HomeMy WebLinkAboutPermit Plumbing 1973-8-27
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LANE COUNTY BUILDh _ ~ PERMIT O'R MOBILE HOME USE
'L1CATION
PERMIT # 1C98L/-73
PHONE
~.1(f7 - ~'I (),7
PERMIT TYPE - BUILDING R. 'MOBILE HOME oose REG. #
PmeL'[;Nk#~1 M -j(JLVG (g~~MU :So
CONTRACTOR '.MAllING ADDRESS. '. ilLf, 'I
PHONE
P(ifl/f~~~N~ZE PO~~ICEA SOeAJ ~7l/,eNS IAJ.'to, 0M-/Jbu~~ s:, :~~rn~
, - ".
PROPERTY LEGAL DESCRIPTION
LOT - BLOCK - SUBDIV.
TWP ,RANGE
/7 e3~
METES & BOUNDS 0 YES
ATTACHED 0 NO
SEC.
__'7:Jt/.c2,.3
TAX LOT #
c:;?0(() ,
CENSUS TRACT
Jq~03 3:2-3QO'
DESSR~E EXISTING STRUCTURES ON PROpERTY ~A~Y ,,: /
H(k)~.,0~~
LE~CCESS TO ~ROPERTY - ROAD NA~ OR #: .
<.0/J,e/)~/It.J/1..4
PROPERTY SIZE-WIDTH / DEPTH
AREA
B~.
CODE
APPLICANT
NAME '
AND
MAILING
ADDRESS .
FOR MOBILE HOME PERMIT ONLY.
Number of Bedrooms
ST5C:~, S TO BE BUILT THIS PERMIT, ,. ..'
'<--<1d~ . ~. D t S .
. ,/
,~.IjjI~
~/~. , '.
'Connect to Existing Sewage System'O or' New, System Req. 0
---
TYPE CONSTRUCTION SQ.'.F!. 3 # &EDROOMS VALUATION
, SEWAGE DISPOSAL
PLUMBING INSTALLED BY
PUBLIC 0
BLDG.
WASTE DIS.
PLUMBING
PLAN ,REVIEW
PARK TRLR.
SEPTIC TANK -g,
. r
$
c90. on
'OTHER 0
FEES' . WATER SUPPLY
PUBLIC l(.
PLUMBING FEES
FIXTURES
." "
.f.-
OWNERO OTHER 0 NAME
PLANS FURNISHED
"YES~~ 0 YES 0
SIGNATURE' OF APPlICANTP--..A _
~ "/~N\.; VlA.. ~ ~
~BY
PERMIT #, d (j "-" I ~
. ':lb~ I /~
SPECIFICATIONS
FACILITY PERMIT
OTHER
NO 0
TOTAL
r20rOO
C~SH.O SEWER
CH"ecK'}/ CONNECTION FEE
" . PUBLIC WATER.
CONNECTION' FEE .
DATE
<f'-d;) 3 -(7)>
DATE
Q'.:) 3-7 3
COUNTY BUILDING & SANITATION
MIN. SEPTIC TANK CAPACITY' ' DRAIN FIELD REQUIRED
WITH DIST. BOX: GAl. . .!L..(JO ' lIN. FT. :3 TRENCH WIDTH FT. -~ OR SQUARE FEET ~
'f/.;Jn" S." 1:. fi. J(, .:".f -k.l( I. ,;.. c..,d C.,d.'I;o<,.' 'Y." /"c..m.'" wrll' 4/,; V
/!/tlUCJ,-.I-.., . ~.f *- If' f) lJ~,...tIlIri)j_j()^ v ~'lJvI .)..OoJ~1. If.' t) f eA#.,'.. h'.JA t;'c:~,,( . ·
f'rD"'-f' y: ~t!. . J?? e:..;'nf;-.j'". d{~ j.... kJ",) "J .J/,~ 1/, C....) e>Jf1I)JJlt/,-: ),1
lY" 0' STRUCro".: OCCUPANCY ZONE "AR YARD P lIC UTlL EASEMENT
5".&/ .1
. BLDG. SETBACKS - FT. FROM CTR. OF, ROAD RIGHT OF WAY
USE CLASSIFICATION
FRONT SIDE INT. SIDE EXT.
SANYAR~N. /J Date P~ANNING .
7GU:/4JP'-lj,d . f ...:;'l..f'?);:
Directions to Find Prope~ty:.M P.T~H7; ,
REAR
D'~'.'42--7/? _J,.
. Date
COpy 1 - OFFICE
COpy 2 - JOURNAL
COPY 3 - AUDIT
Form # C55-1Z