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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