HomeMy WebLinkAboutPermit Sidewalk 1994-10-25
II~
~IPENTIAL - COMME,a::IAL
~ SIDEWALK I CURBCUT .
APPLICATION I PERMIT
SPRINCFIELD
, 225 NORTH FIFT~ STREET
SPRINGFIELD, OREGON 91411
ENGINEERING DIVISION
OFFICE NO. 126-3153
INSPECTION LINE, 126-3169
JOB ADDRE5e. Yl\ \ t==OIV Ii\ wJ \>V'
ASSESSORS MAP NO.* 11 D?'L 7 Lj I
SUBDIVISION, M~2ie VILLA6E:'
0ilNER> t-ImA <; 1I^iJ A-. A ':kl\l'lv ; ~
ADDRESS, ''300 IN \- a. ~ '{ v"\ elD ~
STATE'~ ZIP, Ci f Li 77
TAX LOT NO: '* nCl 101
RECEIPT NO, 17 -z.2:'1-
CA514
C~ECK ~
clm S!>f-eJ
P..IONE NO. ton - ~7S
*
C~ECKED FOR DELINQJENcn;:s _
U.IORK DE6CRIFTION.
SIDEUJALK,..IL... CURS SIDE _ S:;:;SACK
CURB-CUT, RESIDENTIAL _ COMMERICAL _..,
SECOND DRIYEWAY (SEE TRAlTIC )
R:QUIRES APPLICATION FOR A SECOND DRIV:;:WAY(<j',4.1a)
OR A COUNTY APPLICATION FOR FACILITY F.;:RMIT (C 98-2"3)
IF IN THE U.G.B.
DATE 01' APPL;CATION )0,7--10 . Cf4
SIGNED,
-aM'I0L-~
II1-711.q.J '
DAlE:
WORK TO BE PE~"", II:D BY. OUNER V CONTRAC,QR
CON,RACTOR * ~1A-1-r'\1\J r illl.i ~ en cwJ. I f\KSlEGISTRATION NO.* ~"3 7/
.<DDRESS 2..4 :Pit..\l') AI~Pl\12.-1 ~D
:;:XPIRES. :::5 -(J ..55
Pr=.lE. l'Ho I ()c:;tJ:>,
,~__l:""URE FOR lNeFECTION REQUEST.
CALL 126-3169 (RECORDER) STATE YOUR CITY D:;:SIGNATED JOB Nl1."1B:;:R, JOB ADDRESS.TYPE 01'
INSF.;:CTION REQUESTED A'lD l1l-lEN YOU WILL B: READY FOR INSPECTION. CONTRACTORS OR OilNERS NAME A'lD
Pf.IONE NUMBER R:QUESTS RECEIYED B:r~"", 1.CW .lJ1 WILL BE MADE THE;: S.4ME DAY. REQJ:STS AFTER 1.CW
AM WILL BE MADE THE NEXT ~ING DAY
* SEE BOOK
EXISTING BUILDING PERMIT NO. ( IF APPLICABLE)
YOUR CITY DESIGNATED JOB NO. Is1' q Y l \0 Y'L--
REQUIRED INSFSCTIONS
ElJ
SIDEWALK I DRIYEWAY
FOR ALL =NCRETE PAVING WIT~IN
THE STREET RIG4T OF WAY, TO BE
MADE t>FTER ALL EXCAVATING
IS COMPLETE AND FORM ~
AND SUB,BASE MATERIAL IS
IN PLACE
D
CURS I APPROAC~ APRON
AFTER FORMS ARE ERECTE
BUT PRIOR TO POJRING
CONCRETE.
FEes.
SIDEWALKS
$10,00 + $0.15/LF. ( >< )
OF WALK
CURB-CUT
~ $10.00 + $0.15/LF. ( >< )
TOTAL FSR!1JT FEe.
,~ '.
t/P.15
COMMERICAL DRIYEWAYS SHALL
4AYE 5' TO e' FLAIRS
3', O. STA'lDARD
WALK x'
/ ""
t x' J.
.,
.
I ;"!AYE CAREFULLY EXA"1INED THE COMPLETED APPLICATION FOR F.;:RMIT, "''lD DO HEREBY CERTIFY TH.l.T ALL
INFORMATION 4EREON IS TF'aJE A"ID'CORR:CT, A'lD I FURT4ER C:;:RTlFY T4AT A'll' A'lD ALL WI<!( PER'ORMED
SHALL BE DONE IN ACCORDA.NCE WITH THE ORDIN.l.~CES 01' THE CITY 01' SPRINGFIELD, A'lD THE LAll.I5 01' THE
STATE OF OREGON PERTAINING TO THE WOI<!( DESCRIBED HEREIN, .l.'lD Tl-IAT NO OCCUPA'lCY WILL BE M.l.DE
01' ANY STRJCTURE WITl-IOUT PERMISSION OF THE BUILDING DiViSION. I FURTHER CERTIFY Tl-IAT ONLY CONTRACTORS
AND EMPLOYEES WO ARE IN COMPLIANCE WITH 01<5 '''1~5 WILL BE USED ON THIS PROJECT.
\
SIGNED
1JhJ1dA./
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'7
DAT!r/,}f;/ttf/