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HomeMy WebLinkAboutPermit Sidewalk 1999-12-16 "'225~,".'I8liIjl~.SiIi..'R. EEiJ1~, """''''''.''.'...,~'!'I'4t'.: ,~"P~RINQI'IIfL'" ' , 'SPRIf\JGFIE~D~OflEGOf\J,9J4n(~:.', . . ~{~f~~Ji~?~~~&~'~~rl~~::' '~, APPLlCATIONDATE:~"}~/?/ . '. ~.,' ", ,\ ::~~~.t:::;/~';~:~:::~~<".;"'''" . . " . '.'SiTEINF()RMATI()N~;'''!'':".'',''h: . LOCATlor,tOFwORK:'S:2:..' "f:' . APPJCANi~~'~;'~~4ty%,.v. '/14VbLI7NO .-'; ::~\',',~:r<~io,~,;,;: :,~":~'r'~:V,::':,. " ".. . A~DRE5~';1~f;{Y ~iw', . '1:r/ AfII/ i L -"7tJ V -S;f . cl,;;~?H~4l$j*{~T~TE:' . 'L; /L ~. -:"'/:':":\)~~'~,~(';J'49Jm;~3<~~\, ::' - . .' '~'. . ,SUBDiViSiON:..... .' .". ,,' . .. ':JOE~ '."\"/ !":'.,~~;.wt~~I$J}}:!:lCl~\V, ..'.... . . , . OWN' " ,."!l:"~a3~3INVIlO::>. . . "~Jf'~l1~' '4 "",," "-;.,~___:':'},-.-:-(,' , _ '"'" . ."',:,<'-'~.,,1.i;triI~1\r.';H1l~3tJNrra3ZIHOHill V .'. ;AQCii~SSl:.!v,~~l:l~I.-:.~",...L.':J( ~' ":VIICITY: \'/'\\.~'If.,.l!li.fl<i~q:1I9.l;lI<:!JC;;!'.,I.lv"",.J.,,',~~~J~, ;. . .':' ~~.:~:~t,11'~'?'>',!.::\;,.~< ..:30IiON ~ . j ,." ','" . :.'q~/ ~ g-'1" .' /:7-.~h/f'f' "," PERMIT NUM.BER: DATE IS~UED:' \-.. . ", '" ~''r. . PHONE' /.:2 f -: 2s~O T~MA~;j7-r/?-3C//? TAX LOT: '. "ClIOe) '; ZIP: .., \" ~. C"', " " .PHONE: 'STATE: " " ZIP: " ': " ,.;..t, .' ~. REQUESTED PERMITS:':'. '. ~j;.';'(~t';,'f~. . . -"'-'.-'~".;-' ,'. ,'; . D' DRIVEWAy/CURB.CUT/SIDEWALK:...........,....,..................:......:..........................$ 60.00. . i-~."""t'i,~..,s;'~_. .'" '.'~' ~ '_ _" '. . , . . .: :. }M.~,9~~?F SID~~f:L,KIN E~~ES~ OF 9:. U-< o~ . @$O~~$.>., " .(j( ~ID~~~ryEPA!~::F::..:.(!Q~..t?f.?/.~.......,...~.Lt,.:...........,..,...:~ / . .,".,,"''-:~:~#:'..-, ',;,.,'::,:'..>.,..... ,....,:., ," . ~ .', ,.' .' D 'ADDITIOI\I~LDR'VEWAY: ,... ,.."..;...............................;...........,....:..........$ 30.00 ,/ 'J.".: '--,:.;}~~~:$.~r~:~.:y'~'.t>.~, .~ :~ ,: ~ .: - . ~_ . :. " -,' . .' o fBOOI'nF JI\ISUR~NCE' $500,000 MINIMUM IF WORK IS DONE BY PROPERTYOWNER I.,: ;," ,..':;:ldi,f;-,I{~fll:f(.};:;~.f,.i~,,~~t!:r:~.<);;_. >,", , " :,". _.\' . . ." .' . . , .. . :;:,:d;,.,,:;>"~:"?fi:'.:. ,',', .;. '. 'TOTAL DUE WITH PERMIT $' . . - '-"~' -, . - . .;S'.~' . ~ .. CONTRACToR INFORMATION: " ~ " '.- .:~~~(/((/;; /-/(fUG4&M/ . . ' '.' " do/VSf. , CONTRACTOR: . . ~ l'" .ADDRESS: . c::ONTRACTOR REGIS:rRATION NO: . ",:. .-........ it. ".' PROJECT SUPERVISOR: . q . " //?<t7~~ PHONE: EXPIRATION DATE:" ~/;?(J/:b"'d"" PHONE: . II I I f INSPECTIONS: ...,......- . AN INSPECTION REQUEST SHOULD BE MADE PRIOR TO POURING CONCRETE. AFTER THE PROPOSED WORK HAS BEEN F(lRMED ' AND MADE READY"TO POUR.' . "" '. " ,.' , . ',' . . . .", '.:':,.:'..'i...:.:';;,'.::.:..,,1...:....~,.... ',' . .' -. . - I;">.' --. ,.", :" _ 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. ".',: '.,"...~~J:.;...: . ..,," \_~:~"" '.-' ," , '. ,_ '.' , ",,',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 .' "., t~',fl!~;~n~~~,~~!'~~~'~~l~ t~e.Plrmll~88. . . ......: ,.',', '. . ",.' ..' . ,'. '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. . . .".' ' '.,' .:....-.'~~A};~f.t~~~.~~,:~:;tJ1}f-11~-~:::..~...-.':;:~'," -. , . .... '. .. s'~~~ltr~:2b2;;,;~;;~':;;r/C ;:' ~ Date / 2 ~ / t;'" $' 1 -, "~~3~f\X',J;.""'I\~': _ '\I,,/;:r;;.!^, ~'S ...; :~,_. , , ., .J < _' , . ~. -- ~.. '~ .....'.. -...--