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LANE COUNTY DEPT ENV MGT RECEIPT e 334479
~I ~PPLICANT HALVORSON, STEVEN M. ADDR 3538 GAME FARM ROAD,
JLI 1703150002704 SUBDIV
!!. NEL~ BLDG TYPE USE R NO BDRMS 03
CODE APPL NO ACTION DE~CRIPTION
~.r ADD. F Ai-IlL Y ROOM
:oF' .",'<~ . ."::.~.:..."
"
.
SPRINGFIELD, ORE,
LOT BL.I<
NO UNITS 001 NO STm\IES NQ BLDGS 001 .
SQ FT UNIT COST VALUATION FEE DAYS
517 35.25 18224
DATE 10307')
.
..,
.....",'.,1....;:,.
li.:
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.
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Jl_ MECH
1.<:110:
~LI~
L-L.- -.)w44 '19 l:~t:!;;',:<
NO, f. .LX 1 '.11",.. .
;,'",\'- ,
. ,~.....o.:..,t
t~C;.. 00
20 ^ (-/(1
-)
.
4
NG,
co:.mECTORS:
MEeHAN I U1L. FEE:
ST "j L~ SUf<CHARGE
PLAN CHECK I"EE
,.
_, .. '.\1\)
E(4Ch =
4%
50/:'
4.32
54..00
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SIFO
E..'"KEN BY
Eo.
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CPI
F<LH
WF'C
PLAN
ELEV AD DR
CmlPl..ETED BY
FP
ENVH
TOTAL F EElH
166.32 CI<
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t12 . . a
11.;
10
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BOLD
.
SLIP
APPLICATION #J.C..- '2,'2.A4-1~
:i:M~...~ m d1~J(" ~ ~ Name
",1.(\ . (,._. !\.,Sr,c__ Address
, II IN..CI""la~ r 1\Y ~~ q~
I - Ztp Code
The above application is being held for the following rea
G it20J ~ ?Ca\7LA~ ~ '\\-\E.. ~
~ A ~ AUDcr\()~ :It)
~ Cm\.Tl"~12..
~
bne county
CIa
'~'
?J..I,\LJY.S ~~
t'E'Qt-t..c\ ~1)U~
I 'l~ -n\E.. A.~ ll'\~Tltl~
\')...~l.l-1,\ 1\'E- \'li:::.~(\
~ .~ 1.\.I'C\..> Es;..~~
tsE. CANC.E~\:).
,?f:/'b ;rrr1tUfGV
ft/0q;O~&r;
consyuction P:rmits & Inspection Division
J7~ C\~ ClIY'<0. Date \'1--~-1'\
This application will be held until ,>r.-")...\-i.<\, . If the above information,
'or a response, has not been received by that date your application will be cancelled.
The CP & I Division has not received approval to issue your permit from the divisions
ind?ted below:'
(~Water Pollution Control ( ) Elevation ( ) Address ( ) Env. Health ( )
RETURN THIS HOLD SLIP WITH THE REOUIRED INFORMATION
For the status of your permit, contact
687-4394.
LOLD
.
SLIP
lane co~nty
-
APPLICATION # lL- 3~-11
~~~ t-'\ _ ~~"
- <;1Q ul. (^-\.----,t>.,,~
~G-. qi44:R
Zi p Code
The above application is being held by the Permit Processing Section for the following
reasons:
Name
Address
~\VD\N.{\ lR?~\.D~ at\.~E-~
Di vi s ion:
Si gnature:
~-
~ Date 1\-1
· ~~I)..nv"-l
Di vi si on:
~\'"'\" ~?~IM.L
I
Date \ l-1
Co%1-4'3~
Si gnature:
This application will be held until 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 septic tank and drainfield) 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
=
~fr ,,4 e
\~~,~<<~~,dl':::~iZ~S:t~g'T~,_e {1.-
W.\....>:~P.,f...;~.f&h..:.~J.f..L.'Q\V~Ki&~;.?;.g~~\t,:~~t..',gtt_; .-J.
~MrrL~ /~-O\-/~_.
Application for ,,-?.._~A"A/ / A1r/at:7'7~
S true tures now on the property ~'LI re_ ..
\fliPlmINln@!Li:!tH>t9li.iHs'tVl ~ tRtlll.\!!fultlM 0 i(:(liii!ilWtttti
Affidavit: l, ~~ .u_~. ~.. ';'-:J1f'1,,'!:"'....,
. IIIll~~lBtl
If this application is for an agricultural building it will be used for purposes allowed by the State Building Code and
Lane County Code Chapter 10 (zoning) and for no other plJr?Ose. I have the following legal interest in the property:
owner of record; contract purchaser; lessee; holder of an exclusive option to purchase;
~~uly author;z~ to act for th~wner, who ;s knowledgeable of this application.
Signature/Addres'-4~""-1 ~ .~70 ",'<.-T\. ~ ~-n-.c-- ('I.,.... (zio) 97f/s4r
Telephone --9',.- 7:"177 or' Date -'O/'Pn /~ ..
When permi~ rea~ 'Wi~: /~~jlIica'j 0 Owner yGtractor _ .P-~ tl Pho:' .
Owner d"'d?/~ f ~<~,JP~~.- ~p) Phone
Contractor S70 t..<?-!.L......., '='''"'- ~.~ ('I..,..., (zip) ./-.It; Phone '!t::J!f" -~r77
Contr.ctor's DSR# /O~r2 Plumbing by ~_ ",.qv,...... ~~_ (1......._
.. -,./
DO NOT WRITE BELUW THIS LINE
# of employees jf;iof1lfnlt:El
i~~Jll~"~Xisting. BP # Lf!, -/ ~SO -b?
I_I Proposed. SI #
Ii.m
!(o$~j
_-:r.~ .2..-r'
~--
J .J/h; }
DEPARTliENT OF ENVIRDNI1EIHAL 11ANAGEMENTe
PSB. 125 EAST 8TH AVENUE
EUGENE, OREGON 974Dl
~
t~l!~]~;-ff!.;1c{
liAjt.! '2. 7n '-4ira~k1
f""llCEi!lIh;Tj
/.L ';'~3?71'.;.7j
!M}l9R~aWijiifube1is:\
OW\<!Ml!t.!~
/~/ ~:1~
1 hereby certify that this information is true and accurate.
~:s~::::~:~~ltiJI{~~~~~ , ~
-
SI test holes ready
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~. ~ ~
~~~~~/~/
............."7 ~. ~A'.~ f;n ~
;' .", (~ ".....~/~ .
"A~_-='''' /Z-. "'".. ~
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,
". ~"":it'.-"_ '.'.~'-1
!$ll16tfl101i
t*;;6\t(Slie~i
- ~~9'~
02~t? fT
Valuation
Fee
.
- ,.-
5/7"
$
$
$
$
~~~
Proposed - Existing ~
Year Ins ta 11 ed
/
Total Valuation:
1.~i'~i'I~II'~l :~
$
$S~
$
each
each
$
$
$
$
$
$
$
$/ tt.32
Subtotal
4% State surcharge
Plans check fee
Change of Occupancy
TOTAL
=
....../1
-
Zone~... ./L-(;(t. # /Z/ //;
t. rr:;,;'!d". ...s;, f ; t, s;ie
~~ .'.,.
Conments y;t ~ "'..:=<<. :,...... ~ ,~m...:".~
To be typed on permit
PERMIT PROCESSING
Fire Zone
AAPa0cj4l # /t/,/'A Parcel Size ~~'tJ ' '" '
,. 4"'-" ,..
; lnt. ~-, ; re
/ .
f< It 0-.( v~""- &, ~ \M.~
. .......--:;JU. / \'
BY~///Y.
'Use -C~ification
~. b-d~-~
Date /4-..3%J-?9
Minimum setbacks:
CP&I
Type 5' - N
Group 12.- ~
'3
e.w=n
,
To be typed on penmit
By l,;--~~ Date /C~Z.7~7~
For plans information ca.J..l?(area . .Rectoy1 ~ .~. A~-I- '- ,Phone ~...., ...-
Di~ons to siter~..#. ...-_-' p;- . ':/ r4U..-.-/ ,~__..J 4'../#-- , ~-s./
~i-..("~'--~ _ ?~~ _4/~- ~?:"'.ft~;r~~~4':'--:"ft.;t!-~-~'
/-1 SIFD Plans t. CP&I _ set(s) Date Hold Sl ip '/ '-Date Date to
- WPC _ set'(s) Required to PCC Completed PCC
~ CP&I //-7 /Z-z'}-
/ ~ WPC
C7 Planning
o _~~ Works
~ ~evatlon ~/ nfa
C V Address
CI Facil ity Permit
I~I Environmental Health
FOR INFOR~~TION about progress of your application call:
C74-171 ~
\ ~ ~O.w
Permit Control Center
687-HELP
Ilo1,\g'
~
'OLD
(.1
'....~
SLIP
Idne co~nty.
-
APPLICATION # JJ"..- d:2, C) (j -79
~ /
V
/'\.
I
,
Zip
Name
Address
Code I
he 1 d by th/pe rmi t
Processing Section for the following
The above application is being
reasons:
fh &L jL:--:/ t!-(~~ ~~ ,C:i-it-~~ (
p-u::dt~. S f)s - '~I-/ ~{
t~j-11J'J/V '
Si gnature:
o
~~
f2-flO,&P ~
16?O-~
Date //-1- 77
Division:
Si gnature:
Date
This application will be held until 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 septic tank and drainfield) 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
"
.
DEPARTfiENT OF Ei-lVIROi~i~E;nAl IlANAGEl'lENT.
PSB, 125 EAST 8TH AVENUE
EUGEIIE. OREGON 97401
Job Address '7,\--r g /I > _
Township, Rang~ ~ctio~, 13; Lot ..,,-~,-
5ubd;vision /""} -,...,-0: - ~ <"' -:d
Appl ication for '~_ _.J, I / A/,,;;?>~
'Structures now on theiprop;;:ty-~ ~ .,.~ t
- .,., - ,,-
Proposed use of pr.operty: /tI'~esidential
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Affidavit: I. ~:."":1 (;r1asel~~:nl;.-:-=":"---"\. . hereby certify that this information is true and accurate.
If this application is for an agricultural building it will be used for purposes allowed by the State Building Code and
lane County Code Chapter 10 (zoning) and for no other pur;:>ose. I have the following legal interest in the property:
owner of record; contract purchaser; lessee; holder of an exclusive option to purchase;
_ ....,..,.::duly author;z1 to. act for :heJ-"wner, who is knowledgeable of this application.
Signature/AddresS~rr~~. ___ <-"V,'" ,~,,_o;n... .a::!...... l~ (*1~ (ZiD) 971/'4'
--Telep~on~ ~?"-_'?T'7~ or-_ -'. ~ate- - j~jJ.7~,/""'::
When pennit)J ready notify: LI Appl icant LI Owner l..d,.€t>i'it:ractor ~ ,~: /~/Anpl#, LI phone
Owner. /~.-~/.,;!? 4/6'h/ _:?_",-::j'.R .r::::"_,p,..._ -""'(llD) L./....",r Phone
Contractor - i-""'::-- ,: ~ -,.;:;'::'--';': --: --...,..- -::.-~:..: '--- - (liD) '4-1'./'7'v"( Phone -;''?? -7'r77
Contractor's OSR# /~4{<r;( ',- ~ Plumbing'bY -. //f":/. r::'l..." '..~_ ('l"",
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DO NUr WRITE BELUW rHIS LINE
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/~I Commercial
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If Commercial:
Residential:
# of stories
# of bedrooms -:?
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51 test holes ready
# of employees
Fee
Code Description .-.; ./ /.Af!-
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Year Installed
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Assigned Numbers
City
Lot
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{i Industrial
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# of units
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BP # /(1. -I &,50 -bf,
51 #
Sq. Ft. or Unit
# of Sites Cost Valuation Fee
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$
.~/.7? $
.4 Total Valuation: $ $
Plumbing fixtures at $ . .J) P- each $
, Sewer/water conn. at $ each $
Subtotal $
4% State surcharge $
Plans check fee $
Change of Occupancy $
TOTAL $ /;:,1..3?
PERMIT PROCESSING ~one, /' - ? /Cpfr:'?: # [ ./?.j(EL- p~ar;el # .~ Parcel Size .&..,,, -~I'$
Minimum setbacks: 1.. frat..:"" ."'C~ ' 1., side A_h.~.; lnt. c;?":;--/. rear~"'''''' n
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Corrrnents 4 O""'~z~,.,./.a. pr, :'M_/ .,:(A- Il.rr_.~rlI~'_(. \'-",M.MJ J,.\. IA.:;>". -~(J
To be type-:r~ ot;,;;j~-''^'--''''----' .~ ~-,' _'~n_ , BY' /~5/ 'oate..J /.4__::f>/?_~
WATER POLLUTION CONTROL /" / -/- . , - ,
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Installation specifications: gal. tank; ft. of drainfield; max. depth of trenches:
To be typed on permit
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oir:c~ns to site y #V/.af-:";,~. 'c'%_4~'.!---~ ~.-/ ~L-<,;p........,. ~~-!.~-/;f~-/
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)-1 slro Plans to:/CPSI _ setls) Date Hold Slip / Date Date to \
. ?\( wrc setls) Required to PCC Completed PCC
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t../ Planning
/~/ Pu~l,.;c Works
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CI. Address
/~/ Fac 11 i ty Permit
/~I Environmental Health
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FOR INFORt,1ATlON about progress of your appl ication call:
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Permit Control Center
687-HELP (687-4357)
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TO BE COMrLETEO BY '.ALLER:
PERMlr ISSUED TO:
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FOR USE OF SANITARIAI}-ONlY:
System apparently will ~. will not 0
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functi?f':I satisfactorily, and is therefore oppro,cd for OfCUp<IftCY ~ Di~(lppro,ed ~J
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Lano County. Oregon
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Contractor Mailing Address
locat;an al Proposed Bu;lding (and Po.. O'lkeh C!;::;:) 17= Clcc::l
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Existing Structures on Property? c::) I,f so, describ(::
Does property hove legal occeu? UCiJ If so, describe: " . ~ ~0l70 ~
logal Description of Building Site-Metes and Bounds ---C::~l:'l~ L!:l. ('~::.i:" f.,." ,St..
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Size of Praparty' Width Deplh Area
r: ' ... 10 ba built under this permit: Squaro I'oolaIJO Typo al COI1s1,uction
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Plumbing 10 be io' "lied by Owoer (
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Building
Soptic Tank
Sanitary Connection.
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SANITAnON:
COll.DlNI'iiif ~l\JJ~I!.IOl~~G ll:. SAI~lA1VONSPECIFICATlONS
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Septic Tonk: Miniml.'m liquid Copacity with Distribution Box ~ Gals. .'" ""'~"1o~ .t,h": j,..i~:::t:~"\t;6I4v-~_~::-.- ~
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:iubsurfoce Oisposol Field Requirod: OfO Lin. ft. jOQ. Width ~:c,f:;J4.~rt~:; or \ ..' r~5.u ".,' :.'S~ f(:"-~~~
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Zone m Bldg. Setbocks: front ~ Feet fro:T. ':eFlter of Road. Sidt!', !oterior
Ex.eriar III carner lal) ~ Foe. fram Cenlor ,)1 Road.
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CONSTliUCTION TO COMPlY WITH UNIFOllM B'Jll"I~IG CODE AND STATE REC,UlATlOtlS GOVE~N!NG PLlJM31NG A~') SEW-
AGE DISPOSAL.
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A portic.n cf the work ;:overed by this permit sholl bl" sTOrted within 60 .;oy~ from dole and 011 .....or... (omp ("l-"d "Ni, ~..,
year. If not, the permit beco~es invalid unless renewed by the county building ino;pec:or.
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THIS PERMIT tN Ii. "ROMINENT lC<ATlON ON OR ADJACENT TO THE MAIN 'U1LOING SliNG CCNSTiWCTEO.
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