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HomeMy WebLinkAboutPermit Sidewalk 1994-11-22 11DENTIAL - COMMERCIAL : ;~~~~~~C~;~;T. 1)/':10 22" NORT~ FIFT~ STREET SPRINGFIELD, OREGON ':11411 ENGINEERING. DIVISION OffiCE NO. 12&-'1", INSPECTION LINE, 12&-'1&':1 JOB ADDRE55. , ~os- ASSES50R5 MAP NO.*' -=7a i-r V i-ew 1'1 C)~ ?/ Ll-I SUBDIVISION, OUNER> !-lAesA ADDRESS, _~Qn LV ,yail-'Vt'eUI STATE, Of IE 6-011.1 ll.IORK DE5CRIPTI~./ l/ ZIP, q7477 SIDEWALK, CURS SIDE _ DATE OF APPLICATION 11/);;( 1tf lUORK TO BE F'EFO"u"" II::D BY. CONTRACTOR*' ,<;rAToAJ r.Ofl.St. TVlC. ADDRESS :J.'1.FN -F Ai-l'fOr-T 1i!<L ,,...........c:DURC,FOR IN5PECTI~ REQUE5T. SPRINGFIELD .* TAX LOT NO. I {'J I CASH RECEIPT NO, / 55~i- C~ECK .--- crrr,S'~~ P~ONE NO. *' C~ECI<ED FOR DELINCl'JENCIES ::::::::::: S=:TBACK _ CO:1M=:RICAL _ SIGNED, DATE, OL!.NER x.. CONT~C70R -~J# EXPIRES,.? /J.I / 'IS- '. P;.;ONE. ~/-Oo~ CALL 12&-'1&':1 (RECORDER) STATE 'rOUR CIT'r DESIC,NAT=:D JOB NUMB=:R, JOB ADDRESS.rrPE OF INSPECTION REQUESTED ""'Ii' ~EN 'rOU WILL B=: READ'r FOR INSPECTION, CONTRACTORS OR OUNERS NAM=: .I.."D P!-lONE NUMBER l'EOU=:STS l'ECEIVED B=:FOl'E 1,00 .1..'1 WILL BE MADE T~=: S.4.'1E DA'r, l'EOUESTS .:.FTER 1,00 AM WILL 6E MADE T~E NEXT UJORl<:ING DA'r CURS-CUT. RESIDENTIAL _ SECOND DRIVEWA'r (SEE TRAFTIC ) REOUIl'ES APPLICATION FOR A SECOND DRIVEWA'r(..,.,4.1.} OR A COUNrr APPLICATION FOR FACILITY PE~IT (C ~-20') IF IN Tl-lE U.G.9. REGISTRATION * NO. 03.i 71 97'f'0 :L * SEE BOOK EXISTING BUILDING PE~IT NO. ( IF APPLICA6LE ) 'rOUR CITY D=:SIGNA ,ED J06 "0, Isf q 4' / <1)6 I E'-"(frIp; OIeF. ~ SIDEWALK / DRIVEWA'r L.:J FO~ ~L_ CONCRETE !,A;'N~ WIT~JN T~= SIREET RIC,~T OF W_'r, ,0 B= MADE AFOER ALL EXCAVATING IS COMPLETE A'lD FO~ 1lOR< AND SUB-6AS=: MATERIAL IS IN PLACE REQUIRED 1N5F:CTI~5 FEE5. SIDEWALKS 110.00 . 10.15/LF. ( X ) 0;= WALK TOTAL PERMIT FEE. ~ 12. Cf 0 D CURB-CUT 110.00 . f0.15/L.F. ( X ) /~ if) co:-tMERICAL DRlVEWA'rS Sf.lALL HAVE :;' TO 8' FLAIRS ,3'. O. 5Tt...'1DARO CURS / APPROAC~ APRON, AFOER FO~S ARE ERECTED 6UT,PRIOR TO POURING CONCRETE., WALK x' / "" l x' I. 'l, 'I I i-lAVE CAREFULL 'f" EX~~NED T~E COMPLETED .4PPLICA'iION FOR: PERS"irT, ":"'''D DO i-iERESY CERTIFY 71-tL..T ALL !Nro~ATION ~EREON IS TRUE A"D CORRECT, A"D I FURTf.lER C=:R7IF'r T~AT "-'l'r ,;"D .:.LL UiOR< PEI<l"O~=:D Sf.lALL 6E DONE IN ACCORDA'lCE WIT~ THE ORDIN.!..'lCES OF Tf.I=: CIT'r OF SPRING!'I=:LD, -"'D T~E LAWS OF THE STATE OF OREGON PERTAINING TO THE 1lOR< DE:;CRIB=:D ~EREIN, A"D Tf.lAT NO OCCUPA'iC'r WILL BE MADE OF AN'r STRUCTURE WITf.lOJT PE~ISSION OF TH=: BUILDING DiViSION. I FURTHER CERTIF'r ,f.I,;T ONL'r CONTRACTORS .I.."D EMPLO'T'EES Wf.IO ARE IN COMPLIANCE WIT~ ORS 101,0:;:; WILL BE USED ON THIS PROJECT. :;IGNED ~~ r / / /:;.,;;/ 91./ DA,E ( .