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Home My WebLink AboutPermit Building 1974-5-2 (2) . "-~"Cf(jd')i', ". 7'~d'&u":kZ::;;~='":-~ '0. :.p ..(.;', ." LANE COUNaUILDING. PERMIT OR MOBILE 1.-. ,'" BUILDING I:E MH. 0 r [' , PROPERTY OWNER MAILING ADDRESS ~'''~_'i~.' "--------- ---- f. ,', -..~ .... t yJi. JV'-. -..,..::-- Hce USE PERMIT PERMIT NO. 648-74 PHONE " H ILL, ROBERT N. .' CONTRACTOR BUILDER. INC. MAILING ADDRESS 670 W. CE~TENNIAL BLVD., SPRINGFIELD, Oa. PHONE . 746-9916 .' ... SAME PROPERTY lOCATION -INCLUDE POST OFFICE 1204 DoNDEA ST. PROPERTY LEGAL DESCRIPTION - METES, BOUNDS 3[10. ADD IT ION ~lEADO\f GREEN ESTATES 18 02 SECTION 06.'h;L LOT 23 BLOCK TA~T NO. .;;? I ~ EXISTING STRUCTURES ON PROPERTY NONE LEGAL ACCESS TO PROPERTY DONDEA CODE CENSUS TRACT TWP RANGE APPL. NAME & MAILING ADDRESS FOR MOBILE HOME PERMITS ONLY No. of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT AeOVE PROPERTY SIZE - FT. WIDTH 70.84 DEPTH 121.49 AREA Connect to Existing Sewage System 0 New System 0 TYPE CONSTRUCTION SQ. FT. :;; BDRMS VALUATION DIIELL I NG FRANE 1119 G12. (1) 726 e 1. 1'5,828. 2.178. W,OOb. GARAGE-ATTACHED-UNC. SEWAGE DISPOSAL PUBLIC 0 SEPTIC TANK :tJ OTHERD 71.00 50.00 2l:l.00 FEES PLUMBING IN~TALLED BY OWNER 0 OTHER: NAME WATER SUPPLY PUBLIC r5 0 OTHER . , BUILDING It WASTE DISPOSAL PLUMBING PLAN REVIEW PARK TRAILER i TOTAL . 1119.00 COUNTY BUILDING & SANITATION SPECIFICATIONS DRAIN FielD REQUIRED 200 UN. FT TRENCH WIDTH FT. 2 OR SQ. FT. 1100 WITH DIST. BOX: GAL. MIN. SEPTIC TANK CAPACITY 900 , TYPE OF STRUCTURE 5N OCCUPANCY I & J ZONE RA PUBLIC UTIL. EASEMENT 10 . BLDG. SETBACKS.. FT. FROM CTR. OF ROAD RIGHT OF WAY 4r.:' 5' FRONT' SIDE INT. SIDE EXT, AUTHORIZED SIGNATURE - DATE /s/ J.E.BOSS , BY, C. HARBAUGH USE CLASSIFICATION REAR 10' PUE J. SHOOK, SANITAR~AN DATE 5-2-74 JH ,.. 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. (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 97"01 FORM:::: C55-13 ~ . . . <i',;' L.. <fl, '1'- "'.'" .... LANE! COUN'-UILO;NG- PERMIT OR' MOBILE .-- BUILDING []l MtI 0 MAILING ADDRESS H. USE PERMIT PERMIT NO. c:::.---- "--- 648-74 PROPERTY OWNER Ii l\t.. (lOCr.lT tJ. CQNTR,6.(TOR CUllOEl'l, HIe. MAILING ADDRESS PHONE 6~ \:I, CENTIIr;:lIM. BLVD.. O~Q IUGI' III!.\). Q:l. --------~. PHONE 71.JG-~716 un, , ..~A~~ PROPEr.TV lOCATION -INCLUDE POST ,.offiCE , . lro1l ~::,,&A ST. PROPERTY LEGAL DESCRIPTION - METES. BOUNDS SliD. l\:nIYlc:J C(:1;ACOI1 GdltlItJ [WYATtll TWP RANGE SECTION 1 V 02 cG, /f; :J.., LOT 23 GLQer! 1 TA~OT NO. CODE . d;;</~ CENSUS TRACT ADDRESS 'l"'o FOR MOBILE\HbME No. of Bedrooms PE~i~ONL Yv ~ ~ EXISTING STRUCTURES .oN PROPERTY NQr:1I ~ LEGAL ACCESS Ta PROPERTY ~ Otlr:OltA ,\.' J'ROPERTY,SIZE-FT. '~~ ;"D~H l\>.&J DEPTH}~21,t..:> A~EA '7\~ . ~~~~~,~.~ ~~\-~-. Conn ct to Existing Sewage System D TYPE CONSTRUCTION SQ. FT. #: BDRMS New System 0 VALUATION APPl. NAME & MAILING At~1I \. " :"~\-'C-.~ ~ \ , t\.~ STRUCTURES TO BE BUILT THIS PERMIT CcfQo.L I~:l 1"1'l~~J: 1319 Ull? (3) Ie- ;,:,,", :JI)'-''''''.'. , ~tlt.:lCaClTTACfl!:t>o\.l:;c, 72(; CJ 3. ,~- 't, - ~ ~"-\~~ ~~~~~~. .}~~r~I-,;' , \ \ ~ f) . '-'4 Uplll . ..........". l/JDI:.!,;. SEWAGE DISPOSAL . OTHERD (I,W ~;.w.'. ....... ;.J.w FEES PLUMBING INSTALLED BY OWNER 0 OTHER: NAME WATER SUPPLY PUBLIC ~ 0 OTHER PUBLIC 0 BUILDING WASTE DISPOSAL \ PLUMBING ,'" PLAN REVIEW ~ PARK TRAILER SEPTIC TANK Po , TOTAL $ 14:JDIJl) COUNTY BUILDING & SANITATION SPECIFICATIONS DRAIN FIELD REQUIRED 80 I i WITH DIST. BOX: GAL. MIN. SEPTIC TANK CAPACITY %U UN. FT TRENCH WIDTH FT. 2 OR SQ. FT. tw - , " ,- . \ " , .'. ________1 , , TYPE OF STRUCTURE J.~ OCCUPANCY I&.J ZONE R,\ ., PUBLIC UTIL. EASEMENT 10' BLDG. SEl~ACKS __ FT. FROM CTR. OF ROAD RIGHT OF WAY l;"''< ct FRONT -; SIDE INT.:'> SIDE EXT. .... AUTHORIZED SIGNATURE - DATE /0/ J.C.C~'::D , CT, C. It".r.Jt.1.lOf REAR UO' PUz USE CLASSIFICATION J. :1"lOO:t, SAtlIYArlllAtJ _~~Tt , 'pc;..!1.J Jt) 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:..Jor, subsurface sewage disposal and county regulations covering. -, plumbing. All buildings require a certificate of occupancy before' being occupied. ., , . ~ "'\ }.(See Details on Reverse Side) - , ." , _'.J ' "., F"ORM == CSS.13 (POST THIS PERMIT ON MAIN BLDG. AT SITE) LANE COUNTY. DEPT. OF ENVIRONMENTAL MANAGEMENT COURTHOUSE ANNEX. 135 EAST 6th, EUGENE, OREGON 97401 . 1 II . . , SITE I NSPECTI ON \ ApPROVED Cl DISAPPROVED Cl DATE INSPECTOR \ REMARKS FOUNDATION INSprON ApPROVED IE Dr SAPPROVED 1--/ DATF#: ~ -3 .If{NSPEcTOR REMARKSl/r1i1~~~~ .f:./i/-'1i(tf!L ;'~U~{;)!"'~~~ DI'( I~JI3_ '71./ / ?2 /fL @I tf2./ FRAMING INSPECTION ApPROVED Cl 01 SAPPROVED Cl DATE . I N$PECTOR REMARKs~~~~~~hJg.P7( , " LATH OR SHEET"K INSP TIO~~ ?I~"'- :Z.17~ _r /7/1 ~. ,i' ApPROVED ~/ DrSAPp VED 1/ DATE INSPECTOR( '-2' L--. ~ REMARKS FINAL I NSP~ /:Y ApPROVED D'SAPPROVED Cl AATE ,'I-:z J'"..,Jj/ I NSPECTOr('../~ REMARKS--.::J1.d~ '1,1 't{,1t1 (/Ii.. 0 . e./. CERTIFICATE OF OCCUPANCY READY TO ISSUE Cl NOT READY TO ISSUE Cl DATE INSPECTOR REMARKS C, 'IF. 11/, ll-it:t' //1 ,1/-; ~ / ///. .?l/A.(.~c.-~r / ~V'l tC/Jee.- III"" · '. ~~M . . m \..~ ' ~- "'~V-p . ~ f/J~ h.~ ~.~I~ - . 0 ..tJ:- (,vJl. 7t/ V'~-~ , Q.~. / LANE COUNTY TITLE)NSURANCE COMPAN,Y ...... TITlE INSURANCE ESCROWS 941 OAK STREET EUGENE, OREGON 97"01 q,DI/. StVWice (JaLL 3/{./{.-52U C:"'.t.~'>~R... . '" ~) ~..-' ~k.~ ROSBORO LUMBER COMPANY . \ <1\ CERTIFICATE OF INSPECTION Issued at: Springfield. Oregon Inspected on Date: .... . P. O. BOX 1098 . SPRINGFIELD, OREGON 97477 PHONE: 503.746.8411 " "Lumber herein'listed has been inspected and tallied under Grading and Dressing Rule 1116 ',at Rosboro Lumber Company plant by bureau i~spector." Shipment made via: 1'1? [. /""'-.A. Certified Grader i ". ~ 3- 7' 4-2~-74 . 6~t>-7'1- 648-74 CURB CjJT c+-; II _. __ ~ xuduJ~ "Date Permit No.. PERMIT IN THE BOARD OF COUNTY COMMISSIONERS OF LANE COUNTY SIDEWALK WHEREAS, the attached application has been fully considered by the Board of County Com- missioners of Lane County. and it is the opinion a nd 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 870 WEST CeNTENNIAL BLve. SPRING~IELO , OR. or constructing the following facility: DWELL I NG 1204 DONOEA STREET, ~RO. ADD. MEADOW GREEN ESTATES ROBERT N. HILL BUILDER, INC. for placing, building LOT 2< BLK. 1 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 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- for,. 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 : ~' '" < . .' . ..~ LAN'E, COUN'BUILDING PERMIT OR MOBILE BUilDING 0 MH 0 MAILING ADDRESS Hctt USE PERMIT PERMIT NO. '. PROPERTY OWNER PHONE ,.or- . ~ I -.0 ~ . >'. r~:;;: .~:~.:.. ,..,. , . ;;;"i'\ tt. Q:':~;v,~,:.';';". ( , , r " CONTRACTOR MAILING ADDRESS PHONE PROPERTY LOCATION -INCLUDE POST OffiCE ~ .;:~. l~' ":;,~ S.... PROPERTY LEGAL DESCRIPTION - METES, BOUNDS .',1\,. . ,~;"JO-': C~-;Cl:~-;~' C:;!,::-'~J ~~Y[~'iC() TWP RANGE SECTION (; Q:: C-; ..,",,-, t... ,Y ~,..., r~'.8:::. ~ TAX LOT NO. CODE CENSUS TRACT APPL. NAME & MAILING ADDRESS FOR MOBilE HOME PERMITS ONLY No. of Bedrooms C:C:ill):: EXISTING STRUCTURES ON PROPERTY r'~, ,~. I....)."", LEGAL ACCESS TO PROPERTY i);::;;:;'1\ PROPERTY SIZE - FT. _,I"\t, WIDTH t~ IV I DEPTH . , . .l); AREA STRUCTURES TO BE BUILT THIS PERMIT Connect to Existing Sewage System 0 TYPE CONSTRUCTION SQ. FT. +: BORMS New System 0 VAL.UATION >'"". ..". ..............' "'- v\:~::l> ',J0 ". C(.... ~ '_ ~ . '. ',\ I . , f.",::,:."!...:.CJ."'~'.-t\~','::,,;>if:;:, ., ':) 1'; ;. ,..,-- . SEWAGE DISPOSAL PUBLIC 0 BUILDING WASTE DISPOSAL PLUMBING PLAN REVIEW PARK TRAILER PLUMBING INSTAllED BY " SEPTIC TANK '0 . OTHERO f' .UJ ~~;j.J~) ~'.~) FEES OWNER 0 OTHER, NAME WATER SUPPLY .. PUBLIC EJ o OTHER TOTAL . ~~n.\:) COUNTY BUilDING & SANITATION SPECIFICATIONS MIN. SEPTIC TANK CAPACITY '.J" WITH DIST. BOX: GAl. DRAIN FiElD REQUIRED en lIN. FT TRENCH WIDTH FT. " (, " OR SQ. FT. TYPE OF STRUCTURE ,',. OCCUPANCY I ,", J ZONE R~ PUBLIC UTIl. EASEMENT 'I ~; ,.< BLDG. SETBACKS __ FT. FROM CTR. OF ROAD RIGHT OF WAY ~,. . . . . FRONT I.tJ SIDE INT. SIDE EXT. AUTHORIZED SIGNATURE - DATE /:/ ".~.,:{:.;~ , l:~, ~-:. ::..'" ''"'.,~:: USE CLASSIFICATION REAR j() I R!'~ DATE J. ;:':::;~:" f':t~: t'Vc.::a,)~. BLDG. PERMIT - WHITE OFFICE COpy - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENROD Call 687-4065 to schedule all required inspections. All construe. lion 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) f"ORM == CSS-13 (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 fI DISAPPROVED .0 DATE REMARK S GAS PIPING GROUNDWORK ApPROVED .0 DISAPPROVED .0 DATE REMARKS ROUGH PLUMBING ApPROVED JZJ DI SAPPROVED C1 DAT~?"71./ REMARKS ROUGH GAS PIPING ApPROVED C1 DISAPPROVED .0 DATE REMARKS FINAL PLUMBING ApPROVED ~ DISAPPROVED C1 DATE'),.1' ...)'1 , REMARKS FINAL GAS PIPING ApPROVED C1 DISAPPROVED / / DATE REMARK 5 CERTIFICATE OF OCCUPANCY READY TO ISSUE C1 NOT READY TO ISSUE fI DATE REMARK 5 . : INSPECTOR INSPECTOR ... I NSP(CTOR """ INSPECTOR INSPECTOR~~ (/ INSPECTOR INSPECTOR ". .',:'" INFORM^TION REQUIRED FOR BUILDING PERMIT - DWELLING Main Floor 13/ q Sq. Ft. , ., 2nd Floor (above I iving area) Sq. Ft. Garage 7.2& Sq. Ft. I" L,,;:':',:" Carport Sq. Ft. Deck Sq. Ft. ~ # of Plumbing Fixtures (Partial List of Common Fixtures) Water Closets Wash Trays Dishwashers Disposals Water Heaters Bath Tubs ^utomatic Washers Shower Baths Kitchen Sink ; . i '. ,'. ,BUIUlItIG SITE EVALUATIOIl . . # () Building Permit Appl ication No': () Site Inspection () Pre-Permit Investigation LANE COUNTY PLANNING DEPARTMENT I. Zoning Ordinance Compl iance (Zone f?:.A ) Subdivision Ordinance Comptfance 2. ,3. 4. Required Access Building Site (Area, Width, Frontage, Setback) Other (see comments) 5. ell . ('1r-/~ NOT app I i cab I e () () ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) NO YES I (~ ~ () ) q T A- 62-s () (;, TAX LOT C ENS"!'" T RA C T 5,--d <..cld M-eCidow G7-rJt?.....Cjf: APPLICANT: //'1/ L- -2..3 I? \ NAME /17 /, ''':'-/ AODRESS PHONE DATE LI-l ~. 7\/ NAHE DATE /VIA t./ -2-5-74 I , COMMENTS: .~ BUILDING INSPECTION SECTION DATE 6. Plans Submitted 7. Soi I Stabi I ity (foot ings) 8. Flood Plain 9. Other (see Comments) COMM ENTS : NOT . app I icab I e () () l () i~ () V( () , NO YES Iff ( ) ( ) ( ) -' NAHE -,' ~ (!J~~/Clj~'lY. ( TO APPLI CANT: 6--.1,11 A1r . ,@( () Building Permit / Site Inspection: Can be app roved. 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 Lane- COUNTY PLANNING DEPARTMENT. Questions and further information on items 6 through 13 contact the Lane County 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. ( ) (. ) ( ) LANE COUNTY PLANNING DEPARTMENT 135 Sfxth Aven~e East, Eugene, Oregon 97401 PHONE: 342-1311 EXl. 231 C55-28 LANE COUNTY BUILDING & SANiTATION DIVISION 135 Sixth Avenue East, Eugene. Oregon 97401 PHONE: 342-1311 EXT. 411 ,i,\ ,,~ \. .. J . . Date ~':I - ; p... ,"'J.~ . ..f'i ';I :: o~i '.'... ~'.~t ' permit!, ~~'18~'lf CURB CUT PERMIT IN THE BOARD OF COUNTY COMMISSIONERS OF LANE COUNTY '~::_;~r.~Y); WHEREAS. the attached applicatian has been fully cansidered 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 h~reby, ',"'~ "':.~ " h ~ \ \. -., ORDERED, that a permit be and is hereoy issued to ,---_.,.rr."<1 ~, ,">.....--......,".. ~..(;I r;Q~!, ~/~~J..,.) Jp :: .-1) ~ ~),-,:~ C~:'j": ~{:..j~L;:~jln.~ C-1t'uo r.~:Jo::::P:JG~[) (1 (.'1. or constructing the following facility: ~!.~~;;lw,: ,-'" "'" ~".'~ ,~ "'''f> (. ~,' E.":0- " "~.f~ '...~~:_:~....vvncC:V1) ;/~Oo '~JI) {.~::.JU C:J:!C:J G:GVt~ve~ "'t.....}': 1~\j ,\-. . 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 applica.tion a.ndper'rlit. t~e Rul.es and Regulations Gov- erning Facilities to be Permitted upOl), ~Qu.nty., Roa~d':Rights~'Of-Way:.~as" set' fortli by the Lane Man- ual 50.190(2) any amendments theie,to.- and any other applicable regulations, law or ordinance, "'1- . for placing, building " <- ;. .:,G.o u 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. ~J~~~/ f)/(" (p../ IJ ~ 91/ ~ J. ,I This permit is revocable at any time, and will be strictly adhered to and no work other than .1bat specifically mentioned above is hereby authorized. This permit shall be void unless the work herein contemplated shall have been completed be- for.. 19_. Expires ,19_. Inspected and Approvea Approved by Board of County Commissioners By Dot.. 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 INSTALLER'S NAME ~) No: Living Units I Septic Tank: Ft. from well i!huwu Bedrooms B~tps ....::;> J/h. ~ ,.~ PR ED SEWAGE DISPOSAL SYSTEM RECO~ part o~rm to signature and submit both copies wit ppliC?tJ~~' '7// PERMIT NO.~7"% - . / PROPERTY ADDRESS /PtJ cj tC!-7lde~ Water Supply Pub Ii c X Other-Li st Basement Yes NoX /', I~TALLER : Complete top / Stee I 0 Concrete Ii7l No. Compartments I Gal. Capaci ty ~ /O,aEV Inside Dimensions: . ft. Ti Ie Disposal Field: Len9..,th9'b Width Y'R Diameter DePt~9 Distribution Box: Yes X No OWNER ~_./ -L //.~~ ..d// "1 Ot,her Distribution-Type NAME ---..r t7r~,~r ,A/LJb~ ~~ 1"..), HAILING,.r7' It). ~Af~/d' ~~~~ from ADDRESS;} //7 Lot L i n~ Arf.,p //L ~Y/ZlZ4A I Front 03 L~h of L rn;.r7Ft.:-' I Trench r'1'<>tal Sq. I Ft. Between Ipn.6#',. Li.N5'~k6. Width Ft. Lines /0 'lot p~~ (see instructions): Foundation /0 Side ~l/ Rear s1 IFi 11er IFi 11er Depth IFi 11 er,Jlel ow Typer-rlf Above Tllel~ln.lrile/";<ln. '~ , T ~ ~ r - - - ,~: ~, "~ ~ I l ~, I 1L_-""i:' I L c- , Date ~/MO .;...t I, '1'1 / ~I Signature. /A~ .' ~ ( . . CERTIFICATE OF SATISFACTORY COMP~ON J II. For San tarlan Use Only: ~at7: 6 '2'1llt{ In accordance with 1973 Oregon Laws Chapter 835. Section 214 this certificate IS ISSU d as evidence of satisfactory completion of a subsurface sewage disposal system at the above loca~~~. Approved: System Installation conforms to current standards Disapproved: Does not conform to current standards Remarks: C55-11 ~~i~\+&e ~ COUNTY STATE OF OREGON DEPARTMENT OF ENVIRONMENTAL QUALITY ..... . - , LANE COUNTY BUILDING PERMIT OR MOBILE HOM~E APPLICATION J J 'PERMIT TYPE - BUILDING ~ MOBILE HOME nose REG. # PERMIT :#: t;,t/?-77 [ "I'JPE")Y OWNER , /2. _.." / ' M"",A1LlNG ADDRESS PHONE J1d..t4T ''1J-,-i/)d L.Jud!f.<u ,.,h,J") CONTRA'b'R MAILING ADORESS 17 I . ~~ /171) ?d. I!~~ PROPERTY loeA TlON - INC.LUDE POST OF~C.} E /da,t.I JJtnt.,J,,/~:I::- PROPERTY LEGA~ DESCRIPTION", /J /J /J ...... /J '" ~lZ: ...:E!2BlOCK I- SUBeIV. ...:Hz.d! Oc.C.~ - /~/"a_~~ t:::AL6l4 TWP RANGE SEC. TAX LOT # CODE lr ()2- hl-dL/ PHONE ?~~"'7'7/~ 35.~ METES & BOUNDS 0 YES ATTACHED 0 NO CENSUS TRACT APPLICANT /J ~ / NAME ~?J. AND ~ J MAILING ~ a..... t1C-, lid ,42L.I dv.e- Ud DESCRIBE EXISTING STRUCTURES ON PROPERTY IF ANY f7U7t-P LEGAL ACCESS TO PROPERTY - ROAD NAME OR # 7,,_ W /.;1/, ~9 PROPERTY'SIZ(-WIDTH DEPTH AREA ADDRESS FOR MOBILE HOME PERMIT ONLY Number of Bedrooms STRUCTU"S TO BE BUILT THIS PERMIT qr "..~/r:1 t1 ... 11 tVlL21r-' , J-I.4W') od; TOTAL /~9.nt":? Sewage System 0 or New System Req. 0 SQ. FT@ # JR"'Oo..MS VALUATION J J3Jc, :;:2rd') h,t':J " - -- 7U~~ _;)JJ 7 ( /QIJ 0/_ J /' PLUMBING INSTALLED BY / / L) OTHER 0 OWNER 0 OTHER [J NAME I:acIL- ~~ FEES WATER SUPPLY PLANS FURNISHED (/ FAC~iY PERMIT PUBLIC \21' OTHER YES 0 NO 0 YES~/ NO 0 ,I PLUMBIr(G FEES~.B. 0 ~N~TURE OF A),ICANT _/; _ )DATE -,.J 4 FIXTURES \ 'l fi/9?J -tr~7?, c::g;d A<dm.J ..;me; 'I-23-ltl CASH 0 WER ' FEE RECl"IVED;' / DATE .:1 CHECK CONNECTION FEE .:J, 00 ,a.-J r - -7'-,;13 -7 l"iJ PUBLIC WATER q "0 PER~ 15 - .#' I CONNECTION FEE c7 ( C/ 6:? -r~~ "7 ~ Connect to Existing TYPE ~NSTRUCTlON -;t-A-.L7...wf';..- ~ SEWAGE DISPOSAL PUBLIC 0 BLDG. WASTE DIS. PLUMBING PLAN REVIEW PARK TRLR. SEPTIC TANK ~ . 7/. /?C> ....'r/J _ ~ ~ " ~, r>f") MIN. SEPTIC TANK CAPACITY WITH DIST. BOX, GAL. "100 COUNTY BUILDING & SANITATION SPECIFICATIONS DRAIN FIELD REQUIRED - --7 L1N. FT. '21'> 0 TRENCH WIDTH FT. J/ OR SQUARE FEET '-to () ~ TYPE OF STRUCTURE is' AI OCCi~ / M REAR~YARD ,;t:/U:L'/2)EMENT BLDG. SETBACKS - FT. FROM CTR. OF ROAD R1G~ WA"Y '-~ I USE CLA IFI ( o 45 SIDE INT.:::5' SIDEExT:---. REAR / () tvE. .. \iU\l U~~S cf_Z;_;;;'NSP~~k~ I/-(JIJ"~ \t:O"' '0 "o! ;'0"'" . I 1/ f . I COpy I - OFFICE COPY 2 - JOURNAL COPY 3 - AUDIT '. ll..i,m #~3." 12 ..., _.-, " 1.-"