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Permit Building 1978-5-8
:1.',- ':J- 2.'r '';. - ~::": '.i~' fr';!... .....!. ~~ _,J:' .,..I ~ ._r .... .~ '\... --" TRSJI JOB LOCATION ~- ~. , ""'-," ...u... .....J... _~ i..'-.,,- , J..... l....~. : '.~ ::1'. ._.fr:-'l LANECOUNTYPERMT-r- 15'5),; 3Vl .,1 1; j. ~ Acreage or Lot Sj"o Contractor's O.S. # Partitioning # ) Completed Subdivision Lot Bloc~ l€\t;<JTPr~ l~. i11::L.-r-~t'~ 375 W..j'Ih l~ S,' . ,2,:~J:i\':r.~~n.:....D OW'" -c'" ::..:: ::::;~-:.:::. ::-::::......': =....::~..-.::~.=_~. ~~~___,:: :'!Phonf' - ,,_u_. ______ _ Phono oJ/oJ ~V...,;.J..l:. L.. ......J.~...l. W..'~',~.~ Phonp (owner, etc.) when ready. . 7-1!.7 .,r.... J) APPLICANT'S NAME AND ADDRE"" OWNER'S NAME AND ADDREf:C:: CONTRACTOR'S NAME AND ADDRESC:: Mail permit to ( ) Applicant ( ) Owner ..~\t:..l..J..l ,\..i.'\t~.,.;." ~....~~ STRUCTURES NOW ON THE PROPERTY -THIS PERMIT IS FOR i-~t{~.#.~ ~~;-::';;"~~o:~<; SLcG:Q: l1L.J:€ l Contractor. (' ) Prefer to pick up. Call I~H,-~l;~':? _" l~.I.:--~ &(1.::/!:.I."', F,x 1P HOJSi': K03lli' m!jL 2 > # BEDROOMS_# PLUMBING CONNECTIONL- r:XIS'i'L.G IlZLL LXIS'lRG 50S ;.r. WATER SUPPLY SEWAGE DISPOSAl SPP.TIi:GrIC:LD o.'lr:CO'j S.1. # :':: T'2::"'\l\I.D t:::u:u:r 1=.. THIS PROPERTY IS WITHIN ONE MILE OF THE,GEf,Y OF PLUMBING BY I hereby certify that the above statements are(tr<fl.~'accurate, and that I have the following legal interest in the property: _owner of record; contract purchaser; _ potential buyer;'~ realt'or 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 ~tiis'action. I hereby agree to torppjy wi~th all apRlicable Codes relating to this permit. '.' , ~, '.x'-J \~ .<6iL.. 0- ()..I,IJJ--- \, \ ,\--\ \'" . Fee Paid ~ \, Signaturo ~ \{ .. Dato \ '. >", V -" I( 'yN"EW ADDRESS ( ) FACILITY PERMIT TO TRANSPORTATION DEPT. (tI) SPECIAL PMT. AREA, MIN. ELEVATION: t.iJ =-u.,:- BUILDING LANE COUNTY SPECIAL PERMIT AREA Minimum Septic Tank Capacity (Gallons) Type of Construction Group Fire Zone . Drainfield Required, Lineal Feet I lse Classification ." Maximu,,:! Depth ,- ,_ -L. Comments: 1'/-70/3/<:& ~/-P7.E:.. Comments: -;';"V,I -::'.tt.;,~".. "<-c..-.,-C -;.~"A;;'~ ');:/. mIN. ;:=/f\}, FL.c>o;e EL.,EI/AI1ol!.I/o (i.:3.. I' ) 'v (~ ;;'';;:0 /~'/!.-:E-7-r t~.Y-'~ ;./. l~/-) .dfdf'f, DO/SF. r P f< iliA It:.- -'A' E Q~:;,:: (,,- I "", 'q. 10' "~ 4''''''1 p/ ,'",< I':""" /I5nt'f/JL-(- /;'1 NO/!rf{v.//=-:-;rr='.'~,-V C(';I<I/'E:','" __-_ _..-t-;:- "- . ~:;;; ~....-.-~? ....... . .... /.. No '.(,..-::I . I jTT -) r,., 'f - :'//':'''y- ~,u':-.k;<!J. jJ.~b'.:<-<.,,: ~.dfk"'O:.y.f-ot= DoA!R/S sr; .j-,~A;tcJo;:i LJ;~. e:LEv: -..,.., //?:;. ~ ~ ~ ~-...;:/.-' ~. 15 -4 4 ~ , 3 7 ' ....... , >_' . - ,'/- ;c/-;i,". I' / ;, /- (L. ,-P .- / 7c..' By: - ">-. .'>_ Date: " "I'U'" By:'-,.r::. 6'd'r:r-:J ,v"/ ~ 7-. Date:.!:i - - a PLANN ING REQUIREMENTS SATISFIED. By: 1') nu../__/ j',,_;- ":' ~ '-. e.~Date: 1--\ \ ,,-\. \~ \ Cy Dat~ Issued:.ti.-"Q -'7 ~ ZONE: :<" SETBACKS:.f:RONT bu' SIDE FACING STREET (FROMC/U INT.SIDEYARD5' REAR 5' (FROMP/U' _. . ~ ". ",-'-' 4.. .-i... LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE. EUGENE OREGON 97401 . ~ . (:. . , ' , " ;:'. _ ~ ' '. _"POST THIS PERMIT ON MAIN BUILDING AT SITE '......... !B.LD.~~ER~IT-WHITEj BUILDING-GREEN; PLUMBING-CANARY; SANITATION-GOLDENROD; OFFICECOPY-WHITE SANITATION .- "l },.:....~,.y-- .J PHONE: 687.4394 C55.13 ~