HomeMy WebLinkAboutPermit Sidewalk 1995-4-19
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::. .., reSIDENTIAL - COMMERCIAL
."., ' SIDEWALK I CURBCUT ~
, ',- APPLICATION I FERt1IT ~
225 NORTH FIFTH STREET. "
SPRINGFIELD. OREGON ~'411
ENGINEERING DIVISION '
on=lCE NO. '26~3153
INSPECTION LINE: 126-316<3
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SPRINGFIELD
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JOB ADDREe5: tf '7?~ P If I 6 t/, .
ASSESSORS MAP NO.*' I, ~ b 1J ,~ ~ -z... </3 TAX LOT NO: W6C
SUSDIVISION:
RECEIPT NO: If e;/760~
CA5l-1
CHECK
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STATE:
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4>?Lf "D~I.s'(
D~ ZIP: Of7l./7t'I.
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CITY: tt;pf!..t.,NbR.JfzJL
PI-lONE NO'7/f 1-14;!rk
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CHECKED FOR DELINQUENCl:::S ~
O'J.NER:
ADDRESS:
- -
UJORK DESCRIPTION: .,.
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SIDEWALK: ~ CUSS SID:::.
i CUR;3-CUT: ,/ RESIDENTIAL
i SECOND DRIVEWAY (SEE TRATTIC )
REQUIRES APFLICATIO>l FOR A SECOND DRIY:::WAy(rr.4.1a) ~
1/ R A COUNTY APPLICATION FOR FACILITY Pl::~IT (C ~.2""3) L? L
~ IN THE U.G..9. -... ,SIGNED: -P'Y
DATEOFAPekIC~O>l q-I'-fb ~_~-I~4S
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WORK TO 6E FE~D 6)'": Ou.N::R v' CONTRACTOR /"#2<1-
CONTRACTOR*' ~..>()-t'S V tJ-(.,.U6..(/ fhl-(~ REGISTRATION No.*'9~b73 :::XPIRES:
ADDRESS / 5" q to /). Lo&..t2 Wo (li? /Z.U t5-E::U"1'" "7 q.() <J,
5:::TBACK
CO:-1MERICAL
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REQUIRED 1N5~CTfON5
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CLII 126-316<3 (RECORDER) STATE YOUR CITY D:::SIGNAT:::D J05 NUM5:::R, J05 ADDRESS,TYPE OF
INSPECTION REQUESTED A"JD Uh-IEN YOU WILL BE READY FOR INSPECTIO>l, CONTRACTORS OR OUNERS NAM::: A"JD
Pi-IONE NUM5ER REQU:::STS RECEIVED B:::FORE 1:""" AI"'! WILL BE MADE THE SAME DAY, REQUESTS AFTER 1:l2'l2'
AM WILL BE MADE THE NEXT WOR<.ING DAY tJ~~t7
EXISTING BUILDING PE~'.lIT ~ICABLE )
YOUR CITY DESIGNATED J'a NO. Isf 9'.~6c.,tP0 )
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SIDEWALK I DRIVEWAY f /c;~ I Arrl"'-OACH APRON
FOR ALL CONCRETE PAVING WITI-lIN V AFTER FORt1S ARE ERECTE
THE STREET RIGHT or: WAY, TO 5E BUT PRIOR TO PO;.JRING
MADE AC=TER ALL EXCAVATING CONCRETE.
IS COMPLETE AND FORt1 WORK
AND SUB-BASE MATERIAL IS
IN PLACE
*' SEE &>oK.
FEE5:
51DEWALK5
CURB-CUT
WALK X'
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OF WALK /()"I(../>"./. ~c) ~(O
TOTAL FERMIT FEE:
~ 2h. 6 D
~1@.@@ + Y.2?.15/LF. ( X )
=:1(.fO /O~ .If"::: '.1 ~i~~
COMMERICAL DRIVEWAYS SHALL
HAVE 5' TO 8' FLAIRS
3'- l2''' ST A"JDARD
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I I-lAVE ,CAREt-LJLL Y EXA"1IN:D T~E COMPLETED AFPLICATION FOR PERMIT, A"JD DO HEREBY CERTIFY THAT ALL
lNrORMATION HEREON IS TRUE AND CORRECT, A'ID I FURT;"';ER CERTIFY THAT ANY ~'1D ALL WOR<. PER5"ORMED
S;.lALL BE DONE IN ACCORDANCE WITH THE ORDINANCES or: THE CITY or: SPRINGFIELD, AND THE LAUJ5 or: THE
STATE or: OREGON PERTAINING TO THE WOR<. DESCRIB:D HEREIN, AND THAT NO OCCUPANCY WILL BE MADE
or: ANY STRUCTURE W!Tl-lOUT PERMISSlo:-.l or: THE BUIJ...DI~~ DIv!SI01-t I FURTHER CERTIFY 'THAT ONLY CONTRACTOR5
AND EMPLOYEES WHO ARE IN COMPLIANCE WITH ORS '''t.e>55 WILL BE USED ON THIS PROJECT.
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