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HomeMy WebLinkAboutPermit Miscellaneous 1973-1-16 PROttftERTY OCATION -INCLUDE POST OFFICE ~rfl.l . . . PROPERTY LEGAL DESCRIPTION LOT - BLOCK - SU6DIV, TWP RANGE /7 ~3 LANE COUNTY BUILDI~PERMIT OR MOBILE HOME USE _ICATION PERMIT TYPE - BUllDING'J2( MOBilE HOME Dose REG. # -"ERMIT # ~-13 PROPERTY OWNER . MAILING ADDR~ . /J /! PHONE .bu.t. /11 d ..I..0~ :/ 5' 5 ~~ J~K&". ~...{fl.fJ./1i..L, CONTRt;tTOR MAILING ADDEYS / !J 'l2b .l'H2FC '-15 -6 ~ //Cd ;;6 ._Y~kz.u.... / Io\ifES & BOUNDS 0 YES / ATTACHED ErNO ~ J ;z.;2. . .t/. ~ SEC. TAX lOT # CODE b:200 1'f-iTO . . Wd;-.~6-iJ DESCRIBE EXISTING STRUCT RES ON PRUt-lERTY IF ANY J;du,~ - ~~~T~~; ?;!/>?~/. ~ PROPERTY SIZE-WIDTH DEPTH C/"'-""'- '-~REA~.- CENSUS TR APPLICANT NAME AND MAILING ADDRESS FOR MOBilE HOME PERMIT ONLY Number of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT ~ M tf~ Connect to Existing Sewage System D TYPE CONSTRUCTION SQ. FT. or New System Req. 0 # .EDROOMS VALUATION , , ".-.-.~. A~dA.~ 1 PUBLIC 0 BLDG. WASTE OIS. PLUMBING PLAN REVIEW PARK TRLR. < SEPTIC ~THER 0 FEES WATER SUPPLY PUBLIC )( PLUMBING FEES PLUMBING INSTALLED BY SEWAGE DISPOSAL _ F)XTURES CASH 0 S'~ CHECK ~t,iN'ECTION FEE OWNER 0 OTHER 0 NAME PLANS.!:lR~ED FACILITY PERMIT YE~t"L-"I'lO i7'" ~ NO fl1' ~~ /_/~_D73 .~EIVED BY / DATE. (A4)J ___ (J /-/0-7'3 ~#3/73 COUNTY BUilDING & SANITATION SPECIFlyATlONS DRAIN FIELD REQUIRED / L1N. FT. TRENCH WIDTH FT. OR SQUARE FEET .I.1.1l../ PUBLIC UTIl. EASEMENT OTHER ---.2-D. 00 TOTAL -2.-0. DC, _ PUBLIC WATER CONNECTION FEE MIN. SEPTIC TANK CAPACITY R~ Itbo .:J~ ~ -w7~ WITH DIS1. BOX: GAL. /":"1 ,/, TYPE OF STRUCTURE OCCUPANCY REAR YARD BLDG. SETBACKS - FT. FROM CTR. OF ROAD RIGHT OF WAY fRONT Y.r- SIDE INT. ...r- SIDE EXT. .3 S-- REAR ~ I SANITARIAN Da;e rLfrNI~L L..AU. Date BLDG. INSP. /) 96 _ __. A. ~ /?/ Date _41.t)~/S'7.3. "~T""'7; ~J<I:n... ~y.'J ~y.t"t../-/~ -?_? Directions to Find Property:. (/ @/AVV'~ ~~/U./.~ ~ I / f/ USE CLASSIFICATION - COPY 1 - OFFICE COPY 2 - JOURNAL COPY 3 - AUDIT Form # C55-12 Holes are in RECEIPT No, 20266 . o. . 17 03 22.4/+,s. TWP. RANGE.._ SEC, 9~ 20 TAX LOTNO.51ee-CODE' - August .~II 1966 DATE Y A 726-7883 TEL. No.. I?4+- REQUEST FOR SITE INSPECTION Rt. 2. Box 251 BY I1ATTERN. Elden MAILING ADDRESS Eugene. Orggon OWNER OF PROPERTY Virgil Malv81ZE OF PROP, CONSENT OF OWNER? ves NO EXISTING STRUCTURES ON PROPERTY LEGAL ACCESS? Nev~ Street SOURCE OF WATER SUPPLY: PUBLIC xx SPRING WELL: DRILLED DRIVEN DUG DESCRIPTION OF SITE (DIRECTIONS, LANDMARKS, HOUSE OR BOX NO" IF ANY): Off Hayden Bridge to Game Farm Road to Kerns Avenue to Nova Street. to the very end of Nove. Site is at very end. PROPOSED USE OF SITE (NUMBER Kingdom Hall Church OF DWELLINGS, COMMERCIAL OR INDUSTRIAL USE, SUBDIVISION.): 140 members epprox. LXi URBANIZING AREA, L:7 SPECIAL PERMIT AREA, Minor subdivision to be submitted FEE: NO. OF NO. OF SITES ACRES TOT AL I $ $ 5.00 7.VU RESULTS OF INVES.T;,mo" ~:-' 4~~tt'r- ~ ~.fr ./~.~~ ~ ~ .L~ ,~~~".~{50P.~ ~ C'L~{~~y'~-7~~ ~.,~.~,n_ ~~~-e~~~~~J~;.4~ ~~;L i ~~~r~uv~i- .. ,-/~,v"-f7 ~~~f~g.--ec ' ,4l:A. ~rU<. r!~C/#!L 2t%7~ ?t;-:Jt:~~-cL~--r- ,$f.~,,- , BEFORE CONSTRUCTION IS STARTED BRING THIS FORM TO THE BUILDING AND SANITATION OIVISION AND MAKE APPLICATION FOR A BUILDING PERMIT, IF THE PROPERTY IS A PORTION ONLY OF A TAX LOT, A METES AND BOUNOS DESCRIPTION OF THE PARCEL MUST BE FURNISHED. EXACT SPECIFICATIONS FOR THE SEWAGE DISPOSAL SYSTEM WILL APPEAR ON THE BUILDING PERMIT. TWO SETS OF THE BUILDING PLANS AND PLOT PLAN WILL BE REQUIRED. LANE COUNTY BUILDING AND SANITATION DIVISION: C2.c~~ d THIS REPORT 55..125-09 BuiLDING INSPECTOR c{cp s~f::~-- IS NOT COMPLETE WITHOUT THE SIGNATURES OF THE BUILDING INSPECTOR AND SANITARIAN. .I?-- /z;-!t DATE NOTE: NO PERMIT WI~BE ISSUED UNTIL THIS APPLICAT~HAS PERMIT 1;3b-?~ BEEN APPROVED APPLICATION FOR: MOBILE HOME [=:J PLAN REVIEW [=:J [=:J OWNER r:~NameBj(.4-Al~e.~(:~d-re:s k ~~ Zip fV'1 CONTRACTOR ~ tJ~ - 9r/ h.4~~. ~..7'7~tJ:1 ~ Name Address Citi'f {/ Zip O,S, REG. II 11t/t/y 'lWp. / 7 Range-!''?, CONSTRUCTION ~ CllANGE OF OCCUPANCY CJ Phone J 9'.3- Y'..2 ~ 7 Phone Section ~.;;. 1./. 'I Tax Lot t..;J 0 0 Code /' ?-r:?1 Census Tract ~ 1- 3 0 ~ , Property Acreage ACCESS TO PROPERTY (Road Name) ~~f12J). / /J /.1"'.. I Existing Structures on Property: ~ Ad~p~G2J). / / Below fa r Of f ice Us e On1 vXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX Sq. Ft. / UBedrooms Valuation ~ y. ~-~. JI.A?:I-, r:,~.:T- //a/? /l/l an...LJ..Jlbl? - ~ 'P!:.. / / 1 . V I / Subdivision - Lot Block - Width______Depth Property Location - Address/Directions: .~,,?,? PLUMBING: Installe,\ by Owner PLUMBING FEES: _____ 0 of Existing Sewage Disposal ~stem Public c====J communitl f'7l d / Fixtures / J ~ or New System Required [=:J SEWAGE DISPOSAL: Site Inspection # WATER SUPPLY: Well Spring ______ Other Name of Community or Public System (i?~~ FEES: Bldg. Plumbing 3% Surcharge Waste Disp. Plan Review Mobile Home ~~ TOTAL //00 Other [=:J Name Sewage Connection Water Connection PLANS FURNISHED FACILITY PERMIT //- aO /?::J .233 D CASH ~ [=:J YES iL'9- NO C:J YES iKI NO Signature of APPlicant-?A~J ~ Fee Received B;9-'7" ___ Date: /./9/.?',c Min. Septic Tank Capacity Drainfield Required - Lineal Feet Haximum Depth Type of Construction Group Fire Zone Use Classification BIdg Setbacks - from Center of Road Right of Way: Fran t Side Int. Side Exterior Rear Zone PlANNING: DATE: SANITATION : DA~' ...... BUILDING: . ~lD~S !" 0, . I ENVIRONMENTAL MANAGEMENT J1I~: '~J.'')I) C55-12 LANE COUNTY DEPARTMENT OF r ./ ,. : \""~"."'(\-1l\J2'WJ... '\ Cl \ : ,':, .Je: -;., \. ' ;', 4i .. , .;; <'\' j:.' \', ".. . y- \' '.. :. '. '.' ,/ rO .1'\. .. ~ . : 7 .':",., . . '. ' 'L \:, '1"1~"4"""''''' ""'" I \ '. @ --.-......."'.~':.AVENUE ",...:'::'.:; 3000 : KIRK _.._._ ,,__ \ 4200 , .....L-----TJ J --;.~' 5700 . .... \ " :'~200 . . II . f ;-;':'..., . ',t' 4 '~'d;'- :: r 6:'.00 J < . \ . . '. ., I . _____..~IL_____ -\ 1 .., 6100 t " r, " <. .. ". " ~ , , .. ;-+- on .~. , .,' N" " i20Q I H . 1 ( t, I \ 1 . ~ ..~. \~~OU ,--~:':~. 6000 . , '; '6400 .......~.~-i <5600'" \ I I i ~~...;-- !9' .. ''':;-!i-~- . . " -- ',' " .- ...... 4400 .\~I , i ' ..J . , \ 5500 . . . \' \ : . ..... .., U,.!-- . ... . \ ~'..l,,-. r...1,;'", ..... .. ....~-!.~ .. - 6500 5400 . :.\: 4501... , o ~ o 0.:: ....... -, .., ,..~. 6600 . - , . ;;OO~.... ' ''''+_ ',.,,~.. . ,.If6':F'Z"'" ~. -, 510~ t l,4W'JI1L'~'~ '~ \: , ~_......- "...- '^ ~...:~...... . 5104 ~ ~ ~1r-/:""AZr........ , ....u... ~r. ? ,,_ ._*" .. ...:~.or- t' t."!.' ~~.P ~-"_ ,......~ 1~'1 ., ~\ .";;~-'" ~ .l!-.:, 1~' 5102 I ~- :0;;'" .. __.1 ""....,.,., ~ ~r. 4ido \\ -:i 1.4801 _ \1 'I Ii - . ,-N'fg<~-". ..$ ~ t,4601 I ~..- : ~ 1 ., I \l!:~.~ ~. .:.; ~:.OOO' J u, ~800 .. ~ ~'.. , ~I I !. .\' ~ i\; ,,: I ':1 '" u'1\,.~ 'i~. -"~ J \ , .. ..... . ~ ... .., 6700 ~ ..... . . ; ~ G800 .- I \" . ~ ~~"'6-'H''';:; - .-:';i~ I. , \,1 AN"U" p.,-- ".,' >-,.- I- \ G'lOr) '2\. 7~)\' : '2 t 1000' "";';,;'::'" , ....-...r I \ ....... . SJ _ ____ : \." .L . '" .~ to.,,', ......... _._..1 ~"'::""'-', ..:.. '\ --. ....... ~\ .:':.~: ; , . -------:-7N-U- "'WlH".'Cr.o :0 Jocou \-...; ~'C: . OLe. No 4',- . - . . "- 7600 ,. 1'.1 r CU1IN';"\)' -- '-~--;------'.---'."'#' 7300 _2.,~._,,,, 7500 i ,.' 7400 I P- ," .. , " t")". ,'',-.' .~: jt=tJ\... 17301 I ~ I I ----' ,J ,.,. 1-_ ..r........-;:-.~ . '.' 7100 ,...... I<> .J ....... .. Se. i ~ , , :..~, ,.,.'.A. ~