HomeMy WebLinkAboutPermit Sidewalk 1992-4-8
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~::;'Ij.".)t:N IIAL -"'- L".UI~lnt:~L".IAL-
SIDEWALl< I CURSCUT
AFPl-ICATION I PEFl'1IT
SPRINGFIELD
229 NORTf4 FIFTf4 STREET
SPRINGFIELD, OREGON '!l1.411
EN<:;INEER/NGo DIYISION
Oi'l'ICE NO, 126-3193
1N5PECTION LINE, 126-316'!l
.
.
JOB ADDl"iES6'jt:>h L AL~.,-H' '4, , 5-'-
A55E550RSMAPNO.'* /7-03'- 15-4--( TAX LOT NO,*O 17=
5(JeDIYISION,
RECEIPT NO,
CA5f4
Cf4ECK L
4ZbJ
ou.NEl'!< tVA<f'L AA> t:7 lioeN! r3eec:"",
;LbzTf/tA . '5 (.
ZIP, 974-'7'7 PHON: NO,
ADDRE55, I 0 &> "2_
STATE, Or=-
CITY,
SPJ!='L(::/
'*
Cl-lECI<ED FOR DEl.INGl'JENCIES ~
UJOIO!K DESCRIPTIoN:
5IDEUJA1.K< ~ CUR!;I 51DE _ SEreACI<
CUR!;l-CUT, RESIDENTIAL _ Co:1MERICAL _
SECOND DRIYEWA'f (5EE TRAfFIC)
REG1IlIRES APPl.1CATION FOR A SECOND DRIYEWA'f("T-4.la)
OR A COUNTY AFPl-ICATION FOR FACILITY PEFl'1IT (C ~-2"3)
IF IN Tf4E U.Go,S,
DATE OF APPliCATION
SIGlNED,_ A,,____p j-d6~
DATE, 4-18}3,z-
( ,
u)ol"iK TO BE F'E~... Il:D B"'-, OUNER
CONTRACTOR'* L-A 1Z..e,Lp .A, C;:;YV/ {'/ /-I
ADDRE5!l c; 3$ Aia' (0 '71-+ ~F'Cr::>
)(
CON~CTOR
REGISTRATION NO.'*..5 / c/-88
De 974--7'7
EXPIRES, 8j2t hc_
Pf4ONE' 74--7 -834 '3
r-~...=-URE FOR JNSFf:CTION l"iEQUEST,
CALl. 126-316'!l (RECORDER) STATE 'fOUR CITY DESIG!'-IATED JOEl NLJ:"15ER. JOEl ADDRESS,1"rPE OF
INSPECTION REQUESTED AND Il.I-lEN 'fOU WILL 6E READY FOR INSPECTION, CONTRACTORS OR OUNERS NAME A"D
Pt-lONE NUM6ER. REQUESTS RECEIYED eEFORE 1,00 AM WILL ElE MADE Tf4E SAME DAY, REQUESTS AFTER 1.00
AM WILL 6E MADE Tf4E NEXTWOf<KING DAY
'* SEE ElOOK
EXISTING 6UILDING PE~IT NO, ( IF AFPl-ICAeLE )
YOUR CITY DESIGNATED JOEl NO. Isf "7z.o 5 '5
FCEQlJIFCED INSPECTIONS
[B
51DEWALI< I DRlYEuJAY
FOR ALL CONCRETE PAYING WITI-!IN
Tf4E STREET RIGHT OF WAY, TO 6E
MADE AFTER ALL EXCAYATING
IS COMPLETE A"lD FOFl'1 WORK
A"D SU5-5ASE MATERIAL IS
IN PLACE
o
CURB I APPROACI-! AF!<ON.
AFTER FO~S A!<E ERECTED
6UT PRIOR TO POURING
CONCRETE.
FEES,
SIDEWALKS
CURS-CUT
TOTAL nol'<l liT FEE.
t I ( (9'5
co:-l:1ERICAL DRIYEWA Y5 SI-!ALL
;';AYE 5' TO 8' FLAIR5
3'. 0" STANDARD
WALl< X'
/ ""
I. x' I.
.,- .,
1'"
.10,00 + ~0.15/LF. ( X )
OF WALK
.]0.00 + ~.15/LF. ( X )
I;.lAYE CAREFULLY ExA'1INED THE COMPLETED APPLICATION FOR PE~IT, A"D DO f4ERE6Y CERTIFY THAT ALL
1N:"-oFl'1ATION f4EREON 15 TRUE A"D CORRECT, A"D I FURTHER CERTIFY THAT A"Y A"D ALL WOf<K PERl'OFl'1ED
SHALL 5E DONE IN ACCORDANCE WITH THE ORDINk'lCES OF THE CITY OP SPRINc.FIELD, AND THE LAUJ5 OF THE
STATE OF OREGON PEf=ZTAINING TO TI-4E Uk:::>R!< DE5cRISED l-iEREIS, "':'''iD T!-IAT NO OCCUPA'lCY UJILL 5E M~OE
~~ISTRJCTURE WITHOJT PER:"1ISSION OF THE 6UILDING. DivISIoN. I FURTHER CERTIFY THAT o-IL Y Co-I'RACT. OR5
-'-~~=-A~ WITH ORS 101-""5 WI~L 5= USED ON THIS PROf~ f' 1 L----
SIGNED
DATE