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HomeMy WebLinkAboutPermit Sidewalk 1994-10-25 II~ -WIDENT1'~;ALK I ~~~~CI~,L, AFFLlCA TION I PERMIT ' SPRINGFIELD 22" NORTI-l FIFTI-l STREET SPRINGFIELD, OREGON <;\1411 ENGINEERING DIVISION OFFICE NO. 126-'1,,' INSPECTION LINE, 126,';6<;\ Joe ADDREe5. l\q Cj 1==/1 iY v( ew 1) v ASSES50Re. MAP NO.*' 11 O??.7 Lj ] 5UBDIVISION, M~2..\E VIL.LA6E' ~R, t-Irru. <;)v\~ A.A':hI\l)v; ~ t.DDRESS, '::500 W \- a. ~ If \.h e.u...> ~ STAlE'~ ZIP, c; -Jl.n7 UJO!;!K. DESCRIPTION, SIDEWALK, u:::::... '* T AX LOT NO. ()() to I RECEIPT NO, \02.I..<- CA5I-l CI-lECK L CITY, Spfel PrlONE NO. ton - ::E7S '* CI-lECKED FOR DELlNQJENCIES _ CURS SIDE _ SETSACK CURS-CUT, RESIDENTIAL _ CO:1MERICAL _ SECOND DRlvEWA T r SEE TRAfTIC ) REaJlRES AFFLICATION FOR A 5ECOND DRlvEWATr'T,4.1.) OR A COUNTY APPLICATION FOR FACILITT PERMIT rc <;\&-2"') IF IN TI-IE U.G.9. DAlE OF AFFLlCATION )1) ,7Jo -q4 SIGNED, -a,^^ArJ-~- '11-7;:'-'1~ .' DAiE: UJOI':!< TO BE FE~"", IcD BY, OUNER'/ CONTRACTOR CONTRACTOR '*' "')IA~)\J (' u.\..\ '\Te.1A.. m 0)0. I tJ~GISTRATION NO.'*' ~~ 7 J t.DDRES5 2.'1 '::AL\l":> A,12...'VCII2--i ?-D EXPlRE5, ~ -21 ... 15 P;..!ONE, tHo I oc,lJ:>, ...........c......URE FOR IN$F5CTION REQUEeT. CALL 126-'16<;\ (RECORPER ) STATE TOUR CITY DESIGNATED Joe NUM9ER Joe ADDRES5,TTf'E OF INSPECTION REQJE5lED AND ~ TOU WILL SE READT FOR INSPECTION. CONTRACTORS OR OUNER5 NAME A'ID P;.IONE NUMSER REQUESTS RECEIvED e,,,rvr= 1,= AM WILL BE MADE TI~= SA"1E DAT. REQJESTS AFlER 1,= AM WILL BE MADE THE NEXT ='~<.1NG DAT '* SEE 6001< EXISTING SUILDING PERMIT NO. ( IF APPLICA9LE ) TOUR CITY DESIGNA lED Joe NO. Isf q q \ 10 Lj 0 REQUIRED lNePECTIONe [] 51DEWALK I DRlvEWAT FOR ALL CONCRElE PAVING WITI-lIN TI-lE STREET RIG!-IT OF WAT, TO SE MADE AFTER ALL EXCAVATING IS COMPLETE A'ID FORM WORK A'ID 5UB,SA5E MAlERIAL IS IN PLACE D CURS I APPROACH APRON, AFTER FORMS ARE EREClE! SUT PRIOR TO POURING CONCRETE. FEEe. SIDEWALKS .10.00 . .0.15/LF. ( X ) OF WALK CURB-CUT J/() .10.00 . ~.1:;/LF. ( X ) TOTAL PERMIT FEE. ~ 1~.OO COMMERICAL DRlvEWATS SHALL HAvE ,,' TO e' FLAIRS "- 0" STA'IDARD WALK x' / "'" I, x' I, ., 'I .. ",1!l./J7'J{L)d/ SIGNED I rlAvE CAR:~LL T EXA'1INED THE COMPLETED APPLICATION FOR PERMIT, .=.'1D DO HEREBT CERTIFT TI-I.l.T ALL 1N'"..oRMATION HEREON IS TRJE A'ID'CORRECT. A'ID I FURTf.lER CERTIFT TI-I.l.T A'IT ':>''1D ALL UDR;< PER'O!'<l'1ED Sl-IALL BE DONE IN ACCORDA'ICE WITH THE ORDINA'ICES OF THE CITY OF SPRINGFIELD, A'ID TI-IE LAW5 OF THE STATE OF OREGON PERTAINING TO THE WORK DE5CRI9ED I-IEREIN, t.'1D TrlAT NO =CUPA'ICT WILL 9E Mt.DE OF ,""NT STRUCTURE Wln40JT :='EI<:'1IS5ION OF THE 9UILDING DIVISION. I Ft;RTl-IER CERTIF'I' THAT ONL T CONTRACTOR5 AND EMPLOTEES UJl.<O ARE IN COMPLIA'ICE WITI-l ORe. 101~" WILL 9E USED ON TI-IIS PROJECT. , /()/10/~~ DATE I &~-