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HomeMy WebLinkAboutPermit Sidewalk 1994-11-15 1 11~ ~IDENTIAL - COMMERCIAL &IDEWALK I CURBCUT . ---. , APPLICATION I PERt'lIT _. 225 NORTH FIFTH &TREET &PRINGFIELD. OREGON 91411 ENGINEERING DIVI&ION OFfiCE NO. 116.3153 IN&PECTION LINE, 116 - 3169 JOB ADDFiE55. / Lli- :::to /r tlt'eu.J A&&E&&oRS MAP NO.*' \ In?/af 14.l TAX LOT NO~ '*' &uBDIVI&ION, () () 10./ RECEIPT NO, CA$H CHECK OUNER, .J-I A- C S" A- ADDRE&&,~ CO w, l=a i I" /I / e U 1 CITY, ,<; P-..t I at &TATE, (l/?E ZIP, c:r7 477 PHONE NO. u.JOf"!K DEecRIPTION: &IDElUALK, V' CU!'S SIDE ~ S=TBACK CUl~B,CUT, RESIDENTIAL ~ COMM:RICAL _ SECOND DRIvEWAY I &EE TRAFFIC) REQUIRE& APPLICATION FOR A SECOND DRlvEWAYI"T,4.1a) OR A COUNTY APPLICATION FOR FACILITY P=Rt'lIT IC 98.103) IF IN TH: U.c..e. / ,J 11 DATE OF APPLICATION 11/1'1;97- I UJORK TO BE FERFu"", u::D BY. OUNER CONTRACTOR *' S'T.4 t OVl (.l'>Ilsd-) r VI C ADDRES& :J.q:?qL./~ R I} /'IrIJM-+ ed SPRINCFIEUi Wit,.', ~~ ~" 01",-4-10 - * CHECKED FOR DELINQ'JENCI:S -= &IGNED, DATE, '/.. CONiRACiOR REGISTRATION NO.* () 3 :3 7/ q7 L/ (J::J- ~T~ I VI r:-,7 "'r5- :XPIRES, 3/:J.(lq~ PHONE, 4C,/-{)S4,~ r-~CL.'(JFiE FOR INSFECTION FiEG2UEeT: CALL 116-3169 lRECORDER ) STATE YOUR CITY D:SIG~T:D JOB NUMB:R. JOB ADDRESS.TYP: OF IN&PECTION REQUESTED AND UJHEN YOU WILL B: READY FOR INSPECTION, CONTRACTOR& OR OILNERS Nt.M: AND PHON: NUMBER REQU:ST& RECEIvED B:FORE 1,0" A.'1WILL B: MAD: T!-I: &,0.'1: DAY, REQ'J:&TS -'FTER 1,00 AM WILL B: MAD: TH: NEXT iI.IOR'(lNG DAY :XISTING BUILDING PERt'lIT NO. I IF APPLICA.BL: ) *' SEE BOOK YOUR CITY D:SIc;;,NATED JOB NO. Is1' Cf+/7~3 REQUIFiED lNeF'!::CTIONS ca &IDELUALK / DRIVEUJAY FOR ALL CONCRETE PAVING WITHIN TH: STREET RIGHT OF WAY, TO BE MADE AFTER ALL EXCAVATING 1& co:1PLETE AND FORt'l UJORK AND &uB-BA&: MATERIAL IS IN PLACE D FEES: SIDEWALKS 110.00 . 10.15/LF. ( X ) OF WALK CURB-CUT /1 110.00 · ~.I5/LF. ( X ) TOTAL F'!::l"iMIT FEE.. ~ COMMERICAL DRIvEWAYS &HALL HAvE 5' TO 8' FLAIRS 3'- 0" 5Tt...~DARD /2... ~o;- CU!'S I APPROACH APRON, AFTER FORt'l& ARE ERECTED BUT PRIOR TO POURING CONCRETE. WALK X' / "" t X' I. " " I !-lAvE CAREFULLY EXh'1INED WE COMPLETED APPLICATION FOR PEF<'1IT, A'lD DO HEREBY CERTIFY TH-'-T ALL 1N".-oRt1ATION !-I:REON IS T!'alE A'ID aORR:CT, A'lD I FURTl-'ER CERTIFY THAT A'ojy A'lD ALL UOR< PERFORt1ED SHALL BE DONE IN ACCORDANCE WITH THE ORDINA'lCES OF T!-IE CITY OF SPRINC:!'IELD, AND TH: LAUJ& OF THE STATE OF OREGON PERTAINING TO THE iI.IOR'( DE&cRIBED HEREIN. -'-'1D THAT NO OCCUPA'lCY WILL BE M-'-D: OF ANY STR'JCTURE WITHOUT PERt1ISSION OF THE BUILDING DiViSION. I FURTHER CERTIFY 7HAT ONLY CONTRACTOR& .<.ND :MPLO'r'EE5 WHO ARE IN COMPLIANCE WITH ORS '''\.0:.5 WILL BE USED ON THIS PROJECT. ~~/Y/J/ rJ. SIGNED '7 II /rlf- /?f/ I DAiE