HomeMy WebLinkAboutPermit Building 1973-5-4
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LANE COUNTY.~ DING PERMIT OR MOBILE HOMEWsE APPLICATION pet-r,.-.
PERMIT TYPE - BUILDING Di. MOBILE HOME oose REG. # PERMIT:#: 1?'tJO -73
PROPERTY OWNER MAILING ADDRESS PHONE
I( (.e b e.-L, Ch -e sr''!/e_ -12-1, ~ /'~ ;;2. SO r;. ~.
CONTRACTOR i5 _ 7;; __ ) MAILING ADDRESS /J \'
~~ U"\OT~- 41s-S-...L-z- (~~,~. 6..J";>-:JP'?J
PROPERTY LOCATION - ~N..-Cl~ PpST OFFICE -17
ovrA..e--er~ ~~ ~..(n F~az.o-~~'Uoz~~
PROPERTY LEGAL DESCRIPTION ~ METES & BOUNDS 0 YES
LOT - BLOCK - SUBDIV, ATIACHED :VI NO
TWP RANGE SEC. TAX LOT # CODE CENSUS TRACT /1
/7 ('J.3 ~::L 4DO-+-(;,('J{) ,~-,;ll( .;L(- '!i1)1c)!H-
DESCRIBE EXISTING STRUCTURES ON PROPERTY IF ANY -
f2.?r;, (R~ ~P'_t.."
LEGAL ACCESS TO PROPERlf - ROAD NAME OR #
-rlJA.....,~ ~;_ L-F-~ /2....9,
(..,/ -- PROPERTY SIZE-WIDTH DEPTH
?,
V
/02C -7.297
PHONE
,i'
APPLICANT
NAME
AND
MAILING
AREA
ADDRESS
fOR MOBILE HOME PERMIT ONLY
Number of Bedrooms
STRUCTURES TO BE BUILT THIS PERMIT
Connect to Existing Sewage System 0
TYPE CONSTRUCTION SQ. FT.
or New System Req. 0
# 6'EDROOMS VALUATION
(/)
CX~~r
'" /f._~ .?r ( /J ~. I
/ /" ~b >_'
LANE COUNTY SPKIAL PERMIT, ARFA
SEWAGE DISPOSAL
".n ' ,._ INSTALLED BY
OWNER D OTHER ~AME (s:<.,r:U f<:... -rc '-'
PL~S FURNISHED /' FACILITY PERMIT
OTHER ~ YESgl>.!" NO D / YES D NOZ
L') slmiA~ o~~7-3
)- ~ - - -,
- FEE ~/'
PERMIT # ,b- ?
/0 tJ 0 - ..3
COUNTY BUILDING & SANITATION SPECIFI~TlONS
MIN. SEPTIC TANK CAPACITY 1'1 , ~ DRAIN FIELD REQUIRED /
WITH D'ST, BOX, GAL ~ UN, FT. --; 0 TRENCH WIDTH FT,/ ~ OR SQUARE FEET ~ /0
~ ;t;;2~A".1...J Z-;;2t:./ I~.A/j-'~~.J r;d,/;!..J. ~
"f S"O# ~ ~f, (1 iJ1~) _ _ fJ>..- xnJ
r'^'01 ~~,~ iA>",rJv oJ} ~,.../l ~/ 'dv~,
TYPE OF STRUCTURE I OCCUPANCY -V jONE' REAR YARD
Rbi
PUBLIC D SEPTIC TANK K
BLDG. $
WASTE OIS. :20,0 rJ
PLUMBING
PLAN REVIEW
PARK TRLR.
TOTAL :1-0.00
OTHER D
FEES WATER SUPPLY
PUBLIC 0
PLUMBING FEES
_ FIXTURES
CASH ~ SEWER
CHECK r-1 CONNECTION FEE
DATE
.r:-~-7'3
PUBLIC WATER
CONNECTION FEE
.
...-:4:_~
,
I~
,/~~
PUBLIC UTIL. EASEMENT
BLDG. SETBACKS - FT. FROM CTR. OF ROAD RIGHT OF WAY
USE CLASSIFICATION
FRONT SIDE INT.
SANIT~RIAN A Date
~t{) /~AoA_ ~-~.'7.9
D., 'Fld P
Irectlons to In roperty:
SIDE EXT.
PLANNING
Date
BLDG. INSP.
Date
'L\)~: C00NH 3;~;:l..j......i. t'i::tMllj\RM
COPY J - OFFICE
COpy 2 - JOURNAL
COPY 3 - AUDIT
t \ F.,m # (55,1l