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HomeMy WebLinkAboutPermit Building 1977-4-28 -" v . ,"'" ..... ~ ., , "fRS, TI . PERMIT # \ J 7- :!; . I .,." . I, l'll~r JOB LOCATION. / :!~, ~. . J' ./1 ..1 1'1 , . I:' <1. ~_.: .. ..... 7'// LANE COUNTY PERMIT Acreage or Lot Si7e Contractor's O.S. # Partitioning # .( ) Completed Subdivision Lot Bloc~ '. ../o.!.!/. J , ,--;-','1 . /;r Phone. . "-t, . Phone / (/r- ,- Phone (owner, etc.) when ready. / ../t ~ r, '1'1- ." ~ APPLICANT'S NAME AND ADDRF"" OWNER'S NAME AND ADDRESf: I CONTRACTOR'S NAME AND ADDRES" Mail permit to ( I Applicant ( ) Owner , .' " - 'r /_ / .' ,. , I" "~'.. . .. ,... . . " / ,_-r- r ) Contractor. (L-).Prefer to pick up. Call' - ~'{.'5 -. / _'i '/ . .TRUCTURES NOW ON THE P~OPERTY THIS PERMIT IS FOR '-- , . . _ ; J- 1 ,- I .~./ .. I " I ,', i j # BEDROOMS_# PLUMBING CONNECTION&...._ I " WATER SUPPLY. . , . SEWAGE DISPOSAl / r-;- '. '- .J S.1. # 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 , L...., ~ ) 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 -' ,Type of Construction J , "-/ . II CI 'f' . u' ..,.~ .J se assl IcatlOn /'j ~--:+~/./-f"':-lA Comments: r.roup '? . ,./..-e ?---1.__ ..._..~ SANITATION -' Fire Zone......:"-"",_ ... . ," ",{.':"G,>"::!" ~~ By: Date: PLANNING REQUIREMENTS SATISFIED. By: ZONE: :%.' -r- SETBACKS: FRONT / ,". ' By: I!~- ~ tot -_ Date: . I .r / / t Date Issued: (FROM CIL) INT. SIDE YARD :,' REAR , -./ ..../~? :'-o,//.f_" ,Date: , ::' f. ""1 " \. t- 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 \ ......... ~ . BOLD ~ . SLIP bne county - 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" - f!;d6-J - t.f - ,J-D , crnM t'Lbif:-~~ ~~ =1~ Division: LuP, ~~ 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 ~ WI . BOLD , . SLIP , " APPLICATION # 9;7'-/-17 lane couI':)ty - "'" Name Address ,I Zi P Code . ,.. \/',,:' /' "- The above applicat~on is being held by the Permit Processing Section for the following reasons: '\7k) / U + I~. (' '" bCCA.-l'f;",. Yi (over- see ,',- I~...... + Or ddiLuJ - tj~;;O " ^ _ '-7n/IA (;:~" it&tfJM./~ j-tf uP- '.v ~;c.-.-t/j :;t~ Di vi si on: Lv ,p. ,,,- \f\\l. \J Date " Si gnature: ',. , j ,'. ", 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 . ,..,.-