HomeMy WebLinkAboutPermit Sidewalk 1992-4-30
11""10.
~vlj.,.l~I"l1 I~L- - '-VI II
SIDEWALK I CURElCUT
AFPLICATloN I PE~iT
I~~'-I~L- -
SPRINOFIELD
225 NORTJ.l FIFTJ.l STREET
SPRINGFIELD. OREGON <:11411
ENC!rINEERING DIVISION
OFl'ICE NO, 12&-3153
INSPECTION LINE, 12&-31"'<:1
.
.
~~
JOB ADDI"E&e, '72.C(- /J1JJ/lCJ S T
ASSESSORS MAP NO.*' 17. - O? -'''3 5 -4- z. TAX LOT NO, *' tSJ (., I cs> c>
SU6DIVISiON, ).L / J4
13 ~ iJ- J-I C~
ADDRESS, '9'Ze{.... /P/4/A..J
STATE. o!2-- ZIP,
RECEiPT NO,
4- 5 (5
CA5J.l
CJ.lECK ~
p" Zl97
OUNERo
'5T
'774-'77
CITT, '5 r-"F" L t::::'
PJ.lONE NO. 74 CO - S 5PS
*'
CJ.lECKED FOR DELINQUENCIES lS...-
UJORK DEec~IPTION.
SIDBIJAl.K, ::::6...
CURS SIDE _
SET6ACK _
CURS-CUT. RESIDENTIAL _ COMMERICAL _
SECOND DRlYEWAY (SEE TRtoffIC )
REQUIRES APPLICATION FOR A SECOND DRIYEWAn"T-4,1.)
OR A COUNTT AFPLICATION FOR FACILITT PE~IT (C ':\8-2"'3)
IF IN TI-IE U.G.6.
DATE OF AFPLICATION 4-/-:Se>/9"Z-
SIC'NED'~-JP "/J).)L
DATE, 4-;/::0,197_
WORK. TO BE F'E1O!Fv... II::::D 6'(,
CONTRACTOR*'
ADDRESS
.X . OUNER
CONTRACTOR
'*
REGISTRATION NO.
EXPIRES,
PJ-lONE,
r,........cvUi"!E FOR IN&A:CTION I"EQUEST,
~~~~~~~~ )~~~~~C~ ~~~~~ ~~~~~~~~~i'~S~~T~R5 NAME A"D ~'/';.
PJ.lONE NUMBER. REQUESTS RECEIYED 6EFORE 1.<z>o AM WILL 6E MADE TJ.lE SAME DAY, REQJESTS AFTER 1,<Z>O -,
AM WILL 6E MADE TJ.lE NEXT IlJOR!<IN::O DAY
qQJJ\ro1
'* SEE 600K
EXISTIN::O BUILDING PE~IT NO. ( If AFPLICA6LE )
TOUR CITT DESIGNATED J06 NO. Isf
,REGlUIRED IN&A:CTIONS
o
SIDEWALK I DRIYEWAY
FOR ALL CONCRETE PAVING WITJ.lIN
TJ.lE STREET RIGI-IT OF WAY, TO BE
MADE AFTER ALL EXCAVATIN::O
IS COMPLETE AND FoRM IlJOR!<
A'iD SUB-6ASE MATERIAL IS
IN PLACE
D
CURS I APPROACJ.l APRON,
AFTER FO~S ARE ERECTED
BUT PRIOR TO POURING
CONCRETE.
FEES,
SIDEWALKS
.112?00 . .0.15/LF. ( X )
OF WALK .I!:::::
~.J L-. F;
TOTAL FEFiiMIT FEE,
$ 10, "=:>0
CURB.CUT WALK X'
t\0JZl0 + ~.I5/L.F. ( X ) / "'"
COMMERICAL DRIYEWATS SI-IALL l X' I.
I-IAYE 5' TO 8' FLAIRS
3'- O' STA"DARD " ",
I ;.IAYE C'<'REFULL T EXA"1INED THE COMPLETED APPLICATiON FOR PE~IT, A'lD DO HEREBT CERTIFT 71-1'<'T ALL
IN?O~ATION I-IEREON IS TR.JEA'-'P CORRECT, A'iD I FURTHER CERTIFY T;.IAT A""" A'lD ALL 1lOR< PERl'O!<:'1ED
SI-IALL BE DONE IN '<'CCORDA'lCE WIT;.I TI-IE ORDINA'lCES OF TI-IE CITT OF SPRINGFIELD, AND TI-IE LAl$ OF TI-IE
STATE OF OREGON PERTAINING TO T;.IE lX>R< DESCRIBED I-IEREIN, A'lD TI-IAT NO OCCUPA"C"" WILL BE Mt.DE
OF A".,.. STR.JCTURE WITI-IOJT PE~ISSION OF TI-IE BUILDING DiViSION. I FURTI-IER CERTIFY TI-IAT ONL.,.. CONTRACTORS
A'lD EMPLOYEES Wl-IO ARE IN COMPLIA"CE WITI-I OR!> 101.055 WILL BE USED ON 71-11S PROJECT.
SIGNED
DArE