HomeMy WebLinkAboutPermit Curb Cut 1995-8-9
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-PhSIDENTIAL - COMMERCIAL
SIDEWALK I CURBCUT
AFPL ICA TION I PE~IT
...'.
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225 NORTI-lFIFTI-l STREET
SPRINGFIELD, OREGON ~1411
ENGINEERING DIVISION
o:=rlCE NO. '126-3153
INSPECTION LINE: 126-316~
JOB ADDRESS: Lf6 Z.C; {1iAMJJ I { ~~
ASS::SSORS MAP NO.*" - /7 () 7 ~ " Lf t/ TAX LC?T NO."* I {:;3/:;
I
RECEIPT ~O: /~?:to57
CAS!-1 l/
SU::'iDIYISION:
.----. ,
GillER: ~t1f1 At- ~-r-J-eJl lMr ~
/ ' . "'-- Cl r. n iJ
ADDRESS: c..+OZl3 L~ (~ITY: /">)Mtrl
/i - ~--
ST ATE: ~ ZIP: V! -Z ~ 75S PriON:: NO. 77 &.- '81Zi3
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CHECK
*
CH;::CKED FOR DELlNQ:J:=NC!::5 L---
llJC:>R(. DEecRIPTI~y
V
S!D=:uJALK:
CUSS S!D::
RESIDB<TIAL
S=TBAC<
CURB-CUT:
CU, ,II I!::RICAL
S::COND DRIVEWAY (SEE TRAiTIC )
REQUIRES APPLlCATI~ ;=OR A SECOND DRIVEWAY(--T"-4.lo!l)
OR A COUNTY APPLI<=ATION FOR FACILITY PE~IT (C ~-203)
IF' IN TH:: U.G.5.
DATE 0;= APPLICATI~ <?....q J1S
SIGNED:
~
DATE:
llX)~ TO BE FE~D 6Y: J OUJ'.ER. CONTRACi'OR
~ dAA 1/ II nlJlil" , *"
CONTRACTOR*"" . _ '~.'_/ ~~GISTRATION NO. ----
ADDRESS Lf(!)./? CAUM~ ,{ L!~ ___ .
F'ROI-t:vURE FOR 'INz.r-=CTI~ REQUEST:
, CALL 126-316~ (RECORPER ) STATE YOUR CITY DESIG~TEb JqB NlJ:1B::R, JOB ADDRESS,TYP:: 0;=
INSPECTION REQUESTED A"lD WHEN YOU WILL B:: READY FOR INSPECTION, CONTRACi'ORS OR OUN::RS NAM:: t.."iD
P!-4ONE NUMBER REQUESTS RECEIVED B=rDRE 1:12>12> t.M WILL BE MADE Tl-!E SAME DAY, REQUESTS t..,=TER 1:00
A'1 WILL BE MADE THE NEXT lLORKlNG DAY
;X' ='=:=c,. y 1,;/
_ I l~_ ./"-VH-
P~ONE:/7 ~ ?!(3
*" SEE BOoK
EXISTING 5UILDINGPE~IT NO. ( 1;= APPLICABLE) .
YOUR CITY DESIGNATED JOB NO_ isf' Q0, (/I'W
,- '--" - .'--- I
REQUIRED INSFECTJ~S
/
~
I
SIDEWALK ~ DRJVEWAY
FOR ALL CONCRETE PAVING WIT1-4IN
T1-4E STREET RIG1-4T 0;= WAY, TO BE .
MtDE ACi'ER ALL EXCAYATING ,
IS COMPLETE AND FORM WORK
AND SUB.BASE MATERIAL IS
IN PLACE
,,~ CURB I A. . "OAC1-4 APRO:'
,At-iE:R FO~S ARE ERECTI
BUT PRIOR TO POURING
CONCRETE.
FEES:
SIDEWALKS
CURB-CUT
WALK X'
~10.00 .. ~0J5/LF. ( X )
Of WALK
~10_00 + ~.1S/L.F. ( X )
/
~
TOTAL F'E~IT r-t:t::
So
IL~LP()
COMMERICAL . DRIVEWAYS SHALL
HAVE =-' TO B' FLAIRS
3'- 0" ST A'lDARD
X'
'I
1
I riAVECAREFuLL '1' EXA'1INED T!-4E COMPLETED AF.PLlCATiON FOR PE~IT, A'lD DO I-lEREBY CERTIFY T1-4.L.T ALL
IN;:QRMATION HEREON IS TRUE AND CORRECT, A"lD I FURTHER CERTIFY, THAT A"lY A"lD ALL WORK PE~ORMED
S1-4ALL BE DONE IN ACCORDANCE WITI-l-THE ORDIN:"NCES 0;= THE CITY 0;= SPRINGFIELD, AND T~E LAWS 0;= THE
STATE 0;= OREGON PERTAINING TO.T~E WORK DESCRIBED HEREIN, AND T~AT NO OCCUPA"lCY WiLL BE M:"DE
0;= 4Ni STRUCTURE UJIT.--40UT PERMISSION.or: THE BUILD!NG DIVISIOt-l I FURTI---4ER CERTIFY TriAT ONL i CONTRACTORS
"'( ~;::;;::A'N C;:Zc:NCE ~H ORS 101~, WILL BE U,ED C<< T~'S Pf:T 9 _ q j
~a ...:,~~r) DATE "