HomeMy WebLinkAboutPermit Building 1977-2-25
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JOB LOCATION
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PERMIT # 308-77
Bpri~gflelcl Oreryon
TRS, TI
LANE COUNTY PERMIT
Acreage or Lot Si?~
Contractor's O.S. #
Partitioning #
) Completed, Subdivision
Lot
Bloc~
APPLICANT'S NAME AND ADDRI'''''
OWNER'S NAME AND ADDRESS
CONTRACTOR'S NAME AND ADDRF"<:
Mail permit to ( ) Applicant ( ) Owner
JC'hovahs Uitnesses
Sane
u~c::r- lI13U.!.
Church
37 GaEJe Pari" !',;:: Springf. Phonp
Phon~
Phon~ 7"'J-':j0'l?
app.u.c.'1l!1T: (owner, etc.) when ready. "
STRUCTURES NOW ON THE PROPERTY
. Porcer
HIS PERMIT IS FOR
) Contractor. (;t) Prefer to pick up. Call.
,Tchovah niblcsses Chu:cch
~c~anicGl OYBtc~ only
# BEDROOM<:
# PLUMBING CONNECTION5--
WATER SUPPLY
THIS PROPERTY IS WITHIN ONE MILE OF THE CITY OF
WI
SEWAGE DISPOSAL
'11\
S.1. #
1:0
. 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. ,
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Fee Paid $ \. " ". 3~ Signaturp _7, .' ,.; .' 'j/ Dat~ ,,../ /'/ y, I:
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( ) NEW ADDRESS ( ) FACILITY PERMIT TO TRANSPORTATION DEPT. ) SPECIAL PMT. AREA. MIN. ELEVATION:
amments:
Minimum Septic Tank Capacity (Gallons)
Drainfield Required - Lineal Feet
Maximum Depth
BUILDING
Type of Construction
-. Ilse Classification
Comments:
r,roup
Fire Zone
SANITATION
By: Date: By: - Date:
PLANNING REQUIREMENTS SATISFIED. By: ;: Date:_~ \ " \"-..1 l Date Issued:
ZONE:..... -..[. \.. SETBACKS: FRONT SIDE FACING STREET (FROM CILl INT: SIDE'YARD REAR
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LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE., EUGENE, OREGON 97401
POST THIS PERMIT ON MAIN BUILDING AT SITE
lFROM P/L)
PHONE: 687-4394
C5S,13
BLDG. PERMIT - WHITE; BUILDING - GREEN; PLUMBING - CANARY; SANITATION - GOLDENROD; OFFICE COPY - WHITE
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BOLD
lane county
ca
SLIP
APPLICATION #:jo8-11
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JettovAH"'.;. \J.)ITI-le-s<;,~ cl-\\J\2C.t1 Name
?I &A.Ne FA-e.M ~ Address
S P\'2.1 1\.)(.., 1"1 F::I.I'>. ()~~ N-
Zi p Code
.A--TTf"=r-rnoH : (2\Gt::- f'AVL
The above application is being held by the Permit Processing Section for the following
reasons:
-P12O\)lpe -::,.t-A~Mg"HT ~M -trzU'7C:; MA(JVFA-C--rutZfH2..
\J ~e. \ F'f ( t-J (0 TUZ lJ C; C; ~<? 0t12 r:. ~6\' P f-\ B L G' .0 r-:- ..;. ()7 TA-tt+ I1J b
P6~~v)\;,ce.... LOADS 612. c;uBf\.I.lT LOI-J7T~ULTlON ~AIL.S.
?rto()JtN0 ^,Ie:n-IOD CJF (:::>(c.:,-rt2.IBUTlN~ u(JAD-? TO
"'::>F--U ~S2-AL -r/2.U <;,s.es.
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Divi sion: ~\tz.~C-TlO'H -P~fJ.I1'S ": I tJ:>\--c:... I
Si gnature ~\ \ \ +ttJTct+, ~ Datel-/zr;h7
Division:
Si gnature:
Date
This application will be held until 3'-10-,7 . 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 septi c tank and drainfiel d) 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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