HomeMy WebLinkAboutPermit Building 1977-5-18
TRS TI li-()~ -Oh - /I
,
TL. 300
Job Location
8;-0 nc:.I3Ef!.1' LAAlE
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INFORMATION SHEET
) Building Permit
) Site Feasibility Study for Septic Tank.
) Would like to meet on site. Call
Test holes will be ready
Subdivision.
Lot
Bloc~
(
(
Number of sites
(owner, etc.)
.
Acreage or Lot Sizo
Partitioning # ( ) Completed
( ) Pending
APPLICANT'S NAME AND ADDRES~ 1/f=AJAJf<:' tv ~7fM;?L.2.,
OWNER'S NAME AND ADDRESS, if different from applicant's_
CONTRACTOR'S NAME AND ADDRES~
Mail permit or results of site feasibility study to ( ) Applicant ( ) Owner ( ) Contractor.
( ) Prefer to pick up. Call . (owne/r etc.) when ready.
STRUCTURES NOW ON THE PROPERTY IIO{).5E-, CALAt;E-
PROPOSED USE (this permit) /lOCl5E .40017-"'0,(/( \-<(, \.....""--a.r.r-. (~~\-... I ~c.."",," ~ '\2........ ~<Q
I ~,"'-__' / .~ ~
'" ~~ (existing or proposed well, etc. If public, name of system)
?;?.D rtL?,E,e T LN. .5f?'€'/NtjP/tLD
Phono 7sL7-03<57
Phono
Phono
WATER SUPPLY
UJI'..LL.
SEWAGE DISPOSAL SE'pTfC ThAlK reX/57/ltfC ')
'-- ./
(existing or proposed septic tank, etc.) S.I."
PLUMBING BY
) PROPERTY IS WITHIN ONE MILE OF CITY (
Address
C;E5
******************************************* OFFICE USE ONLY BELOW THIS LINE *******************************************
( ) New Address Necessary
ZONI=
) Facility Permit Ne'cessary
SETBACKS: Front, . Side Facing Street
(FROM CENTERLINE OF ROADI
) Special Permit Area.
Minimum Elevation:
.
Interior Side Yard Rear
(FROM PROPERTY L1NESI
To: Planning/Building Inspector/Sanitarian/Surveyor.
This applicant appears to have a problem with
Your assistance will be appreciated.
By
Permit Processing Section
Responco'
C55.12
By
DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
Permit Processing Section
125 East 8th Avenue
687-4394
nivision
'--'- -..&"
'.
1'-:12-06.1.1
TL 1:10 ,
JOB LOCATION
C2'l !'llbert Lane
PERMIT # \1~
Spr1ngHeI<iO!'e~n
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TRS, TI
LANE COUNTY PERMIT
Acreage or Lot Si7D
Contractor's O.S. #
Partitioning 4f
( ) Completed
Subdivision
Lot
Bloc~
APPLICANT'S NAME AND ADDRF""
OWNER'S NAME AND ADDRES"
CONTRACTOR'S NAME AND ADDRES"
Mail permit to (vI' Applicant ( ) Owner
~:1:,,18 "U!..;>le
Gzn r11bcre T~~.e
~Jl:?9..-'rr.~ ell ~ ,it\'0::C.:i Phonp
Phonp
Phonp
(owner, etc.) when ready.
7::7-!J357
[;a-;e
StiJ:'e
) Contractor.
) Prefer to pick up. Call
STRUCTURES NOW ON THE PROPERTY
~!St1D~ Gouse ano enrage
.
THIS PERMIT IS FOR
Bousl; "~d1Ucn
iinl) en ftt
Value ~9UEC.(n
# BEDROOMS
# PLUMBING CONNECTIONS-
WATER SUPPLY.
l~ dI'~.J. .!. Y ueOnt
t1~1st
!Jl!to
lUccnt!n
:J1Il1!lV r;o~
. SEWAGE DISPOSAL
Pdo t 7lJnTt
S.l. #
J
THIS PROPERTY IS WITHIN ONE MI LE OF THE CITY OF
. PLUMBING BY
I hereby certify that the above statements are true and accurate, and that I have the following legal interest in the property: ...'!...l.owner of r~cord;
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.
,I ~ \" ,. '/I I, ,. 1/;":-1.,' ,( " /,/' Tl
Fee Paid $ \.>\~,~ - '. ~ .. :" '1660 Signaturp ~, ,;/'/"-' > I,':' .fL'd~';" Date! f, ,,7.(~
) NEW ADDRESS ( ) FACILITY PERMIT TO TRANSPORTATION DEPT ) SPECIAL PMT. AREA. MIN. ELEVATION:
,
--
Minimum Septic Tank Capacity (Gallons)
Drainfield Required. Lineal Feet
Maximum Depth
BUILDING
- :' -' Type of Construction 7'
.' Ilse Classification
Group
Fire Zone
SANITATION
.--
,r, . '0_""
~.t'...__
~
Comments:
Comments:
I '-,,' /" --?;, .J"' '.<': a-;.,
.
By: Date: '
-
PLANNING REQUIREMENTS SATISFIED. By:
ZONE: ,.j" SETBACKS: FRONT
By: .' ;. .<.' '/', Date: ,~-~-77
Date: ., Date Issued:
SI6E FACING STREET (FROM <;:1L) INT. SIDE YARD .) REAR ' (FROM P/L)
LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE., EUGENE, OREGON 97401
POST THIS PERMIT ON MAIN BUILDING AT SITE
PHONE: 687-4394
C55.13
BLDG. PERMIT -WHITE; BUILDING - GREEN, PLUMBING - CANARY; SANITATION - GOLDENROD; OFFICE COPY - WHITE
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