HomeMy WebLinkAboutPermit Land Drainage Alteration 1997-6-12
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.' . Lan(Aild Dra~nage" AI,. jrati~n Permit
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City of Springfield
22S Fifth Street, Springfield, Oregon 97477 - Development services
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Date ,?f Application 5 /<i{ 1'17 Expiration Date:
Property Owner ':ilhlltp \). Li vJl~"
Address: {"" 61 /4" l'r '5+-. I
Phone: 7t../I-Mp 35
City ~f.{ ~'t!State: Ol..ZiP.2Wl8
Site Address:
o UGB
.6.83/ ~~?'"
Tax Map No: / #.t:!)-:;;> . ~ =5'~
.' Sprin9field, Ore90n
Tax Lot: .::>, ~ <<:re:..
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FILL, Quantity
Supplier
, Source Location
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.' Material
K~+- V\1i:ll.-'~1 I /C;n c.w. 1
V - f /
EXCAVATION, Quantity ~ Destination:
Supplier: 6~ t.o+ , Project Supervisor ~l ~'L.\JltlWJ
Address ---1I:>?,~l \+1[. 5+' ,Phone 1'(-4 - (,,(,.1/<;"
,
GRADING, Quantity
~SITE PLAN Be.(JUir{!rf Data:Quantity of maleriai, Property lines and descriptions, Tax map and
lot numoer; ::;,Ie addreSS,l:xlsl1ng contour lines, Proposed contour lines, Existing drainage
ways, Proposed drainage ways, Significant trees and foliage, Ground cover, Soil types,
B~ildings, Septic systems, Sewers, Areas subject to,floodln9, Utilities, Areas subject to land
slides, Proposed site Improvements.
o CROSS SECTIONS,
o SOILS & GEOLOGY PLAN,
o DRAINAGE, POLLUTION AND EROSION CONTROL PLAN
o REPLANTING PLAN
o ADDITIONAL INFORMATION,
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STATE s:
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COMPANY NAME:
PROJECT SUPERVISOR:
ADDRESS:
COMPANY NAME:
PROJECT SUPERVISOR:
ADDRESS:
.' PHONE
CITY
.. PHONE
CITY
STATE
CONTRACTOR NAME:
PROJECT SUPERVISOR:
\>wlLD 'L\"Al~... / ~r AlAJ(FH
s~ I ( . PHONE I
Registration Number:
ADDRESS:
STATE: . ZIP:
MOBILE PHONE:
, Expiration Date:
, CITY:
OFFICE PHONE
EMERGENCY PHONE:
FAX
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 are in compliance
with ORS 701.055 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 fallowing the receipt by the
City of notice of completion of the describ d w rk and specify, at the City's sole desecration. any additional restoration work
required to return the site to a standard a cepta Ie to the City. The permittee will be notified in writing of any work required
and will have thirty (301 days from the ta of e notice to complate the work. Work not completed at the end ot the thirty
days wi/l be performed by the City a cos will be billed to the permittee.
.
I further agree to en~ ~t all re uir d i sp ctions are requested at the proper time, that project a. ddress is readable from
the street, and ~ rl v d set f ~PI . remain on the site at all times during construction.~
Signature '() A I . Date Sf " /7
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DRAINAGE,
o Storm, 0 Ditch, 0 Culvert, 0 Natural
WETLANDS, Description
FLOOD PLAIN, Zone:
,., :. I
, FEMA Community Panel No.:
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",',.... .......
,
FLOODWAY, FEMA Community' Panei No::
, Date:
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PLAN CHECK FEES:
UP TO 100 CUBIC Y ARCS
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 f~r each additional 10,000 cubic yards or frac~on thereof.
'.,. ;"
200,001 CUBIC Y ARCS OR MORE
GRADING PERMIT FEES:
UP TO 100 CUBIC YARDS
101 TO 1,000 CUBIC YARDS
'),.oOl,TO 10,000 CUBIC YARDS
10\000 TO &0,000 CUBIC YARDS
, '
$30.00 Y.
$30.00 For the first 100 cubic yards, plus ,',
$14.00 for 6ach additional 100 cubic yards or fraction thereof.
$156.00 Fo'i-: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.
100.001 TO 200.000
Pian Check Fee:
/.50..cJ70
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Date:
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Receipt:
.;{011 ( Date: 6 ~(6q7
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Estimated Volume:
Received By:
Grading Permit fee:
4400
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Date:
Receipt
Received by:
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0 Pianninq Date:
0 En9ineering t....~ I_ I ,. ,
Date:
0 Building: Date:
0 Maintenance: Date
Permit Number "'7./a"7.:?o
Issued by:
Date:
FinRI Inc:np~tinnc::'
Planning: ~ It....
FItE~O
Engineering: D!2.A,o-{
Date
(,,/1 'l-J '17 c..rJ
'f. M 'AII.'Sm..-
,;..11.10.,
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III:""''=-::\ 'OEm -OF VTfLlTlG5
TO Tttf:. F"e,...I(. S~!.T~~ ~ll
5-ra.t!l!:';fDate
.
Buildin9:
Date
Maintenance:
Date:
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