,.-.. LANE COUN~UILDING PERMIT OR MOBILE ;........ " . . BUilDING lli!:: MH 0 PROPERTY OWNER MAILING ADDRESS ---..y -~"'- r__________..'.__.-.'''~,--,~,- >_,..-.... - iA~> '1 u ~/.;.-' r>-' ., L. /"-" ~--.:- H.' USE PERMIT PERMIT NO, C:~1~--t: PHONE 71f6-<',i'1(, PHONE Hill. i:ODEI1T n. CONTRACTOR 370 \lEUT CE,JTff;NIAl. SPRHIGF 'F:LO. OR::GOtJ MAILING ADDRESS SA~F.: PROPERTY LOCATION -INCLUDE POST OFFICE l1c;O CONOEh- .t.1EADOl-J GI1EEN ESTATEO TIIIRD (.001 TQoON- PROPERTY LEGAL DESCRIPJION - METES. BOUNDS LOT 21 ~EADO~ GRrED EOTATES I THIRD ADDITIOK) TWP RANGE SECTION TAX LOT NO. CODE :JI;: 9.;?1,~ CENSUS TRACT L 02 06 , I, 3 ,'\-11'12 A EXISTING STRUCTURES ON PROPERTY APPl. NAME & ~AILlNG ADDRESS FOR MOBilE HOME PERMITS ONLY No. of Bedrooms II III tJONE LEGAL ACCESS TO PROPERTY DONDEA STREET PROPERTY SIZE - FT. WIDTH 12'5 DEPTH 70 AREA STRUCTURES TO BE BUILT THIS PERMIT Connect to Existing Sewage System 0 TYPE CONSTRUCTION SQ. FT. # BORMS HOI.1E tRAClE 1087, 12 I'll 291~ C , New System 0 VALUATION 12.<;;1, GAnAGE-ATThCHED A~O UNCEllED II. ., t.. t. 1:'" ,:0 SEWAGE DISPOSAL PUBLIC 0 BUILDING WASTE DISPOSAL PLUMBING PLAN REVIEW PARK TRAILER PLUMBING INSTALLED BY . OTHERD %.00 20.00 21."i0 FEES OWNER 0 OTHER, NAME WATER SUPPLY PUBLIC III( 0 OTHER ~J ..JACtt!W~j SEPTIC TANK 0 TOTAL . Q7."i0 COUNTY BUilDING & SANITATION SPECIFICATIONS DRAIN FiElD REQUIRED UN. FT 200 TRENCH WIDTH FT. j OR SQ. FT. c~:,) MIN. SEPTIC TANK CAPACITY WITH DI5T. BOX: GAL. ~OO f TYPE OF STRUCTURE OCCUPANCY 5 .~ AND J BLDG. SETBACKS n FT. FROM CTR, lOF...RO,fD RIGHT OF WAY FRONT 50 SIDE INT. 1'1- -( SIDE EXT, REAR 7 AUTHORIZED SIGNATURE - DATE /0/ J.E. Booo BY CHARlEO HARDAUGH ZONE PUBLIC UTIl. EASEMENT USE CLASSIFICATION J nt-I R S 1-4-7\' SG OHN -' DOll, .. .., DATE 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 FORM := C55-13 r ,.~' -~ , .... ~/{!l~ T I? R '(J,,:Ls' ~th TAX LOT c3~37,~~~~ APPLlCA'(2 No. d?""/~ -7...1 . Ni\l1E ~ YJ, 7'...L/./ AODRESS , BUILDING SITE EVALUATION ~ ( ) I ) ~. Bu i I ding Perm i t App I i cat ion Site I nspect ion Pre-Permit Investigation PHONE DATE /.,:2 -/r.;- 7_7 LI\NE COUNTY PLANN I NG DEPARTMENT I. Zoning Ordinance Compl iance (Zone R-A ) Subdivision Ordinance Compl iance NOT app I icable () () ( ) ( ) ( ) ( ) NO YES NAME DinE ? -', Required Access ( ) ( ) ( ) ( ) (~- (~ (Y (--( ~~~ ( ) / ~/~/, "3 / " 2. 4. Building Site (Area, Width, Frontage. Setback) Other (see comments) , , 5. ~ '---- COMM ENTS : "- '- BUILDING I NSPECTI ON SECTION NOT NO YES appl icable ~ 6. Plans Subm i tted ( ) ( ) ~) 7. Soi I Stab i I ity (foot ings) ( ) ( ) 8. Flood Plain ~ ( ) ( ) 9. Ot he I' (see Convnents) ( ) ( ) COMMENTS: NAME DATE &.i~l:i-/jt[ SANITATION SECTION NOT NO YES J~ DATE app I i cab I e 12/21.1z ~ 10. Sewage Disposal ( ) ( ) ( ) II. Us ab I e Area ( ) ( ) ( ) 12. Water Supply ( ) ( ) ( ) 13. Other (see Comments) ( , ( ) () COMMENTS: TO APP LI CANT:, ( ) ( ) ( ) Building Permit / Site Inspect ion: Can be approved. )- 1'- 7~ C4? Cannot be approved at this time as indicated on item NO. above. Quest ions and further informat ion on items I through 5 contact the Lanc- COUNTY PLANN ING DEPARTMENT. Ques t ions and flirt her i nformat ion on j tems 6 through 13 contact the Lane County Buildinq and Sanitation Division. Wi II be held in this office unl'; I you can resolve l'he problems indicat"d. Is being returned. . Your buildin~ permit appl iC.1t.ion fee is being returned under separate Cu.Jer. Your .ff LtlNE COUNTY I'UINN ING UEI'/IRTMENT 13," Si)<l'h Avellue [~sl. EU~jClle, Ilf'''9"n 97401 1'lllmE: 341..1:111 [;XI,211 LANE COUNTY BUILDING & S/\NITiITION DIVISION IJ'l S i Xl" ~Vclll'" Llst. E"~ICIl". On"lon 9740 I PIlLlIlL: Jljl-1311 OT. Ifll .. ._._.__._--~--_.__.- ---.. '..~i55:28--.. ,..,-- ., , LANE COUNT&ILDING PERMIT OR MOBILE BUilDING o. MH', 0 MAILING ADDRESS HOeUSE PERMIT PERMIT NO, .' 'I: PROPERTY OWNER PHONE '. , .,-) " . . ~.~: ~ /'~,:" 'V-,'~q ~ ~. '. CONTRACTOR MAILING ADDRESS PHONE PROPERTY LOCATION - INCLUDE POST OffiCE ~ ~~ '/:':::~ (' :~~''>:) ~,,;:;~v., .::(::) i"~;C'll~~C:; 1 PROPERTY LEGAL DESCRIPTION - METES. BOUNDS '. .;~ .> '/'. ::-'J C) .. e'"'' j ~ '. ,,~ c .;:~:;:) :.~"~:'-./'IC]n SECTION TAX LOT NO. CODE CENSUS TRACT TWP RANGE .../ ~ .r, , .." APPL. NAME & MAILING EXISTING STRUCTURES ON PROPERTY . "~,' ~ r'-.~ .F) ..v.... , \~\ \ LEGAL ACCESS TO PROPERTY ~ ~;::..~:~t~ ; ~.:~.-' .~' PROPERTY SIZE - FT. , ADDRESS 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. :It aCRMS New System 0 VALUATION ~~l~.~.~.:: ' . , " '~""'~~"') '- r, ."-1,\ _ , ~ -\.-~'\'''_ \ ~~- \\_'r' 't>:.~, " SEWAGE DISPOSAL PUBLIC 0 BUILDING ~.~ -\\1: \ __ ",,!,'.\ \ " .. f "'\.. '-. . \l\"'I,-~,'r,',>J'1i-~~' ~,,\.~,V~_ ~S>.~~~ PLUMBING INSTALLED BY .iP'.'f-!'\' , t"" :-. " ,<>..,,/ < J.C,j. ()'JlJC- :\_ FEES OWNER 0 OTHER. NAME WATER SUPPLY . " t,o', SEPTIC TANK 0 OTHERO WASTE DISPOSAL PLUMBING PLAN REVIEW PARK TRAILER \~ , '\ '. ......, ''\ - \~ , .x ...., PUBLIC ,(!JI o OTH ER , . TOTAL s 'j: " -.)1 Q .,d MIN. SEPTIC TANK CAPACITY WITH DIS1. BOX: GAL ~.:-:~) COUNTY BUilDING & SANITATION SPECIFICATIONS DRAIN FielD REQUIRED tiN. FT TRENCH WIDTH FT. " " ,. <'"..... OR SQ, FT, \ > \ \ , .\, \~\ ,\ , , '<', '. " ~ TYPE OF STRUCTURE .,. , OCCUPANCY t (' :~~ J ZONE PUBLIC UTll. EASEMENT BLDG, SETBACKS _. FT. FROM CTR,t OF::ROAD RIGHT OF WAY FRONT SIDE INT. ~ 'ti SlOE EXT, AUTHORIZED SIGNATURE - DATE USE CLASSIFICATION REAR 1 . , ,'-l' 0 0 r'" ,.. i'....-"\,,.. ,.t: "~'."'h'->-'-,:..J I':'~~'::!~:::; " t)C':~~ ::"C::i.1 ,~ {l ..a". (' . -;, --, ',~; . ~ ~ 1'. ~_::) DATE 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 i F'ORM := C55-;l 1\ . . . , '. -, I I SITE INSPECTION \ \ ApPROVED Cl DISAPPROVED Cl DATE INSPECTOR REMARKS FDUNDATION INSPECTION ApPROVEO ~~ DISAPPROVEO ~ DATE /" . -' . ; - '." . ~/ , .- / ,;:' /.~:./ INSPECTOR " ! REMARKS FRAMING INSPECTION ~~ ApPROVEO Iv( DISAPPROVEO /7 DATE "7-11-71{ INSPECTO~ REMARKS --0-- ~':1'.t{;fj -/..>:;-'.17/ ~l:&;... ,'-1l/!.-"t."'g.....1.-/~l'f'. A-U~t.(7;:{I,AJ,~/I-tn<, ~~ ~~7i.1 O' _ ~, / /' , I (~<4V~e6L. ~"J-//"7"'~ tEl LATH DR SHEETROCK INSPECTION 1 ApPROVEO ~. DI SAPPROVED L-! DATE:2 - 7-/ -7 t..j INSPECTOR &. CI REMARKS FINAL INSPECTI~ ApPROVED ~ DISAPPROVED Cl DATE J/'". J;- JtI INSPECTOR {?f rv., f L.-> ... REMARKS CERTIFICATE OF OCCUPANCY READY TO ISSUE /7 NOT READY TO ISSUE Cl DATE INSPECTOR REMARK 5 .i' ~~ :Z'll/).".JJ{~ II'D f)(}"?lR.o ... '. i\ ~.' , . . - . , I , ( It" l n;- r, \" .. .J" t.... April 10, 1974 Mr. Dan Desler 1700 Highway 99 North fugene, Oregon Rf: Building Pcnmlt # 2416-1l 17-05-06 Tax lot # 1600 An Inspection of tho d~~lllng unit covered by the Dbove mentIoned buildIng permit revcDls that the follo~lng corrections will be requIred before tho d~olllng Is occu~Jed and to meet the minimum requirements of the LDno County Building Code Dnd Plumbing Code. I. Front porch must have dirt removed fram around the ~ a mIni- mum or 6 Incheo clearance muot be malntDlned between the ground Dnd any wood member. 2. Main center bC6m under house must be properly bolted together. 3. Whore flcor Joist butt against center bc~, JOIBt hangors must be Installed to glec proper support to floor Joist. 4. All Dnchor bolts In foundation must be provided with washer and nuts. 5. Fastners must be provided to t~e dwelling to foundation. 6. All foundation vents mUBt be properly screened Dlso some vents In foundDtlon wall at back of house hove been covered over ~Ith plywood. 7. 1/4 Inch pl~d has boen used as siding on foundation walls ot rear of house. MinImum pl~4)od thIckness Is 318 Inches. 8. Must provide a deck or statfs from g&ass slIding doors from both bedrOllll1s. 9. Due to the separation of roof beams to rldgc beem all beam clIps must be rGmOved and stIrrup type hangors Installed thIs would requIre D minImum stdrrup hanger for a 4 x 8 Inch membor. . . . . , ..,' '" IIr [, Hr. Olin Desler Aprl I 10. Ig74 Page 2 10. Ridge beam In the kitchen area must be tighter to dr~ both sections ,of beams up tight. The following Is a list of plumbing corrections that are necessary to comply with the minimum code requirements. I. Hust provide for a cleln out for main sewer line. 2. 4 Inch outside vent and cleln out must be removed Ind sealed off. 3. TWo couplings on 2 Inch line under house must be removed and replaced with proper fittings. 4. Plastic water line under house must be removed and replaced with approved pipe to a distance of 5 feet outside the building. 5. Must provide the proper drip pan under water heater. 6. Drlln from water heater cannot eermlnate under the house. Drain must be piped to the outside. The I'ove correctIons must be done and Inspected and approved before the dwell- Ing can be occupied. Please call this office when corrections hive been made to arrange for the necessary Inspections. If you have any questions on this mltter, please contact this office. We wish to thank you for your cooperltlon In this matter. John E. Boss, Chief Building Inspector Construction Permits & Inspection Division cc: Bob Johnson Art Rhodes JEB:slf ;, LANE COUNT_ILDING BUilDING D~ MH 0 MAILING ADDRESS PERMIT OR MOBILE HOeuSE PERMIT PERMIT NO, ..' " ' . "I'" oJ PROPERTY OWNER PHONE :;1~".., ~':::;'"'.~v ~. CONTRACTOR B',-D ~,;I''''')''' r~::":~..,-t~l,",:,o f ~:J::~r:;:- :-tf)., ~ ;...~r.:::1 MAILING ADDRESS PHONE ~6:~:~ PROPERTY loeA nON - INCLUDE POST OFFICE ~1~.;' ~~>:~:~?Din t~~~~~" O'r:r.iJ ~:rT^Y:~;, 1t11[~_" ~t::)IY(:C~:-' PROPERTY LEGAL DESCRIPTION - METES, BOUNDS Lr"o "1 ""'''1'' r>". "M r:r'y'"'''' I O-'I~~ C"'" "'C~) ,....-1 <....:. ~...f.-.L..,:" \.....~ ,.~J ~.,)..'-lw,......., 1.' ~4,) _\..6 .~...~ TWP RANGE SECTION TAX L.OT NO. CODE CENSUS TRACT . " C] c5 ".:',';0: ~'_,~_: (\ APPl. NAME & MAILING ADDRESS , FOR MOBILE HOME PERMITS ONLY No. of Bedrooms ~jrlL EXISTING STRUCTURES ON PROPERTY t~~~::- LEGAL ACCESS TO PROPERTY ~';~3r.":-~^ ;'Yll. .!:.... PROPERTY SIZE - fT. WIDTH 1~,:3 DEPTH .'':, I,: AREA )' , Connect to Existing Sewage System D TYPE CONSTRUCTION SQ. FT. # BCRMS V(~C;:::; New System 0 VALUATION STRUCTURES TO BE BUILT THIS PERMIT . .~,....., ...~......... 1C~;1 " 'j'1 rn) . ,. ,. '""\, >C ["'l (; .~ ~/" , " .J C"",:l\~:;'>IWY c;::;) l\::J 0.1:)1;:.,1,110 SEWAGE DISPOSAL PUBLIC 0 BUilDING WASTE DISPOSAL PLUMBING PLAN REVIEW PARK TRAilER . OTHERD rj().~j ~:o.c.::J tll.r:~ FEES PLUMBING INSTALLED BY OWNER 0 OTHER: NAME WATER SUPPLY PUBLIC ~Ej: 0 OTHER , . ,....'.,"": SEPTIC TANK 0 TOTAL $, <J7..1;:: COUNTY BUilDING & SANITATION SPECIFICATIONS DRAIN FIELD REQUIRED L1N. FT Fen TRENCH WIDTH FT. l OR SQ. FT. (' "\ I MIN. SEPTIC TANK CAPACITY \ WITH DIST. BOX: GAL. SX c-- \ , ;;~:\.,r;. : TYPE Of STRUCTURE '~ J OCCUPANCY (ltlC> J ZONE PUBLIC UTlL. EASEMENT BLDG. SETBACKS __ FT. FROM CTR.lOF-R<2.AD RIGHT OF WAY FRONT ~(- SIDE INT. \1:;0 7 SIDE EXT. AUTHORIZED SIGNATURE - DATE USE ClASSlflCA liON REAR ? "J_~':. cV' Ct~~~co tbc:;~~~-:s~ 'C".' .~~.,,...... '1 ,-. v ,..,'~ ., \.........~..i ."IV.. DATE '---......:, r"" 1 ' ..,. 't. !~ " l.. f~~ BLDG. PERMIT - WHITE OFFICE COPY - WHITE COUNTY. TAX - PINK PLUMBING - CANARY BUilDING - GREEN SANITA!ION - GOLDENROD Construction to comply with uniform building code and county regulations covering plumbing and sewage disposal. All bu'i1dings 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 \ FORM:: C55i 13 . -If':.' . .~ '. i ~ . SLAB FLOOR PLUMBING GROUNDWORK ApPROVED ~ DISAPPROVED ~ DATE INSPECTOR REMARK 5 GAS PIPING GROUNDWORK ApPROVED ~ DISAPPROVED L / DATE INSPECTOR REMARK 5 ROUGH PLUMBING ApPROVED ~ DISAPPROVED L:::7 DATE INSPECTOR REMARKS"\"""I,.,P UJA....L~ &IfC.J.,..J) P/..~"" ~/l4I t'"'cr// .;'".1 ;/.A...do#,'IJ",,~ 2...~tJ.7"" ':Jt.d' , ,r n 3/ l\ . /.. ,1.-l ; (... ::>f~' /i'V VI :/YO!-LN r: --t;t?'O:/ ~; ROUGH GAS PIPING ApPROVED L:::7 DISAPPROVED L:::7 DATE INSPECTOR REMARKS FINAL PLUMBING ApPROVED KJ DISAPPROVED L:::7 DATE'- -_? /-7'1 I NSPECTO,u REMARK 5 FINAL GAS PIPING ApPROVED L:::7 DISAPPROVED L:::7 DATE INSPECTOR REMARK S CERTIFICATE OF DCCUPANCY 1:- . READY TO ISSUE L:::7 NOT READY TO ISSUE / / DATE REMARK 5 ~ ;.~S) Moll J ".J) "t,l~ L eiY/L.;:o ~ - ~-~ <-/,~ '{/ INSPECTOR , . ~NDIVIDUAL SEWAGE DISPOSAL SYS~RECORD WInstaller: Complete top part Pform to ~ signature and return both copies to Lane County Building Sanitation Department. Pr-RMIT 0_ ". . ". Instal~er's Nam~~ Atf)Irt(J UlI(~7JN NO"Livih~/nits jBedrj?omslBajhS SeptJ.c TanK: Ft. from well Steel iJ Insl.Oe UJ.InenSl.ons: ,t't. Length Width Applicanl' Name Rnh..rtN,Hil1 I Property Address 1190 Oondea I Basement I Water Supply Yes 0 No l]' Public Il" Other-List 2410-73 Shook Concrete llil' No. Compartments Gal. Capacity, IDOO I Tile Disposal Field: Depth Distribution Box: Yes aI:. No 0 Other Distribution- Type Diameter Address Feet from Well Lot Line cf,-'-S~'-'~ ,- Front flo Side )0 Rear /" Length of L nes - Ft." Trench ITotal sq~Ft.betweenIFiller IF~ller deothlFiller depth l./OO2.!NJ3. 4. 5. 6. Width 2... ft. .1co llines Ie> I Type / I)., at,olve .L, bt7llOW / 'n , e 1n ~ "1 E!: 4? 1..... Sketch (See instructions): 970 West CeRteR~'~l Foundation \ 0 Mailing lcQI r-- I I I , -10'- I,f' , I I I In I , I 'tD I ,I 020 I I (0 - r- ~: ------ t I I 10 I I I - - -' I ~ - \ ~I - .--, .2 .,-' 1- -, 110' I I .r tJ/7 -\4ou!;'E Date 3-~-7'1 Signature h:_,J2o~ Date:~~7~ (\9>Qn w <k Oani tarian; s ~i~nature For san~rian Use Only: ~proved: System Installation o Disapproved: Does Not Conform Remarks: Conforms to Current s~ndards to Current Standards Lane County Building & Sanitation Dept. CS5-1l LANE COUNTY &ING PERMIT OR MOBILE HOME" APPLICATION PERMIT TYPE - BUilDING ~ 'MOBilE HOME Dose REG. # ~ PERMIT:#: d C; 10 -7.3 ~Y OWNER MAILING ADDRESS, PHONE -}) ?trlLtd /1 . g?1J (~J. f1!2/n'1i.;W/'; ~-f.l/'L 71h-9CJ/t:, CONTRACTOR' MAILING ADDRESS I t' PHONE /}d~ P;O~ERTY loeA liON - INCLUDE POST OFFICE ~ tJ Iltlo f)1f-n~~ - ..8!!L/ '7nh7 d ~ ..D1.i'J?-.- ~ah A ~d#d/ .~~ /ld IV' //~ SEC, ;;, ~CldtJ.uJ ~1Jd.4L &:L1~ TAX LOT # CODE METES & BOUNDS 0 YES ATTACHED 0 NO PROPERTY LEGAL DESCRIPTION LOT - BLOCK - SUBDIV, TWP RANGE CENSUS TRACT APPLICANT NAME AND MAILING ADDRESS FOR MOBilE HOME PERMIT ONLY Number of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT 1'0",..0-= ~ :;'<{..... ()zjJ DESCRIBE EXISTING STRUCTURES ON PROPERTY IF ANY ----:h I!'I'> q- LEGAL ,~ESS TO PROPERTY - ROAD ~Mj OR # .(k!.-k'77~a.- ~. PRO~fRTY SIZE-WIDTH -DEPTH /~.s AREA ?rO ;L/I'://n€!- Connect to Existing Sewage TYPE CONSTRUCTION FA> ~-DJ;=;- System 0 SQ. FT. /O,?7P/ /~ -=-'9~P .,5J or New System Req, n # BEDROOMS VALUATlOtj (.:i) /4.94'1- .J' ,f' ,;)- /~tf.;; ~ ~L - /?ZtMNf lvneLdn:L , SEWAGE DISPOSAL PLUMBING INSTALLED BY PUBLIC 0 SEPTIC TANK ~ OTHER 0 OWNER 0 OTHER g-mME 0JiJrk., \40<St1n BLDG. $ L .,~,OO FEES WATER SUPPLY PLANS FURNISHED FACILITY PERM~T WASTE 015. J~.(70 PUBLIC ~ OTHER YES ~o 0 YES 0 NO ...-- PLUMBING ;;,;] I , .:S () PLUMBING FEES e!, ;7!' 0 0 SIGNATURE OF APPL , DATE PLAN REVIEW ~ FIXTURES / I t;o ~ 7" JI~JVt%P3 PARK TRLR. CASH ~R FEE" RitEI D BY / DATE CHECK ONNECTlON FEE ..,,1. ,tJd ,J( A7 Y 0/-0/23 ~9 '7.<D PUBLIC WATER PERMIT # TOTAL CONNECTION FEE /50 -::JC//O -73 - COUNTY BUilDING & SANITATION SPECIFICATIONS MIN. SEPTIC TANK CAPACITY WIT~ DIST, BOX, GAL. q () 0 DRAIN FIELD REQUIRED UN. FT. f}., C> C> TRENCH WIDTH FT. 1:\ OR SQUARE FEET (, 0 (\ TYPE OF STRUCTURE 51f/ OCCU/~...,- BLDG. SETBACKS - FT. FROM CTR. OF ROAD RIGHT OF WA"y ~ .c:-: t.(/-7' \:R,ONT QI t:::J/ SIDE INT. liE _ r I SIDE EXT. (~ 1~7kPL~ Directions to Find Property. / ~\/:~ 'AAo PUBLIC UTlL. EASEMENT USE CLASSIFICATION REAR 7 , _/ /~~;;?;LDG'IN~~~ I_L/_7LDQIO // {/ I" COPY I - OFFICE COpy 2 - JOURNAL COpy 3 - AUDIT form # C5S-12