HomeMy WebLinkAboutPermit Sidewalk 1991-4-22
225 NORTI-l FIFTI-l STREET
SPRINGFIELD, OREGON ~'4"
ENGINEERING DIVISION
OFFICE NO. 126-3'53
INSFECTION LINE: '26-3'6~
RF"~'IDENTIAL - COMME~trIAL
~, SIDEWALK I CUReCUT ". .,' ,
APFLICATION I PERMIT
1I/~"
SPRINGFIELD
Joe ADD~ee: ~ ~ 1 -;:S3 \&\.A...(L,~
ASSESSORS MAF NO.*' 1"7 - D Z - ~ "3 -"3 3T AX LOT NO. *' J 9>0 )
SUBDIVISION: GArc ~p(-r Plf~ Pi {Zs r lid) ·
OllNER: -5repcyt!.T. 5ht 11-t.
ADDRESS: WS1-S5 ~ db.,.. CITY, Sjs({c:(
v'
STATE: tJi< ZIF,17-f73 ',FI-lONE NO. 7ft" 410
RECEIPT NO: \ Cj 8 z7
CA51-1
CI-lECK ~-
. *'/
CI-lECKED FOR DELINQUENCIES
WOfO!K DESCRIPTION:
SIDEWALK: '>( CURB SIDE
CURB-CUT, RESIDENTIAL
SECOND DRIVEWAY (SEE TRAFFIC)
REQUIRES AFFLiCATION FOR A SECOND DRIVEWAY(.,.-4.1a)
OR A COUNTY APFLICATION FOR FACILITY PERMIT (C ~-2"3)
IF IN TI-IE U.G.6.
SE~ACK' 'Y--
CVI u I~RICAL
DATE OF APFLICATION
4-lzz.kl
SIGNED: '~p J1JJA,
DATE: - 4 f 2.. ~/9- (
I ( ( -
WORK TO 6E PE~D BY:
'X
OUNER CONTRACTOR
*'
REGISTRATION NO.
EXFlRES:
FI-lONE:
CONTRACTOR *'
ADDRESS
~-'.J." ~e..Y
~D~ FOR lNeF=CTION ~QUEST:
CALL '26-3'6~ (RECORDER) STATE YOUR CITY DESIGNATED JOB NUMBER, JOB ADDRESS,11 r~ OF
INSPECTION REQUESTED AND UJI-lEN YOU WILL BE READY FOR INSPECTION, CONTRACTORS OR OUNERS NAME AND
FI-IONE NUMBER REQUESTS RECEIVED BEFORE ,:"" AM WILL BE MADE TI-lE SAME DAY, REQUESTS AFTER """
AM WILL BE MADE TI-lE NEXT WOfO'KlNG DAY
*' SEE 6OOK.
EXISTING BUILDiNG PERt1IT NO. ( IF AFPLICABLE )
YOUR CITY DESIGNATED JOB NO. Isf ~/6? 8'B
"
~QUI~D INSPECTIONS
...-
V
SIDEWALK I DRIVEWAY
FOR ALL CONCRETE FAVING WITI-lIN
TI-lE STREET RIGI-lT OF WAY, TO BE
MADE AFTER ALL EXCAvATING
IS COMFLETE AND FORM WOfO'K
AND SUB-BASE MATERIAL IS
IN FLACE
CURB I Arrr<:OACI-l APRON,
AFTER FORMS ARE ERECTED
BUT PRIOR TO FOURING
CONCRETE.
FEES:
SIDEWALKS CURB-CUT
(0 ~
.10.00 + .0.15/L.F. ( X ) .10.00 + ~.15/LF. ( X )
. OF WALK
WALK X'
/ "\
TOTAL PER1IT r-ct::
s /1 ~
COMMERICAL DRIVEWAYS SI-lALL
I-lAVE 5' TO 8' FLAIRS
3'- "" STANDARD
X'
"
"
I !-lAVE CAREFULLY EXAMINED TI-lE COMFLETED APFLICATION FOR FERMIT, AND DO I-lEREBY CERTIFY TI-lAT ALL
INFORMATION !-lEREON IS TRUE AND CORRECT, AND I FURTI-lER CERTIFY TI-lAT ANY AND ALL WOfO'K FERFORMED
SI-lALL BE DONE IN ACCORDANCE WITI-l TI-lE ORDINANCES OF T!-lE CITY OF SPRINGFIELD, AND TI-lE LAW5 OF TI-lE
5TATE OF OREGON FERTAINING TO TI-lE WO~ PE5CRIBED I-lEREIN, AND TI-lAT NO OCCUPANCY WILL BE MADE
OF ANY 5T CTURE WITI-lOUT r ,ri!J dSSION OF'TI-lE BUILDING DIVI51ON. I FURTI-lER CERTIFY TI-lAT O;;L Y ONTRACTOR5
AND EMF irEE5 UJI-lO ARE I ,.cOMFLIANCE WITI-l ORS '''1-''55 WILL BE USED ON TI-lIS PR~7T.
, '- , -, . ..' # 22-, 71
51GNED DATE