HomeMy WebLinkAboutPermit Sidewalk 1994-11-15
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'"
. ~5IDENTIAL - COM1'1E~CIAL
~ SIDEWALK I CUR6CUT..
APPLICATION I PERMIT :'. -
Ii~
225 NORTH FIFTH STREET
SPRINGFIELD, OREGON ~1411
ENGINEERING DIVISION
OFFICE NO, 176-3153
INSPECTION LINE, 176-316~
JOB ADDRE58. --57 S /Il/flll/ 51." .5?',e/~fiG.cz..~ \
ASSESSORS MAP NO.*' nn~0~( TAX LOT "10:* \()~~
SUSDIVISION,
O'J.NER, ___ h)fV@ J1'Y ~
ADDRESS, ___ r?O /lJjfj)1.fJ,v )jf-.
STATE, ....-- ~ ZIP, --=-'7'7';452-
Uk:>Rl<: DESCRIPTION.
SIDEWALK, ~ CUSS SIDE_
CURS-CUT, RESIDENTIAL _
SECOND DRIVEWAT (SEE TRAFi'IC )
REQUIRES APPLICATION FOR A SECOND DRIV=WATr'T-4.1a)
OR A COUNTT ,t.PPLICATION FOR FACILITT PERMIT (C '?;8-703)
IF IN THE U6.9.
CITT, ~~
PHONE NO. .3.~.3'-Y.l"1'.1~
S:TBACK
COMMERICAL ~
DATE 0.= APPLICATION
II /;~/f'l
SPRINCFIELD
RECEIPT NO, I S ~ "ill
CASI-I
CHECK ~
11-- 0/44
*'
CHECKED FOR DELINQU:NCI:S' 4
j
'*
~ t;:..~
11-1S'.f-#
.SIGNED,
DAiE:
1lX)RJ< TO BE FE~~ I:::D BY: OI.!.N:R ~CONTRACi'OR
CONTRACTOR't---~'-IANNO~ IiAMI L-r"OI-.^ REGISTRATION NO':-{,62.30 EXPIRES'<..-b/sks-
ADDRESS ,~?'f'fo ISoLaN'O 67'~-r -'7p.IlJI..a:..Pi.lU-p PHONE'.,.-'7<,170:O:\\,
PROCEDURE FOR lN5FECTION REauE5r.
CALL 176-316~ (RECORDER) STATE TOUR CITT D:SIG~TED J05 NU:-19:R, J05 ADDRESS,lTFE 0.=
INSPECTION REQU:STED A'lD II.\-IEN TOU WILL 9: READT FOR INSPECTION, CONTRACTORS OR OUN:RS NAi'"1: 4'lD
P~ NUM9ER REOJ:STS REC:IVED 9:r",,,,", 1,0" t.'1 WILL 9: MAD: TH: SAME DAT, REOJ:STS AFTER 1,00
A'1 WILL BE MAD: TH: NEXT Ul::>!<!<ING DAT
*' 5:: BOoK.
EXISTING SUILDIN'" PERMIT NO. ( IF APPLICABL: )
TOUR CITT D:SIGNA TED J09 NO. Isf '1Lf I 741
REQUIRED lN5F\:CTION5
mlDEWALK I DRIVEWAY
FOR ALL CONCRETE PAVIN", WITHIN
TH: STREET RIGHT 0.= WAT, TO BE
MADE At::iER ALL EXCAVATINCI
15 COMPLET: AND FORM WOR<
A"lD SU9-9AS: MATERIAL 15
IN PLAC:
D
CURS I APPROACH APRON
AJ=TER FO~5 ARE ERECiE
SUT PRIOR TO POURING
CONCRETE.
FEE5. SIDEWALKS CURB-CUT WALK x'
~10,OO . ~0.15/LF. ( X ) ~10.00 . ~.15/LF. ( X ) / ""
OF WALK
COMMERICAL DRIVEWATS SHALL l x' I.
J J,S-{) HAVE 5' TO 8' FLAIRS
~ 3'- o' STt.'lDARD " "
TOTAL F\:RMIT FEE.
I HAVECAREFuLL T EXA..,INED THE COMPLETED APPLICATION FOR PERMIT, ':"'lD DO HEREBT CERTIFT TH.l.T ALL
1N"...oRMATION HEREON 15 TF'aJE A"lD CORRECT, A'lD I FURTH:R CERTIFT THAT A'lY ,j,'lD ALL WOR< P:!Q'ORMED
SHALL BE DONE IN .l.CCORDANCE WITH THE ORDIN"-'lCES 0.= THE CITT 0.= SPRING:FIELD. AND THE LAWS 0.= THE
STATE 0.= OREGON PERTAININ6 TO THE WORK DESCRIBED HEREIN. "-ND THAT NO OCCUPANCT WILL BE M4DE
OF ANT STR'JC - U.lIT!-lOJT PERMI!'>SION 0.= THE BUILDING DiViSION. I FURTHER CERTIFT TI-IAT ON~ 7TRACTOR5
4ND EM WljO~, ,'" COM,o>LIANCE WITH ORS 1"1,05l> WILL BE USED ON T!-lIS ~:~77r
DATE '