HomeMy WebLinkAboutPermit Sidewalk 1994-10-25
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-WIPENT~I~;AL:-/C~~~IAL
AA"LICATION I PERMIT
111';\0
225 NORTf.I FIFTf.I 5TREET
5PRINGFIELD, OREGON ~1411
ENGINEERING DIVI510N
OffiCE NO. 126-3153
IN5PECTION LINE, 126'316~
Joe ADDREe5. Y4-il ya-lV'VI-ew'Dr'
A55E55ORS MAP NO.*' 110?'Z..7 Y I
5U6DIVI5ION, M~L-\c VIL-i..A6f'
OJ.NER, t-\m;.. <; 'i\f\~ A-. ^ ':fu Ov ; ~
=DRE55, ':;Y-;O W \- a. ~ '( III e.v...l W
5TATE,~ ZIP, Cl, Li77
llJOi':K DESCRIPTION.
51!:>EWALK. u::::::...
SPRINGFIELD
TAX LOT NO: *' 06 tol
RECEIPT NO, 15ZZL
CA5H
Cf.lECK v'
cn" SDfeJ
Pf-lONE NO. to~ 7 - :::J57S
*'
Cf.lECI<ED FOR DELINQUENCIES _
CURS 51DE _
5ET9ACK
CURS-CUT, RE51DENTIAL _ CO:-1MERICAL --,.
5:COND DRIVEWAY I 5:: TRAFi'IC )
I':Gl'JIRE$ AA"LICATlON FOR A 5ECOND DRIVEWAn"T.4.1.)
OR A COJNTY AA"t..ICATION FOR FACILITY PERMIT IC ~-2"3)
IF IN TI-lE U.G.6.
DATE OF APPLICATION ,If) .7-1" ..q<l
5IGNED,
DAiE:
WORK TO BE FERFv"" IcD e".... OUN:R V CONTRACTOR
CONTRACTOR *' <)jA-'f7))\.J r ol\.l "'re..JJ..J'n 0)0. I (I.ICs1:C=I5TRATION NO.*' ~~ 7 }
=DI':5$ 2..4:At.1n Ad2..?~1 ?:D
- a ,'vI.J.N-/A... 'o.
\n-7}.i..q~ .
EXPIRE5, j..2..) -,75
Pf-lONE, tHo I IlCjtj:;"
~...c"....URE FOR IN5FECTION REQUEST.
CALL 126-316~ (RECORDER) 5TATE YOUR CITY DE5IGNAT:D Joe NUM6:R. Joe ADDRE55,TYPE OF
1N5PECTION REQUE5TED A'lD lL\-;EN YOU WILL 6: READY FOR IN5PECTION, CONTRACTORS OR ou.NER5 NAME A'lD
PI-ION: NUM6ER REQUE5T5 RECEIVED 6="~r= 1,00 AM WILL 6E MADE Tf.lE $AME DAY. REGl'JE5T$ t.FTER 1,00
AM WILL 6E MADE Tf.lE NEXT IlJORl<(ING DAY
*' 5EE BOOK
EXI5TING BUILDING PERMIT NO. ( IF APPLICA6LE )
YOUR CITY DE5IGNATED Joe NO. 15~ G'L\ \ Iot.+D
REQUIRED INSPECTIONS
[]
D
51DEWALK I DRIVEWAY
FOR ALL CONCRETE PAVING WITf.l1N
Tf.lE 5TREET RIGHT OF WAY, TO 6E
M=E AFTER ALL EXCAVATING
15 COMPLETE AND FORM IlJORl<(
AND 5U6'6A5!: MATERIAL 15
IN PLACE
FEES.
SIDEWALKS
CURB-CUT
.10.00 + ~Z>.15/LF. ( X ) So
OF WALK
~10.00 + ~.15/LF. ( X )
TOTAL PE~IT FEE.
,S
1~ .'-t7
COMMERICAL DRlVEWAY$ 5HALL
f.lAVE 5' TO 8' FLAIR5
3'. 0" 5T A"lDAf<D
CURS I APPROACf.I APRON
AFTER FORM5 ARE ERECTE:
6UT PRIOR TO POURING
=NCRETE.
.
WALK x'
/ ""
I. x' I,
., "
I ~AVE CAR:::.t=LJLL Y EXA~I~D Ti-JE 'COMPLETED APPLICATION FOR PE~tT. ,.:.....JD DO i-lEREBY CERTIFY 'r14.t..T ALL
l~rO~ATlot'-I ~EREON 15 T~E A~D'CORRECT. A"tD I FURTI-lER CERTIFY TI-lAT A""-JY A~D ALL u.oF<:<: PE:'"';:"v;"':.lIl:::.D
5HALL 6E DONE IN ACCORDANCE WITf.I Tf.lE ORDIN-'-NCE5 OF Tf.lE clrr OF 5PRINGFIELD, "'ND THE LAUJ5 OF Tf.lE
5TATE OF OREGON PERTAINING TO Tf.lE UJORI< DE5CRI6ED HEREIN, -'-ND THAT NO OCCUPANCY WILL 6E M.L.DE
OP ANY STRJCTURE WITHOJT PERMI5SION OF THE 6UILDING DIVI51ON. I FURiI4ER CERTIFY THAT ONL Y CONTRACTOR5
AND EMPLOYEE5 WI-lO ARE IN COMPLIANCE WITf.I ORe 101.<*5 WILL BE U5ED ON Tf.l15 PROJECT.
5IGN#~~
/(j /1&/?~
DATE I I