HomeMy WebLinkAboutPermit Land Drainage Alteration 1999-1-16
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,,~':~;.;. ' (.', . :ity of Springfield
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.:.....:-" ~ This permit is required for any site activity in the flood plain and everyw, Iiere'sitealtera~;d~ consists of
~ fifty (50) cubic yards of material or more andlor if a drainageway is affected; within City limits and ,
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Date of Application
I. /6.99
Permit Expiration Date: :..', '
Site Address:
D~~'I m'_,u
f.:,1?'3'1 ~ St-
. .,.,.,: ~.. 'Springfi~ld, Ofegon
. 0 '. . -,: .~:71
Property Owner
Address:
Phone:
City, .'
,l>tate;<:. Zip_
: -';< ;
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UGB Tax Map No: , 3 'D2, - () 3-1 ~
Journal number applicable Land Use Application
Tax I,.ot:
2-&:;0
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FILL, Quantity 86. l' () vcls
Supplier .Boh t'J,,,~./~
GRADING, QuantiN
, Source Location (/"..:.; >,J-zI';.' :'
, Material ',;.! "'. :y:..mi~""
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01
/00 1/01-
Destination: 7S,.....
Project Supervisor,
, Pllone
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EXCAVATION, Quantity
Supplier:
Address
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SITE PLAN Required D8f8:Quantity of material, Property lines and descri()tion~;"Tax map and
lot number, Site address, Existing contour lines, Proposed contour 'lines. Existing drainage
ways, ProJ:!osed drainage ways, Significant trees and folialle, Ground cover, Soli types"
Buildings, Septic systems, Sewers, Areas subject to flooding, Utilities, Areas subject to land
slides, Proposed site improvements.' , :", '.' .
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CROSS SECTIONS,
SOILS & GEOLOGY PLAN,
DRAINAGE, POLLUTION AND EROSION CONTROL PLAN ~,,~ k'6
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REPLANTING PLAN
ADDITIONAL INFORMATION,
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COMPANY NAME:
PROJECT SUPERVISOR:
ADDRESS:
COMPANY NAME:
PROJECT SUPERVISOR:
ADDRESS:
,PHONE
CITY
STATE
, PHONE
CITY
STATE
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CONTRACTOR NAME: ~"'P ;t./;;;/~ CH~1w./;VL ;\{
PROJECT SUPERVISOR:6.Mo ::z;?'LLlD( PHONE",74-4./%71 '
Registration Number: P457/ . Explratlon,l?ate: /,y~
/J;{ 75'" $ ,CITY: .:::J.A/'./,"
, ZIP: 9797X" OFFICE PHONE 'FAX ~1/,;J-7-
S"79- ~5o.s EMERGENCY PHONE: "
ADDRESS:
STATE: (;k..
MOBILE PHONE:
I understand that I. or my successors may have future plans for my property which may be anticipated or unanticipated at
this time. I understand that such future plans may require permits and developement approvals from the CitY of Springfield.
I understand that notwithstanding any approval of this land and Drainage Alteratlon-Permlt:(LDAp)/that 8t,th~e time of
application of f~re permits or approvals the City may review and reconsider all Ictlons which I'or ,my IUCC88aOre hive
undertaken persuant to this LOAP. I understand that the City may as a condition of any future ~pproval; requlre'th'e
undoing, changing, or modification of any actions which I have undertaken as a result of the Cttys....approval.of this LDAP.
By signature, I state and agree. that I have carefully examined the completed application and do hereby certify that all
information herein Is true and correct. and I further certify that any and all work performed shall be done in- a'ccordance
with the Ordlnancas of the City of Springfield, applicable City Standard specifications and,Drawlnii,;;'-and the laws of the
State of Oregon pertaining to the work described herein. I further certify t.hat only cof),tractore and _ emplo_yees' who are In
compliance with ORS 701.066 will be used on this project. - ::'-'.-
The City may inspect the work site described in this permit at any time during a,one year'period followlng'the receipt by
the City of notice of completion of the described work and specify. at the Clty"s 80Ie..deaeer8tlon, any additional restoration
work required to return the site to a standard acceptable to the City. The permitt~ wUJ be notified In writing 'of any work
requirad and will hava thirty (30) days from tha date of tha, notica to complete.the worle; Work not cOmplatad lit the end of
the thirty days will be parformed by the City and the costs will ba billad to tha p.rmlttae. .' ' ,
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1/6/1998
o DRAINAGE, 0 Storm, 0 Ditch, 0 Culvert, 0 Natural
o WETLANDS, Description
o FLOOD PLAIN, Zone: , FEMA Community Panel No.:
o FlOODWAY, FEMA Community Panel No.: , Date:
PLAN CHECK FEES:
UP TO 100 CUBIC YARDS
101 TO 1,000 CUBIC YARDS
1,001 TO 10,000 CUBIC YARDS
10.000 TO 100,000 CUBIC YARDS
100.001 TO 200,000
$20.00
$30.00
$40.00
$40.00 For the first 10,000 cubic yards, plus
$20.00 for 'each additional 10,000 cubic yards or fraction thereof.
$220.00 For the first 100,001 cubic yards, plus
$20.00 for each additional 10,000 cubic yards or fraction thereof.
$340 For the first 200,001 cubic yards, plus
$6.00 for 8ach additional 10,000 cubiC' yards or fraction thereof.
200,001 CUBIC YARDS OR MORE
GRADING PERMIT FEES:
UP TO 100 CUBIC YARDS
101 TO 1,000 CUBIC YARDS
1.00i TO 10.000 CUBIC YARDS
10,000 TO 100,060 CUBIC YARDS
100,001 TO 200,000
$30.00
$30.00 For the first 100 cubic yards, plus
$14.00 for each additional 100 cubic yards or fraction thereof.
$156.00 For the first 1,000 cubic yards, plus
$12.00 for each additional 1 ,000 cubic' yards or fraction thereof.
$264.00 For the first 10,000 cubic yards, plus
$54.00 for e8ch additional 10,000 cubic vards or fraction thereof.
$750.00 For the first 100,001 cubic yarda, plus
$30.00 for each additional 1 0,000 cubic yards or fraction thereof.
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Estimated Volume:
Plan Check Fee:
31~
Receipt No:f)~~ Date: 1~:<<f.if1
Received By:
Date:
Grading Permit fee:
Receipt No:
Date:
Received by:
Date:
l
0 Plannina Date:
0 Engineering Date:
0 Building: Date:
0 Maintenance: Date
Permit Nuinber
Issued by:
'Date:
RAQuirArl FinAl InR:pAr.tlnn~'
Planning:
Date
Engineering:
Date
Building:
Date
Maintenance:
Date:
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land and Drainage activity as outlined in this permit has been completed in accordance with
the provisions ofthis permit.
LlIt"d tend Drainaae a~tivilV as outlined in this permit has not been completed in accordance
wltn 1M prOVISId11S ot tn,s permit.
Land and Drainage activity was performed prior to application for this permit.
~ccepted by:
Date: