HomeMy WebLinkAboutMiscellaneous Plans 1978-10-10
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. APPLICATION
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I :WNER (IF DIFFERENT'
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MAIL COMPLETED PERMIT ;0 ....PPllCA~WNER/CONTRACTOR (CIRCLE
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CONTRACTOP
I. PRESENT USE OF 'ROPERTY (r..ldentlal; l'fplt of forming: tomm.rclal or Industrial: vacant; elc.)
2. OESCRIBE STRUCTURES NOW ON THE PROPERTY. NOTE ANY STRUCTURES TO BE DEMOLISHED.
3. IMMEDIATe PLANS FOR THIS PROPERTY (THIS APPLICATION) ARE:
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... FUTURE PLANS:
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PHONE
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PHONE
CONTRACTOR'S ORE. STATE LICENSE
ONe) 0 PREFER TO PICK UP. CAl'
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Sketch (Al oil rood_ (8) boundaries of property (e) elCiltlng/propos.d building. (0) exilting/proposed .ewe"" disposal areas (E) edlling/proposed
driveway. (G) ea..ment. (HI dralnageway., .treams, creeh, any other, pertinent feoture.}, If commercial or indu.trial, .how Iree.tanding .igns. pork.
In; areas. INDICATE DIMENSIONS, _
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5. PLOT PLAN,
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j. SITE INSPECTION TEST HOLES READY (DATE)
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9, PROPOSED WATER SUPPLY WELL- SPRING STR~ LAKE- PUBLIC:
10, ElECTRIClTYFURNISHEDBY _ _~ IJ A -
n, NATURALGASBY JJ,nf"''1~f ?1~~J /.,.~
12. fiRE DISTRICT c::; ANr ., ~ t. b
13. SCHOOL DISTRIC; ~ ..)// II
U. PLUMBING BY L.. ~"IJ;,I'A
6. TOTAL LOT SIZE OR ACREAGF
8. METHOD Of SEWAGE DISPOSAL
BEFORE YOUR APPLICATION CAN BE PROCESSED YOU MUST FURNISH:
A%,,1l PLOT PLANS
(DIMENSIONED)
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BY
nATF
EGAl DESCRIPTION
LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
0...171
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
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