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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./ ~/ '7 DAT!r/,}f;/ttf/