HomeMy WebLinkAboutPermit Building 1976-4-20
NOTE:
NO PERMIT
_ (~(/ _ PERMIT I~~S-~~.'
I8Ir. BE ISSUED UNTIL rltts APPLICA'IW HAS BEEN APPROVED f\~
APPLICATION FOR: \
CONSTRUCTION
~
MOBILE HOMB
[=:J
CHANGE OF OCCUP AIlCY c:::=J
[=:J OWNER~ LA
~
CONTRACTOR f!t,., hp V"1~
Name
Existing Structures on Property:
30/92/
Twp. J"7 Range -:;c:
SubdivisibB---.__. ~~
ACCESS TO PROPERTY (Road Name)' I2>~E 'PA-/Zh'1
-
//0/;1":-
~.,(/~
Section
IS
O.S. REG. 0
Lot
Block
Property Acreage
,if
35~ L-
Property Location - Address/Directions:
I?~ -r-.........:t-,... ~
.
V-s-
/
/
~;r Office f6,e OnlVXXXXXXXX. XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX~XXXXXXXXXXXX
~~ . 'V- ~ ~ ~~.~. Fe. ~~Bedrooms / Valuation
I . ~ I /
~...r.Y-.::::.e..~ :::;~/{'-e'r("d~ '\:::l.e...:......J.:...t/1 /
..- .I ____ /
SEWAGE DISPOSAL: c-,...:. I ./'
Site Inspection If ( lX. ~
Existing Sewage Disposal System
[=:J
~ew System Required [=:J
FEES:
PLUMBING:
Installed by Owner c=J
Public
c::::J
WATER SUPPLY:
Well Spring
Other
Community c::::J
of Community or Public System
Bldg.
Plumbing
3% Surcharge --
~,.- \.....00'_.
Waste Disp. ~
Plan Review
Mobile Home
~L GJ{j"ES:
V n of
.: -
Sewage
connect~
IP~D
YES [=:J
Water
Connection
Min. Septic Tank Capacity
-
Draintield
nature of Applicant:
Received~ ~
- /' ~Il] !
Required - Lineal}e€t 'V--MaXimUm Depth,
/' fi IJ . -~ /
/ .J. /"" ;l1ol1.r /
I (~""~o. '
/ Jr!~ j)IV /
Fire ~nE'" ?)A . ArJ Use Cla~ication
l~ ./
./
o
TOTAL
,-,:) .......
~\".,;..,
,
Type of Construction
Group
Bldg Setbacks - from Center of Road Right of Way:
Front
Side Int.
Side Exterior
Rear
Zone
PLANNING:
DATE:
SANITATION :
DATE:
BUILDING:
DATE:
C55-1Z
LANE COUNTY DEPARlMENT OF ENVIRONMENTAL MANAGEMENT