HomeMy WebLinkAboutBuilding Miscellaneous 1978-10-5
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LANE COUNWEPARTMENT OF ENVIRONMENT~ANAGEMENT
~ 3' 125 EWr 8TH AVENUE, EUGENE, OREGO.01
~~N~~ISI~:ent ~in9 C<-A m
Partitioning' []pendinq [JCompl;ted
Parcel No.
AVERAGE PROCESSING
TI""
Partitionina Reouired
Other 1
4. !lATER POLLUTION CONTROL
~ New Slte Inspectlon(a)
60S Construction [] New
Number ot Bedroom81
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o Repair
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Other ~~ ~
I ot Employees
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CONSTRUCTION PERMITS AND INSPECTION
(See above tor . of bedrooms/' of employees)
o :~obl1e Home $
o Permanent
o Temporary
o Renewal
~ruct:u'1.e \ Sq. Ft. Valuation
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~ Total V,lu~tion
~ Plumbinq fixtures at
Sewer !Water Conn. ^t
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r:ach $
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Subtotal
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T ~ \. \d::'l
.\ State Surcharge
Plana Check Fee
Change of Occupancy
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Address
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TOTAL BUILDING PERHIT FEE
MinimUfll .tructural setbacks: .,
FrOM centerline: of street: Front ~~ I
Exterior Side ~S
From interior lot lines: Side,~ Rrar ~
[] Comm'l plans 8~et to applicant [] Curb ~ to applicant
PUBLIC LAN~ddress ~nlmum Elev.tion
PUBLIC WORKS ~aCllltY Pe<mit
EINIRON><ENT~E'LTN (''t. ~
Ch.C~'- " ~C'd -bY\_"- \!\f.\ TOTAl.
AFFIDAVIT: It this permit is for an agricultural building, I hereby declare that this building
will be used for agricultural purposes as allowed by %oning and/or the State Building Code, and
tor no other purpose. I further certify that the statements and other information submitted on
this app~'~~_.'~~ e true and accurate, and that I have the following legal interest in the
property -A.ovner f recordl contract purchaser; lessee; holder of an exclusive option
to purcha r y authori%ea-to act for a person wno-has the !OIlowing legal interest:
; or that the owner of record is kn05'ldgeable of this
application, if I am not the owner. .f furi}her a ree t{;"c p~y 'th all appl cable codes rell!lti.n9
to this permit. / "/ /
Date \Cy ~ Applicant' s Signature AL.l. _. h./.I"'t1.
1 THIS IS YOUR RECEIPT, AND DOES NOT GIVE YOU PERMISSION TO BUILD.
POI'. INFORMATI ABOUT THE PROGRESS OF YOUR APPLICATION, CALL PERMIT CONTROL. 687-4357 (687-HEI.P)
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Ca.h
~ne county
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C74-170