HomeMy WebLinkAboutPermit Sidewalk 1993-8-24
1I~ ~5IDENTIAL - COMMEJiiCIAL
__ 51DEWALK I CURBCUT .
AFPLICATION I PEfi!MIT
225 NORTH FIFTH 5TREET
5PR1~IELD, OF!EGON '31.411
ENGINEERINGI DIVI510N
OFFICE NO, 126-~15~
IN5PECTION LINE, 126-~16'3
JOB ADDI<!:&&. 'LZ"3}\'\ ,J\- s-r
A55E550R5 MAP NO,'*' 170 '32:> 17 ~ 7_
TAX LOT NO. '" '5Get)
5UBDIVI5ION,
ou.NER> 5 PI{ 1)1J/P r 1[t-lJ tj17lJry 6v tJ7Zo
ADDF!E55'2- '2--3 ;t/ttfL1?/;J sr crn-, S/RIJl/i/Ki-O
5TATE, ef2:G ZIP, 97</77 PHONENo.1~~-f'~S/
UJORK DE6CRIPTION.
5IDEWALK. L
CURB 51DE _
CURB-CUT, RE5IDEl-lTIAL _
5ECOND DRIYEWAY (5EE TRAFFIC)
F!EQUIF!E5 AFF'LICATION FOR A 5ECOND DRIYEWAy("T-.4Ja)
OR A COJNTY AFPLICATION FOR FACILITY PEfi!MIT (C '38-2~~)
IF IN THE U65.
5ET6ACK _
COMMERICAL _
DATE OF AFF'LICATION
1j-2-'I-'13
SPRINGFIELD
~~
F!ECEIFT N~\ OD"51
CA5H -
CHECK _
'*
Cl-lECKED FOR DELINQUENCIE5 _
5IGNED,
DATE,
~
~,~~c,5
-t'"
WORK TO BE FEIOiFv"" I1::.D BY,
CONTRACTOR '*' }.(et117- WAR ~___
ADDF!E55 ~J::; q. SOJE"", I cd.J ,^A
OUNER t/ CONiRACTOR
'*
F!EGI5iRATION NO, (I] r?
~,...... -
1(:) ~4--q-z.,
~cP,
EXf'IF!E5,
PHONE,
.-.-..--i::....JRE FOR lN6FeCTION I<!:QUE&T,
CALL 126-~16'3 (F!ECORDER ) 5TATE YOUR CITY DE51GNATED JOB NUMBER, JOB ADDF!E55,TYPE OF
IN5PECTION F!EQUE5TED AND U,q-lEl-l YOU WILL BE F!EADY FOR 1N5PECTION, CONTRACTOR5 OR ou.NER5 NAME AND
PHONE NUMBER F!EQUE5T5 F!ECEIYED BEFOF!E 1""~ .AM WILL BE MADE THE 5AME DAY, F!EQUE5T5 AFTER 1.,"",
.AM WILL BE MADE THE NEXT WOI<l<ING DAY
Q r-
€X15TIN(:, AlJII n"""'- rt:FlM,y "~, : ;r ,.\:"1"1 I, ^li'lE: )- /'" I '=? I 2 c:;- J-.-,
YOUR CITY DE51GNATED JOB NO, 15~ ~
,.
'* 5EE 600K
I<!:GlUII<!:D IN&FECTION&
[Z]
51DEWALK I DRIYEWAY
FOR ALL CONCF!ETE PAVING WITHIN
THE 5TREET RIGHT OF WAY, TO BE
MADE AFTER ALL EXCAVATINGI
15 COMPLETE AND FOfi!M WOI<l<
AND 5UB-BA5E MATERIAL 15
IN PLACE
D
CURB I APPROACH APRON,
AFTER FOfi!M5 ARE ERECTED
BUT PRIOR TO POURING
CONCRETE,
FeE&. SIDEWALKS 3D' CUR6-CUT WALK X'
.11Zl.1Zl1Zl + fIZl.l5/L.F. ( X ) .11Zl-"'1Zl + tIZl.l5/L.F. ( X ) / "'-
OF WALK
J cj- ~O COMMERICAL DRlYEWAY5 5HALL k x' J,
HAYE 5' TO e' FLAIR5
. ~'- ~. 5TANDARD ,
TOTAL. FEF<t1IT FeE.
I HAYE CAF!ERJLLY EXAMINED THE COMPLETED AFPLICATION FOR PEfi!MIT, AND DO HEF!EBY CERTIFY THAT ALL
INFOfi!MATlON HEREON 15 TRUE AND CORRECT. AND I RJRTHER CERTIFY THAT ANY AND ALL WORK PERFORMED
5HALL BE DONE IN ACCORDANCE WITH THE ORDINANCE5 OF THE CITY OF 5PRINGFIELD, AND THE LAW5 OF THE
5TATE OF OREGON PERTAINING TO THE WORK DE5CRIBED HEREIN, AND THAT NO OCCUPANCY WILL BE MADE
" OF ANY 5TRlJCTURE WITHOUT PEfi!M1551ON OF THE BUILDING DIVI51ON. I FURTHER CERTIFY THAT ONLY CONTRACTQR5
AND E~O/~ U,q-l0 ARE IN COMPLIANCE WITH 0R5 1~1-,*& WILL BE U5ED ON THI5 PROJECT,
~~. Q, p/ UI-13
51c.NED I DATE