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
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