HomeMy WebLinkAboutPermit Sidewalk 1994-11-15
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~IDENTIAL - COMMERCIAL
.- , :~~~~~~ ~~iT .
225 NORTH FIFTH STREET
SPRINGFIELD, OREGON '31-411
ENGINEERING DiviSION
OffiCE NO. 116,3153
INSPECTION LINE, 116-316'3
JOEl ADD~5e. / S.~ Fa;.... 1/ i P. u )
ASSES50Re MAP NO.* n D'31. '14 \ TAX LOT NO: *' Olo1c,O
SPRINGFIELD'
RECEIPT NO, 015"4-1S'
CASH
SUBDiViSION,
CHECK
OUNER, f-I A ( S A
ADDRESS, '~ 00 U J. +=n i I" \II 'f'J lJ )
STATE, oe. F. ZIP, q7477
....--
CiTY, ~ 9-5/ uL
P.4ONE NO.
*
CHECKED FOR DELINQUENCIES -=::.
lJ.k:)RK. DESCRIPTION.
(/'
CURB SIDE ~
RESIDENTIAL (/'
SIDEUlALK,
SETSACK
CURB-CUT,
S:COND DRIY!:WAY (S:E TRt-'TIC )
R!:Gl\JIR!:S APPLICATION FOR A SECOND DRIY!:WAYI.,.,4.1a)
OR A COUNTY t.PPLICATION FOR FACILITY PER1IT (C ~-103)
:~:r: :::~ICATION I J! /'1 I q1
CO:1MERICAL _
SIGNED,
DATE,
UJOF'il<. TO BE FE"" ORlIED 6Y. OUNER
CONTR.4CTOR * <;ra+O tJ COI1~t. 1=' Y\ C ,
ADDRESS :J..q,'',ql./- - R A; v(Y>"''+ r<J. I
I
r-.........."'OlJRS FOR IN&PECTION ~QlJEST.
~ CONTR.4CTOR
R!:GISTR.4TION NO.*' (J 3 "371
B 0Qt?I/H' () 12. f?
R&T~
Il.~4
EXPIR!:S. 3/:J//9S-
P...o.olE, f'iH ~ J (}f) ~
LKR/-06't.(3
CALL 1;6.316~ (R!:CORDER ) STATE YOUR CITY DESIGNAT:D J09 NImS:R, JOS ADDR!:SS.TYP: OF
INSPECTION R!:Gl\JESTED A'lD Ill-IEN YOU WILL SE R!:t.DY FOR INSPECTION, CONTR.4CTORe OR O\UoIERe Nt.:-"1: "''lD
PHON: NUMSER. R!:Gl\JESTS RECEIY!:D B=r~""" 1,00 A'1 WILL SE MADE T...: SAME DAY, REQJ:STS -'FTER 1,00
A'1 WILL BE MADE THE NEXT Ill::>RKINC: DAY
* S:E BOOK
EXISTINc:. BUILDING PER1IT NO. ( IF APPLICABLE) ,
YOUR CITY D:SIGoNATED JOB NO. Isf 44- [-,54 .
~QIJI~D INSPECTIONS
~
SIDEWALK / DRIY!:WAY
FOR ALL CONCR!:TE PAvlNGo WIT...IN
TH: STREET RIGoHT OF WAY, TO SE
MAD: AFTER ALL EXCAVATINGo
15 COMPLETE A'lD FORM WORK
AhlD SUS-SA5: MATERIAL 15
IN PLACE
D
FEES.
SIDEWALKS
CURB-CUT
110.00 . ~0.1S/LF. ( X )
OF WALK
10
110.00 . 10.15/LF. ( X )
TOTAL PERMIT FEE.
~
11.)0
COMMERICAL DRIY!:WAYS SHALL
HAY!: 5' TO 8' FLAIRS
3'. O. STA'lDARD
CURS / t.PPROt.CH APRON.
AFTER FORMS ARE ER!:CTED
BUT PRIOR TO POURING
=NCRETE.
WALK x'
/ '\.
I. x' I.
" 'I
I HAY!: CAR!:FULL Y EXA.."NED THE COMPLETED APPLICATION FOR FER1IT, "''lD DO HER!:BY CERTIFY TH.AT "'LL
IN''rORMA TION HER!:ON 15 T!'a.JE A'lD CORR!:CT, A'lD I FURTH:R C:RTIFY THAT -"'lY A'lD 'A.LL lliORK PERl'OR1ED
SH"-LL 6E DONE IN .ACCORDANCE WITH THE ORDI'l-"'lCES OF THE CITY OF SPRINc..FIELD, AND THE LAWS OF THE
STATE OF OR!:GON PERTAININGo TO THE Ill::>RK DESCRI6:D H:R!:I'l, -"'lD THt.T NO OCCUPt.NCY WILL SE M-"D:
OF .ANY STR.JCTUR!: WITHOUT PER1ISSION OF THE 6UILDINC: DiViSION. I FURTHER CERTIFY THAT o.olL Y CONTRACTORS
'~ A'lD EM:~ IN C~= WITH ORe 101.0;,5 WILL SE US:D ON THIS PROJE;~ //4/ qtj
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