HomeMy WebLinkAboutPermit Land Drainage Alteration 1999-3-19
This Side To 8e Filled Out by Applicant
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, This permit is required for any site activity in the flood plain and everywhere site alteration consists of I
.. fifty (50) cubic yards of material or more and/or if a drelnegeway Is affected, within City limits and
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Date of Application 311", /"1 Permit Expiration Date:
Property Owner At'- Q....iJI.u ~J. (Ll Phone: <::::Lfl-':?o...l. - !lB~
Address : AJ; 3(;, s-'7q A J~,,,,, l,.,.-.....L. City ,<:/.1 State:O.L Zip ~~.5'
Site Address: /c;f166 /;'/4<';"'/1...
,Springfield, Oregon
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Ta,x lot: 2 I m
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UGB Tax Map No: 'B-O'l.~()3-11
Journal number applicable land Use Application
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,."./ , /"). 0 ,:~1' 30 ('A it..
W:J Fill, Quantity -t7 V#-!>, Sou fee location
Supplier ,,-~r::I0.. ,1....1'- Cf'~J..-----' Material
o GRADING, Quantity
[B" EXCAVATiON, Quantity ;')0 yal:,j",
Supplier:
Address
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Destination: Qt,,..,tl. ...}.,Jtb O<e-/,s:Ja
Project SupervisO'r lLt ,'fi ;cU_
! Phone
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SITE PLAN Requireclbata:Quantity of material, Property lines and descriptions, Tax map and
lot number, Site 'address, Existing contour lines, Proposed contour lines, Existing drainage "
ways, Proposed drainage ways, Significant trees ana folialle, Ground cover, 5011 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,
REPLANTING PLAN
ADDITIONAL INFORMATION,
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COMPANY NAME:' '/)7o,,-1'f~"- ~
PROJECT SUPERVISOR: lZ.ivll..
ADDRESS:
COMPANY NAME:
PROJECT SUPERVISOR:
ADDRESS:
{r>,h~ .s;-,;L- ~"",,"""'1 j.,c, ~M
CITY
STATE
, PHONE
CITY
STATE
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A '(, s"...J.., YJu. GVt&I
4.,,-- 5--1-.1.' &
Registration Number: "14 V82
'C>0Y?C( AI,11,{,,/u",L . CITY: Y/>..o.--
STATE: ,ZIP: OFFICE PHONE JbivA--
MOBilE PHONE: '1"111-11.).7) , EMERGENCY PHONE:
CONTRACTOR NAME:
PROJECT SUPERVISOR:
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PHONE ,)aJ - UBI.(t-
. Expiration Date:~ ;J n (k;;)
ADDRESS:
FAX 3:U-V8~
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i understand that I.or my Buccel80rs 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 un4erstand that notwithstanding any approval of this Land and Drainage Alteration Permit (LDAP), that at the time of
IppqCltlcn cl lu\Ure permlto cr epprcvels the City mey review Ind rlconslder In eotiono whlch I or my .ucce..cro heve
und~noken persuent to ,this LOAP. I understend thet the City mey es I condition of eny Mure Ipprov.I, rollulrl,the
undoing, changing. or modlllcatlon 01 eny actions which I have undertaken "' a rasu~ cf the CIty'. epproval of thl. LOAP.
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By signature, I state and agree, that 1 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 tha Ordinances 01 tha City 01 Springlield, applicabla City Standard spaclflc.t1ono and Orlwlngs..and thel.ws 01 the
State of Oragon pertaining to the work described herein. I further certify that only contractors and employe88 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 foilowlng the receipt by
the City of notice of completion of the described work and specify. at the City's 80le 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 to II required inspections are requested at the proper time, that project addreaa,la readable from
7he street ." 8 approved t of ~m8ln on the site at all times during conatru_ctJr: . ::" .
a ure .. e;::,..s.....-.... Oata 311f(PJ _ '
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ji"."" NO.'I't'l'i-D3m~1 tdIuJ.\'-3-25~~~
i '. .,..r..'~ ','
. ,', ~ 2000
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1/6/1998
o DRAINAGE, CI Stonn, CI Ditch, CI Curve'rt, CI Natural
~ WETLANDS, Description V\tlv\€-
~ FLOOD PLAIN, Zone: C , FEMA Community Panel No,: l.j I Sc; '1.l. O{){J t..j A
o FLOODWAY, FEMA Community Panel No,: , Date:
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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 OR 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 YARDS
101 TO 1,000 CUBIC YARDS
1,001 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',OOO cubic yards or fraction thereof.
$264.00 For tha 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
$30.00 for each additional10,QOO cubic yards or fraction thereof.
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Estimated Volume: (00 C--c--,
pran Check Fee: :$ 2D - cJb
Received By: K ' 1~m_--lL-
Grading Permit fee: Qt--iD q!!..
Receipt No: ~72-f3 Date:<-SJ~)qS
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Date: '2> /2 ~ r 4. ~
Date: ~-/3-9 9
Receipt No: 0.33 '1-8 (
Received by:
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Date:
f6 ('DA, -/f.l11 /.p 3--1
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~ Engineering '7?J1SL---
o Building:
o Maintenance:
Date:
Date: cf-/? /qq.
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Date:
Date
Permit Number Issued by:
'Date:
RAqlllrArI FinAl Inc::nj:l,..tinnc:::
Planning:
Date
Engineering:
Date
Building:
Date
Maintenance:
Date:
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lend end Drainage activity as outlined in this permit has been completed in accordance with
the provisions of this permit,
Land end Drainllae ac.tivitv as outlined in this permit has not been completed in accordance
wltn tne prOVISIons Of tnlS permit.
, Lend and Drainage activity was performed prior to epplication for this permit,
Accepted by:
Date: