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HomeMy WebLinkAboutPermit Building 1977-8-28 TRS, TI . , ... /, , JOB LOCATION. ? - ':. PERMIT # '.'/f"f'" '. " /' ~ J r LANE COUNTY PERMIT Acreage or Lot Si70 . Contractor's O.S. # , .' Partitioning # .( ) Completed Subdivision. Lot I Block / '. ) Contractor. (v). Prefer to pick up. Call ' '. /,,,""- Phone . 'r. . Phono Phone . (owner, etc.) when ready. 1'.... APPLICANT'S NAME AND ADDRE~C: , OWNER'S NAME AND ADDRESC: CONTRACTOR'S NAME AND ADDRI=C:C: Mail permit to ( ) Applicant ( ) Owner J- .r . , , , STRUCTURES NOW ON THE PROPERTY_ .HIS PERMIT IS FOR . . , -._.___1 '" SEDROOMC: '-I '" PLUMBING CONNECTIOl\jS~_ I ,," WATER SUPPLY SEWAGE DISPOSAL S.1. # ( 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 '=---N . ='>'oJ _ Maximum Depth mments: _., ~- .~ . ........r.c. .,-........ . . 'C _. :..--..._ ,_ _'. ~_~-n _~~~_~__. BUILDING Type of Construction Use Classification r:roup Fire Zone Comments: -C~'i'("~:~;"~"'_'_ "'."'lfl TI ~~__ I - - - ' - . ~-~ -.:.::; d~ ~.,~~~:~,=:'~,:.:::,::"w-~~:"'~.-<.:;::'~=-"" --+i7"~.i.:.-_. 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 \ C55.13 POST THIS PERMIT ON MAIN BUILDING AT SITE BLDG. PERMIT - WHITE; BUILDING - GREEN; PLUrv'iB1NG - CANARY; SANITATION - GOLDENROD; OFFICE COpy _ VVr-ilTE . ~ c:? /" 6 Job Location //7/5 ~~ .' I '7 03 ;<;2, /.] TRS, TI Written Directions INFORMATION SHEET ;J-FctS-77 r~. <7:~ r:>.-- -3 / ILl -~ ) Site Feasibility Study for Septic Tank. Number of sites ) Building Permit / 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. ;j~ PROPOSED USE (this permit) ~ ~ ../nPA/) WATER SUPPLY R...u;,J~ f{) ~ ) Contractor. STRUCTURES NOW ON THE PROPERTY "'- J/)1fl7~ ~A1 tbJ,,~ ~ ~/j../ ~Lot/ ~ Block c; 7<1 t,-/J.t/P (~xisting or proposed well, etc. If public, name of system) Phone Phonp Phonp Contractors O. S. # :fI:~r()("JTlC:::; Lj 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 TRS;-'TL 17-3 - d;;}, /.3 ,,),780 ., Subdivision Lot Block c; '" ..... Q 1-- ~ (" ''0 ~ ~ l VI " t/ "' ~ -< Q. / ;,;16 ftu..rn ;flqO a. u-e.... . . Vicinity Map - N C74-150