HomeMy WebLinkAboutPermit Building 1974-4-25
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LANE COUNTY BUILDI. PERMIT OR MOBILE HOME USE eLlCATION .
PERMIT TYPE - BUILDING'2< MOBILE HOME Dose REG. # PERMIT:#: (,..,05'- 7"1
rPR7!-~ ~~AI~~Z~:~H--<- ~~~4. -?:z4~N?35(
CONTRACTOY ,/ MAILING ADDRESS PHONE
I PROPERTY LOCATION -INCLUD&~
,
PROPERTY LEGAL DESCRIPTION
LOT - BLOCK - SUBDIV.
TWP RANGE SEC.
I, II D.'6 Q~,~.~.
APPLICANT. ~ t.K~
NAME I';;
AND /lT313y ~6 /
;~:~4);PAY/~/
- FOR MOBILE HOME PERM1T ON~
Number of Bedrooms
STRUCTU}fS JO fE BUILT THIS PERMIT
IfrlCJA '-/-, l5V\
SEWAGE DISPOSAL
PUBLIC IZ1
SEPTIC TANK ""h!!
fJ (~_--
FEES
Srcl
\~ clt
hQ ,I o-v.) .
hcv<:.;'P
t91A.
METES & BOUNDS 0 YES
ATIACHED 0 NO
TAX LOT #
f:,7cm
CODE _ '7 CENSUS TRACT
01 Cf-cw .2 I-I f)"t.1S
DESCRIBE EXIST~f(;~S ON PROPERTY IF ANY
ut ~
LEGAL ACCE~S TO PROP~TY ~AD NA~ O~ #
(~\'n:P _ ~ My\ Kd...
PROPERTY SIZE-WIDTH DEPTH AREA
Connect to Existing
TYPE CONSTRUCTION
:?Q X 1'2-
Sewage System D or New System Req. D
SQ. FT. "# BEDROOMS VALUATION
;2b4 6)_12-. 31 {''T
OTHER
PLUMBING INSTALLED BY
OWNER~ OTHER 0 NAME
PLAN"S FLrRNISHED FACILITY PERMIT /'
YES l'l( NO, 0 YES 0 NO &:,."-
___ SI~A.!UREY AP~~ / DATE
CJ. ~;7R'.....f7~d----./
FEE ~ED~ Q(L. li-I b -7DtJ
PERMIT # I
/
/
BLDG.
WASTE DIS.
PLUMBING
PLAN REVIEW
PARK TRLR.
OTHER 0
WATER SUPPLY
PUBLIC k
PLUMBn~.G)'EES
3- FIXTURES~ 3
$.
q.-
TOTAL
3t;. -
CASH 0 S~
CHECK ~NNECTlON FEE
PUBLIC WATER
CONNECTION FEE
=
COUNTY BUILDING & SANITATION SPECIFICATIONS
r
MIN. SEPTIC TANK CAPACITY
WITH DIST. BOX: GAl.
L1N. FT.
DRAIN FIELD REQUIRED
TRENCH WIDTH FT.
/
OR SQUARE FEET
PwT 'VJ D r~n. +- D~
YJ".l<~
TYPE OF STRUCTURE
.bIV
OCCUPANCY
/
BLDG. SETBACKS - FT. FROM CTR. OF ROAD RIGHT OF WAY
FRONT ~4 S SIDE INT. S SlOt-fl:'.
E: .,:!fi'L~
COPY 1 - OFFICE
COPY 2 - JOURNAL
COPY 3 - AUDIT
Ilrrrrra... Form # CSS-12.
~n .5;/
/
/ /
~ZONE
J ~ USE CLASSIFICATION
REAR ~ /1
Date BLD 'pN' '.... ~ J 12. # / P Date
'1-/7- 7 r? ~ ~ L/ -:..2q-;.. 7~
\ f /
Ct!l"".J . C\l.Jed-
REAR YARD
PUBLIC UTll. EASEMENT