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Home My WebLink AboutPermit Building 1974-8-29 (2) ~' /,'. ,-----.--.----, .-'- _...;, .. L,'l " .. "If.' " , PR6p~RfY ,OWNER . ROBERT N HILL BUILDER CONTRACTOR SM~E PROPERTY LOCATION -INCLUDE POST OFFICE ,68~ OUXE STREET SPRING,'ELD. PROPERTY LEGAL DESCRIPTION - METES, BOUNDS LANE COUN.UILDING PERMIT OR MOBILE BUILDING 0 MH 0 MAILING ADDRESS 8(0 WEST CENTE~NIAL MAILING ADDRESS H. USE PERMIT PERMIT NO. 1 EG5- "j!, lLvlrS-7t! SpnING,'ELD. ORE. PHONE 7116-c)~16 PHONE ~ OREGON LOT 2';j BLOCI( 2 RANGE ';jRD ADDITION TO MEADOW GREEN ESTATES ~E6:7, 3 T;Jl"fZtJ 9' COOE CENSUS TRACT EXISTING STRUCTURES ON PROPERTY TWP 18 02 APPl. NAME & MAIliNG ADDRESS SPR lNG, 'ELD, OREGON FOR MOBILE HOME PERMITS ONLY No. of Bedrooms ROBERT N. HILL BUILDER NONE LEGAL ACCESS TO PROPERTY DUKE STREET 870 WEB. CENTENNIAL PROPERTY SIZE - FT. WIDTH DEPTH AREA STRUCTURES TO BE BUILT THIS PERMIT Connect to Existing Sewage System 0 TYPE CONSTRUCTION SQ. FT. :.: BDRMS 1112 @ 16.10 ~9 @ 5.'!) New System 0 VALUATION D~/E LL I NO 1-1,903.20 2,700.68 2O,bOij.00 GARAOe: .~ / SEWAGE DISPOSAL PUBLIC [] BUILDING WASTE DISPOSAL PLUMBING PLAN REVIEW PARK TRAILER 1 ~JsURCHARGe: SEPTIC TANK 0 ~ OTHERO 9b.00 ~.OO 2'5.00 PRIOR PLUMBING INSTALLED BY OWNER 0 OTHER: NAME WATER SUPPLY FEES PUBLIC 0 o OTHER TOTAL 1.21 $ 172.21 COUNTY BUILDING & SANITATION SPECIFICATIONS MIN. SEPTIC TANK CAPACITY WITH OISl. BOX: GAl. 900 DRAIN FIELD REQUIRED 150 UN. FT TRENCH WIDTH FT. 2 TO 3 I OR SQ. FT. ~ TYPE OF STRUCTURE OCCUPANCY 5N I & J BLDG. SETBACKS __ FT. FROM CTR. OF ROAD RIGHT OF WAY FRO~T 45". .SIDE INT. 5 SIDE EXT. AUTHORIZED SIGNATURE - DATE /s/ J. E. 600s Bv C HARBAUGH ZONE PUBLIC UTIl. EASEMENT USE CLASSIFICATION REAR 7 DATE J SHOOK/SANITAR IAN 8/29/74 01: BLDG. PERMIT - WHITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITAjlON - 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) FORM:: CSS-lJ (POST THIS PERMIT ON MAIN BLDG. AT SITE) LANE COUNTY, DEPT. OF ENVIRONMENTAL MANAGEMENT COURTHOUSE ANNEX, 135 EAST 6th, EUGENE, OREGON 97401 , .-, . ~~. l~tbs-7J I /1, R -:Z S (0 TAX Lor CEtlStt TRACT APPLICANT: II '/1 8 Id Ni\l1E iT I Q / f Y .5 ADDRESS BUILDING SITE EVALUATION r , (i. ( ) ( ) Building Permit Application No. Site Inspect ion rhG +0 PHONE DATE y;- ),~ - 7(/ Pre-Permit Investigation LANE COUNTY PLANNING DEPARTMENT NOT NO YES NAME app I icab Ie 1. Zoning Ordinance Compliance ( ) ( ) ( ) (Zone ) 2. Subdivision Ordinance Compl iance ( ) ( ~\ ( ) . 3. Required Access ( ) cY), dY~ 4. Building Site (Area, Width, ( ) ( ) ( ) Frontage, Setback) 5. Other (see comments) ( ) ( ) ( ) DATE COHHENTS: BUILDING INSPECTION SECTION NOT NO YES NAME DATE app I i cab I e <<) 6. Plans Subm i tted ( ) ( ) 7. Soil Stability (footings) W1 () ( ) . 8. Flood Plain (J1 ( ) ( ) e t~!~~ 9. Other (see Comments) (i) ( ) ( ) 't-~e-'7'1 . COMMENTS: f SANITATION SECTION NOT NO YES /~\UL- DATE app I icab Ie h 10777'/ io. Sewage Disposal ( ) ( ) , 11. Usable Area ( ) ( ) ( ) 12. Water Supp I y ( ) ( ) ( ) 13. Other (see.Comments) ( ) ( ) () I . COMMENTS: TO APP LI CANT: ~ -'11 Your ~ 'J~ ()1 ( ) ( ) ( ) ( ) 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 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 pcr~it appl ic.]tion fee is being returned under separate cover. LANE COUNTY PLANNING DIVISION 135 Sixth Avenue East, Eugene, Oregon 97401 Phone (503) 687-4186 LANE COUNTY ENVIRONMENTAL }~NAGEMENT 135 Sixth Avenue East, Eugene, Oregon 97401 Phone (503) 687-4065 C55-28 r , ~ 9/9/74 . permitt. 1665- 74 J ? ~ 0-7 y' C~RB CUT )f: / .:Dat~ 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 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 ROBERT N. HILL Bu I LDER 870 WEST CENTENN I AL SPR I NG" ELD, OREGON for placing, building or constructing the following facility: LOT 2i BLOCK 2 iRD ADDITION TO MEADOW GREEN ESTATES DUKE STREET 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. 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. 3. SIDEWALKS WILL BE CONSTRUCTED IN ACCORDANCE WITH THE ATTACHED SIDEWALK SPECI,ICATIONS AND DRAWING M98-49. THE STANDARD CURB TYPE SHALL BE CONSTRUCTED UNLESS OTHERWISE SPECI,IED: 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 9/9/7'i , 1 9---15. Expires ,19_. Inspected and Approved Approved by Board of County Commissioners By Dat.. ~A ",1A'.t: 1'L:r -{U./ c . , , . .- 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 cOUNaUILDING PERMIT OR MOBILE BUILDING D MH 0 MAILING ADDRESS nltJ N):~7 r.E:rlTCtl~HAl. MAILING ADDRESS Ha USE PERMIT PERMIT NO. c ),;1'/'1 .' PROPERTY. OWNER PHONE ['lOI3ETI'l r~ flu,,- r:tlH.um CONTRACTOR r:~:1 cr' '7 A r".:I" . ' ~ r - <,(~. ...." . PHONE ,;^71: PROPERTY LOCATION - INCLUDE POST OFFICE ')r::o.., ).,.." f'..c._ "'r' I'~~' ['1." ""'.. ~~~.I'l "..\i......~ ,- .....".. \~~f.,..~1I . ;.. ,~j I . ""'. "~-JlI.lb\1 PROPERTY LEGAL DESCRIPTION - METES, BOUNDS : elY ~Yl Ill,GCIl 2 ""10 i\!<on'SC:l 'in [,:e::'"lOW G~CI!:l C-:~TA7rrn TWP RANGE SECTION TAX LOT NO. CODE CENSUS TRACT nJ APPL. NAME & MAILING ADDRESS ~~:J .:-:jYOEtoO", C-neco:J FOR MOBILE HOME PERMITS ONLY No. of Bedrooms O? oj .' r.O'1f.~T tJ. l'lL.!. ';tI~Lr:7'l EXISTING STRUCTURES ON PROPERTY N'o:lE LEGAL ACCESS TO PROPERTY O:J:tf! ~)VRr~T 0' '" · '~nw C,-,.. ..,. A' ,h.... '>......,J~ .c..-I...F.:I.....I-.o PROPERTY SIZE - FT. WIDTH DEPTH AREA STRUCTURES TO BE BUILT THIS PERMIT Connect to Existing Sewage TYPE CONSTRUCTION SQ. 1112 (1 ~() System 0 FT. # BDRMS 1\). !~ New System 0 VALUATION ::"':~~.H:::J ~ '/!l~.'>~' (:--~ ~":.~A~~ ,- jJ ........ , n "'-.") r;' I. 0 (. ..., ,:).',t~'~.'.:J , OTHERD :..i~), lX' :}J.OO 25.00 F"IO:l FEES PLUMBING INSTALLED BY OWNER D OTHER: NAME WATER SUPPLY SEWAGE DISPOSAL PUBLIC D BUILDING WASTE DISPOSAL PLUMBING PLAN REVIEW PARK TRAILER ~i::J:; :~:l^,:CE SEPTIC TANK D PUBLIC 0 o OTHER TOTAL , , .r:l H2.a COUNTY BUILDING & SANITATION SPECIFICATIONS DRAIN FIELD REQUIRED l'i> tiN. FT " TRENCH WIDTH FT. ,: YO 5'; OR SQ. FT. ;po MIN. SEPTIC TANK CAPACITY WITH DIS1. BOX: GAl. ~U) .. TYPE OF STRUCTURE ;-,,~ .;.' OCCUPANCY I C".l ZONE PUBLIC UTll. EASEMENT BLDG. SETBACKS _ FT. FROM CTR. OF ROAD RIGHT OF WAY t14 FRONT 'J.,; USE CLASSIFICATION 181 J. SIDE INT. :; SIDE EXT. AUTHORIZED SIGNATURE - DATE s. eGIS CY C :L')r.P\~~H REAR 7 J S:;~:l:lh~rlITi\..I'\N DATE "'h'::>/',') '" "-~ .... , I. . BLOG. PERMIT - WH ITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENROD Call 687-4065 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 an Reverse Side) " rORM ::= C55-13 (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 GROUNDWDRK . . ApPROVED / / DISAPPROVED ~ DATE INSPECTOR REMARKS GAS PIPING GROUNDWORK ApPROVED ~ DISAPPROVED ~ DATE INSPECTOR REMARKS ROUGH PLUMB I NG ApPROVED fK! DISAPPROVED C1 DATE 9-:l1J-7'1 INSPECTOR-4// REMARKS ROUGH GAS PIPING ApPROVED ~ 01 SAPPROVEO C1 DATE INSPECTOR REMARK 5 FINAL PLUMB I NG ApPROVED ~ REMARKS DISAPPROVED ~ DATJ~/;.J -,/t(' INSPEC ~~ / !' ~ FINAL GAS PIPING ApPROVED C1 DISAPPROVED ;---y DATE INSPECTOR REMARKS CERTIFICATE OF OCCUPANCY READY TO ISSUE ;---y NOT READY TO ISSUE / / DATE ~. REMARKS INSPECTOR . , , , <' ., . ..,. Datp . . Permit No. CURB CUT 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 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. be and is .. ORDERED. that a permit 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 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 M9S.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. ,. :; 1 " /"'." ., '''.. ; ~.. <--..... ( 0;,,' -. --, .' ", -, ",., ) . 2 {'" . ( .C~-. . 0' .', ':.. ~:. ~ ~ ," r; V /(tv ,rJ-?4 ~ r 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- .f fort> , 19-----L. Expires 19_. Inspected and Approved Approved by Board of County Commissioners By Dato By Director of Public Works WHITE - OFFICE FILE GREEN - RESIDENT ENGINEER PINK - PERMITTEE BLUE - ROAD SUPERVISOR ORANGE - BUILDING & SANITATION DEPT. YEllOW - REAL ESTATE c98 - 7 9..r:::: '""'1 . , LANE COU. BUILDING PERMIT OR MOBILE HtlE BUILDING [J MH 0 MAILING ADDRESS USE PERMIT PERMIT NO. -/ . PROPERTY OWNER PHONE .. J ~., .' . " CONTRACTOR MAILING ADDRESS PHONE PROPERTY lOCATION - INCLUDE POST OFFICE , " . . , PROPERTY LEGAL DESCRIPTION - METES, BOUNDS #', "-' '.' TWP RANGE SECTION TAX LOT NO. CODE CENSUS TRACT APPL. EXISTING STRUCTURES ON PROPERTY NAME & MAILING ADDRESS LEGAL ACCESS TO PROPERTY " .( \, \.... ,J '" \. \'''': P~OP,ERTY SIZE - FT. WIDTtf DEPTH AREA \ FOR MOBILE Hq~E,'PERMITS ONLY No. of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT ... '~'.\ -'" " . , ... Connect to Existing Sewage System 0 TYPE CONSTRUCTION' SQ. FT. t:; BDRMS New System 0 VALUATION J ". ~ . ,\ \ ~\.~-(S\ ""v SEWAGE DISPOSAL PUBLIC 0 BUILDING WASTE DISPOSAL PLUMBING PLAN REVIEW PARK TRAILER , OTHERO ,( FE~~ .,\ ." " \ ~-- ~. P~UMBING INSTALLED BY OWNER '0 OTHER: NAME WATER SUPPLY SEPTIC TANK 0 PUBLIC 0 o OTHER , TOTAL , MIN. SEPTIC TANK CAPACITY WITH 0151. BOX: GAl. COUNTY BUILDING & SANITATION SPECIFICATIONS DRAIN FIELD ~,EQUIRED UN. FT TRENCH WIDTH FT. OR SQ. FT. . - , .. "., \\ i". t' , '"\J ~ .. \ . l' \ ,1 .' ~ (~ }""\: s.. \ , ., , ~.:-,~ \~.._ _' .'::0 \ . \ - .." !~NE"J.. 'I' ~ ~~.\ "';' . \. TYPE OF STRUCTURE OCCUPANCY . h '\ \ ~. ", P~'l1C''UTIl. 'EASeMENT BLDG. SETBACKS FT. fROM (TIt OF ROAD RIGHT OF WAY USE ClASSIFICA liON FRONT SIDE INT. SIDE EXT. AUTHORIZED SIGNATURE - DATE REAR DATE 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) pORM ~ C55.13 (POST THIS PERMIT ON MAIN BLDG. AT SITE) LANE COUNTY, DEPT. OF ENVIRONMENTAL MANAGEMENT COURTHOUSE ANNEX, 135 EAST 6th, EUGENE, OREGON 97401 .'~ -..- . . S!TE INSPECTION ApPROVED L::::l DISAPPROVED L::::l DATE INSPECTOR REfl.J'RKS FOUNDATION INSPECTION ~ /./ ApPROVED LL: DISAPPROVED 1--/ DATE 11'1 - ~Lf INSPECTOR~ REMARKS DK~ ~fl/l ~/L'~~.d2tA-'l t;vjj'7111t' - ;1 A'/l -- (I),f' 7J) tth- ~,. .j)~M ~ r;r t::I/~ _ q<' -/Fr' ~ i' V J' -..f . , (i!,J ) ~~ FRAMING IN~P~ ApPROVED O,SAPPROVED /7 DATE/O -J.~ 71/ INSPECTOM 81 REMARKS LATH OR S~E7NSPECTION ApPROVED DISAPPROVED INSPECTOR~ ~ 1/6'- 1--/ DATE1fL~.7t/ REMARKS FINAL INSPECTION ~~ ApPROVED ~APPROVED L::::l !~ATE.2' 7-7b INSPECTO~ . REMARK S /JM;;( ~ Ii. / q -7 il f/L . I rt ~.~7;IJ",~~ CERTIFICATE OF OCCUPANCY READY TO ISSUE ~ NOT READY TO ISSUE ~ DATE INSPECTOR REMARK 5 A,/ ..... //t., , ______J:/J /l/1'f/~t.N';"f/ li7 -vv' .......-_. dI ,..,. Itf6~-"'7t/-7Iit! J&, ~6- l)~~ ~ . . , "- ,--_,l INSTALLER: ~omPlete top INSTALLER'S NAME ,I). 11.111 p UAA J f7-Li.,.jng ~ f(,.~ 6 ( Bedrooms Baths P,.AD SEWAGE DISPOSAL SYSTEM REC~ {l" , part ~m to signature and submit bO~ies with a 1 ication,. .. PERMIT . 166':;-.7Lf, PROPERTY ADDRESS JS DUKE STREET 3~ ~~ Basement Water Supply Yes No V Publ ic t/" Other-List Septic Tank: Ft. from well Steel 0 Concrete I7YNo. Compartments Gal. Capacl ty ~ J/'y>/\ , Dimensions: F,t. / Ti Ie Disposal Fretd: - . /' Width ~ Diameter .:l Depth Distribution Box: Yes'" No Other Distribution-Type ROBERT N HILL BUILDER Inside LenJ1th OWNER NAME SPRING'IELO, OREGON Length of Lines-Ft. I Trench1 1 {4"2.0>3.. 4. 5. 6. Widt~ Plot Plan (see instructions): Total Sq. Ft. Feet from / WEll AI(}U~ Foundation Jrt. Lot Li ne' J I ' ,/ Front I/J Side I rl Rear l't I 't. Betwe7 IFille.'i IFiller Depth IFiller Below Lines/b Tvpel"i AboveTilea..inJrile~ in. MA I LING ADDRESS 870 WEST CENTENNIAL ~ L'r-. '~~~ 1; , .I;~'" '0 '- - - . ~ ~ .() ,~," Ll>1~, ~ \w / l'b ) ~ 'X :3;;..1 - "< \~ t - ~ $Y't5..\N L-.ilVe "f\' ~ -t- '\ ') ~ ~J ." \ 5epf ~c. OCT 11 i974 2!:.iJ K_ ~Mf COUNTY I.j. ~VI;WNMf1'iTAL MGMT. '\.l:>7 -.,r - H6use /') Si~ature ..,t~ -uV (V~<-A"./h:.::: CERTIFICATE OF SATISFACTORY COMPLETION ~- Date: In-?--,-/-7 V In accordance with 1973 Oregon Laws Chapter 835. Section 214 this certificate is is~u~d as evidence of satisfactory completion of a subsurface sewage disposal system at the above loca~'o . Approved: System Installation conforms to current standards Disapproved: Does not conform to current standards Remarks: Gv-tAj e. ! . I Date For Sanitarian Use Only: C55-11 Sa ~'~n~s LA~OUNTY STATE OF OREGON DEPARTMENT OF ENVIRONMENTAL QUALITY Signature lANE COONlY Building DEPAR'IMENI' OF ENVIRON1ENrAL Mobile Home APPLICATION FOR BUILDm:; PERMIT OR MOBI HCME USE NOTE: No pennit will be issued mtil this applicati PLEASE PRINr 'J) J 0 J-.-:;. PRurrJ:ur LOCATION 3~%S- cU~~ ..d.P'.or .1yj",'l ;f';~~ ~ ~,f- . PERMITif /tCS--7 tl , 'MP -/Ji!. RAN:;E t::?-:J.- SEC. 0 ~ TAX wr if CODE CENSUS TRACT wr 00. ../? BLOCK el SUBDIVISION...1"lL tt4./. h- m.//. ./....7 ~ E~ PROPERlY SIZE ACCF.5S TO PRur=y, ALL .J.:t,d W)D'IH ~h7 DEPlH /';,7. d / OR ACRElGE DESCRIBE EXISrm:; STRUCIURFS ON 1HE PRuruur 7ltf11~ / AP~1eLf~. 1I;d ~J~ ~~ g'1~ ~J ~A'1-:i;;...,;~PHctlE 7C/t,,-tj9tt wl'UNICIOR p - . MAII.IN; 0 - 0 NAME e1a-D _ ADDRESS .&n#n" _ PHONE ~-'Z- BEUM FOR OFFICE USE ONLyi. :.:..-. :.:. :...:. :...:.:.:. :.:.:.:. .;;.;.;.:.:. :.:.:.:. :.:.:.;. :.:.:.:.;./. ;.;.;.;.;.;.:.:.:.;. :.:.:./.:./. ;.;./.;./.:./.:. ;.;. ;.:.AA AA:, ~~tures to be builtfrbbile Home sq. f~/~,(() 1/bedrooms valuation /.. f.~, ///::; r- _">" (7) /7Q-n "?,.10 'V'~-I t . "c3'v~ - , ",' ./"7 ___~L..- , Jt)'7) 9. {" tJ ~ '?,.,o J, 'it .;. v r;, u '-(. v':; / f ~ewage J.iisposal: /J, _ ~ S,ite Inspection 1ffIL/V-v Existing sewage disposal system 0 or new system requir;d~ Well 0 Spring 0 Other / , Fees Plumbing Installed by ();.mer Other ~: Plumbing Fees Sewer corme6i: ter cormection '7 4{ of fixtures inspectiori fee q inspection fee.:2 , / l>(t I r] Ca~ Plans fu:r;>~hed Fac~ty Pennit ~eck Yei:J23 ~fu CJ /J JY!:li, ~,Q Signature of Applicant~ If~ 1). /li// date J?.,.:U-:Jf Fee received by tZ. d. -" date J;-7.2.J/? <-/ , .# i , I Min. Septic tank capacity Drainfield required / ;-, / . with dist. box: Gallons CloD Lineal Feet /~/ Trench Depth .L.j.... ~ or Sq. Ft. J OD -/ / I Type of Structure() IV Occupancy /Cfr::r Fire re Blgd. setbacks-tt. from center ot road liighi: ot way Front y ~ Side Int. S- Si~ Exterior Planning date ~\\&\ \\ date }V'ding date F~ R- 2-:< - 7,<1 \J ..)!lI.J..,k'. d2 '7/7'( r ~-<4.~ ~.2~' ';;1/ Water ~~yl~: Public~strict Name Bldg. 9? 00 Waste Dis. t57). " U Plumbing ~ ,~ ,., r) Plan Review Trailer . 1% surcharge I, d.-I TarAL I 7 J... J-J C55-12 Use Classification Rear :;7 Zone R7'i