HomeMy WebLinkAboutPermit Building 1977-4-28
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LANE COUNTY PERMIT
Acreage or Lot Si7e
Contractor's O.S. #
Partitioning #
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Subdivision
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Phone
(owner, etc.) when ready.
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APPLICANT'S NAME AND ADDRF""
OWNER'S NAME AND ADDRESf: I
CONTRACTOR'S NAME AND ADDRES"
Mail permit to ( I Applicant ( ) Owner
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) Contractor. (L-).Prefer to pick up. Call' - ~'{.'5 -. / _'i '/
. .TRUCTURES NOW ON THE P~OPERTY
THIS PERMIT IS FOR '--
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# BEDROOMS_# PLUMBING CONNECTION&...._
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WATER SUPPLY. .
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THIS PROPERTY IS WITHIN ONE MI LE 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 $ ;:;:' '7. t - S' 5t>g3:z.. Signature' Date
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) NEW ADDRESS ( ) FACILITY PERMIT TO TRANSPORTATION DEPT. (1/) SPECIAL PMT. AREA. MIN. ELEVATION: iI', ';'/ d,,,V
.. Comments:
Minimum Septic Tank Capacity (Gallons)
Drainfield Required - Lineal Feet
Maximum Depth
BUILDING
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Comments:
r.roup
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SANITATION
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By: Date:
PLANNING REQUIREMENTS SATISFIED. By:
ZONE: :%.' -r- SETBACKS: FRONT / ,". '
By:
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Date: . I .r / / t Date Issued:
(FROM CIL) INT. SIDE YARD :,' REAR
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SIDE FACING STREET
(FROM PILI
LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE., EUGENE, OREGON.97401
POST THIS PERMIT ON MAIN BUILDING AT SITE
PHONE: 687-4394
C55-'3
BLDG. PERMIT - WHITE; BUILDING - GREEN: PLUMBING - CANARY; SANiTATION - GOLDENROD; OFFICE COPY -WHITE
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APPLICATION # '1;74-17
Name
Address
Zi P Code
The above application is being held by the Permit Processing Section for the following
reasons: I I r 1 I ~
Un COlier g€P1,'c... +o..v-..~ +0(' bCO- 1"/01" -
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Division:
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Date
Si gnature:
Division:
Si gnature :
Date
This application will be held until , If the information
required above has not been furnished by that date your application will be cancelled,
Fees paid for waste disposal systems (site inspections and/or applications to install
the septic tank and drainfield) are nonrefundable, Some refund may be made on the
building and plumbing portion of your application if cancellation is necessary,
In the event a Planning or some other long-term problem exists over which you have
no control we will hold the permit until the problem is resolved and we receive word
from you as to whether to proceed with permit issuance or process a cancellation,
PERMIT PROCESSING SECTION - 687-4394
C74-139
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APPLICATION # 9;7'-/-17
lane couI':)ty
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Name
Address
,I Zi P Code .
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The above applicat~on is being held by the Permit Processing Section for the following
reasons: '\7k) /
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Yi (over- see ,',- I~...... + Or
ddiLuJ - tj~;;O " ^ _
'-7n/IA (;:~" it&tfJM./~ j-tf uP- '.v
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Di vi si on:
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Date
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Si gnature:
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Division:
Si gnature:
Date
This application will be held until If the information
required above has not been furnished by that date your application will be cancelled,
Fees paid for waste disposal systems (site inspections and/or applications to install
the septic tank and drainfield) are nonrefundable. Some refund may be made on the
building and plumbing portion of your application if cancellation is necessary,
In the event a Planning or some other long-term problem exists over which you have
no control we will hold the permit until the problem is resolved and we receive word
from you as to whether to proceed with permit issuance or process a cancellation.
PERMIT PROCESSING SECTION - 687-4394
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C74-139
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