HomeMy WebLinkAboutPermit Miscellaneous 1979-11-13
~~. -~'. -- .. . POST THIS PERMIT ON MAIN BUILDING AT SITE
! ... JOB ADDRESS:.:1Sf' ~~,et CONSTRUCTION PERMIT #
TRS, TL:
Subdivision:
I ?3~7 9
This permit for the referenced property is hereby Setbacks and other conditions of approval must be strictly observed. Violation can
result in revocation of this permit, citation under provisions of Lane County's Infraction Ordinance, and/or other remedies allowed by law.
Construction approved by this permit:
'ater Suppl~:
Appl icant/ Address:
Owner/Address:
Contractor/Address:
Contractor's OS #
PLANNING DIVISION
WATER POLLUTION
CONTROL DIVISiON
Setbacks
Interior property lines
A:Jge of road right.of.way
~uilding foundation
Wells, other water sources
CONSTRUCTION
PERMITS/INSPECTION
DIVISION
Directions to Site:
Date Issued:
---
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Telephone:
Telephone:
Telephone:
Total Construction Value:
,- . ~
# Bedrooms;
# Plumbing Fixtures: ;)..,
# Employees:
Zoning: Partitioning # Parcel #
Minimum required structural setbacks, from: centerline of road, front:
side exterior: ; interior property lines: ;rear property line:
Special Instructions:
Parcel Size:
; centerline of road,
For information call 687.4394,
Site Inspection # Installation specifications:
lineal feet of drainfield required; max. depth of trenches:
Special Instructions:
gal. min. septic tank capacity;
Septic Tank
10'
10'
5'
50'
Drainfield
10'
10'
10'
100'
For information call
, between 8:00 . 9:00 a.m.,
Type of Construction:
Instructions:
Group:.
Fire Zone:
Use Classification:
. ,
For plans information call between 8:00 a.m. and 9:00 a.m., "
For inspections (see back of this permit) call 687-4065 between 8:00 a.m. and 5:00 p.m.
DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
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By:
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6ne county
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SLAB FLOOR
PLUMBING GROUNDWORK
.'
ApP'RO'lED n DISAPPROVEO Cl DATE
INSPECTOR
REMARKS
GAS PIPING GROUNDWORK
ApPROVED ..Cl 01 SAPPROVED Cl DATE
I'NSPECTOR
REMARKS
ROUGH PLUMBING
ApPROVED Cl DISAPPROVED
/7 DATE
~__I-'7if /f1J
.. l.
INSPECTOR
REMARKS /riMA,
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ROUGH.GAS PIPING
ApPROVED Cl OISA,PPROVEO Cl DATE
INSPECTOR
REMARKS
r I NAL PLUMB HJG
ApPROVEO /~ DISAPPROVEO Cl DAT~J';f~I'~~INS~ECTOR____~
REMARKS
FINAL GAS PIPING
ApPROVEO Cl DISAPPROVEO / / DATt
INSPECTOR
REMAR"KS
CERTIFICATE OF OCCUPANCY
REAOY TO ISSUE Cl NOT REAOY TO ISSUE /7 DATE
INSPECTOR
REMARKS
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