HomeMy WebLinkAboutPermit Land Drainage Alteration 1997-5-20
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C i t Y 0 f Sp r i n g fie I d
225 Fifth Street, Springfield, Oregon 97477 - Developmerlt services
Date o~ Application I:-I? - r 7 Expiration Date:
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Property Owner C Lrf ~ ~vcL-, f- P: A 'i e e"5 i-ev
Address :~9 ~-o ~"...Ir-...... ~(... lot,./" 8;~
Phone: 'l'~6 o-}O 0 ^7
City 3"c.-iu-e State:aff'.Zip'9'.'7.~..,t?
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Site Address: 6' 9 .5"1.( tJ1: -~ i--c L G ~
o UGB \Ta>t Map No: /,?~2-?,~~"" ~.::>
, Springfield, Oregon
Tax Lot:,.(5 ~
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SOILS & GEOLOGY PLAN,
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DRAINAGE, POLLUTION AND EROSION CONTROL PLAN
REPLANTING PLAN
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"'.A:DDITIONAL INFORMATION,
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COMPANY NAME:
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PROJECT SUPERVISOR:
ADDRESS:
COMPANY NAME:
PROJECT SUPERVISOR:
ADDRESS:
" PHONE
CITY
STATE
.' PHONE
CITY
STATE'
CONTRACTOR 'NAME: --k:-lr~\t'f,~\.-,J o. E 5L ~
i PROjECT SUPERVISOR: '$.4--&-t e,
,R.e.gist~<Ition Number: 2i!ff?~
~D'DRESS: h 9 &C:> (?1"CJ... i- ~:GL
STATE: /') r- '"" , ZIP: q7~'" oy'
MOBILE PHONE:
PHONE '7 c.t:-I; .f1p6'7
.' ~<,E?<piration Date: 9'9-~?
t4r-~"-I " '; CITY: .5b r- ~ArG 1=~~Ld:l'
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OFFICE PHONE ~~.e ~O? FAX
I EMERGENCY PHONE:
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By signa~ure, I sta,te and agree, that I have carefully examined the completed application and do hereby certify that all
information herein is true and correct, and I further certify that any-and all work performed shall be done in accordance with
the Ordinances of the City of Springfield, applicable City Standard specifications and Drawings, and the laws of the State of
Oregon pertaining to the work described herein. I further certify that only contractors and'employees who are In compliance
with ORS 701.055 will be used on this project. '
The City may inspect the work site described In this permit at any time during a one year period following the receipt by the
City of notice of completion of the described work and specify, at the City's sole desecration, any additional restoration work
required to return the site to a standard acceptable to the City. The permittee will be notified In writing of any work required
and will have thirty 1301 days from the date of the notice to complete the work. Work not completed at the end of the thirty
days will be performed by the City and the costs will ba billed to the permittee.
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I further agree to ensure that all required inspections are requested at the proper time, that project address is readable from
the street, and the 1Jf.roved set of plans will remain on the site at all times during construction.
Signature!' (0 ----II J 1__/1 0 < cc> J~/ , Date S - 2 0 - q 7
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DRAINAGE,
o Storm, 0 Ditch, 0 Culvert, 0 Natural
WETLANDS, Description
FLOOD PLAIN, Zone:
, FEMA Community Panel No.:
FLOODWAY, FEMA Community Panel No.:
, Date:
PLAN CHEC,K FEES:
UP TO 100 CUBIC YARDS
101 TO 1,000 CUBIC YARDS
1,001 TO 10,000 CUBIC YARDS
10,000 TO 100,000 CUBIC YARDS
100,001 TO 200,000
$20.00
, $30.00
$40.00
$40.00 For the first 1 0,000 cubic yards, plus
$20.00 for each additional 10,000 cubic yards or fraction thereof.
$220.00 For the first 100,001 cubic yards, plus
$20.00 for each additional 10,000 cubic yards or fraction thereof.
$340 For the first 200,001 cubic yards, plus
$6.00 for each additional 10,000 cubic yards or fraction thereof.
200,001 CUBIC YARDS OR MORE
GRADING PERMIT FEES:
UP TO 100 CUBIC YARDS
. 101 TO 1,000 CUBIC;: YARDS .
$30.00
$30.00 For the first 100 cubic yards, plus
$14.00 for each additional 100 cubic yards or fraction thereof. '
$156.00 For the first 1,000 cubic yards, plus .
$12.00 for each additional 1,000 cubic ya~ds or fraction thereof.
$264.00 For the first 10,000 cubic yards, plus
$54.00 for each additional 10,000 cubic yards or fraction thereof.
$750.00 For the first 100,001 cubic yards, plus
$30.00 for each additional 10,000 cubic yards or fraction thereof.
1,001 TO 10,000 CUBIC YARDS
10,000 TO 100,000 CUBIC YARDS
100,001 TO 200,000
Estimated Volume:
~c:J~ ~
Received By: fi~"
b //y~ ,.,'
Grading Permit fee: ~~$ ,~).
Received by: ~~.-
~ ~/c/
o ~IJ k~ TO T#:fE .~L/A.YC ?U'AJ~~ ~~~
o NR'V ~lJ1J r-/)ll/J7llJl- A?bUULCf lJUt!l?/)J~ ~ /il~.
r (~At;: ~,~jw'j ~/A!~?::r '
Plan Check Fee:
Receipt:::?~~&? Date: S-~"?
Date:
Receipt :z.. ~~?'/
Date:
.Date:
~-2o~?'
~ Planning l. N .( Jl \ I <1.-~ tJ't ~ IIV' oN' .M-...l...UvJ'-ls Date: sl...-z-o J.q'\]
O t>AA1~A6~. "'M(,~"\~~e..... f.I~ ~~l"'" c,o""t.-..' all.-i...., we4r: 1I.J(i.A~, Ci/L:"
En~meen.ng ~.'" l.l.t h 1LL- f"b\i~ c\.w.'^"''l.Cl- \::<df?"" , Date:~1Llp..7
o Building: dJ(; U~ Date: S"'/,U1~?
, \', ( I I
o Maintenance: Date
~l
Permit Number ??~S 2S2
Issued by: r
Date: ~""':2~"'-::;;"'",
. ,.
EiJ:Htl In~nections'
Planning:
Date
Engineering:
.Date
Building:
Date
Maintenance:
Date: