HomeMy WebLinkAboutPermit Curb Cut 1994-4-27
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RESIDENTIAL - COMMERCIAL,
.,;.....,.-.. .....i;.>
SIDEWALK / CURBCUT
AFPLICATION / PER1IT
"c:.=::...,..;......_
22S NORTH FIFTH STREET
SPRiNGfiELD, OREGoN ~1411
ENGINEERING DIVISION
OR=ICE NO. 126-3153
INSPECTION LINE: 126-316~
RECEIPT NO: 0 I "Z.. 5""0 ~
CA$H
CHECK'
~
?.1NER: . 5if!<u/JA , J I A-1
I
ADDRESS: 2-6/9 c..~o/2J(/E
STATE:O~/J ZIP: 97~77
lllORl<. DESCRIPTION:
*
CITY: S'p/'?f)\.kbPI€Cf) CHECKED FOR DELINQUENCIES
PHONE NO. 74.6"-7404-
SIDEWALK: CURS SIDE
CURS-CUT: X RESIDENTIAL _X
S!:COND DRIvEWAY (SEE TRAFFIC )
R::QUIR::S AFFLICATIONFOR A SECOND DRIYEWAn.,.-4.1a)
OR A COJNTl" APPLICATION FOR FACILITY PE~IT (C SB-203)
IF IN THE U.6.5.
SETeACK
CO:1MERICAL
DATE 0:= AFFLlCATION
4/2- re:r4-
SIGNED:
:ae-'~
4/2- -f1/#
DATE:
WORK. TO 6E FE~D 6Y: OUNER
CONTRACTOR* e1l1EIUtLf) exCrlV4T/AJG.
ADDR::SS 42.5"0 t1.JE5T t;;TH AVG", I
X CONTRACTOR
REGISTRATION NO.* (4-17 3 EXPiRES: 7//4/14
J5U~,JJ~ 0/28, 17402 e-530bpr40NE: 34~---J~-O;-
PROCED~ FOR lNe:-::CTION REQUEST:
CALL 126-316~ (RECORDER) STATE YOUR CITY DESIGNATED JOe NL.r.15ER, Joe ADDRESS,TYPE 0:=
INSPECTION REQUESTED Al>.lD Wi-1EN YOU WILL eE READY FOR INSPECTION, CONTRACTORS OR OUNERS NAME A"lD
P~NE NUMeER REQUESTS RECEIvED eEFORE 1:00 AM WILL eE MADE THE SAME DAY, REQUESTS A,=TER 1:00
A"1 WILL eE MADE THE NEXT WORe:::.ING DAY
* SEE eoOK,.
EXISTING 6UILDING FER1IT NO. ( IF AFFLlCAeLE )
YOUR CITY DESIGNATED J03 NO. Isf
------
cr40S'12-
REQUIRED INSPECTIONS
SIDEWALK / DRIvEWAY
FOR ALL CONCRETE PAVING WITr4IN
THE STREET RIGHT 0:= WAY, TO eE
MADE AFiER ALL EXCAVATING
IS COMPLETE AND FO~ WORe:::.,
AND SU3-BASE MATERIAL IS
IN PLACE
IX
CURS / Arr:-.:OACH APRON:
At-iER FO~S ARE ERECTED
BUT PRIOR TO POURING
CONCRETE.
TOTAL FERt1IT H::t::
$ , {"2 i 33
"- -
0~
. .. .. I
~10..00 + S>0.15/L.F. ( X ) 15,5;:::
. P2,32.->
+- jD,CX::> ,
Cv, II IERICAL DRlvEuJA Y5 SHALL .
HAvE 5' TO 8' FLAIRS 12.3"3
3'" 0" STANDARD'
WALK x'
FEES:
SIDEWALKS
~10.00 + ~0.15/LF. ( X )
OF WALK
/ ~
x'
"1
I r4AvE CAREFULLY EXA'1INED. THE COMPLETED AFPLICATION FOR PE~!T, ':"'''lD DO r4EREBY CERTIFY THAT ALL
INFO~ATION l-!EREON IS TRUE AND CORRECT, A"lD I FURTl-!ER CERTIFY Tr4AT ANY AND ALL WORe:::. PE!'Q=ORMED .
SHALL BE DONE IN ACCORDANCE WITI4 Tl-!E ORDINA~CES OF THE CITY 0:= SPRINGFIELD AND Tl-!E LAWS 0:= THE
STATE 0:= OREGON PERTAINING TO THE WORe:::. DESCR/SED l-!EREiN, AND Tr4AT NO OCCUPANCY WILL BE M.L.DE
0:= ANY STR! JURE WITHOJT ~ISSION OF THE BUILDING DIVISION. I FURTHER CERTIFY THAT ONLY CONTRACTORS
AND EMPLOY. E40jRE COMPLIANCE WITH OR5 101.055 WILL BE USED ON THIS PROJECT.
YV---, 4-,/2-7/14-
DATE
SIGNED