HomeMy WebLinkAboutPermit Sidewalk 1994-10-25
II~.
~IDENTIAL - COMMEiiCIAL
----'-W SIDEWALK I CUReCUT .
AFPLICATION I Fi:RMIT
22" NORT!-I FIFT!-I STREET
SPRINGFIELD, OREGON ~1411
ENGINEERING DIVISION
OFFICE NO. 126-31,,3
INSPECTION LINE, 126-316~
J06 ADDR!:e8. L\ '?15 Flt\Y' 1/\ ~W 1:>r
ASSESSORS MAP NO.*' 11 0?7.7 Lj 1
SUBDIVISION, ~ Ut.U,fZ-l e V \ L.i..A6 r-
Oil.NER, +-Irw<;)y\~A,A'fI.A {1\,; ~
ADDRESS, '300 vJ I- 0.. ~ V III elV -.r::y:
STATE'r:Je- ZIP, C\, Lil7
"
SPRINGFIELD.
TAX LOT NO: '*' no 101
RECEIPT NO, 10-z.-z.-z.-
CA$I-I
CHECK .........
CITY, Spfd
P;.IONE NO. (on - ~7S
'*'
CI-IECKED FOR DELINQUENCIES _
lI..IORK DEecRIFTION.
'I ~ID==" ^' v. .. /'
~ =~~.IL..- CURS S!DE _ SETElACK
CURS-CUT, RESIDENTIAL _ CO:-1MERICAL _,..
I SECOND DRIVEWAY (SEE TRAR'IC )
I REQUIRES APPLICATION FOR A SECOND DRIVEWAY("T-4.1.)
OR A COUNTY .t.PPLICATION FOR FACILITY PERMIT (C '38,2"3)
IF IN T!-IE U.G.a.
DATE OF APPLICATION 11) ,7...10 -'14
SIG~D,
Dt..EI
WORK TO 6E FE~D 6.,... OUNER v CONTRAC70R
CON7RACTOR '" "')/A-1"{))\J r ~J\1 ~ en L\)V. J fJCs1:GISTRATION NO.'*' ~"3 7 J
ADDRESS Z.4:A<-I"h AI~'P~I ~])
,- a /\AArJJ- I4iAA
In -7.t:, -'1~' ------
EXPIRES, '3 -2) -15
P;.4ONE. tHn I () c,lj ::>,
,...~...,;....i.Jl'<E FOR IN~CTION R!:G:lUE5T.
CALL 126-316~ (RECORDER) STATE YOUR CITY DESIGNATED JOB Nlm9:R, JOB ADDRESS,T'\"PE OF
INSPECTION REQUESTED A'lD lll-!EN YOU WILL 9E READY FOR INSPECTION, CONTRAC70RS OR OUNER5 Nt..ME A'lD
PI-IONE NUM9ER REQUESTS RECEIVED BEFORE 1,= .L."1 WILL BE MADE T!-IE SAME DAY, REQJESTS -"FTER 1,=
AM WILL BE MADE T!-IE NEXT Ul:)RKING DAY
'*' SEE BOOK
EXISTING BUILDING PERMIT NO. ( IF APPLICABLE)
YOUR CITY DESIGNATED JOB NO. 151' q y I b ....f~
R!:QIJIR!:D IN5Fl:CTION5
ElJ
D
SIDEWALK I DRIVEWAY
FOR ALL CONCRETE PAVING WIn.UN
T!-IE STREET RIC;4T OF WAY. TO BE
MADE AFTER ALL EXCAVATING
15 co:-1PLETE A"iD FORM WORK
A'lD SUB-BASE MATERIAL 15
IN PLACE
FEE5:
SIDEWALKS CUREl-CUT
~l!D,!D!D + ~!D.15/LF. ( X ) d<S- ~1!D.!D!D + SID.15/LF. ( X )
OF WALK
TOTAL PE~IT FEE:
,~ ,
COMMERICAL DRIVEWAYS SI-IALL
4AVE ,,' TO e' FLAIRS
3'- ". STA'lDARD
l3 ,1 Cj
CURS I APPROAC!-I APRON
AFTER FORMS ARE ERECTE!
BUT PRIOR TO POURING
CONCRETE.
..
WALK x'
/ ""
I. x' I.
., "
I ;.lAVE CAR=rlJLLY EXA'1NED THE 'COMPLETED APPLICATION FOR PERMIT, -'ND DO HEREBY CERTIFY T4kT ALL
INFORMATION HEREON 15 TRUE A'lD'CORRECT, A'lD I FURTHER CERTIFY T4AT A'lY -'ND ALL UOR< PER!'ORMED
SHALL BE DONE IN .l.CCORDANCE WIT4 T4E ORDINkNCES OF TI-IE CITY OF SPRINGFIELD, A'lD T;.4E LAWS OF TI-IE
STATE OF OREGON PERTAINING TO TI-IE \OC>R< DESCRI9ED 4EREIN, kND TI-IAT NO OCCUPA'lCY WILL BE MkDE
OF ANY STP.JCTURE WITHOUT PERMISSION OF TI-IE BUILDING DIVISION. I FURTI-IER CERTIFY 7H-'-T ONLY CONTRAC70RS
AND EMPLOYEES UJI-IO ARE IN COMPLIANCE WITI-I 0R5 1"1~" WILL BE USED ON TI-IIS PROJECT.
SIGNED ~/lA./JU~ ~
/d /-2f?t/
DATE