HomeMy WebLinkAboutPermit Building 1987-9-2
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PERMIT #
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LANE COUNTY PERMIT
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Contractor's O.S. #
Partition i ng #
) Completed
Subdivision !o(t nrtd1.f:fll!T1 9'.!"i ::::'~ro P-[1tl~
Lot ::3~ Blocl< :\::>
APPLICANT'S NAME AND ADDRESS
OWNER'S NAME AND ADDR~C::C;
CONTRACTOR'S NAME AND ADDRESS
Mail permit to ( ) Applicant ( ) Owner
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) Contractor. (B) Prefer to pick up. Call
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Phonp
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Phonp
(owner, etc.) when ready.
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7/47-;3492
STRUCTURES NOW ON THE PROPERTY
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-HIS PERMIT IS FOR
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(1 !}G~:1R'GeD)
# BEDROOMS
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..i # PLUMBING CONNECTIONS
WATER SUPPLY
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SEW AG E D I SPOSA L C!tv CCG~l? .- 8I)itSl.oCfj1J?iX~
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THIS PROPERTY IS WITHIN ONE MI LE OF THE CITY OF
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. PLUMBING BY
I hereby certify that the above statements are true and accurate, and that I have the following legal interest in the property: !Fr" 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. I hereby agree to comply with all applicable Cod~s relating to this permit.
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Fee Paid $
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) NEW ADDRESS
SANITATION
) FACILITY PERMIT TO TRANSPORTATION DEPT.
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) SPECI1:\L PMT. AREA. MIN. ELEVATION:
Minimum Septic Tank Capacity (Gallons)
Drainfield Required - Lineal Feet
Maximum Depth
BUILDING
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I Jse Classification
Group
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Fire Zone
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Comments:
~omments:
By: {" J" Date:
PLANNING REQUIREMENTS SATISFIED. By:
ZONE: -,,' ,'1..:. SETBACKS: FRONT "-
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By:
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SIDE FACING STREET
Date: '.. .... 'i,. Date Issued: <':"1';" A'" ,-c i('V(F-T
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(FROM CIL) -'NT, SIDE YARD REAR (FROM Pill
LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE., EUGENE, OREGON 97401
POST THIS PERMIT ON MAIN BUILDING AT SITE
C55,13
BLDG. PERMIT - WHITE; BUILDING - GREEN; PLUMBING - CANARY; SANITATION - GOLDENROD; OFFICE COPY - WHITE
PHONE: 687-43\
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ex.) Building Permit } Site Feasibility Study for Septic Tank. Number of sites
Acreage or Lot Size "'lOx-qc,}( 70 )< gO Test holes will be ready ?
Partitioning # . ( ) Completed Subdivision 1$1'(' ('ldf'"LLX1D'Y' ~ ;LlE..I\JLO fJAiZ(Lot .3
( ) Pending
APPLICANT'S NAME AND ADDRESS 5u..~u:..cJ YAeeo e..Du..c;;.K I CfS7 A~D~ oJ W, fuO~
OWNER'S NAME AND ADDRESS, if different from applicant's ~A.u..€. A& AA?ClCAr-.J--(' ,
CONTRACTOR'S NAME AND ADDRESSQDPUGAI\.}..-('
Mail permit or results of site feasibilit~sWQY to ( ) Applicant ( ) Owner ( ) Contractor.
(X-) Prefer to pick up. Call '74'7- CS'9'<;;1Z (owner, etc.) when ready.
, ,iUCTURES NOW ON THE PROPERTY S, F 0 -' '+' GA12A6E
5.~.D (I BEDe:CO.M.)
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PROPOS6D USE (this permit) Odd..-L.k'.01'\ ...yO
WATER SUPPLY (\vry ~e~
SEWAGE DISPOSAl Q.t/y St;;WE..e..
PLUMBING BY N. .4 .
( ) PROPERTY IS WITHIN ONE MILE OF CITY (
Job Location CJ 5 (
on CeY> fe. )''If),'tJt../ (To Wcn'~ S
INFORMATION SHEET
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Block
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Phone 747- 349z.
Phone '
Phone
Contractors O. S. #
.3 QX'..15-1"f k.J 6 BEDe.OOM..?:1
;) If BEDROOMS A"o b.e- (4 )
(existing or proposed well, etc. If public, name of system)
(existing or proposed septic tank, etc,) S.1. ==
Address ,
*******************************************OFFICE USE ONLY BELOW THIS LINE *******..*..********..***************...****...........
( ) New Address Necessary ) Facility Permit Necessary
ZONF SETBACKS: Front Side Facing Street
(FROM CENTERLINE OF ROAD)
To: Planning/Suilding Inspector/Sanitarian/Surveyor.
This applicant appears to have a problem with,
Your assistance will be appreciated.
Response:
) Special Permit Area. Minimum Elevation:
Interior Side Yard Rear
(FROM PROPERTY L1NESI
By
- Permit Processing Section
By
DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
Permit Processing Section
125 East 8th Avenue
687-4394
C55'12
f)ivision
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