Loading...
HomeMy WebLinkAboutPermit Septic Tank 1976-3-10 .."... -' , " ,/ ~.. - ',;. -:.. ..,... LANE 90UNTY PERMIT FOR: PERMIT NO. 331-;'6' ';',~ .:- SOS CONSTRUCTION [] MOBILE HOME PLAN REVIEW [] CHANGE OF OCCUPANCY [ DOwner n"M:1..~tA,.I I D",...1_".. --,uNAI\iIE- --,J........., Route 10 ADDRESS' Box 269A, Euaene Oreoon e-IT'? ZIP CODE ::: ---" _.- _.' ---7- 7.J/-7401i PHONE Q Gontractor Same NAME '"ADDRESS // Subdivision NA ( //) Ra~;,~Q3 _,,:~e6tion !\Ii.\. Lot /// CITY ZIP CODE s.Lt \> '-\ ~ -- 0 lo~ Census Tract )"NE 0.5. 'Reg. # ,Twr 17 23 Tax Lot ( 200' Code 004-04 Block \, Acreage ,~,', R III 1 ,hi " .:; /!lIh' I t"\f:\a -c-.._ - -- ~ -" ~. ~.. -~\lV- / / / Access tQ Property (Road Name): /'/ Width - /' ~ ....'\ \4 Existing Structures on Property: ~~~~~ S~~~~~!0?f~~~~ Directions to Property - Address: s 1//1 Moi ~nl1i>h n~ i)",,,, A..,,,,,,, I!:"",,,,,,, DA ^" 10 '" '..4.. ~, .. ~-.. ---...... ----...-..::i. -- -oJ --'-01 '!~'=''.^! ~~!!~ !.TRUCTURE (# BEDROOMS) PC!l"mlt for Rena; r of S~H/Jaap. . \{1ir~ f'~y. ~Jl~~_ 4 E~~~~y,=~!: " j.FT. , , ni!tnn~llll ~\lc:tt:lm " +LA~F r.OIlI\I1 v' ~PI='(:TAI VALUATION ~ Rat!. Pl=tiJITT ARi=.n. SEWAGE DISPOSAL: PUBLIC [] SEPTIC TANK [ BUILDING PLUMBING 3% SURCHARGE= , MOBILE HOME= WASTE DISPOSAL. PLAN REVIEW, OTHER [] Wate\" Dist PLUMBING INSTALLED BY: OWNER [ ] 'OTHER [ 1. 'NAMF WATER SUPPL Y:PROPOSED '[ ] 'E'XISTING [] , [ ] PUBLIC [] COMMUNITY -,NAME: [ ] PRIVATE WELL [ l OTHER - SPECIFY: .~ '.....--..:.;, 1)1: n/'l. o..W'OV'lcI TOTAL ?J:: 00'/ CONSTRUCTION PERMITS & INSPECTIONS AND WATER POLLUTION CONTROL SPECIFICATIONS MIN. SEP-::r-I'C-~CAPACITY: GALS. (1J?O,f) ) MIN, DRAINFIELD ?nn L1N. FT. MAX. TRENCH DEPTH, ~nll INCHES -~. 'ill1l~1:i'lff-~1;;'n-ili'lf'ijl:)1r1 nl!:!>t-J;Yld'! '~o}"'lIr;;:;;'1Q !t",~... ...I",,,,,,,,,,,,';...,,,,,, .... ..1......... oa.... ..-60_.._.6...__ .- -'. --. -=---~ - ..........rr __..__..u. ...-_ _""'" ",.,....Vw'"'" ,,",v -.J"'lI.~VIV\I,lI~ ~l~ ratls::qil"~p ~'ii':;)" in(j-Pl'/> f'fi'nm ;llll,lf.)H~ 1<f4~h.rl~"'';'''~''ftl...lo TYPE OF CONSTRUCTION GROUP _ FIRE ZONF STAY 100' FROM ALL WELLS USE CLASSIF. SETBACKS, FT. FROM CTR. OF r/W: FRONT SIDE EXT. FT, FROM PROP. LINE: SIDE INT. REAR ZONF AUTHORIZED SIGNATURES: /s/ ~r;:"III"'nl>'>'; ,,.,....4...... ISSUANCE DATE: '.lIl n /7h ...11 t'l'l -.. --.." -..-... .....-. ......... BLDG, PERMIT - WHITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING,- GREEN' SANITATION - GOLDENROD \. IMPORTANT: . " Call 687-4065 to schedule all required construction inspe<;tions, Call 687-4061 to schedule all required septic system inspections, All construction shall comply with the State Buidling Code, D,E,Q, standards for subsurface sewage disposal and the State Plumb.ing Code, All buildings require a certificate of. occupancy before being occupied, . (See Details on Reverse Side) (POST THIS PERMIT ON MAIN BLDG. AT SITE) C55-13 LANE COUNTY, DEPT, OF ENVIRONMENTAL MANAGEMENT COURTHOUSE ANNEX, 135 ,EAST 6th, 'EUGENE, OREGON 97401 '-"',""- TRS, T' ,f . <, ,y" -;) -0> "7 ? ,j ,j=t.p ~J< (["".~" ..-:;::> r-;,; /_'" . (-{;. ~-!/" ~'~ \, ~ ?J!/(f) ~ " ,,/J~ PERMIT # ',,:.~ JOB LOCATION /i.~'('/){ e:!5r~!:3:. /1:;;'-:'://) ,/f:;,..;~.;:;Lt;:::?~~'. ' '0 ~ ~'/c .. # / ',: LANE COUNTY PERMIT Acreage or Lot Si?p Contractor's O.S. # ' i Partitioning',#, ( ,) Completed Subdivision , Lot Block , , ;. /! , '~7 a 11./ ~;,;J :O~..:el.(jJ,1P:eo <:& Cj )tiJo ~~fiS; eZ/tJ A7ro'Y. ;?y9 /j.B..l.?e;'/~~ _c:SA.i'~,7G: / -<;",4:/I.,;/l!fb ) Gontractor. ) Prefer to pick up. Call Phone Phone \ . Phone' '-.. \ (owner, etc;-.)~ ready. '",- :" , / -;/hT ;1_ ?d~:f? pf CJ~ ." Ai~,f>"V<(,#' 'APPLICANT'S NAME AND ADDRESS OWNER'S NAME AND ADDRESS CONTRACTOR'S NAME AND ADDRESS, Mail permit to ()-(Applicant ( ) Owner ( STRUCTURES NOW ON THE PROPERTY / ~'S~V THIS PERMIT IS FOR, 10' .1{2..PL~Aff',..i;;;?~~/ X fjPLJL..J # BEDROOMS #PLUMBINGCONNECTIONS _1/ a-" ~' \ WATER SUPPLY. ~/A,~w&../Aft~~Uat::lJr: SEWAGE DISPOSAl' Se-~/G. , S.1. # .. ;~ THIS PROPERTY IS WITHIN ONE MI LE OF THE CITY OF .::5.Jl?b/'V~a.o . PLUMBING ~t, OI.4../1:"\II._r<.- ... '. , .J 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 said ow~is aware and approves of this actiOn. I hereby agree to comply with ~II applicabl~ Codes relating to'this permit.. ' ./ <<"?, J-" ~ ~ . r:1Z., & /.> ~ //; /;, / / .A:.. /,I -=z:. --6 t;. jf.-=;; k Fee Paid $ /~ . """V ' ".' ' Signature A-':Z:J,-:? ~ /;ft7'-;}'! h.d'~ JI/"'Da1p .;;;.if1/~1 f P ~-"., . . tY ",./ If", OJ ifF' ( ) NEW ADDRESS ( ) FACILITY PERMIT TO TRANSPORTATION DEPT. ( ) SPECIAL PMT. AREA. MIN. ELEVATION: SANITATION Minimum Septic Tank Capacity (Gallolls) Drainfield Required - Lineal Feet Maximum Depth BUILDING' Type of C;:onstruction IJse Classification Group Fire ZOne Comments: . Comments: -' By: Date: BY:_.?"'.''''~::~-_:-' ',1/'1:'1 ') Date: ,5--.,3(1- f)l} --. PLANNING REQUIREMENTS SATISFIED. By: ,"15ate: Date Issued: tj-I-77 ZONE: SETBACKS: FRONT SIDE FACING STREET (FROM CIL) INT. SIDE YARD REAR' (FROM P/U' . , \, " ~ ~~,.:, ~fN'I;:~C~;~NT~ DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE., EUGENE, OREGON 97401 PHONE: 687-4394 , " .... POST THIS PERMIT ON MAIN BUILDING AT SITE C55-13 BLDG. PERMIT ~W.HITE; Bl!.ILD.lNG -GREEN;- PLUMBING - CANARY; SANFrATION =-GOLDENROD; OFFICE COPY-WHITE .,,..' \ SLAB FLOOR PLUMBING GROUNDWORK ApPROVED I / DISAPPROVED / I DATE' INSPECTOR ~EMARKS GAS PIPING GROUNDWORK ApPROV~D I I D~SAPPROVED I I DATE' INSPECTOR REMARKS ROUGH PLUMBING ) ~ _ ApPROVED / VI DISAPPROVED I I, DATE r/S-/77 'IN~PECTOR~~' REMARKS b-9':....77~, 'ZJI(~,. ~~~~a 5'-;z.,7~'77 ~~ 4' ~' - '?T , ROUGH GAS PIPING ApPROVED I I DISAPPROVED I I DATE INSPECTOR REMARKS HNAL PLUMBING ApPROVED / I DISAPPROVED I -/ ,/?!,jf' (D ~ , "" I . p/1Y/.7 INSPECTOR REMARKS FINAL GAS PIPING ApPROVED / I DISAPPROVED I I DATE INSPECTOR , REMARKS ctRT! F I CATE OF OCCUPANCY f\ . \ , RE~DY TO ISSUE I I, NOT READY TO ISSUE / I DATE INSPECTOR REMARKS TRS, TI ~~ \ l\ -- U~ ~ d.. S -V-....r, ~ob Location, :5 Y03 ~ ~ \ ~'-I I \I \~_\ ~ ~~ c7g~fJ-/c:, INFORMATION SHEET (X) Building Permit ~( ). Site Feasibility Study for Septic Tank. Number of sites / ( ) Would like to meet on site. Call (owner, etc.) Acreage or Lot Size /~7 ')( .5' 99 / Test holes will be ready Partitioning # ( ) Completed Subdivision ( ) Pending APPLICANT'S NAME AND ADDRESS ;!/t/;e/~/'.J::7.R P OWNER'S NAME AND ADDR'ESS, if different from applicant's CONTRACTOR'S NAME AND ADDRESS <:;'/l/llf Mail permit or results of site feasibility study to (1 ) Applicant ( ) Owner ( ) Contractor. ( ) Prefer to pick up. Call (owner, etc.) when ready. '- , Lot Block ~ ~~, jffl9 )/e' jJf,;g;5' -;J> :3 ~ 3 -"37;2 -z-, ,/. /3/JYLL'5) ) ?r/}Z?;;x'.?ff/l E;h.&..t/~ Phonp 7r?-7i/!Jo <;A ~ Phonp Phonp STRUCTURES NOW ON THE PROPERTY PROPOSED USE (this permit) CrP/) 1/ j7 II/J~d hk? ~' - WATER SUPPLY ~JJV?J',)lL) ;;r/tfE-P~<;,T, L/J//Y (fJ/pry ~)l/TI-I f'/JRE r;-A/1?R'5 - ., .- - f'.,t.JrP, ;{!r7" h, Ie; 7(, SEWAGE DISPOSAL 5e' ?TIC- 7/tjV/{ (existing or proposed well, etc. If public, name of system) (existing or proposed septic tank, etc.) S.1. ~N. -~(o PLUMBING BY ) PROPERTY IS WITHIN ONE MILE OF CITY ( 5.1PIf//VC rdEL,L/ Address ******************************************* OFFICE USE ONLY BELOW THIS LINE ******************************************* ( ) New Address Necessary ZONF ) Facility Permit Ne1cessary SETBACKS: Front Side Facing Street (FROM CENTERLINE OF ROAD) ) Special Permit Area. Minimum Elevation: Interior Side Yard Rear (FROM PROPERTY LINES) To: Planni ng/Bui Iding Inspector/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 nivision , ':.' ,. - ~ SPRI~GFIELD, ORE~ON 97477 FIRE DEPARTMENT' August 19, 1977 .\- - Lane CoUnty Yout...l;. Care Center, Inc. -3405 Baldy Vie,., 'Eugene, OR 97401 Attention: 'JoM T~ Fioto, Director ;A . Cli':...--C ~ " ~~- i?r' " "", < , ,4TH AND NORTH A STREET tii~ 'fiNj.3137 - The above facility has been inspected ,and is al-'l-'Loved for occupancy the the extent of the jurisdiction of this " deparbr.ent. ,_,' BUREt\U' OF FIRE PREVEl\i'TION (2~~ A.M~ Matsler, Lieutenant , St:' lUl'JGFIELD' FIRE, DEPARTMENT 150 North 4 th Street .' Springfield, OR 97477 jba cc:,Jolm Smeed, Lane County Building DepartInent 'fu.,T'l Ewen, Deputy State Fire ~..;rrshal' , < , ,A~CE8V~ ~ ., , Lane County' ' u;;,O , Censtruetlon p' '. , ' . , " ermlts & 'Ins ' , " ' , <, peet,on Div;sion A Va 22 _\,<.;', ,~971., ~""""" "",< , ' ,) ',' ",",' ...~~ : r.~ l" - .. . .....: ~. ~ i.' . ~ c. ' d:.", .~. .'.. .. . '~':'. !.' - .' " '. .. . . /. .,:.,. i~' :; .... -; ,.,l .'..... - .' "I- ~ he TRS, Tl /'7- t1:3 -2.? - ~ I' e Job Location 2~'..2 S"~ If'r / tf "... ~ Of L~A/P'; /f/f'. (p;~ /- 77 Q'7y /J I , ?iv ht "9 )1fI~' ) D...;IJ:,;\:i rCIIII;~ INFORMATION SHEET ) Site Feasibility Study for Septic Tank. Number of sites ) Would like to meet on site. Call (owner, etc.) Acreage or Lot Size ,;(.1 J9 Test holes will be ready Partitioning # ( ) Completed Subdivision ( ) Pending . APPLICANT'S NAME AND ADDRESS .2/~rA.;U:? /', ??-{'t) ~LL!".5" ;rr /1> OiJ;( 2(.4 h- 11:-"l;{Y#~ OWNER'S NAME AND ADDRESS, if different from applicant's~l9J.n Y' CONTRACTOR'S NAME AND ADDRESS $Ah41:::' Mail permit or results of site feasibility study to ()() Applicant ( ) Owner ( ) Contractor. ( ) Prefer to pick up. Call 74/7-7.y/Jl. - (owner, etc.) when ready. Lot Block Phone '747-7~OO Phonp Phonp STRUCTURES NOW ON THE PROPERTY / Jr'd'5/ D.r#C r PROPOSED USE (this permit). WATER SUPPLY ?i3?/H"RIrl.1 hJJ71()C' V/$T.. (existing or proposed well, etc. If public, name of system) SEWAGE DISPOSAl SI:'}?7/r-- ~A.v1 "5' L:' L r (existing or proposed septic tank, etc.) S.1. # PLUMBING BY Address Jrr /0 /3 J ~ ,2,1: q /f EWc;V[~ 9),1/'1 (y'(PROPERTY IS WITHIN ONE MILE OF CITY ( SPR'Ig6 r/f~ p ******************************************* OFFICE USE ONLY BELOW THIS LINE ******************************************* ( ) New Address Necessary ZONF ) Facility Permit Ne1cessary SETBACKS: Front Side Facing Street (FROM CENTERLINE OF ROAD) ) Special Permit Area. Minimum Elevation: Interior Side Yard Rear (FROM PROPERTY .liNES) To: Planning/Bui Iding Inspector/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 A ven ue 687-4394 I) ivision I I YES' I LI NU' I I YES I' I "u SignaMe of APt'hn~~~ Fee Received BYr/fLZ' ,Date3'-Je'-7b :J;i!li6. . Septic Tank ca,pacity. /;1.trO, _ ",D Drrllaiinn}f . eld, Required - Lineal Feet ,~ Maximum Depth .$0 P , ,..,' d.,A,"':/'n#.i,.).. '~, '~~ ~ 'J~~~ ~, ~ r~ ~ 'i1..AA'7A;;,A, - .4 I J..i..' - ~ ' ~~,:;<k:.'-} -=-. r,_:.0-<. ~ ItI1JF 1"-- <1// q,4~ !J~ 3-,~ {-- 7 c:., PERMIT if BEEN APPROVED ,..'/ MOBILE HOME I PLAN REVIEW I CHANGE OF OCCUPANCY ~ Pi,,:: w f:j rs 0 LJ3 01; Lid.' '!Cr., b , j3 0 l' .2 ~ q H ,'if. ilf,1! IVI<' Me ,Q7t;' 7 ~7- 7'1oi . ,Name ,.I Address ~ City 'Zip' Phone I , City I Zip Tax Lot ,.;z.o'O Code OCl ~ <!censu~ Tract ;' I Subdivision Lot Block Property Acreage ACCESS TO PROPERTY (RoadName)~Lv't to 1:'lJ LANE"" I Exi"ing S"='u'" on Prope"Y'':;> },lAD >>" *' tC/lm4' A.A8 OUII-1' Il $ /I~~DIb ~1vPI. fi,?- J'}""S . ' , " I ~J' .J /. r:" 7'1" l ',I / Property Location - Address/Direc~ions: ' /~ miL;!" S (W 1/1 Or j/J;/J[pml7lV &.' 6'l2te; 1?D ,OA/ ''81JLP ~ -.k/L!t<.(' L'fWl:/j PA~ 1Jlfn/".lA/ '?nui.-.P/I./(j C 8ouli.5/l1 ml :SJi-r~ ~C.Vl ~r/ ~KtiJl1 KO, , , ,I) Below fo r Off ice Us e OnlyXXXXXXXXXXlQOCXXXXXXXXXXXXXXXXXXXXXXXXXXXXXxxXxXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX o -' Sq. Ft.j/ " ?...e;o,\ms, Valuation' fv/;Fp...4.-1/1Z. ,v V :S.D. ~ I , (... ) ) , , - I ~ - ,YlM C!i/nvt)- /?1.~ / [) l J / 1/ I Cfi{Lt~~' ~-M-,f!d.. .Lf..~",}. " " SEWAGE DISPOSAL: tI '~t'-~ ("(~~ i,)Xry s.Pt;t!j~~~k"JI,.,I~'~Hau~ -"': ,Site Inspection II . A 'f.' .st'tfig,pS~wJie DispoS!11 System or ew System Required I " j , 'Public/ I I ' WATER SUPPLY: / Well SPring' Otl:lrr' Community I I Name of Community or Public System ~ 1''''''' J W \.1 , ~~1~~~~' by awnttft' /it r I PLUMB~NG FEES: ' l ' # of Fix ures Sewage ~ Connection &,5' ,.t9-() ; II II~ -,-;:;),5., f)::O' Il..-""f. CHEC PERMIT WILL BE ISSUED UNTIL ../ C9(:J , THIS APPLICATION'HAS APPLICATION FOR: v CONTRACTOR Name Address Phone O.S. REG. II Twp. IYJ Range~I?, ~Section ~~ Width Depth --0JA-r tit<. FEES: j){~'.Ri r.'" I Name Bldg. Plumbing Water Connection 3 % Surcharge Plan Review PLANS FURNISHED FACILITY PERMIT Waste Disp. Mobile'Home TOTAL Type of Construction Group Fire Zone Use Classification 'Bldg Setbacks - from Center of Road Right of Way: Front Side' Int. Side Exterior , Rear Zone PIANNING: DATE: SANITATION: DATE: BUILDING: ~lt/.~ ~-s:-7h COUNTY DEPARTMENT 6{ ENVIRONMENTAL MANAGEMENT DATE: '/ C 55 - 12 LANE I PERMIT 1fc2ftj'--7 b NOTE: NO PERMIT WILL BE ISSUED UNTIL THIS APPLICATION HAS BEEN APPROVED APPLICATION FOR: CONSTRUCTION I I nur(,()()ref L, MOBILE HOME I PLAN REVIEW !?D\/!es Rf /0 ~dress City ,ffo X 026 9A Zip .. , CHANGE OF OCCUPANCY L.~ Euq Y7YO/ JPho7Y"7 -7L/oc . ,,, I ............'\ I OWNER Name CONTRACTOR Name Address City Zip Phone O.S. REG. fI 1Wp. ---Ll Range (i~ SectiorJ ~ Tax Lot 02cro Code lj;..()/ Census Tract Subdivision Property Acreage Width Depth Lot I Block ACCESS TO PROPERTY (Road Name) Po /dy ()/-fW L1 Existing Structures on Property: - RCl& () S'io f1 ~ :7 '''pmy Lo,""on - Ad~m'/D~'fr'. . () d /9 r ~ . ~. . .~-1.f. VI). V '-7 ~ V . .. Below fo r Off ice Use OnlYXXxxxxxxxxxxxxxxxxxxx4xxx~~xxxxxxxxxxxx~xxxxxxxxxxgxxxxxxxxxxxxxxxxxxxxxxxxxxxx RC\d1n, S\-rA41~ (lad- ~PC(lJDa~~~':i\ F\ ~ V}~ ~~Bi~ooms{ \)~ _('v~~O~t/y) rh.;tIl1Qo TCJ; f}Y p '~€- I~(} t"f-v. ~ /~ (1 dn }~*( -fJ lA:+-~, ~ u. ~~/i f.}-v... ~ nt aX" 1W\. LJ '^^ . r--> fh( P - r b? -' //1 (:!.-/tJIcIf.i . - , - ~ ~ J...: / - ..-- Exi ting Sewage Disposa~stem~~ or New System Required WATER SUPPLY: Public tfJ.>n Well Spring Other communi:; I'~: I Name of Community or Public System o J l' n j' ~~ PLUMB,.! G: 0 t Insta ledi1J.Y r;; Othe~ PLUMB NG FE If j ~ ''4,,:, ~ 7 f ixtures ~ewage ) ../ c~;ction V PLANS FURNI'!lltED SEWAGE DISPOSAL: Site Inspection fI , . FEES: Bldg. Jo. :-- I Name Plumbing Water Connection 3 % Surcharge Waste Disp. Plan Review FACILITY PERMIT TOTAL do.-- ./ I YES ,~ Signature of Applicant: ~ Fee Received By: 'kf?'-:- .;;;.. v .----. , I YES r I' NO :.""~ Date:.d)-025~-7b / Mobile Home ... d~~---",/S'. Min. SePtic~ Capacity B~~_ ~~e~d Required - Lineal Feet Maximum Depth Type of Construction Group Fire Zone Use Classification DATE: /~I-.. / ~A /1'/ .., Zone ?/t.:::r' ( ~a.'r)_ 11' CytING?'.~"i-'2"?(o COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT r . :;; Cenw of end Rig" of w& ~ L-~ Front N 1'1~ "'=Side""Int. ,~-'-~ 'Si=deJ;;ii:erior'==--:" '---rt.ear- /'? Su e.v~e~~..,94U!l..d P0i~ n(fJ.I 3,t,/ffe, C55 - 12 LANE