HomeMy WebLinkAboutPermit Septic Tank 1973-8-25
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LANE COUNTY
BUI!DING KJ
BUILDING 'PERMIT OR MOBILE
MH D
MAILING ADDRESS
.HOME U~t: PERMIT
PERMIT NO.
<.. '"to:.
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168,~... 73
,.PHONE
"7 J.~ '1 ~n&J:),7
PHONE
PROPERTY OWNER
Nc Cut\thQi'h' KOfl
CONTRACTOR
. 704'G~rdGnwQ~ $. ~unGn~~~r~~on
MAILING ADDRESS
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PROPERTY LoeA TION - INCLUDE"PO'ST 'OFFICE
CQnt'onnial toAspon- t4.lrns' into Gord6nl:J{)vS~ .. /; mHe.on rlnM;
PROPERTY LEGAL DESCRIPTION - METES, BOUNDS
TWP
RANGE
, SECTION
TAX LOT NO,
CODE
CENSUS TRACT
11
03
34.'2.3
200
iq~O~ s2...~09
EXISTING STRUCTURES ON PROPERTY
~ousca'... Oilll"r.H'31l<.:l .. {,Df'n
LEGAL ACCESS TO- PROPERTY
APPL <
NAME
&
MAILING
ADDRESS
FOR MOBILE HOME PERMITS ONLY
No. of Bedrooms.
STRUCTURES TO BE BUILT TH,ls PERMIT
Gel ralanwlilV
PROPERTY SIZE - FT.
WIDTH.
DEPTH.
AREA
':;\ 6\Ci"G!ii
Connect to Existing Sewage System D
TYPE CONSTRUCTION SQ. FT, # BDRMs
New' System D
VALUATION
&t0DQ1 i r S; [) . S .
en
<I:
FEES
PLUMBING INSTAllED BY
OWNER D OTHER: NAME
WATER SUPPLY
SEWAGE DISPOSAL
PUBLIC D
BUILDING,
WASTE DISPOSAL
PLUMBiNG
PLAN REVIEW
PARK TRAILER
SEPTIC TANK [ji.
OTHERD
2€.LOO
; OJ
PUBLIC ~
D OTHER
TOTAL
~.
2€LOO,
COUNTY BUILDING & SANITATION SPECIFICATIONS
DRAIN FIELD REQUIRED
MIN. SEPTIC TANK CAPACITY
WITH DIST. BOX: GAl.,
200
lIN.FT
3
TRENCH. WIDTH, FT.
OR SQ. FT.
600
Pump s0p~ic 1l:Qlfi'lk. If tiall'lltis if} good con~Htili>i'1I re:placooent'l:3iU nat benocc$sary. g~staul
'cHztrif!>l!tiorrn ~oJ{ Cll'ld 200 g:llna&i feet of dralnfiold tCit'Jelrd front ~rd. ~1&i.,tain dr8i~lorics
,as s~al1~J Q5 p0ssi~iG.
TYPE OF STRUCTURE
OCCUPANCY
ZONE
PUBLIC UTll. EASEMENT
.5 ~
BLDG. SETBACKS n FT. FROM CTR. OF ROAD RIGHT OF WAY
USE CLASSIFICATION
FRONT
SIDE INT. SIDE EXT.
AUTHORIZED SIGNATURE - DATE
is/J.g. Boss by Recav(i)s
REAR
~. Coots, Soni t~rlrn
DATE
8-25-13
BLDG. PERMIT - WHITE
OFFICE COPY - WHITE
COUNTY TAX - PINK
PLUMBING - CANARY
BUILDING - GREEN
SANITATION - GOLDENROD
Construction to comply with uniform building code and county regulations
covering plumbing and sewage disposal. All buildings require a certificate
of occupancy before being occupied.
(See Statement on Reverse Side)
(POST THIS PERMIT ON MAIN BLDG. AT SITE)
.,
'LANE COUNTY, BLDG., & SAN. DIV., COURT HOUSE, EUGENE,OREGON 97401
'" FORM # C55 -13
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CENSUS' :r
BUILDING SITE EVALUATION
~ Building Permit Application No. /bJ'-;L-73
() Site Inspection
() Pre-Per~it Inve~tigation
APPLl~ . " / ')
NAME ~-~~
ADDRESS
PHONE
DATE
, /
cf/2c3/~ _
LANE COUNTY PLANNING DEPARTMENT
J.
Zoning Ordinance Compliance
(Zone
Subdivision Ordil)anceCompl i
, ,
NOT
app I icab Ie
() ( .)
NO
YES
NAME
DiHE
3.
4.
::~~~~:: ::::S:Area. Wid~'" .
Frontage, S~~~
Other (see comments)
( )
( )
( )
( )
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( )
( )
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2.
5.
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COMMENTS:
BUILDtNG INSPECTION SECTION NOT NO YES DATE
app I i'cab I e n C{'}}.,1/7J,
6. Plans Subm i tted ( ) ( )
I 1'-
7. Soil Stability (footi ngs) 0 ( ) i ( )
8. Flood Pl.a in . L.v ( ). ( )
9. o t he r (see Comments) , (/ ( ) ( )
COMMENTS:
SANITATION SECT! ON NOT NO YES NAME DATE
apD I icab I e (0 i(.~~.tJp4 cr-J. t~7J
10. Sewage D i spos a I ( ) ( )
II. Usable Area ( ) ( ) ()
12. Water Supp I y' ( ) ( ) ( )
J 3. , Ot he r (see Comments) ( , ( ) ( )
COMMENTS:
TO APPLICANT:
Your Building Permit / Site Inspection:
M' - Can be app roved. ?/.??/7 ~@ .. .
.~) Cannot be approved at this time as Indicated on item NO. above.
Questions and further information on items I through 5 contact the Lane-
.COUNTY PLANNING DEPARTMENT. Questions and further information on items 6
through 13. coiltactthe Lane County Buildinq and Sanitation Division.
(,) ~il I be held in thls office until you can resolve the problems indicated.
() Is being returned.
() Yourb~ilding permit appl ication fee is being returned under separate cuver.
l.ANE COUNTY PU\NN I NG DEPARTMENT
135" ~1.)(thAvcnUe E.ast, Eugene, {)r~9on 97401
f"l1oNE:' 342--131.1: EXI. 231
LANE COUNTY BUILDING'& SANITATION DIVISION
135' Sixth jl4"er.lue East, [u~lene, Oregon ~~71+01
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PROPERTY OWNER
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CON~RACTOR
LANE COUNTY BUILDING PERMIT OR MOBILE HOME U~t PERMIT
BUILDING ~1tJ MH D PERMIT NO.
MAILING ADDRESS
~Cf! 1(pj~1 Hilit.(fl:~rflli&lP 3~ ~;:'J:'\ffi'i\~~. Ort!f"~:'cjj
MAILING ADDRESS
}(<~}t~~j
PHONE
:1~~/l~~Jij,t,~?
PHONE
PROPERTY LOCATION - INCLUDE ~,O~T <?FFICE
-. . ft tl, L'jj'...,' r'1j~i{!"(" Q
GMte.rHlllth to t~!~.~~ ;:~. "tul"Cm$ . nto. .;iaH',1"k~11t!n~V ~j. '" i: rni lo .Yi,fi Ii' k;h~: .
PROPERTY LEGAL DESCRIPTION ~ METES, BOUNDS
TWP
~i
UJn
SECTION
~l$..:~..:tn
TAX LOT NO,
CODE
CENSUS TRACT
RANGE
~~OQ;
E:...GJ -';2...:\01}
EXISTING STRUCTURES ON PROPERTY
I'fn1,u.:a ... (~,i.ra~f.b ... harm
LEGAL ACCESS TO PROPERTY
f~ci1."a~~,t)lHV
PROPERTY SIZE - FT.
APPl.
NAME
&
MAILING
ADDRESS
FOR MOBILE HOME PERMITS ONLY
No. of Bedrooms
STRUCTURES TO BE BUILT THIS PERMIT
WIDTH
DEPTH
AREA
.3 lJ.(;r{i'l~
Connect to Existing Sewage System D
TYPE CONSTRUCTION SQ, FT, # BDRMS
New System D
VALUATION
fl~~}:t~!r S.fJ.5.
(';'~,
;;J;
SEWAGE DISPOSAL
PUBLIC D
, BUILDING
WASTE DISPOSAL
PLUMBING,
PLAN REVIEW
PARK TRAILER
$
FEES
PLUMBING INSTALLED BY
OWNER D OTHER: NAME
WATER SUPPLY
SEPTIC TANK ~
OTHERD
2llfJ,,4J{)
PU BlIC [!j]
D OTHER
TOTAL
:I:
20.~t;)
COUNTY BUILDING & SANITATION SPECIFICATIONS
DRAIN FiElD REQUIRED
3
lIN. FT
TRENCH WIDTH FT.
OR SQ. FT.
6HG
MIN. SEPTIC TANK CAPACITY
W,ITH DIST. BOX: GAl.
~a"~Jt1
f:C;ip f.;;;:~IU{~ d;~fi.h. W~l ~:~:;;;!~r. ~::1> hv ~JQtr,;j eOr~dBU'tJ.lJ; t:\'fp..we~:nEtr;t ~j!IH (.1J,}r~ t.'!D 'tHi:~;&SiG;(:ry. fr!~~UJ~~
(;i~8l:rH,,)'Li;jJ,i(Jn ~:U~~ iii;}f~ UCiU lll: j ~01e:l;i' lH'~\!Jt 01' SIi'"f/lbH~JI'W<H~ ttlW~y(v "ll':mt ~7.;jf;~YQJ.. neH1tilH1 'U'<l'l'~ in iit::';
d~ i3[i(Jj~ k<v~ os DQ$QJH);e.
TYPE OF STRUCTURE
e l'.~
j..p L'~
OCCUPANCY
I
ZONE
PUBLIC UTll. EASEMENT
BLDG. SETBACKS u FT. FROM CTR. OF ROAD RIGHT OF WAY
FRONT SIDE INT. SIDE EXT.
AUTHORIZED SIGNATURE - DATE
l'fr! J.C. no~s by fk~l.YC1~
USE CLASSIFICATION
REAR
u. CG~ts. S~~i~~~~~
DATE
~J~2~~~'l:)
BLDG. PERMIT - WHITE
OFFICE COPY - WHITE
COUNTY TAX - PINK
PLUMBING - CANARY
BUI~DING - GREEN
SANITATION - GOLDENROD
Construction to comply with uniform building code and county regulations
covering plumbing and sewage disposal. All buildings require a certificate
of occupancy before being occupied.
(See Statement on Reverse Side)
(POST THIS 'PERMIT ON MAIN BLDG, AT SITE)
LANE COUNTY, BLDG. & SAN. DIV., COURT HOUSE, EUGENE,. OREGON 97401
~
~'FORM r C55-13
SITE I NSPECT I ON
ApPROVED /
/
DISAPPROVED /
REMARKS
FOUNDATION INSPECTION
ApPROVED /
/ DISAPPROVED /
REMARKS
FRAMING 'INSPECTION
ApPROVED /
/ DISAPPROVED I
REMARKS
LATH OR SHEETROCK INSPECTION
ApPROVED /
/ DISAPPROVED /
REMARKS
FINAL INSPECTION
~. It'" ;"!:
I DATE
/ DATE
/ DATE
/ DATE
APPROVED / / DISAPPROVED / / DATE
REMARKS ./ /.. /
"~Jfh7q;,~/
CERTIFICATE OF OCCUPANCY
READY TO ISSUE /
I NOT READY TO ISSUE /
REMARKS'
~
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j':- ,.
/ DATE'
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INSPECTOR
INSPECTOR
INSPECTOR
INSPECTOR
/
,/
INSPECTOR
INSPECTOR
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LANE COUNTY
BUILDING m
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BUILDING' PERMIT OR MOBILE HOME
MH D'
MAILING ADDRESS
lJ@~8o~C~0C\? D. (b~X'C'JUO.. tlf?Or,[;Jll
MAILING ADDRESS
DPERMIT
PERMIT NO.
/1,. :, .t(~/' :.:. . '7 :::'
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"to
PROPERTY~OWNER
O(:8L>67~5
PHONE
c.~c, ~MU((;rlJJU~ C~OQ
CONTRACTOR.
5lLl5i",,0t"0.11
PHONE
PROPERTY LOCATION - INCLUDE POST OFFICE
Gow~C..'VwUOn ~O l$dfjfir;~' ~Wi'WO 6C\)g(i;) COG'@C2:1Q7 3.. '" '/~ (~UUo...'f'..,'1l t"6(!0TI\(~
PROPERTY LEGAL DESCRIPTION - METES, BOUNDS
'f1.~'!~~ li;'l'.~j~.~
TWP
RANGE
SECTION
TAX LOT NO,
CODE
CENSUS TRACT
u~
($>>
!]P.)o 12. ;;}
2@@ U~~q)91 f;}-::~)1(~:0
EXISTING STRUCTURES ON PROPERTY
t!~~gO "" ~l~r?e~;'J Q OOffCil
LEGAL ACCESS TO PROPERTY
E:)OI?EJ05t"X)'\'7
PROPERTY SIZE - FT.,
APPL
NAME
&
MAILING
ADDRESS
FOR MOBILE HOME ,PERMITS ONLY
No. of Bedrooms
STRUCTURES TO BE BUILT THIS PERMIT
WIDTH
DEPTH
AREA
51 i')Gl?(':).
Connect to Existing Sewage System D
TYPE CONSTRUCTION SQ, FT, # BDRMS
New System D
VALUATION
cq;;oUw tb.l0.0o
<<:JD
,',1..
SEWAGE DISPOSAL
$
,
FEES
PLUMBING INSTALLED BY
OWNER D OTHER: NAME
WATER SUPPLY
PU&lIC D
BUILDING
WASTE DISPOSAL
PLUMBING
PLAN REVIEW
PARK TRAILER
SEPTIC TANK ru~
OTHERD
;;}@..@D
PUBLIC Q
D OTHER
TOTAL
~
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COUNTY BUILDING & SANITATION SPECIFICATIONS
DRAIN FiElD REQUIRED
MIN. SEPTIC TANK CAPACITY
WITH DIST. BOX: GAl.
Zl@@
lIN. FT
~
TRENCH WIDTH FT.
OR SQ. FT.
f2.r;y)
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~~, OO~8BG epQfu. Q~ ~C@~ 80 a~'~ ~6~jD~U$~ ~~UOGC=O~~ ~nuu r.@~ ~o OCGQSOCVVo OwGBOOG
mG~U'uljQj~ti~f:;;J 10m m~:;J ~mu u ij u~u. \iG~e ov (Jr?OnIJlJVUO~C 8@:-;.'Ol?(] itre:m~ ~tQ0I?(lo c,;;,)u\~toti~ (J~'OUDUU~';~,:'j
co D~J)UUc:) OG ~~oo~Uo.
TYPE OF STRUCTURE
OCCUPANCY
ZONE
PUBLIC UTIl. EASEMENT
5 fJ n
BLDG. SETBACKS _. FT. FROM CTR. OF ROAD RIGHT OF WAY
FRONT SIDE INT., ' SIDE EXT.
AUTHORIZED SIGNATURE - DATE
./f!Jf .Do fio De::)!) bV flCC'V"OD
USE CLASSIFICATION
REAR
[1" @{!Q~CI QC~fil):0dQ
DATE
I"~
Uo;20o?3
BLDG. PERMIT - WHITE
OFFICE COPY - WHITE
COUNTY TAX-PINK
PLUMBING - CANARY
BUILDING - GREEN
SANITATION - GOlDENROD
Construction to comply with uniform building code and county regulatiqns
covering plumbing and sewage disposal. All buildings require a certificate
of occupancy before being occupied,
(See Statement oriReverse Side)
(POST THIS PERMIT ON MAIN BLQG. AT SITE)
. .LANE COUNTY, BLDG, & SAN. DIV., COURT HOUSE, EUGENE, OREGON 9!401
\ FORM#C55-13
SLAB FLOOR
PLUMBING GROUNDWORK
ApPROVED I
REMARKS
I DISAPPROVED /
ApPROVED I
GAS PIP I NG GROUNDWORK
REMARKS
ROLiGH PLUMB I NG
ApPROVED I
., REMARKS.
ROUGH GAS PIPING
ApPROVED I
REMARKS
FINAL PLUMBING
ApPROVED /
REMARKS
FINAL GAS PIPING
ApPROVED /
.REMARK.S
J .'
/ DiiTE
I . DISAPPROVED i___1 DATE
I DISAPPROVED /
I DISAPPROVED /
I DISAPPROVED /
/ DISAPPROVED I
READY TO' ISSUE /
CERTIFICATE OF OCCUPANCY,
REMARKS
/ DATE
I DATE
1 DATE
/ DATE
I NOT READY 'to ISSUE /
~ R~~
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f_
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INSPECTOR
INSPECTOR
INSPECTOR
I NSF,'ECTOR
INSPECTOR
INSPECTOR
I D",f'1'?'ZlNS"C<OR~
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IND IVIDUAL '. SEWAGE' D1 SPOSA. ,{STEM ~ RECOR1;) " '.,
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In.st~ner: Complete 'top .' part9'f,,:fC):im t<?
.sigri~thr'e. and return,' ~oth 'c:6p.i~s )~o .Lan~ ,
County Building, Saili tation'.[)eI)art!:tlenL " '-.
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'Ins~ap~r~1 N~e~~dar J i
No. Liviri<} Uni. ts Bedrooms Bath,s
'~~7__) I.
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.' ;F~'~fr6I!i well ' Steel 0
Ins,~C1e .DJ.mens~ons:' Ft. ,
Length' 'width
!\pplicant,
_ Name.' '7
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No;;':':' ") hAL.~?3:-
... :':Coots'
Property .Add:ress .....
. . Gardenw'aV ,"
. .Basement "'/ Water ~p'ly C '. ..
~es)&._ N~ O',~:.:- '.'Pcl$lic ~ : Other-List
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Tile' ;Bispqsa,T rie:J~:, . ,"'., ,-.
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Feet frprn,' " "'-}, :
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. ~.: Lot.' Lil\e .::;.< :':~~'.~.' " ~
"Front '.:,'~ " .- 'Side.' Rear.,.'"
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D~pth
Ken M'c Cutcheri
Mailing,
Address. '
704\..r.~rde.rntlay s
f'~ n'rprnn.' . "" .,'".. ".
Len~ of Lines. -. Ft. " ...Trench." Totalsq:. Ft .betwe'en
l.rv 3. 4~':"' 5. 6,' Width7{ftt.' (POb,:,li~'e's 10:.>
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F~r' ,sanitaria.ni'Qseonly:': . ; .' _ 00 .,
" ~Approve~'~'. "syst~Iq i~stallatiori' ',conf~Pns.':fo:. ~\lrrent,.',standards
" D. Dis'app.rqv~d;'Oo' : Do'es Not confonn'~o;.cuJ::t;'en~ 'rstanda~ds:-',';','Oo)~
Remarks: '", . '.' ,'.' " 'Y, 1';'."~":'
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Laneoeounty 'Bti.i!dA.pg-"&$.~nitat~.~n. Dept.~
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