HomeMy WebLinkAboutPermit Building 1978-9-19
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LANE COUNTY PERMIT,
Acreage or Lot Si7'" ~0 a ';7 1.4h 0
Contractor's O,S, # to!;<\\
Partitioning # r.-\\;lil
(Completed
Subdjvisionn~
Lot
Blocl<
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""TRUCTURES NOW ON THE PROPERTY:....
--
) Contractor.
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k'\Jd"im Q11l'>
} Prefer to pickup. Call
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Phon~7 4\s...1<331
Phone
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(owner,etc.) when ready,
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THIS PERMIT IS FOR
1t':6"i" _li~nh: L,n IDfi h oft: ^ M'llIe' d~t 1.&i'Dl sal f' ~'
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"# BEDROOMS nQ..# PLUMBiNG CONNf:CTIOr\)S_~~
WATER SUPPLY
THIS PROPERTY IS WITHIN ONE MI LE OF THE CITY OF
~V\\hl~1'!
SEWAGE DISPOSAl
Gl~p~ie
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. PLUMBING BY
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I hereby certify that the abo\(e statements are trUe and accurate, and that I have the follovvinglegal interest in th~ property: owner of record;
. contract purchaser; , ,potential buyer;' ',realtor or agent. I further certify that (if not the owner) I am authorized to act for the owner of'
record, and that said owner is aware and approves of this.action.1 hereby agree to comply with all applicable Codes relating to this permit: '
Fee Paid $ f;) ~ 1lt\ . :' Signature liJl Wl@&"<e~~e Eo ~.,i,nh&\1.ri Dati>" 1])-1....76
hp;-l.-NEW ADDRESS JI))-FACILlTY PERMIT TO TRANSPORTATIO'N DEPT, "vii- _ (~(SPECIAL PMT, ARE-A. I\~IN. ELEVATION:/lJIJ~
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SANITATION BUILDING
,-
Minimum Septic Tank Capacity (Gallons)
Drainfield Required.~ Lineal Feet '
Maximum Depth
Type of Construction
UseClassific3tion
Group
Fire 7-one
Comments:
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By: ,~.. Date: By: ,,,,_',.( f .rb--r ;:,1 ' ~'" Qate:'" , -- I-e.': _ ",/
, PLANNINGREQUJREMENTS SATISFIED. By: SWS>~iUi tte].le~ Date: ~""U-U<:; DCJte,ls~ued: C\-\'\~~~
'ZONE: ;a' " SETBACKS: FRONT 45 r~IDE FACIN.,G STR.~~,E~.!J:T: ,(F RO~M C/L). 1~"G.,,-SIDE YARDS 0 ,REAR12~ (F ROM P/Ll'-
LANE COUNTY DEPARTMENT OF ENVI RON,MENT ALMANAG EMEN,T, '12~EAST8TH AVE.,' EU.G,E'NE, OREGON-97401 PHONE::' 687-4394'
C55.13
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BLOG, PERMIT - WHITE; BU1LDING,- GREEN; PLUMBING - CANARY; SANITATiON - GOLDENROD; OFFICE COPY,-' WHITE
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\OST THIS PERMIT ON MAIN BUILDING AT SITE
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FLOOD PLAIN MANAGEMENT
Department of Public Wor~~
125 East 8th Avenue
Eugene, Oregon
687-4195
TO:
/ PERr,lIT PROCESSING
PERtHT NU~1BER ~~o4 --'8
PLAI~NING '
PARTITION NU~1BER
PUBLIC HORKS
SUBDIVI SIGN
OTHER
SITE ADDRESS
PERMIT VALUE IS A SUBSTANYIAL IMPROVEMENT.
YES '
NO ~
SITE IN FLOQD HAZARD AREA
YES
NO
SITE LOCATION IS WITHIN A FLOOD HAZARD APPROXIMATE STUDY AREA, EXTRA
PRECAUTIONS MAY BE APPROPRIATE TO ASSURE THAT THE BUILDING SITE WILL
BE REASONABLY SAFE FROM FLOODING.
SITE LOCATION IS WITHIN A FLOOD HAZARD DETAIL STUDY AREA.
I,
1. MINIMUM FI,RST FLOOR ELEVATION OF , (M.S.L.) REQUIRED.
2. MINIMUM FOUNDATION ELEVATION OF (M.S.L.) REQUIRED.
3. MOBILE HOME TIE DOHNS REQUIRED IF GROUND ELEVATION THAT MOBILE HOME
WILL BE PLAC~D ON IS BELOW THE REQUIRED MINIMUM FIRST FLOOR ELEVATION.
4. 'SITE LOCATED WITHIN A DESIGNATED FLOODWAY CHANNEL, BUILDING PROHIBITED.
RECOM~~ENDATIONS :
DATE
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LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
125 Eft 8TH AVENUE, EUGENE,OREGON 9 1
c=J, PLANNING DIVISION,
Partitioning'
'Parcel No.
<Kif
FEE
"current Zoning
[]pending []Completed
Partitioninq Reauired
Otherl
,$
~. " ' WUER' POLLUTION CONTROL "of Sites
:' New Site Inspection(s)
, 5DS_ Construction 0 New 0 Repair.
Number of Bedrooms I
.. Coromercial/Industriai - of Employees'
"'Other
$
$
$
$
~ CONSTRUCTION PERMITS AND INSPECTION, '
~ (See above for" of'bedrooms/' of employee!)
,0 ,:~obfle Home'
o Permanent
o Temporary
, " 0 Renewal
'Structure Sq. Ft. -,' Valuation,
&-v- AL I ~6 /'4Od../) 'If.I1I
U/H-t:'-, ~./-".L1..6..t2.O e.,,<:r), l/tJO
FEE
$
$
$
$
$
Total V~lu.'tion $ 9"/1 t/ $ 9,. d 0
PlUll\bing fixtures at $ Elch $
Sewer/Water Conn. lit <; r:ach ~
Subtotal $
4\ State Surcharge $ " ,~ t.,
Plans Check Fee $
Change of Occupancy $ ~3~
TOTAL BUIL'oING PERMIT FEE $
Minimwn structural setbacks:' ' " '/
From centerline of street: Front t/5 .
Extedo~ Side /VII,
SideSI Re'ar'/:A' ;:/#E '
appUca~t 0 Curb cut to appl1ca~t
From interior lot lines:
[] Comm'l plans sheet ,to
~PUBLIC LANDS [] Address : ~MinimUll\ Elevation
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PUBLIC WORKS" 0
Facility Permit
ENVIRONMENTAL HEALTH n
,Ch.c~ '!579 ,L'Rec,'d bykLr~
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AFFIDAVIT: If this permit fs for 'an agricultural buildi~g, I hereby declare that ,this building
will be used for agricultural purposes as allowed by zoning' and/or the State Building Code, and
for no other purpose. I further certify that the statements and other information bubmitted on
this applicatig,o are true a,ndaccunit:e, and that I have the followi'ng legal interes~ in the
property: ~wner of 'record; contract purchaser; lessee'; holder of an exclusive option
to purchase;- duly authorizea-to act for a person wno-has the IOIlowing legal interest: ,
-,-- ,
; 'or that the owner of record is knowledgeable' of this
application, if I am not the owner. I further agree to comply with all applicable codes relating
to this permit. ' ' --l, j) _ A. . IJ, /J' :
Date9-7-? Y Applicant_'s ;Signatur~~ c{f~'Ci, (J./ '
Cash
TOTM.
THIS IS YOUR RECEIPT. AND DOES NOT GIVE YOU PERMISSION TO BUILD. :
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FOR INFORMATION ABOUT THE PROGRESS OF YOUR APPLICATION, CALL PERMIT: CONTROL, 687-4357 (687-HELP)
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