HomeMy WebLinkAboutMiscellaneous Miscellaneous 1978-5-7
~
Ecs'.clo
Surname
.,~ <\ t't. J.:Wl: .':V;.
." ,~t'4
Range Section Tax Lot Code Census Tract
I Date I Owner Owners Consent
Yes No
'i ....,. ~ ;) ~'. ~:
Receipt No,
5l:) G/A/V'V
f=' 0-- r VV\
THIS IS A PRELIMINARY REPORT WHICH DOES NOT INSURE THE ISSUANCE OF A FUTURE
BUILDING PERMIT, ANY PLANS OR EXPENDITURES MADE IN RELIANCE UPON THIS REPORT
ARE AT YOUR OWN RISK:
REQUEST FOR SITE FEASIBILITY STUDY
Name
and
Addresp
':it;;J "-.?'j)!,: !}. Bn:cc1o
:I.
No. Sites
(', '~'''''':;:'' ~-; # 0
~y.;..L.....L":':'~H'''';'''''..~. 'reo
,)7~77
No, Acres
TOTAL
$75.GO
$
$ 75oC~
ll.l5G ilc:...""'l!;:,J,::.i:g Dr.-:l'V'G
Sorinq
I Proposed Use of Property
l.1eD :l.clm:1CC
Name Ispec i a 1 Permi t Area I Urban i zing
Yes No Yes No
Is Property Within One Mile of a City?
What C i tv? Yes No
Other
Soecifv
Area
Telephone No.
Applicants Interest in Property
Property Size Legal Access - Road
:i.~ " S .:; r.U'Y:c~J ~~D~ F 8m !lODd
Existing Structures
20~r:c
Proposed Water Supply
Publ ic District
Well
Prooertv Location: (Directions)
APPROVED
g
NOT APPROVED
"\p~,~;n,(?J 9.10;:- (J~.,:):Jt!::2GCC UOW.:l130 cl~.o~ooc:!. in ereo of teet h~1eo :"0:;:' mco
.,.,,,,'; 1-1...", ,~,~o,..;.",..,.:; ",." "~o:!."Ir.:lA14 10 '.~ ,,-,. 0" ,....... "':""00" g'w.,'~(~ '".0
_...~"_.._~--u Loll:. ....,A............<;,.;\ _!...... Ilo:o.t. 1.. J. 4W "'" ..'"'......!:!~:I... t.;a..... :""-0,4 r. ....\io:.Wii.:I.___
C:'.~Z2l' t:.hO:l li..i'.::1 llws::.,h~'2d f~~C ~O t:h(~ ~:o~ of f:hc Y.':lVGl' ~c~~h.
.
OAR Chapter 340 Divlsion 7 Section 72-020 (6),
This report shall remain in effect until issuance of a permit to construct,
unless in the meantime conditions on this or adjacent properties have been
altered in any manner which would prohibit issuance of a permit in which
case this evaluation report shall be considered null and void. Technical
rule changes will not invalidate any evaluation report issued pursuant to
this section,
BEFORE CONSTRUCTION IS STARTED bring this form to the Department of Environmental
Management and make application for a building permit. If the property is a por-
tion only of .a tax lot, a metes and bounds description of the parcel must be fur-
nished. Exact specifications for the sewage disposal system will appear on the
building permit, Two sets of building plans and a plot plan will be required.
LANE COUNTY DEPT, OF ENVIRONMENTAL MANAGEMENT
135 EAST SIXTH AVENUE, EUGENE, OREGON 97401
.Jot"Ll :;:;?t,;.~~!:;,;_~;.;':'...;.i_~ 2..\.
Author i zed Signature -:,..!.. /.:
C55-32 B
Oate