HomeMy WebLinkAboutPermit Sidewalk 1995-6-28
I1F~
rSIDENT~'~~K I ;~~RCIAL
AFPLICATION I PE~T.'
225 NORT~ FIFT~ STREET
SPRINGFIELD, OREGON ':\1411
EN6INEERING DIVISION
OfrICE NO. 126-3153
INSPECTION LINE: 116.316'3
SPRINCFIELD
JOB ADDR;::55, -;202-- -FIHfLIIJ":,v.../.
-'-SSES~R.5 1'1"-"' NO.* 11 03 Z. -r q I
RECEIPT NO, 180?r--
T-'-X LOT NO: '* /D
CA~
5U9DIVISION,
C;.<EC< ~
O.:N:R, J-l A :5t:. A
ADDRESS, 300 \AI .
STAT:, Ore
u..oR<. DE5CRIPTION,
5!::>8..!J.t..Li<.: ~
CUR9.CUT:
(f!72.../1J-1-/ ~I-J A r::t:rz... ')
~Ji.Ie....Vltfr.Af...l CITY, 13>PelioJt-F"/frJ1
ZIP, "f1Q71 Pi-lONE NO.
'"
Ci-!EC<ED FOR D:LINQJ~C;E5" .!:
CUSS SiD: _
~5rDg...;TrA!... _
5-:BAC.~ _
CO~R1CAL
S:COND DR;V=Ul.t. Y IS:: TR.L.FFIC )
REQUIRES AFFLlCATION FOR A S:=C= DRIV=WA,I'T,4.1.)
OR A COUNTY "-FFLlCATION FOR F"-CILlTY F:"~IT IC ':\8-203)
IF IN TH: U'<;5.
rdz7lf'-
.51G:~::;:
~o f? Ie.
!)"- T: OF AFFLlC"- TlON
D47:::
UJClRK TO BE PERrv"", leD BY, O~R
CONTR.<.CT O;;! *' ""3rr A --r 0 J.-I t"/\I-i.C,7f!.vcfloJJ
"'-"'DRES5 z.tj'3'1q~ A/f'f'oi!f eel.
~ONT;;!ACTOR
*
REGISTR.<. TiON NO. <:3""-' I
EXF;RES.~,2./. 96
F'-'=:'~"I. tJS~.1
,,",,-,,"C:I.AJRE FOR IN5FECTION REQUEST.
c.t..LL '26-316~ (FECORDER ) STATE YOUR CITY D:SIG:!-U:.ED JOe N'..t.'"'i5:R. J09 ADDR::55,T"i"'P: 0:=
1N5PECTION REQUESTED A"lD Uh-U::~ YOU WILL 9: ~ADY'FOR INSP:CTIO\!. CONTR.ACTO~ O~ OCN:~ N.L..'"':: t..."lO
P~ NIJ"19=R. REQU:ST& RECEIYEP 9=r......~ 1:0~.l..'1 WILL 9: MADE Ti-!: SAME DAy. R:OJ:STS ~=TER 1:00
A"1 WILL BE. MADE: n4: NEXT ~ING DAY
EXI5TIN::; ~ILPING PE~IT NO. ( rr AF'PLlCAaLE )
* S== o~
--~
YOU::;?: clrr D.=5IGNATED J05 so. lsf
'lc;/ O~/
REGlUIRED 1N5FECTIONS
[Ef
SID:WALK I DRIY;;WAY
FOR ALL CONCRETE PAYING WITrllN
Tl-IE STReET RIGHT OF WAY. TO 9:
Mt..DE ,l.,,=rER AlL EXCAYAr~
IS COi1FLETE .AND FORM WO~
A"lD sua-BASE M.t.TERIAL IS
IN PLACE
D
,_ CURS I AFFRO"-CI-l "-PRO:
At-ocR FOR;1S ARE ER::CT'
BUT PRIOR TO PO~RING
CO~CRETE.
FEES, SIDEWALKS CURB-CUT WALK x'
~10,00 . l-0.15/LF. ( X ) ~10.00 . Y.2:l.1:;,/LF. ( X ) / "'-
0;= WALK
If COMMERICAL DRIV=WAYS SHALL I. x' I.
HAVE 5' TO 8' FLAIRS
S 3'. O. STA",DARD 4 1
TOTAL FEF<t1IT FEE,
1 HAY;; CAREFuLLY EXA'1IN:=D TJ.J: COMPLETED APPLICATION FOR PER;1IT, ,:,ND !)O HEREBY CERTIFY 7H"- TALL
lNi=OR:'1ATION I-lEREON 15 TRUE A~ CORR.:CT. A'lD I RJRTj..;ER CERTIFY' 7f-1AT A"lY ...\"lD .ALL WOR< PE~O;:;?;1ED
5rlALL BE DONE IN ACCORDA'lCE WITI-l TH: ORDIN-'-'JCES OF THE CITY OF SPRINC;;:IELD, AND Tl-l: LAClS OF THE
STATE OF OREGON PERTAINING TO THE WORK DESCRI9:D HEREIN, A'lD Tl-lAT NO OCCUP"'",CY W:LL 9E MAD:
OF .t.~.,.. STF11CTU~ lllI7;~O.JT PE~ISSI():\l Of r....E BUILD!NG D/V1SI0t-l I FUR71-l=R CERTIr=Y 7t..t..~1 OOL j COSTR.ACTO~S
..<.ND EMPLOYEES WHO ARe IN COMPLIA",CE WITH ORS 101.055 WILL BE USED ON THI5 PROJECT.
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