HomeMy WebLinkAboutPermit Land Drainage Alteration 1998-4-1
:,." 0 0 ......do And Drainag41 "Iteration' P~rmit.
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Date of Application
City of:Springfield
22S Fifth Street, Springfield, Oregon 9747~De';el~rllis~crs
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4/1 /98 E~piratio~: _.---\JJJJ ' ~
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\ \' \ 6- /-""'. Phone: 541 747 1509
~ ~-?o.// . CitySpnngtJ.~Ml:OR Zip 97478
Property Owner Ken Kearney
, Address : jBU~ Jasper RO.
Site Address: 3A05 Jasof':T' fin
o UGB Tax Map No: 18S-2W-06-13
.. Springfield, Oregon
Tax Lot: 9801 &9900
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FILL, Quantity 1000 CY '.
Supplier
GRADING, Quantity 1455 CY ,
, Source Location
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. Material
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EXCAVATION, Quantity 1455 CY
Supplier:
Address
Destination: on si te
, Project Supervisor
.. Phone
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SITE PLAN' Required Da(a:Quantity of material, Property lines and descriptions, Tax map and
lot number, Site address, Existing contour lines, Proposed contour lines, Existing drainage
ways, ProJlosed drainage ways, Significant trees and tOlial/e, Ground cover, son types, I
Buildings, Septic systems, Sewers, Areas subject to flooding, Utilities, Areas subject to land
slides, Proposed site improvements.
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CROSS SECTIONS,
see aradina olan
SOILS & GEOLOGY PLAN, see attached letter
DRAINAGE, POLLUTION AND EROSION CONTROL PLAN see grading plan
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REPLANTING PLt\!'l see aradinaolan
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ADDITIONAL INFORMATION,
COMPANY NAME: EGR & Associates,
PROJECT SUPERVISOR: --1?",,1 Matsuda
ADDRESS: 2535 B Prairie Rd~
, COMPANY NAME:
PROJECT SUPERVISOR:
ADDRESS:
Inc.
.. PHONE 541 688 8322
CITY
Eugene
.' PHONE
STATE OR
CITY
STATE
CONTRACTOR NAME: C ~ n-k-v- \ i Y\-e~ E)( Ct1l..lo...... -\-t'oV\
PROJECT SUPERVISOR: "\2,y-a. d ~ (' (I.-\" l ""on . PHONE('5l.l I ') 1'+7- Gj ;:),1 S
f!egisJration Number: . Expiration Date:
'ADDRESS: AnD, :'S:,t~ t 5 ~ S-he e.::t , CITY: S\,r:~.,.(Uj d
STATE:()~ ,ZIP: 91'11( OFFICE PHONE 74,,'1;;).\5 FAX'l47-,;;Vd.,
MOBILE PHONE: , EMERGENCY PHONE:
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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 accordance with
the Ordinances of tho City of Springfield, applicable City Standard specifications and Drawings, and the laws of the State of
Oregon pertaining to the work described herein. I further cortify that only contractors and employees who are in compliance
with OAS 701.055 will be used on this project.
The City may inspect the work sito described in this permit at any time during a one year period following the receipt by the
City of notice of completion of the described work and specify, at the City's sole desecration, any additional restoration wor~;
required to return the site to"8 standard acceptable to tho City. The permittee will be notified in writing of any work required
and will have thirty (301 days from the date of the notice to complote the work. Work not completed at the end of the thirty
~ays will be performed by the City and the costs will be billed to tho permittee. .
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I further agree to ensur that all required inspe ions are requested at tho proper time, that project address is readable from
the street, and tho p roved set onPlans il emain on the sito at all times during construction.
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, La~_ :I~nd Drainage ~ JtWratiol1l Permiti!-
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o Stor~: 0 Dit~h, 0 Culvert, 0 Natural
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DRAINAGE,
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WETLANDS, Description
FLOOD PLAIN, Zone:
, FEMA Community Panel No.:
FLOODWAY, FEMA Community Panel No.:
, Date:
. $:~
PLAN CHEC,K FEES:
UPTO 100 CUBIC YARDS
101 TO 1.000 CUBIC YAROS
1.001 TO 10,000 CUBIC YARDS
10.000 TO 100.000 CUBIC YARDS
100.001 TO 200.000
$20.00
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~(J.01fFor 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 tor each additional 10,000 cubic yards or fractlo'n thoreof.
$340 For the first 200.001 cubic yards, plus '
$6.00 for 8ach additional 10,000 cubic yards or fraction thoreof,
200.001 CUBIC YARDS OR MORE
GRADING PERMIT 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
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Estima;ed 0~,~~~~" \ /
$30.00
$30.00 For the first 1 00 cubic yards, plus
$14.00 for 8ach additional 100 cubic yards or fraction thereof.
$1'56.00--I'0r the first 1,000 cubic yards. plus'
;11'2:OO,for each additional 1,000 cubic yards or fraction thereof.
)'2'64:00 For the first 10.000 cubic yards. plus
$54.00 for each additional 10.000 cubic yards or fraction thereat.
$750.00 For the first 100,001 cubic yards, plus
$30.00 for each additional 10,000 cubic yardS or fraction thereof.
r:jo +..., ;,:; (, + 3'" \
Plan Check Fee:
.4'('\~
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Receipt:
Date:
Received By:
Date:
Grading Permit fee: I '~. :'~R~ b~40b2...Date:6It'b18 ~
Recei~y. i ....... ~ ~ate: . 5
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Building: /2/~ "7 ~__......
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Maintenance:
Date:
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Date:
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Date
Permit Number
, "Issued by:
, Date:
Fln81 Insr,,~,..ttnn~'
Planning:
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Date
Engineering:
Date
Building:
Date
Maintenance:
Date:
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