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HomeMy WebLinkAboutPermit Building 1976-10-18 ,'Y ,~. y' CONSTRUCTION [] MOBILE HOME L>]- PLAN REVIEW [] CHANGE OF OCCUPANCY [ ] d __ --A/ a",_~ /I!?/- .ctP._/~, _ A. U 9~V~.p ?<M:_."... <?/.:/ (J" -- - NlME I' --.. -' ---- ./ ADDRESS.....' r:J" CITY If' ~.. ZIP CODE' -PHONE o Contractor ~- " 'N'AME ,.,.11. q, ;; \\:;:::~A LANE COUNTY PERMIT FOR:,,': /"1/7 PERMIT NO. S.5?j"7t, DOwner ADDRESS CITY ZIP C:ODE PHONE O.S. Reg. # Tw~ " ..,. Range -,,>11 Section ..::r ~ Tax Lot /.~. rP~ Code Census Tract Subdivision Lot Bloc~ Acreage /11'." r" Width Access to Property (Road Name): rc:::. ., "_ ~ - , ~-~ - .B-h~ <57C; Depth Existing Structures on Property: A/~_ Directions to Property - Address: ~., ~ ,"f/.? _/...... p."...~ E.;.--- h_ _. /~J_ _~_;:/ /.:. 7'J'~,,:- ,//::- i./__./., ~__ ~>~"L_ STRUCTURE (# BEDROOMS) SQ. FT. P~-k ~A/"/_ /._~_ .9~/~ ~? /1./) -,., - -... . / - , ,; ;"..,. p/ /. VALUATION ""'T',,::-___// t"!'" ^ ~ SEWAGE DISPOSAL: ? 6' &. /"iJ PUBLIC l J SEPTIC TANK 1M OTHER l BUILDING PLUMBIN" 3% SURCHARGF MOBILE HOMF WASTE DISPOSAl PLAN REVIEW ~.,., - PLUMBING INSTALLED BY: OWNER [] OTHER l) NAMF WATER SUPPL Y: PROPOSED [ J EXISTING [J ,-:IF'> /1,( f>l' PUB L1C [ J COMMUNITY - NAME: [ ] PRIVATE WELL [ ] OTHER - SPECIFY' /R... /.... .-9 ~ TOTAL @ / 352 CONSTRUCTION PERMITS & INSPECTIONS AND WATER POLLUTION CONTROL SPECIFICATIONS MIN. SEPTIC TANK CAPACITY: GALS.j I'M r) MIN. DRAINFIELD "J () () , , !" "'_.'" ~~..:.L _ ~"....t I .../":.4..,,...... -,......,_1<\11 ;,'1..' J'.~,......- I.lJt'~lC- L1N. FT. MAX. TRENCH DEPTH t+1 ,... // P,",.I"'. " r I? 0, ..', .f? INCHES 1/ "'.. A l.nr d 7,',J.AJ ( . . TYPE OF CONSTRUCTION GROUP FIRE ZON~ STAY 100' FROM ALL WELLS USE CLASSIF. SETBACKS - FT. FROM CTR. OF r!W: FRONT <{""n SIDE EXT. FT. FROM PROP, LINE: SIDE INT. .... REAR c;- ZON~ '2::"'~ n BLDG. PERMIT - WHITE OFFICE COpy - WHITE IMPORTANT'. COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENROD / ISSUANCE DATE: 'o-.-f/ Jt.._ t:-;--;;.~ _ /eJ// :9' /~_ " '-,...I - I' ''/ , - Call 687.4065 to schedule all required construction inspections. Call 687-4061 to schedule all required septic system inspections. All construction shall comply with the State Buidling Code, D.E.Q. standards for subsurface sewage disposal and the State Plumbing Code. All buildings require a certificate 01 occupancy before being occupied. AUTHORIZED SIGNATURES: Isl (r-:;"/..fX ~, _~ ..., - ,~- (See Details on Reverse Side) (POST THIS PERMIT ON MAIN BLDG, AT SITE) C55.13 LANE COUNTY, DEPT. OF ENVIRONMENTAL MANAGEMENT COURTHOUSE ANNEX, 135 EAST 6th, EUGENE, OREGON 97401 1'- .. SEWAGE DISPOSAL SYSTEM RECO. ' " to signature and submit bot opies with application. . PERMIT NO. /I1P S0I9- 7/'.. PROPERTY ADDRESS JUit ~ j'tuJ' ~ {tixi G-A/'A 'fJ.- F Arv.^ R n . Water Supply Publ ic Other-List W;;:'/- t- Gal. Capacity /5 tJ 0 INSTALLER: Complete PRAED top part o~rm Septic Tank: Ft. from well Steel D I D () -r Inside Dimensions: Ft. Lenqth Width Diameter Depth OWNER /1') NAME (J.~ ~~ bL=:2~.-.-..L (1- I" hi /J Feet from MAILING /X"/..~I1~__//f._..~~, WEll /00""- , , -." 'I.'.' ,..",... ADDRESS 0 / /. .4.d/ ~. Lot L i.ne ~~ ~~ ~ f?Y..?.? Front Length of IPnes-Ft7/lTrench I Total Sq. I Ft, Between Ha02/Db3. 4, 5. 6. Width2. Ft, L./{J () Lines 10 'lot Plan (see instructions): INSTALLER'S NAME T /3-1) SO P-rEL. E:AJ" No, Living Units Bedrooms Baths II> " 1't I ~ "- ~ I" {~i'lll" ~, 1$ \\V, ,"Z) 'I , l'3 , (;:-1 ) J, r' \ ) ,'l> I /~ 'J t.ldJ '( /)1</ IN t> l( Date NOV. Ib- 71, Basement Yes No Concrete ~o, Compartments Tile Disposal Field: Distribution Box: Yes ~ No Other Distribution-Type ~ Foundation Side Rear IFille~ IFiller Depth (Filler Below Tvoe / '3- Above Ti le.2 in.ITi Ie 6 in, wf5L-J.- T\)tJ~ {}lI~/l. f IJO.Nl)f</lt!} /, . ~ ./ ~ J...... ~ <:::> ~ r. br""\~ L1 rOI"l' If-D j lJo v ~\, f' RE,CEIVED ~ .---..-.,- NOV 1 'l1976 ~g CQUNTY ~VIff@NMgnAb MGMT. _.J .... Gt:Jt S i_qnature!r#~AI f ~;:(Tj/,.-.-. CERTIFICATE OF SATISFACTORY COMPLETION ' , 11 ~O J- For Sanitarian Use Only: .. Date: /1---t-7 I n accordance wi th 1973 Oregon Laws Chapter 835. Sect i on 2,14 thi s cert i f i cate is issued as evidence of satisfactory completion of a subsurface sewage disposal system at the above loca~~~. Approved: System Installation conforms to current standards c==J Disapproved: Does not conform to current stan~ards Remarks: C55-11 " 4 5-;!nitarian's LANE COUNTY STATE OF OREGON DEPARTMENT OF ENVIR'ONMENTi\L QUALITY .. ~ I , c,.. .