HomeMy WebLinkAboutPermit Plumbing 1986-10-13
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for:
FOR OFFICE USE ONLY
Lane County Authorization
PLUMBING
Appl~ca tion/ '? :? ') G') b-r
Perm~ t # ...-J v=<=<. -t/ ..10
TOWNSHIP
RANGE
SECTION
~ TAX LOT nOUT OF
27 '~") 1 0,500
LOT/PARCEL BLOCK
1 8
PROPOSED USE OF PROPERTY
[J Residential D Industrial
D Commercial D Public,
17
03
SJBDIVISION/PARTITION (if applicable)
~_ 'PAeJL. '21JJ')-Ann
LOCATION ADDRESS STREET
1205 Anderson Ln., Springfield
STRUCTURES CURRENTLY ON PROPERTY
CITY ZIP
SFD
DIRECTIONS TO SITE
E on Centennial - N on Anderson
OESCRIPTION OF PROPOSED WORK - BE SPECIFIC
Plumbina - relocate water meter to front yard & install new water
= OF BEDROOMS # OF STORIES # OF EMPLOYEES \-IATER SUPPLY
(.0'
svc. line
from Meter to ~ i'roposed
I Existing
TELEPHONE NUMBER
DECLARED ~ VALUE
, o;mER' S NAME AND ADDRESS
BLATCHLEY, Carolyn same
CONTRACTOR'S NAME AND OSR. # ~ Pl..-UMf?L^!;:I .::z;s:::-z.o-r f.i?7-
/~..tt, ; ":.,,y,; \'!-a-t-:r rl':~.,":, P.O. Box 8, Spnngfleld 97477 (Tm Hanley)
, ~RJ.~T TO BE MAILED TO (NAME AND Auu.Kl:oSS)
~
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TELEPHONE NUMBER
746 1676
!<."Cor-nONE NUMBER
I HAVE CAREFULLY EXAMINED THE COMPLETED APPLICATION ,'OR PERMIT, ar.d do hcrelJY ce rtify that all infonnation hereon is true and correct, and that I
have the following legal interest in the property: Downer of record; 0 contract. purchaser; Dauthorized agent.
I fccrther certify that any and all work performed shall be done in accordancp. with the Ordinances of Lane County and the Laws of the State of Oregon
pertaining to the work described herein, and that NO OCCUPANCY will be made of any st,rncture without the permission of the Building Division. I fur-
ther certify that registration with the Builder's Board is in full force and effect as resuired by ORS 701.055, that if 'exempt the basis for exemption
is noted hereon, and that only subcontractors and employees who are in compliance with ORS 701.055 will be used on this project, I HAVE READ AND
CHECKED THIS ~CATION THOROUGHLY.. 9 ~ _4_//
j '~/Y7/J/7-IY ~1lI"-l:r ,~ //2; ~ ;{ /"k~ /"
NAME (please print) / ' ... SIGJ$-ru1lE fl ' "DATE
! '
I
READ THIS SECTION CAREFULLY. YOUR AUTHORIZATION ~AS BEEN BASED ON THE FOLLOWING CONDITIONS!
[] PLANNING/ZONING: Zone
Parti bon #
Parcel #
Parcel Size
Minimum Setbacks: CL, front
CL, side
interior
rear
Date:
10-3:4-86
/7
~-
COMHENTS:
NO SPECIAL PLANNING ACTION REOUIRED.
Installation
Specifications:
Gallon
Tank
Lineal Feet
of Drainfleld
Installation Record Issued? DYes D No
Maximum Depth
of Trenches
o SANITATION: S. 1. #
B. P. #
COMl-IENTS:
Date:
n
o PLANS EXAMINATION:
U':e (ct) t OF vJk7't?;r!- 1.1 Ne
COMl-IENTS:ftAA)~ S\4Af do.- c.oMW w.D9845Er,. Ap/~ Fa;,.<<..Mb.,"~~.8E BY A
UC&JJ$D PWMf!E;E. L..EAvF: ~~""'<1JUEl:>13yfnt/lJ7Y L)J~0c:o/l.~
~ roe IAJSPFr:r10AlS. Date: IO,L&!B0 D
Type
Group
PE,"IT APPROVE' BY BUlLOING 'FF'C'AL/""GNE' Coo, 'R' 455'~ ~"~,,
LANE COUNTY DEPARTMENT OF PUBLIC WORKS LAND MANAGEMENT DIVISION, 687-4061,
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
SEE REVERSE FOR INSPECTION INFORMATION
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