HomeMy WebLinkAboutPermit Sidewalk 1994-8-30
111'30
~IDENTIAL - COMMERCIAL
. SIDEWALK I CURBCUT .
AFPLICATION I PE~IT
225 NORTf.I FIFTf.I STREET
SPRINGFIELD, ORECOON ~1411
ENCOINEERING. DIVISION
OR'ICE NO. 126-3153
INSPECTION LINE, 126-316~
JOB ADDRE&e. qZLf
ASSES50RS MAP NO.*'
M,M~
SUBDIVISION,
OiLNER,
ADDRESS,
Af2c..I.ll~ ~ J.c-f-
qUI. Mh\\-.l.
~ fL- ZIP, 17t./ '1
STATE,
SPRINGFIELD
RECEIPT NO, 1l{5Y 'Ii
CAS!-!
Cf.lECK V
=* \~c{ (0
TAX LOT NO~ *'
CITY, :'::;OP~P/e.J.P
Pf.lONE NO. 1q(.,-tr.1.L1
*'
Cf.lECKED FOR DELINQUENCIES _
SETBACK ~
CO:1MERICAL ~
SICONED,
DATE,
1~
~,
Q- ~I -tj<.j
WORK TO BE F'EF<f'v..... I~D BY: OUN:R
CONTRACTOR *' \! ()c, 'fr .u M6/~ &.
ADDRESS 7.77__ V'A.)..J Bu~
FF"'"'r-:::nURE FOR IN5FECT(~ REQlJE5T.
CALL 1,6-316~ (RECORDER) STATE YOUR CITY DESICONAT"D JOB NLJ:'15ER, J05 ADDRESS,TYP" OF
INSPECTION REQUESTED A'lD II!-<EN YOU WILL S" READY FOR INSPECTION, CONTRACTORS OR OllNERS N"-'1E "-'lD
Pf.ION!: NUM5ER REQU"STS RECEIVED BEFORE 1,00 A'1 WILL 5E MADE Tf.lE SAl1E DAY, REQJESTS AFTER 1,00
AM WILL SE MADE Tf.lE NEXT WORKINCO DAY
llJORK DEecRIFTI~.
SIDEWALK, /,./' CURS SIDE _
CURS-CUT, RESIDENTIAL _
SECOND DRIVEWAY (SEE TRAfFIC)
REaJIR::S APPLICATION FOR A ~COND DRIVEWAY('T-4,1a)
OR A COUNTY t.FPLICATlON FOR FACILITY PERMIT (C ~-,03)
IF IN TI-IE U,C,.s. <RIa /I 10 .1
DATE OF APPLICATION '4-":ZY.crLf
CONTRACTOR
RECOISTRATION No.*'4/'fIJS
*' SEE BOOK
EXISTfNC; SUILDINCO PE~IT NO. ( IF t.FPLICASLE )
YOUR CITY DESICONATED JOS NO. Is1"
SIDEWALK I DRIVEWAY
FOR ALL CONCRETE PAVINCO WlTf.llN
Tf.lE STREET RlC04T OF WAY, TO 5E
MADE AFTER ALL EXCAVAilNG
IS COMPLETE A'lD FORM ll.OR<
AND SU5-SASE Mt.TERIAL IS
IN PLACE
REQUIRED 1N5PECT(~5
~
FEE5:
SIDEWALKS
.10_00 . .0.15/LF. ( X )
OF WALK 10. &oj
$
TOTAL PERMIT FEE.
D
CURB-CUT
.10,00 + ~.I:;/LF. ( X )
COMMERICAL DRIVEWAYS Sf.lALL
f.lt.VE 5' TO e' FLAIRS
3'- O' SoTA'lDARD
EXPiRES, q /1 irS-
Pf.lONE, 48S ~(
CfLf !?z-1
CURS I t.PPROACf.I APRON,
AFTER FORMS ARE ERECTED
SUT PRIOR TO P.OURINCO
=NCRETE.
WALK x'
/ ""
l x' J
"
I f.lt.VE CAI'<:FULL Y EXA'1INED TI-'E COMPLETED APPLICATION FOR PE~IT, A'lD, DO,.f.lER::SY CERTIFY Tf.lAT ALL
IN""rORMATION f.lEREON IS TRUE t.'lD CORRECT, A'lD I FURTf.lER CERTIFY Tf.lAT t.NY A'lD ALL ll.OR< PERFORMED
Sol-'ALL SE DONE IN ACCORDANCE WITf.I TI-'E ORDINA'lCES OF Tf.lE CITY OF SoPRINc.FIELD, AND TI-'E LAws. OF ,TI-'E
SoTATE OF OI'<:COON PERTAININCO TO Tf.lE ll.OR< DESoCRI5ED 4EREIN, AND Tf.lAT NO OCCUPANCY WILL SE MAD'E .
OF ~Y-S~' TURE WITf.lOJT PERMISoSoION OF Tf.lE SUILDING. DIVISION. I FURTf.lER CERTIFY TI-'AT ONLY CONTRACTORS'
A'lD EMPLO ES UJ;.IO ARE IN CatlPLIANCE ijJlTf.I ORS 10l.os5 WILL SE USED ON Tf.lIS PROJECT. " .
( / A/:/<J /.- ~ R/~/9y
SICONED / - DA~70~~-S4~ O~ 10"0