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HomeMy WebLinkAboutPermit Sidewalk 1995-6-22 Il,ra....o \", 225 NORTf< FIFTf< STREET SPRINGFIELD, OREGON "11"11 ENGINEERING DIVISION Ofi'ICE NO. 126-~15~ INSPECTION LINE, 126-~16"1 ~5IDENTIAL - . .......-'.~ COMMERCIAL SIDEWALK I CURBCUT .,' APPLICATION I PER:-1IT ~ ) ~PRINCFIELO . ,_.~".., , JOB ADDRE55, 'fd(,t s :r::.-rJlJ\ .S-r-- :'SSES50RS MAP NO.* 1,9< oZ:lv UZ-~ 5USDIVISION, OJ..NE R: N\~ (0'75 tffL- :.DDRESS, STAT::: ~ DE5CRIPTI~, 5!DSl.!.JALK: CURS-CUT: ---- T:'X LOT NO: "* tJ Cf4 !50 RECEIPT NO, 119$'6 CHECK ~ CA5H 1J. \ k:..E.-< ( \f l! !;;t ZIP, 97Cf7{. CITY, 6P,z.(f.Jr.,~ P;.ION: NO. lq!~O'H~ *~ ......l=C;..-=-D =OR D=r I~""""':=--'C:=-S' , '-f""l_ ~ '. __ ,....._=.:.... ,_ CUSS SIDE _ ~SIDENTIAL _ ==BAC< _ CO;-'II'1:.R.1C:...L SECOND DRIVEWAY (SEE TRAFrIC J REQUIRES APPLICATION FQR A 5:COND DRIVEWAY('T-4.1.J OR A COl.JI'-.lTY t..FPLICA7ION FOR FACILITY PS~lT (C s.8-203) Ie IN THE UG.5. DATE OP APPUCATlo-J fip~ /" ..j''2~('" / I~ -7:z,.ft )' ,SIGN:D, DAlE: ~UNER ~RK TO BE PERrv"", II::D B.,..., '" CONTRt.CTO~ ' ,.~..::>!:)RE: 55 CONT~CTOR '* REc"IST~TION NO.. ::.XPiRES: P;"';O~=: r-1'<V'-'I::VURE FOR IN$FECTI~ REQUES>T: CALL 126-316"1 (RECORDER) STATE YOUR CITY D:SIc,,!-1ATED JQ5 Nu:-15ER, J05 :.DDRESS,rn='E c;: INSPECTION REQlJE5iED Alo.JD lU-l:EN "rOU WILL 8= READ"r FOR INSP=CTI~, CONTRACTO~ O~ Ou;...::::~ NJ..;-;= .4..'10 Pl40NE N1.L"1aER REQUESTS R.E.CEI\lED S:=.......ro;.:. 1:00 .L.."1 WILL 8E MADE Tl-IE SAME DAY, REQ~=ST5 t.r=iER "1;00 .0.,'1 WILL BE MADE THE N:XT LLIOR<:ING DAY '" s== =^~ ..._~ REQUIRED INS>F'!:':CTI~S> ROES>: SIDEWALKS EXISTI:--.r.:; 5:JILDING P::~IT NO. ( rr= APFLlCASU:: ) YQUR CITY DESIc"N:'TED J05 NO.. Isf 9S/(')/ / D ~R9 / APA'1CACf< APRe ~R FOR""lS ARE ERECi: BUT PRIQR TO PO"RING CONCRETE. SIDEWALK I DRIVEWAY FOR ALL CONCRETE PAViNG WITHIN THE STREET RIG4T c;: WAY, TO 9E M.4DE .4=TER .ALL EXCAVATING: IS COi"1PLETE AND FORM \.IX:l~ ,A"'D SU9-9A5E MATERIAL IS' IN PLACE CURB-CUT ~10.00 . ~.1:;./LF. ( X ) WL..L< x' ~ \~ I.'" x' '~' I " 'r ~10.00 . ~.1:;./LF. ( X ) 0;= WALK ID.--I-- $ TOTAL F'!:':Rt1IT ROE: J5"C2c/ -::(3&D !'3.{d) COO1MERICAL DRIVEWAYS SHALL HAVE 5' TO 8' FLAIRS ~'- 0" STA"'DARC> I ~AV'E,CA~~LL Y Ex...:..~INED T.I-4: COMPLETED APPLICATION FOR PER71IT, ~lo.JD DO t-lEREBY CE~TIFY 71-1.L.T ALL IN""rOR:'1ATION I-!EREON 15 TRUE A~ CORRECT, A"'JD [ FURTr-1ER CERTIFY TI-lAT A~""" ~~D ALL 1.LOR< FE~O~ED SHALL BE DONE IN ACCORDA"'CE WITf< THE ORDIN"-'JCES OF THE CITY c;: SPRINC:f'IELD, AND TH: LAt:J5 c;: THE 5TATE 0;:. OREGON PERTAINING: TO TI-lE tOC)Rl<, DE5CR-19ED HEREIN, A"lD Tl-lAT NO OCCUPANCY WILL 9:: M,.!,DE OF .4SY 5TRJCTURE UI'T~O'JT PER:"11551QN OF 11-1E 9U1LD!NC:I DIVISION. I FUR7J-l=.R CERTIFY 71-1.:.T ONL.,... COS7RACiCC(:::; AND EMPLOYEES WHO ARE IN COMPLIA'JCE WITH ORS 101<*5 WILL BE USED ON THIS PROJECT. ,~;kJ /7I;t h-7.Z-9LS- DATE