HomeMy WebLinkAboutPermit Sidewalk 1999-12-16
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APPLlCATIONDATE:~"}~/?/
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PERMIT NUM.BER:
DATE IS~UED:'
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PHONE'
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REQUESTED PERMITS:':'.
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. D' DRIVEWAy/CURB.CUT/SIDEWALK:...........,....,..................:......:..........................$ 60.00. .
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.: :. }M.~,9~~?F SID~~f:L,KIN E~~ES~ OF 9:. U-< o~ . @$O~~$.>., "
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D 'ADDITIOI\I~LDR'VEWAY: ,... ,.."..;...............................;...........,....:..........$ 30.00
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o fBOOI'nF JI\ISUR~NCE' $500,000 MINIMUM IF WORK IS DONE BY PROPERTYOWNER
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.. CONTRACToR INFORMATION:
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CONTRACTOR:
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c::ONTRACTOR REGIS:rRATION NO: .
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PROJECT SUPERVISOR: .
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EXPIRATION DATE:" ~/;?(J/:b"'d""
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INSPECTIONS:
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AN INSPECTION REQUEST SHOULD BE MADE PRIOR TO POURING CONCRETE. AFTER THE PROPOSED WORK HAS BEEN F(lRMED '
AND MADE READY"TO POUR.' . "" '. " ,.' , . ',' . .
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CURB CUTAND,SIDEWALK INSPEcTIONS CALL 726-3769 (RECORDER) STATE YOUR DESIGINATED CITY JOB NUMBER/PERMIT " .
NUMBER; 'JOB ADDRESS; TYPE. OF INSPECTION REQUESTED. AND WHEN YOU WILL BE READY FOR INSPEGTION. CONTRACTOR'S
.' OR'OWNER~SNAMEAND PHONE NUMBER: REQUESTS RECEIVED BEFORE 7:00 A.M.WILL BE MADE THE ,.
SAME DAY; REQUESTS AFTER-7:00 A,M. WILL BE MADE THE NEXTWORKINGDAY.INSPECTIONS ARE TO BE CALLED IN.
. AFTER EXCAVArlONS ARE MADE 'AND FORM WORK IS IN PLACE BUT PRIOR TO POURING GONCRETE.
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",,',i<,.' ., .', ~, YOU ARE REQUIRED TO CALL , .'
'jA".i','//'.:'THE LANE UTILITIES COORDINATING COUNCIL'S
. ':.~;~:'>;'~>': .::"'/'ONE'CALL NUMBER" 1-800~332-2344' .
.'.~:-,.:: :v~:,;""",~'Srqi~;~;!"~<" .. 48 ,HOURS BEFORE DIGGllilG " . . . ' .',
SIGNATURE:"<<; ..... "
. .' AMO\:lNT:RECEIVED':~ . DATE PAID: id....l b -"\ "\' ,
"::;REt~I~;~6~'~~i\~~\1.<~: "",;. .RECEIVED BY:. . ~,
BY-si~~:r~'!!t;sr~;e:~~~'~~';~;':lli~i I ha~ecaref~lIy examined the completed application and do herebycertitv that all i~forrTlljticin 'tlerei~ .
is tru9,and:correCI"andHurttier certify that-any and all work'performed shall be done in 'accordance with the Ordinances of ' ,
the'CI,W:of;Spnpgfl.,eld, app.1 ica!>.le. Citv.Standara specifications and Drawings, an.d the la,ys of the State .Of Oregon pertaining tei.the work
g~'~~(~~_~~;~th~l, ~~Iy co.ntr~c~or~ and arnPloyaaa whO a.r~ ',ncomphance W~~h ORS 7:01.~6WI~1 b~ und '. . '. ':
. The ~iiv.m!ly.lnspecflhe..;yoik',slie described I.n this permit at any time duri~9 a:one year period foilow,ing the receip!by. the City of notic,: ,
of completlo,j!ofJhe:desc"b~d.work and specltv. at the Clty's sole descresslon, any addItional restoration work reguoreCf to return .the site "
to a standard'acceptable to.the City. Thepermitlee will be notified in writing of any work required and will have thirty days (30) from the '
dateSlf.t. he;nOtice'!Ci',COIJ!Plete. !.he wo.rk. Work ~ot'completed at the end of Ihe thirty d,ays Will be performed by .' ".,
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'1 furthor agree to ensure that all reqUlreg mspe~tlons'are requested at the. proper time. that'prolect address IS readable from the
street; ,.imc the approved selofplans Will remam on the site at all times durin9 construction. . . .".' ' '.,'
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