HomeMy WebLinkAboutPermit Building 1977-11-1
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LANE COUNTY PERMIT Ju l'lA...t-e~ 1f.!.---.;:'~- U
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Acreage or Lot Si7P Partitioning :# ( ) Completed Subdivision
Contractor's O:S. # , '"'.' Lot
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APPLICANT'S NAME AND ADDRESS~t^-<-c(/ L . .1.-.lj-:..r.-/r"'l_'"
OWNER'S NAME AND ADDRFC:S II
CONTRACTOR'S NAME AND ADDRESS I,
Mail permit to ('-)~pplicant ( ) Owner ( ) Contractor. ( ) Prefer to pick up. Call
STRUCTURES NOWON THE PR~E.'lTY ~rO J. ..JCU /1..___
THIS' PERMIT IS FOR./t.e../i O~ 0.F L;
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'WATER SUPPLY __. /'V ....~-
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Block
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. Phonp t;Jb- cr:?s-o'
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Phon~'
(owner, etc.) when ready:?"
THIS PROPERTY ISWITHIN ONE MILE OF THE CITY,OF
SEWAGE DISPOSAl
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# BEDROOMS
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# PLUMBING CONNECTIONS
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S.I. #
PLUMBING BY
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I hereby certify that the above statements are true and accurate, and that I have the following legal interest in the 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 ~i"lo~er is aVilare and_<;!P3oves of this action. I hereby agree to comply with all applicable Codes relating to this permit.
Fee Paid $/61. '-r 0 C!...JI cr V '.J Signature I~~~-Yc:# /~,,~ Date
( ) NEW ADDRESS ( ) FACILITY PERMIT TO TRANSPORTATION DEPT. ) SPECIAL PMT. AREA. MIN. ELEVATION:
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Comments: ; L?_'". ..4,!,
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By: , Dat~(''--) By: '--:.;2. (~.... t..-,:~. > .?u'7C.. Date: /1- J? - 17'
PLANNING F3E9UIJ~;E.!VIENTS SATISFIED. By:--I-W~ v D~te: 1./-1-7 '7/'.1' Date Issued: "'-JOv e:J/77
ZONE: ///'/1 SETBACKS: FRONT I SIDE FACING STREET (FROM CIL) INT. SIDE YARD REAR (FROM/P/U
Minimum Septic Tank Capacity (Gallons)
Drainfield Required - Lineal Feet
Maximum Depth.
BUILDING
Type of Construction
Ilc:;e Classification
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SANITATION
Group
Fire Zone
7"\', .
Comments:
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LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE., EUGENE, OREGON 97401
PHONE: 687-4394
PqST THIS PERMIT ON MAIN BUILDING AT SITE
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C55-13
BLDG. PERMIT -'Wt-i,ITE; BUILDING -'-'-GREEN;"PLUMBING - CANARY; SANITATION -GOLDENROD" OFFICE COpy - WHITE
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7;? 3D~., 77
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zoo Job Location 7o'-t ASfiS}..J., a\(::J~{S of<.. '1'7'10 I
0,,", c.evd"t'lv\ VlLC,,\ I +ur..... {'t'\~ t- D... hAs p0v\ (bb \;~ h t Dc...r~ Au'f-'z.en) . _ b<oL f;:.r wl-,~'k.. ~,
INFORI\ItATION SHEET I
Wri tten Directions
E'^-\t-
(X') Building Permit
) Site Feasibility Study for Septic Tank. Number of sites
Acreage or Lot Sizl>
Partitioning #
Test holes will be ready
Subdivision
Lot
Block
) Completed
( ) Pending
\PPLlCANT'S NAME AND ADDRESS D~v,~d A. t.J:\k....,).,1'
OWNER'S NAME AND ADDRESS, if different from aJ.?plicant's -
CONTRACTOR'S NAME AND ADDRESS mi-~e:lF
Mail permit or results of site feasibility study to r ) Applicant (X) Owner (
( ) Prefer to pick up. Call (owner, etc.) when ready.
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EZ,u'~e 0 fl.. 9', "" 0 ,
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Phonp 72' - oOJ;S-c
Phonp
Phonp
) Contractor.
Contractors O. s. #
STRUCTURES NOW ON THE PROPERTY ~LASe, bc.;.n'\
PROPOSED USE (this permit) Re... rooP hoViS'€....
i RPl"irrgns 3
WA TER SUPPLY (existing or proposed well, etc. If public, name of system)
-
SEWAGE DISPOSAl (existing or proposed septic tank, etc.) S.I.:It
PLUMB I NG BY _ Address
~)() PROPERTY IS WITHIN ONE MILE OF CITY (rfn'~Fl'Ci,^,: e-,,",:~ ~~ )
*******************************************OFFICE USE ONLY BELOW THIS LINE ************,*******************************
( ) New Address Necessary ) Facility Permit Necessary
ZONF SETBACKS: Front Side Facing Street
(FROM CENTERLINE OF ROAD)
) Special Permit Area.
Minimum Elevation:
Interior Side Yard Rear
(FROM PROPERTY LINES)
To: Planni ng/B ui Idi ng 'nspector /Sanitarian/Surveyor.
This applicant appears to have a problem with
Your assistance will be appreciated.
By
Permit Processing Section
Response:
C55-12
By
DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
Permit Processing Section
125 East- 8th Avenue
687-4394
r)ivision