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HomeMy WebLinkAboutPermit Sidewalk 1995-4-19 1I~ ::. .., 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 . ,\ , .",. '.' SPRINGFIELD " 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 ~ STATE: ~'1INILf- ~~ 4>?Lf "D~I.s'( D~ ZIP: Of7l./7t'I. It}((L~q! CITY: tt;pf!..t.,NbR.JfzJL PI-lONE NO'7/f 1-14;!rk '* ./ CHECKED FOR DELINQUENCl:::S ~ O'J.NER: ADDRESS: - - UJORK DESCRIPTION: .,. ! . ~ 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 ..1' .~ ~F \, y ~ --v. --.....-- -- ~ ~ 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 '-- '~~ REQUIRED 1N5~CTfON5 ~ ----'- , .--"'-. -/\.. 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 ) I " __ ~"\...--- _~__J 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' " ~1@.@@ + ~@.15;LF. ( X ) '" - 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 / ~ , 'I X' 1 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. 51CJ4~ /;; ~~~ . DAlE ,~k .