HomeMy WebLinkAboutPermit Land Drainage Alteration 1999-12-9
..' \' , .
, ,:,.__..)./ '. " . '~y of Springfield
This Side TD Be Filled Out by Appllcsnt
'. ~:{:'~ ! .' '
.- 'j
....bO...:":ii This permit Is required for any site' activity In the flood plain and everywhere site alterat;~~ consists of
. fifty (50) cubic yards of material or more andlor .if a,dralnagewey is affected, within City Umlts and
r-
-
~
u.J
c..
Z
o
-
~
UJ
~
<(
UJ
LJ
<(
Z
-
~
o
o
z
<(
o
z
:s
Date of Application 'Dec. e. ,qqq
Property Owner FdiJ"'Lo<lt::;.....>'; '<;:; ).=..,;..1
Address: 'P. c:::>. 'e>o'\oc' ,..seq
Site Address: 7i!~ ~-' . ~-=--. .~~
Permit Expiration Date:
CClS"P .
Phone: tP8CO.~o
City I:::u~State:~ip~( ,
~
,Springfield, Oregon
1'5~.
Tax Lot: 3a:>e~ '
o
UGB Tax Map No: ISwc:>3-t'>3. ~
Journal number appUcable Land Use AppUcation
o
o
o
FILL, Quantity
Supplier
GRADING, Quantity
EXCAVATION, Quantity
Supplier:
Address
Source Location
, Material
...
'~
Destination:
Project Supervisor
, Phone
"
3~~ '. ,.
)( SITE "LAN Required Data:Quantlty of material, Property lines and descriptions, Tax mep end
lot number, Slta addrass, Existing contourlinas, Proposed contour lines, Existing drainage
ways, Prollosed drainage ways, Significant trees and foUalle, Ground cover, son types"
'Buildings, Septic systems, Sewers, Areas subject to flooding, Utilities, Areas subject to land
sUdes, Proposed site improvements, "
o
o
~
o
o
, ,
CROSS SECTIONS,
SOILS & GEOLOGY PLAN,
DRAINAGE, POLLUTION AND EROSION CONTROL PLAN
REPLANTING PLAN
ADDI':nONAL INFORMATION,
. .'," .',
COMPANY NAME: Sc::hsud+,:Sb rim 05 klild ff1C. ' PHONE-485 .a3S~
PROJECT SUPERVISOR: AH.....:;...:- t-4- ~el A.\A
ADDRESS: lz,05 oAIoC :!'T" CITY C::vCe>ENE STATE OR.
COMPANY NAME: , PHONE
PROJECT SUPERVISOR:
ADDRESS:
CITY
STATE
CONTRACTOR NAME: 12>rt:a.m Gzi> 1 h...c:hr19 ' Inc.'
PROJECT SUPERVISOR: OoN ~~ PHONE33S, 9.P45'
Registration Number:~ ,Expiration Date: fS.I'2.f:!>Ot!J
ADDRESS: P.O~ &r z.G:>4BQ ,CITY: EU~,"_
STATE: OR , ZIP:~ OFFICE PHONE33e.c:r3~ j::A>S..s:s8-~
MOBILE PHONE: Cf I Z- Sc.:.Cl4 ,EMERGENCY PHONE: ' "
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 (LDAPl, that ~ the time of
application of future permits or approvals the City may review and reconsider all actions which I or,my successors..have
undertaken persuant to this LDAP. I understand that the City may as a condition of. any future app'rovdl, require the
undoing, changing, or modification of any actions which I have undenaken as a 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 aU'
information herein Is true and correct, and I funher cenify 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, '8nd thelaw8,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 8 one year period foilowlng the recelpt,by
the City of notice of completion of the described work and speci!y, 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 funher agree to ensure that all required inspections are requested at the proper time, that project address Is readable from
the street, and" approve9Jset ~ p~~ ~i11 remain on the site at all times during construction..
Signature {tJd -{If ~~. ,Date /~9/9/
JoUfrlfL/ 110. / qqq-/J. -()J..q9 JJtUlL: h/9hq /&uJ+-/
~~~ 991foQ7 4t>gO~ 'O%Z/I+
"
I-
.....
~'
~.
LoU
c..
Z
o
-
~
LoU
~
<(
LoU
o
<(
z
-
~"
{),
o
z
<:
o
z
:s
1/6/1998
o
}
o
DRAINAGE, (J Storm,
(J Ditch, (J Culvert, (J Natural
~M€' ~
,FEMA Community Panel No.: 41034G1l41 r
WETLANDS, Description
FLOOD PLAIN, Zone: X
FLOODWAY, FEMA Community Panel No,:
, Date:
"
"PLAN' CHECK"FEES:
UP TO 1 00 CUBIC YAROS
101 TO 1.000 CUBIC YAROS
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
~~..M + VOlumA-C.D",b<2.1 "..1~
$20,00
$30,00
$40,00
$40.00 For the first 1 0,000 cubic yards. plus
$20.00 for each additional 10,000 cubic yards or fraction thereof.
$220,00 For the first 1 00.001 cubic yards. plus
$20.00 for 8ach 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
$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
$30.00 for each additional 10,000 cubic yards or fraction thereof.
~~ ,..
.....:..
1,001 TO 10.000 CUBIC YARDS
10.000 TO 100,000 CUBiC YARDS
100,001 TO 200.000
Estimated Volume: I r::)() c:..y
Plan Check Fee: <$ f:f:J -
g.'B.
Grading Permit fee: ~ Lj-Lf. 00
,ID
Date: 12..{'1 1'1'1
,
Received By:
Receipt No: ~4
Date: L;2.lar Jq~
, ,
Receipt No: 3 ft; '-1-7 q
Date: 12.-2..0 -Cj ~
Date:
Received by:
EM:rc"'~,_c,.. - ~~ ATTAc.,...c,O &-oADl A(ro Cti:>tZ. ...r ~_'~l "T"o,...,,~
, "
c(
'~.
{J'
'tr
,.' -
Date:J.2:l.1km
Date: 12.I'olrl....
Date:
Date
;(.~
~ Ie-. pL~
Plannln~
Engineering
Building:
~.. \
, ,Maintenance:
Permit Number
'Date:
Issued by;
RRQlllrArt FinAl In~pFH'~tlnn~.
Planning:
Date
Engineering:
Oate
Building:
Date
Maintenance:
Date':
o
o
o
Land and Drainage activity as outlined in this permit has been completed in accordance with
the provisions of this permit, ,
LlIntc d tand DrainllQe ac.tivitv as outlined in this permit has not been completed in accordance
WIth :he provlslO'hS ot thiS permit,
Land and Drainage activity was performed prior to application for this permit,
Accepted by:
Date: