HomeMy WebLinkAboutPermit Sidewalk 1991-4-23
-.
22& NORT14 FIFT14 STREET
SPRINGFIELD, OREGON 91411
ENGINEERING DIVISION
OFT'ICE NO. 126-31&3
INSPECTION LINE, 126-3169
~p?IDENTIAL - COMME8ICIAL
,!,;' SIDEWALK I CUR6CUT ...
AFFLICATION I PE~IT
1I/~
SPRINGFIELD
Joe ADD~ee: /../ '1 t C{ IJ .Jf.u/d6
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ASSES50R5 MAP NO. / 7. _ 0 L.. - -..; -::;;:; -"7"'") TAX LOT NO. / 7 Co 0
5UBDIVISION, c2J4..-r€. b 'll6.. 'l(/ ~ li!:. I::-.
OUNER: ~_ 1:. v4 .-v.1Z-~
ADDRESS: I J.. ^ ~ L..:Z 94-.
RECEIPT NO: i'ff{41
CA514
C14ECK
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CITY:~'
v
FI-lONE NO. 6 f'J - g--o t,CI
*
Cl-IECKED FOR DELINQUENCIES
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STATE: ~
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UJOFi!K DEec~IPTION:
ZIP, q 7 Lf tJ '!J
SIDEWALK, v- CURe SIDE
CURe-CUT, RESIDENTIAL
SECOND DRIVEWAY (5EE TRAFFIC)
REQUIRES AF'FLICATION FOR A 5ECOND DRlVEWAY(WT'-4.1a)
OR A COUNTY AFFLICATION FOR FACILITY PERMIT (C 98-212')3)
IF IN TJ.1E U.GI.6.
SETBACK
~
Cvl II IJ:RICAL'
DATE OF AF'FLICATION
'I-It{ - q I
SIGNED,
DATE:
j3rt- ~.
4/23/''lr
WORK TO BE PE~D BY:
CONTC^CTOR'*"."..'. ". . ~',/'.-i . -:.-. ..::,.-.~,
~ !~ r" 'I' ::"-~ - '. 't
I. . .,,-
ADDRESS /2,2.L/ z., 2-11H I't,
y OlLNER 'VIA CONTRACTOR
REGISTRATION NO.* NI/4
6uc;e/IJc
EXPIRES, N/A
PJ.1ONE: '. ~/{:S "".}j'O"L
~D~ FOR IN5FECTION FEQUE8T:
CALL 126-3169 (RECORDER) STATE YOUR CITY DESIGNATED JOB NUMBER, JOB ADDRESS,TYPE OF
INSPECTION REQUESTED AND UJI..lEN YOU WILL BE READY FOR INSPECTION, CONTRACTOR5 OR OlLNERS NAME AND
PI40NE NUMBER. REQUESTS RECEIVED BEFORE 1,12')12') AM WILL BE MADE T14E SAME DAY, REQUESTS AFTER 1:12')12')
AM WiLL BE MADE T14E NEXT WORKING DAY
* SEE 6OOK.
EXISTING 6UILDING PE~ITNO. ( IF APPLICABLE) A)('1> eIJ-e
YOUR CITY DESIGNATED JOB NO. Isf 9 J 0'3 7 0
Fi?EQlJI~D INSPECTIONS
/' SIDEWALK I DRIVEWAY
V FOR ALL CONCRETE PAVING WIT14IN
T14E STREET RIG14T OF WAY, TO BE
MADE AFTER ALL EXCAVATING
IS COMPLETE AND FO~ WORK
AND 5UB-BA5E MATERIAL IS
IN PLACE .
CURe I Ar-r-ro::OAC14 APRON:
AFTER FO~S ARE ERECTED
BUT PRIOR TO POURING
CONCRETE.
FEES:
SIDEWALKS
.10.00 .. .0.1~/LF. ( X )
OF WALK
CURB-CUT
.10.00 .. ~.1~/L.F. ( X )
WALK X'
/
~
TOTAL FEFiNIT n:c::
$
I :3 I DC)
COMMERICAL DRIVEWAYS S14ALL
14AVE &' TO 8' FLAIRS
3'- 12')" STANDARD
X'
"
I 14AVE CAREFULLY EXAMINED T14E COMPLETED APPLICATION FOR PE~IT, AND DO 14EREBY CERTIFY T14AT ALL
INFO~ATION 14EREON IS TF<1JE AND CORRECT, AND I FURT14ER CERTIFY TJ.1AT ANY AND ALL WORK PERFO~ED
S14ALL BE DONE IN ACCORDANCE WIT14 TI-!E ORDINANCES OF TI-!E CITY OF SPRINGfiELD, AND TI-!E LAWS OF T14E
STATE OF OREGON PERTAINING TO TI-!E WORK DESCRIBED 14EREIN, AND TI-!AT NO OCCUPANCY WILL BE MADE
OF ANY STRUCTURE WITI-!OUT PE~ISSION OF TI-!E 6UILDING DIVISION. I FURTI-!ER CERTIFY TI-!AT ONLY CONTRACTORS
AND EMPLOYEES UJI..lO ARE IN COMPLIANCE WIT14 0R5 112')1.i?J5!;' WILL BE USED ON TI-!IS PROJECT.
cY~ r:~/~L/
SIGNED ? ,. ,
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