HomeMy WebLinkAboutPermit Building 1985-8-14
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ane oun~ u Orlza IOn or:
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FOR OFFICE USE ONLY
Application/ '7--:::> "?// ~tp-'
Perm1 t # ---x"'( 7~ '1'-O...J
I SEc:;P~i31 TAXl? ?~;3
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~r~URES CURRENTLY ON PROPE~ ' ~ /' /
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.017 77/~ ~~<;'~/~ /.?r //0~.L/
~ESCRIPTlON OF PROPOSED w~ - BE SPECIFIC _ / /. _ - / _ L DECIfRED ~ VALUE
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= OF BEDROOMS -::::<? lit OF BT?9~/ .JI"'L I" OF ;~~YECS .......-1 \.JA1'ER SUPPLY /7 0 Proposed
'7\, //// /'V ~/?6' .~~/ z--r, ~xisting
07l~ND.ADPRESS <//?d-l/. --z::...- ~~ - /? .....-z,/";::::7J~TE4PHONE NUMBER
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I HAVE CAREFULLY EXAMINED THE COMPLETED APPLICATION f6R PERMIT, dr,d uo hcreuy certify that all information hereon is true and correct, and that I
have the following legal interest in the property, Downer of recol"d; Ocoll,:rat.:t;. PllrChaser;~thorized agent with evidence of authority attached.
I f-.:.rther certify that any and all wor); performed shall be done in accotdilncf: ...i th th~ Ot"d.1.uanceS of Lane County and the Laws of the State of Oregon
pertaining to the work described herein. and that NO OCCUPANCY ...ill be made of aT'j' structure without the permission of the Building Division. I fur-
ther certify tha.t registration with the Builder's Board is in full force imd effect as re~uired by ORS 701.055, that if 'exempt the basis for exemption
is noted hereon, and that only sub ontractors and employees who are71'n com liance W{1'th OR 701.055 will be used on, this project. I HAVE READ AND
CH IS APPLICATION THOROUG Y. /71 /1 d
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N~E (please print) SIGNATURE
""wmIP / 7 I RANGE t:73
S~BDIVISION/PARTITION (if applicable)
PROpOSED USE OF PROPERTY
~esidential 0 Industrial
o Cc.mmercial 0 Public,
v..eaoA!
DATE
READ THIS SECTION CAREFULLY. YO~R AU HORIZATION qAS BEEN BASED ON THE FOLLOWING CONDITIONS!
o PLANNING/ZONING: Zone ffd~on #I Parcel #I Parcel Size .#"M -
C c' /
L, front L. side .l.nter..l.or _ ./"7 rear
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Date, ,. r-F~/S-rrJ ~
, /
Minimum Setbacks:
CQlot\fENTS: ~~
K'sANITATION: S.
'1: .. Installation
Specifications:
......
1. j'
B. P. # Installation ,Record Issued? Dyes D No
Gallon Lineal Feet Maximum Depth
Tank of Drainfield of Trenches ~
PN~../,<::;./Js' C',t1.V~VJ 7f:~~~";'~~,.46. _ '~
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COMHENTS: ~
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, 0 PLANS EXAMINATION: Type
Group
Use
COMl-lENTS :
Date:
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PE~o1ED BY BUlLOINC"~rthL~~D NEE (oer ORS 456.805(1)) - DATE',
LANE COUNTY DEPARTMENT UBLlC WORKS LAND MANAGEMENT DIVISION, 687-4061,
. 125 EAST H AVENUE, EUGENE, OREGON 97401 '
SEE REVERSE FOR INSPECTION INFORMATION
C 14-25 R84-
Idne county
.
~
ACTI~Y INFORMATION eHEET
..,
COMPLETE THIS SECTION. INCOMPLETE FORMS WILL BE REJECTED!
1 --'k~ C4-/U- t;Jt J:r .1k~/GtV~
PERSON MAKING aEQUEST
N /7 M/Io..", .j/~
MAiLING ADDRESS
B'IIL'.'1 r!//@,zo.. 7?~1l!
ciCIlY STAt:( ZIP CODE
t/fC(- (,7/7 77'/ - 711</0/
BUSINESS TELEPHONE # HOME TELEPHONE #
2 PROPERTY ADDRESS ~?:Zt./.2 -1~",1"
(IF DIFFERENT FROM MAILING AUUKt5Sj
~.,., u %/p!ev
- PROPERTY OWNE~
72 q2 4"" e, h-rm K'n..."/
MA I LI NG ADDRESS
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PC~
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Sl"ATE
9:?y??
ZIP CODE
BUSINESS TELEPHONE # HOME TELEPHONE #
h.o',? P';.j) ~~4-( a
3 MAP & PARCEL NUMBER (from tax maps in Department of Assessment and Taxation
(REQUIRED INFORMATION) or from tax statement)
17 b3 ~2 / ,1 J?tf 00
TOWNSHIP RANGE SECTI ON TAX LOT(S) OR PARCEL # ZONING
"TOWNSHIP RANGE SECT! ON TAX LOT(S) OR PARCEL # ZONING
TOWNSHIP RANGE SECTION TAX LOT( S) OR PARCEL # ZONING
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP:
4 SUBDIVISION (if applicable) tf/l-/e/.,J I.dtJoJ LOT
, 0'
5 REQUEST (state exactly what you plan to do) FilA -.2~73
ACRES
::z BLOCK::2
~~rO"~/ a,c,rrt,-
6 DIRECTIONS TO SITE: 1Ia-rlc.u} ~~/ 'It'}
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** FOR STAFF USE ONLY **
ZONE/LAND USE:
BY: DATE:
TIME IN:
OUT:
NUMBER
-
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DATE
.
=!
LAND MANAGEMENT DIVISION / 125 E. 8th AVE., EUGENE, OR 97401 / 687-4061
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LANE COUNTY DEPl ENV t'iGT F:ECUF'T 'II' ~,~3248::) Di-HE 08i ::;8'
APPLICANT VANCLEAVE, DANI ADDR 1473 WILLAMETlE ST.,r:: UGENE. OREGON 1-'
Tl,,~' 1703221318800' SUBDIV 'LOT "'Ll<.
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OWNER NME MURPHEY, JAMES ADDR 3242 GAME FARM RD., SPRINGFIELD,ORE[ I~
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