HomeMy WebLinkAboutPermit Building 1977-8-28
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JOB LOCATION.
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PERMIT # '.'/f"f'"
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LANE COUNTY PERMIT
Acreage or Lot Si70 .
Contractor's O.S. #
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Partitioning #
.( ) Completed
Subdivision.
Lot
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) Contractor. (v). Prefer to pick up. Call '
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Phone . 'r. .
Phono
Phone
. (owner, etc.) when ready.
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APPLICANT'S NAME AND ADDRE~C: ,
OWNER'S NAME AND ADDRESC:
CONTRACTOR'S NAME AND ADDRI=C:C:
Mail permit to ( ) Applicant ( ) Owner
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STRUCTURES NOW ON THE PROPERTY_
.HIS PERMIT IS FOR . .
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'" SEDROOMC: '-I '" PLUMBING CONNECTIOl\jS~_
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WATER SUPPLY
SEWAGE DISPOSAL
S.1. #
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THIS PROPERTY IS WITHIN ONE MILE 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: _owner of record;
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.
Fee Paid c:: Signature Date
) NEW ADDRESS ( ) FACILITY PERMIT TO TRANSPORTATION DEPT.__ ( ) SPECIAL PMT. AREA. MIN. ELEVATION:
SANITAT-ION .~.'
1JfiW@f.:i{.. Minimum Septic Tank Capacity (Gallons)
~~' Drainfield Required. Lineal Feet
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. ='>'oJ _ Maximum Depth
mments: _., ~- .~ . ........r.c. .,-........ . . 'C _.
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BUILDING
Type of Construction
Use Classification
r:roup
Fire Zone
Comments:
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BY:;,,-;;,~c~:';.f:;;.;. Date:"'" ~:;.?.. By: Date
PLANNING REQUIREMENTS SATISFIED. By: -r Date: " Date Issued;:71-'f<;_:7.
ZONE: SETBACKS: FRONT SIDE FACING STREET (FROM CILl INT. SIDE YARD REAR -- (FROM P/~)
LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE., EUGENE, OREGON 97401 PHONE: 687.4394
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C55.13
POST THIS PERMIT ON MAIN BUILDING AT SITE
BLDG. PERMIT - WHITE; BUILDING - GREEN; PLUrv'iB1NG - CANARY; SANITATION - GOLDENROD; OFFICE COpy _ VVr-ilTE
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Job Location
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Written Directions
INFORMATION SHEET
;J-FctS-77
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) Site Feasibility Study for Septic Tank. Number of sites
) Building Permit
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Acreage or Lot Size _/ -< 6
Partitioning #
Test holes will be ready
. Subdivision. /Mo..cLd/E~. _) ~
) Completed
( ) Pending
APPLICANT'S NAME AND ADDRESC: E f") v1 e. s-l- E /..16 ~/ d.
OWNER'S NAME AND ADDRESS, if different from applicant'< (
~NTRACTOR'S NAME AND ADDRESS
il permit or results of site feasibi~ty ~tudy!.q ( ) Applicant ilfOwner (
Prefer to pick up. Call 7,/ (p - (" j y X' ( owner, etc.) when ready.
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PROPOSED USE (this permit) ~ ~ ../nPA/)
WATER SUPPLY R...u;,J~ f{) ~
) Contractor.
STRUCTURES NOW ON THE PROPERTY
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~Lot/
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Block
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7<1 t,-/J.t/P
(~xisting or proposed well, etc. If public, name of system)
Phone
Phonp
Phonp
Contractors O. S. #
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SEWAGE DISPOSAl
(existing or proposed septic tank, etc.) S.I.;:
pLUMBING BY
Address
) PROPERTY IS WITHIN ONE MILE OF CITY (
~ New Address Necessary ( ) Facility Permit Necessary
NF SETBACKS: Front Side Facing Street
(FROM CENTERLINE OF ROAOI
) Special Permit Area.
*4+ 4*** *******..... *********** *************** OFFICE USE ONLY BE LOW THIS LINE *** ***. ***.*.* **.. -11-****.. ****.. **...... .4... *.............
Minimum Elevation:
Interior Side Yard Rear
(FROM PROPERTY L1NESl
To: Planning/Building InspectorlSanitarian/Surveyor.
This applicant appears to have a problem with
Your assistance will be appreciated.
By
Respon~o'
C55.12
By
DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
Permit Processing Section
125 East 8th Avenue
687-4394
Permit Processing Section
nivision
Plot
Plan
Job LOCatiOnJ~dre?) /7/S-: ..._-ILa-w~ d{:l ~.."
Permit /J c:2ft.fS-7 For.Lf;tr/n>>J:s;.,c)S. P;{rmit /J For
Permit /J For ' Permit /J For
Permit /J Fo~ Permit /J For
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Subdivision
Lot
Block
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Vicinity Map
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C74-150