HomeMy WebLinkAboutPermit Land Drainage Alteration 1999-10-14
This Side To Be Filled Out by ApplicBnt ..' , c,: I . ~L
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. _ This permit is required for any site activity in the flood plain and everywhere site alteration consists of
--.. _ fifty (50) cubic yards of material or mora and/or if a dralnageway Is affected, within City limits and
Date of Application Permit Expiration Date: .~
P"portyOwM' l/~lL lA."'9 PhoM' "A>.-I~~
Address: '1. f) '~i=.().Wo,rf) \\fAy City b..l .~~~ZiP9fWj,
Site Address: 2QOC)~\-"X'( ~ LAv.nt ~~etuIQP"\ lAllIil~Q~eir . Springfield, Oregon
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UGB Tex Map No: n -O~ -2..l-1 0
Journal number applicable Land Use Application
FILL, Quantity bDO c..y. ,Source Location DzLTIt ~tJO ~ hllUWI- J -, . :
Supplier · . Meterlel..t..aA.,<>'nO() K I)r! \ if.? "- 't~
GRADING. Quantity. bO <: y - '
I)(CAVATION, Qu.",lty Cl f)n O..tl".tl,,",j!el :T~\J) 'ii f...,1tl1&,1 "
Supplier:, Project Supervisor \ ~ \Vb.eP:2.ry (J,..),~ ~
Address.p (').~n{( 2.~ t::l.~t-..Q... '{1"lO1.. Phone34\-I'l.(,)~
Tax Lot:
. SITE PLAN RequIred Dete:Quantlty of material, Property lines and descriptions, Tax map and
';,r1ot number, Site addrass. Existing contour IIMS, Proj:losed contour lines, Existing drelnege
'1.,.,~u ways, Proj:losed drainage ways, Significant traes anCl follage, Ground cover, Soli types.
./ ../ Buildings, Septic systams, Sawers, Areas subject to floodlOg, Utilities, Areas subject to land
slides, Proposed site improvements.
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CROSS SECTIONS,
SOILS '& GEOLOGY PLAN,
DRAINAGE, POLLUTION AND EROSION CONTROL PLAN
REPLANTING PLAN
ADDITIONAL INFORMATION,
COMPANY NAME:
PROJECT SUPERVISOR:
ADDRESS:
COMPANY NAME: .
PROJECT SUPERVISOR:
ADDRESS:
, PHONE
CITY
STATE
,PHONE
CITY
STATE
.CONTRACTOR NAME:
PROJECT SUPERVISOR: II
Registration Number: 104 f.:J4 I
ADDRESS: J r-r1 ~ b'.. f] ~""
STATE: jJJ!.. ~,ZIP: 61740 ~
MOBILE PHONE: Cj5"3-711~ -
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PHONE.1.<JJ4-lI9)f') 1/ c:{ ~-71/ '6
, Expiration Date: I .~ / '20(') r)
, CITY: t:.. Wf" ,,--()
OFFICE PHONE~4-q9-)P) I FlAX 5Gl.mo
EMERGENCY PHONE:
't5rAn ~_<:::,
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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 Alteration Permit (LOAP), that at the time of
application of future permits or approvals the City may review and reconsider ell actions which I or my successors have
undertaken persuant to this LDAP. I understand that the City may 88 8 condition of any future approval. require the
undoing, changing, or modificatIon of any actions which I have undertaken 8S 8 result of the City's 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 accordance
with the Ordinances of the 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 certify that only contractors and employees who ere in
compliance with ORS 701.055 wlll be used on this project. .'
The City may Inspect the work site 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
work required to return the site to a standard acceptable to the City. The permittee will be notified in writing of any work
required and will have thirty (30) days from the date of the, notice to complete the work. Work not completed at the end of
the thirty days will be performed by the City and the costs will be billed to the permittee.
I further agree 0 ensure that all required inspections are requested at the proper time. that projeCt address is readable from
the street. 8 he app~v'JA\ '" of ~Ians will remain on the site at all times during construcfon.- J
Slgnatur. . n-'J., ~ Oat. ( ct~
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Bu,Jlctucg PQ!l.'1'lUt::Jf;, ~ri 1__ ' ,~I$3C
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1/&/1998
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DRAINAGE, 0 Stann, 0 DitchjJO Culvert, 0 Natural
WETLANDS, Description fl~
FLOOD PLAIN, Zone: y. ' FEMA Community Panel No,: 4~ 9 L..113~ F
FLOODWAY, FEMA Co,<';munity 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
200,001 CUBIC YARDS DR MORE
$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 each additional 10,000 cubic' yards or fraction thereof.
GRADING PERMIT FEES:
UP TO 100 CUBIC YAROS
101 TO 1,000 CUBIC YARDS
1.001 TO 10,000 CUBIC YAROS
10,000 TO 100,000 CUBIC YAROS
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 each additional 10,000 cubic yards or fraction thereof:
$750,00 For the first 100,001 cubic yards, plus
$30.00 for each additional 10,000 cubic yards or fraction thereof.
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'Estimated Volume:
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Receipt No:
3 S-~z..Date: /o/J'f/q0.
Plan Check Fee: % -;0 cI)?
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Received By: ~ (},{''') V>--
Grading Permit fee. 1f_ f 00 .
Date:
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Receipt No: 35'192
Date:/D!ZS)qj
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Received by:
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Date:
~ Planning .,( /;J1t-
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'o;l;I Engineering.~_...~,~
O B'ld' . ./
UI Ing:
, 0 Malntanance:
Date: !C(ZI /'1'7
Date: 17*
Date:
'Date
Permit Number
Issued by:
'Date:
RAqllirArl Fim~1 Iru:~""p,..'ti"nc'
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 of this permit. .
LlInd and DralnaQe ac.tivi.v as outlined in this permit has not been completed in accordance
Wltn the proVls'dhs of thiS perm't,
Land and Drainage activity was performed prior to application for this permit,
A,ccepted by:
Date:
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