HomeMy WebLinkAboutPermit Sidewalk 1998-6-20
4F5IDENT;I~;AL:-1 ~~ZiRC'AL
. .4F'PLlCATION I PER"1IT
225 NORT~ FIFT~ STREET
SPRINGFIELD. OREGON <31411
:NGINEERINU DIVISION
Ofi'ICE NO. 176 -3153
INSP"CTION UN:, 126,316<3
111"..0
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.~~=~~~=~ M'ONO* /7-63-2.7- '-II
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5U3DIVISION,
O.:NER I--\-,A,~..6. ,
ADDRESS, ?Jon \/0
STAT:, 012-
ll.iOR<. DE5CRIPTION,
S!::>=ult.LK -.r
CJR'3 ~ CUT:
SPRINCFIEL.D
- 6~ A--r-rb.~~o
T"-X LOT NO: '* .z~
CASH
R:C:IPT NO, 1191'i
Cl-i"C<
( e>el t.. W .""'S HA f,l:e.. "
F-A.\e\1 \\::-\Al CITY'6P.eli-l(,.,~/r;.t.D
ZIP, OJ 7417 P;..ION: NO.
v-
*,/
C;..;ECi<.ED FOR DELlNQ~:NCiE5 -'-
CUS?:9, 51::>:
S::BACK
R:S108'ilAL. _
CO;-J"1=RICAL
S:COND DRIV=W.4Y (S"E T~IC )
REQUIR:S APFLlCATION rOR A 5:COND DRIV=WA"-('T,4.1.)
OR A COllNTr" t.F'PLICATION FOR F~CrLlTY ~~JT (C ':.8.2C::>3)
Ir IN m: UG.5.
.5IGlNE:;:
.-
D.4T: or .4PFLIC.4T1ON l. .t.o-?>
DAE:
~
@-/~lS
UiOR< TO BE FERl"u"", II::D BY: OCloER r~T:'<ACTOR
C~TR"-CTOR* 61' P,1Q't-J c-() j..( !G:re.uc:tl f"J/J REGISTR"-TION NO.*~~., I
=DR:5S 2.'1 ~LJ. -t:a, A''''B.?t2..-r e.rI, t:::,j J/...,t::::J.J&. . ",\2...
r-r<vc..<:vURE FOR IN&FECTION REQUEST:
C.4LL 126-316<3 (R::C=ER ) STAT: YOUR CITY D:5IG;lAT"D J03 Nu:-13:R, JOB ADDR:S5,T'r'P" or
INSPECTION REQUE5TED A"iD lU-1EN .,...OU WILL 5= R::A::>Y FOR 1N5PECTlo-.l, CONTRACTO~ O~ ~RS N..t.;--;:: t.."JC>
pJ..io..E NU1'1B:R R::QJ"STS RECEIVED Ba=oRE 1,00 "-'1 WILL B: MAD: TH: SAM: DAY, R::QJ:5TS "-"TER 1,00
A'1 WILL BE MAD: T!-l: NEXT ~INC= DAY
"* SEE BOoK
REGlUIRED INSPECTIONS
FEES:
TOTAL PERMIT FEE,
:XP:RES, b:2../ ~ '"
P;";O'JE, <I" / -0$c'J'2.
EX!STING- SUILr:>rNC:: PE~IT NO. ( IF ,APPLICABLE)
YOUR CITY D:SIGNATED J03 NO. Isf -Ii 7'5{) 997
~SIDEWALK / DRIVEWAY
FOR ALL CONCRETE PAVING WITHIN
TH" STRE:T RIG!-lT 0;= WAY, TO BE
t1tDE .l..=TER ALL EXCAVATING
15 COi'"'iFLETE AND r=ORM WO~
A>olD SU3,3A5" MATERIAL IS
IN FLACE
D
,- CURS I APPROACH .4PRo.
A:-lER FO~S A~ ERECT:
BUT PRIOR TO POJRING
CONCRETE.
W4L< x'
/ ~
t x' ./.
"
I ;..I.c.vc: -CARER.JLL Y EXA'"1INED T}.JE COMPLETED AFPLlCATia-.l FOR PEF<:MIT. "="'''D DO t-lERESl CE::O;7rr=y 71-tL.T ALL
'Ni=O~ATION t-lEREON IS ~E A"ID CORR.:CT. A~D I FURTf.:ER CERTIFY T~AT A"Y ~"D ~L lLiOR<. PE~O~ED
S~ALL BE DONE IN .4CCORDA>olCE WIT~ TH: ORDINA'JCES or THE CITY or SPRINC=f'IELD, AND TH: LAC.l5 or THE
STAT: 0;= OREGQ'J PERTAINING TO THE WORK DE5cRIB:D !-;"REIN, A>olD THAT NO OCCUPA'JCY WILL B" MAD:
OF t..~.,... STFalCTU~ U"i;40JT PER'11SSlo:-.J OF TI-lE 9t1ILD!NG DIVISION.. I FUR71-lER CERTIFY 7h'...\T ONL"i'" COSTRACTC::;::S
.<.ND EMPLOYEES WHO ARE IN COMPLIA>olCE WIT~ OR!'> 101.0:.5 WILL BE US:D ON TI-IIS PROJECT,
--=:> ~
SIDEWALKS
.10.00 . ~.15/LF. ( X )
or WALK
S(D'" --t' tij)'~,/~Z- 1'2.<)<>
SIGNED
CUR9-CUT
.10.00 . ~.1:;,/LF. ( X )
~
COMMERICAL DRIV=WAYS SHALL
HAVE S' TO 8' FLAIRS
3'- O' STA'JDARD
2.2, DO
~
DATE
~-ZO-q-S