HomeMy WebLinkAboutPermit Sidewalk 1994-5-16
225 NORTH FIFTH STI<EET
SPRINGFIELD, OI<EGON '31411
ENGINEERING DIVISIoN .
OiTICE NO. 126-3153
INSPECTION LINE, 126-316'3
/'1 - }, (C .. J /
JOe ADDR!:55, ~ "uU ~ ~ ~A 0 W
ASSESSORS MAP NO.* 17 _ 0 ~ _ :< S' ~ -Z~ TAX LOT NO. '* 2700
"".5Pe./t08,F'/c..L. D CHECK ~ .
0UJ-lER> "54(5. / ."IfA." . . * I
ADDI<ESS, PO~'F -"'3.a>o /.Jt2.'50';~y,~SPR:.I&Gf1B.I-::> CHECKED FOR DELlNQJENCIES~
o e.. ZIP, 970--77 PHONE NO. 74-tb-g4.5 (
iil'3O
RESIDENTIAL -
u-e
COMMERCIAL
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SIDEWALK I CURBCUT
APPLICATION / PE~IT
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SPRINGFIELD
.,~.~
. RECEIPT NO, ~
CASH
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I
Df 277w
SIGN~D'~A/?4J ~ l)1J
DAn;:, ")-((P L 9 ct' j
I
SUBDIVISION,
ST.4i'E:
WORK DEecRIFTION,
SfDEWALK: ~ CURB SlOE ~
CUR!3,CUT, RESIDENTIAL ----'--
SECoND DRIVEWAY (SEE TRtJ=i=IC )
REQJIR"'S AFFLICATIO'-l FOR A SECOND DRIYEWAYr"T -4.1.;
OR A COUNT'( ,1...FPlICA710N FOR FACILITY P::::~iT (C '38-203)
IF IN TriE U.G5.
SEtBACK ~
CO, n-I"RlcAL
PATE or: APFLlCAT10N
WORK TO BE FERrv"", Iz::D BY, OUN"'R
CONT!<ACTOR * II 0 E ['':C'd') 'rr7 4C'/('.) P ,~
.---.,z
CONT~CTOR
if
R!"'",IST!<ATiON NO.
ADDF?E.55
''? (= 'J' 75
- .
~........~~
UWII\..J&
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b(&~iCJtE: 974-0IpiJONE, 951- 742.'11
EXPIRES:
t-,",,-,'-t::';URE FOR IN5FECTION R!:GlUEST,
c.4[L 126-316'3 (RECOf?Z)::R ) STATE YOUR CITY DESIGNATED JOB NLr.'15ER, JOB ADDRESS,TYFE OF
INSPECTION REQUESii::P A~D l.J..ll-!EN yOU WILL BE READY FOR lNSFECilo:-.l, CONTR,t..CiOR5 OR OJ.NE~S N.L.:-iE: .L.."-ID
P~E NUMBER 'F?EQUE.5i& RECEI\IED BEF-O'RE 1:00 .L..'r1 WILL BE MADE T~= 5A"'1E OA1, REQUEST5 hFlER "'1:00
.4'1 WILL BE MADE THE' NEXT !LORKING DAY
EXISTING: BUILDING PER!1IT NO. ( IP APPLICABLE)
YOUR CITY DESIGNATED JOB NO. 151' 94072-0
*' SE'E"BOOK
R:EGlUIR:ED INSPECTIONS
~
51DEWALK / DRIVEWAY
FOR ALL CONCR!"'TE PAVING WITHIN
Tl-lE STREET RIGl-1T OF uJAY, TO 5E
MADE A.:-iER ALL EXCAVATING
15 =MPLETE A>,jD FORl'1 !LORK
AND SUB-BASE' MA TE'RIAL 15
IN PLACE
D
FEES,
S!DEWALKS
t10.00 . Y.Z>.1!'>/LF. ( X) f 8
OF WALK
CURB-CUT
t10.00 . Y.Z>.\:,/L.F. ( X ) .
TOTAL PEF:t1IT FEE,
~
/2,{0
COMMERICAL DRIVEWAYS SHALL
t-lAYE S' TO 8' f=LAIR5
3'- 0" STA~DAR:D.
CURB / APPROACI-I APRot'-J:
At-iER F0R"15 ARE ERECTED
BUT PRIOR TO FO:.JRING
CONCRETE.
WALK x'
/ ~
I x' I,
.,
., .,
I :...1A\/E CAREF'JLL..,... EXA"""1IN:=D Ti-JE COMPLETED AFPLICATloN FOR PER'""iIT, ,..:....-.,10 DO HEREBY CERTiFl 7J-tL.. TALL
Ih~~AT\ON HER:EON IS TR"JE A~D CORRECi, A'lD \' PJ.Rl~E.R CER.iY;::''!' il-\,L.i A""\Y ;:''''4D t..LL u.:of<K,. PE~O~IED
S'-1ALL BE DONE' IN ACCORDANCE WITH THE ORDIN-'oNCES OF THE CITY OF SPRINGFIELD, AND Tj-jE L-'ol:JS OF THE
STATE OF OREGON PERTAINING TO TI-4E lUORl'< DESCRIBED HEREI~, AND T+-1AT!'-iO OCCUPANCY WILL 9:: H,!.,DE
OF AN.,... 5iRUCTURE WITl-10JT FE~15510l'J OF THE BUILDING DiVISION; I FURTl-lER CERTIFY iHAT ONLY CONiRACTOR5
-'-ND EMPLOYEES WHO ARE' IN COMPLIANCE WITH ORS liZ'I.055 WILL BE USE'D ON THIS PROJECT.
j,
SIGNED
DATE'