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HomeMy WebLinkAboutPermit Sidewalk 1994-10-26 '" II~ -=W' IDENT11~;ALK I C~~TIAL APPLICATION I PERMIT 225 NORTH FIFTH STREET SPRINGFIELD, OREGON <;\1411 ENGINEERING DIVISION OM'ICE NO. 126-3153 INSPECTION LINE, 126-316<;\ JOB ADDREe5, Y'irCj ASSESSORS MAP NO.*' F(!.'l V I/i -t,W \) oj 110??..7Y] 5UBDIVISION, MlW\2iE VIL.L.A6E:' Hrru. <;)y\~ A., -t\" il'v; ~ hDDRESS, ?JOD IN \- tl. ~ V III eu.J ~ ZIP, C, I Lj 77 OilNER, STATE,OC- l1JOf'!l<. DEe.cRIFTION, SI!:>EUJALK, ..IL::... CURS SIDE TAX LOT NO~ '* M 101 RECE IPT NO, t t7 Z "Z--1..- CA&H CHECK "./ CITY'Spfe1 P",ONE NO. (on - ::875 '* CHECKED FOR DELINaJENCIES _ SET9ACK _ CO:1MERICAL ~.. SIGNED, DAiEl WORK TO BE FERF,.,,..,. Il:::D 6.,..., OUNER v CONTRACTOR CONTRACTOR *' <:::;1A-1~,\l (' 1)")\"\ ~,rT1 O)V. J NGcGISTRATION NO.*' -:;)?J 7 J ADDRESS 2.CJ=:H-c..11'1 AIe...'i'?rI2.-, ~]) CURS-CUT, RESIDENTIAL _ SECOND DRIYEWA Y (SEE TRt.I'T'IC ) REaJIRES APPLICATION FOR A SECOND DRIYEWAY('T,4.1.) OR A COUNTY APPLICATION FOR FACILITY PEF<:'1iT (C ~-2"'3) IF IN TH: U.G:.5. DATE OF APPLICATION )0, LIo . Cf4 - a /'v\ ArJ- t4-u-. II1-7J-i ..q~ EXPIRES, ::5 -2) ,,15 P",ONE, t/lnl ()Cj1J:J, '-~"'l:::""URE FOR IN&Fl:CTION REGlUEST, CALL 126-31&<;\ (R:CORDER) STATE YOUR CITY DESIGNA>:D JOB NU:'1B:R. JOB ADDRESS.TYPE OF INSPECTION R:QUESTED A"ID IIIrIEN YOU WILL B: REA!:>Y FOR INSPECTION, CONTRACTORS OR OIlNERS NAME A"ID PI4ON: NUMBER R:QUESTS RECEIYED B"rv...: 1,ClO Al1 WILL BE MAD: n-lE SA'"1J: DAY, REaJESTS t.FTER 1,ClO AM WILL ElE MADE THE NEXT UJORll(ING DAY *' S:E ElOOK EXISTING ElUILDING PEF<:'1IT NO. ( IF APPLICAElLE ) YOU"! CITY DESIGNATED JOB NO. 1St q L( 110 4 to SIDEWALK I DRIYEWAY FOR ALL CONCRETE PAVING WITHIN THE STREET RIGHT OF WAY, TO El: MADE AFTER ALL EXCAVATING IS co:1PLETE A"lD FOF<:'1 UJORll( A"lD 5UEl-ElASE MATERIAL IS IN PLACE REQUIRED INSA:CTIONS [] FEES, SIDEWALKS 110.00 + 10.15/LF. ( X )~t) OF WALK TOTAL A:RMIT FEE, ,~ . 1 q,oa D CURB-CUT 110.00 + 10.15/LF. ( X ) COMMERICAL DRIYEWAYS 5J-IALL HAYE :,' TO 8' FLAIRS 3'- 0" 5TA"I!:>ARD CURS I APPROACH APRON AFTER FORMS ARE ERECTE: ElUT PRIOR TO POURING CONCRETE. . WALK x' / "" l x' t " 'I I ",AYE CAR;rlJLL Y EXA.."N:D THE COMPLETED APPLICATION FOR PEF<:'1IT, "'''ID DO HEREBY CERTIFY THt. TALL INFORMATION HEREON IS TRJE A'iD'CORRECT, A"ID I FURTHER CERTIFY THAT A"IY AND ALL UORK PER'ORMED SHALL ElE DONE IN t.CCORDA'iC: WITH THE ORDIN"'''ICES OF THE Cln- or 5PRINC:FIELD, AND THE LAU15 OF THE 5TATE or OREGON PERTAINING TO THE UJORll( DESCRIBED HEREIN, A"ID THAT NO OCCUPA"ICY WILL ElE MADE OF "'NY STRUCTURE WITHOJT PEF<:'11551ON or THE ElUILDING DIVI51ON. I FURT}.jER CERTIPT' THAT ONLY COl"RACTORS ,:~ //:;_~"" - ,.-." ~ "~D ~ ;"::;7~/ 9sL