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HomeMy WebLinkAboutPermit Septic Tank 1995-11-20 225 FIFTH STREET ; SPRINGFIELD, OREGON 97477 ENGINEERING DIVISION" OFFICE TELEPHONE (5031 726,3753 INSPECTION LINE (503) 726,3769 , ',~ DATE ISSUED: /t,2tJ -t(5' PERMIT NUMBER: SEE REVERSE SIDE FOR REQUIRED INSPECTIONS C?_.c;-/5f; '3 '. o Plans attached (Plans must meet City of Springfield Code Chapter'X Article V showing existing and proposed site conditions:) ",j LOCATION OF WORK, SITE ADDRESS: ?Ja...IC;- HAVoei-I f;f. ed, TAX MAP: CITY: f7fi.t1.t'f1IEE1//)'~TATE: t5tZ- ZIP: t?7qT1 TAX LOT: SUBDIVISION: OWNER: "P~..HlA KA /111' ADDRESS: U/~ f!I).-Wg;.J N CONTRACTOR: " CITY: ~;./fj/:iPfP'" ADDRESS: PHONE: ~ ~2/1 ,STA;rE: --'2l! ZIP: 9147'1 ...'1j.., ,~ .' PHONE: APPROVED BY: ~L006.l.PLAIr:i':, -&5 ~\, ... t. . WETLANDS BY: h0 a--€NGINEERING BY: ~ DRAINAGE: A..}., hd_ GRADING: 0 IL , SLOPE: (!J.'t2-, SOIL CONDITIONS: S-n::.tP, . DATE: '. f.f / 'UJ li.C'COMMENTS:':'t., D'A -tE: \ Ii'! U; /1 c: COMM'~f..{fs~;"~~ DATE: /;-;-7-95 COMMEt:J;-"S;V 4L1~J60 /A.! .z:k4Id/;6E :;;0JAI,F-, o~& E 714 T/QrJ R;e ~176 COMMENTS: -r-7 , / P / LL /-iE1Zh'7/ 7" ,/ALIO /=;;R, /HiS 77k'Ll/'//d7 r= .S,.J,j/'.. I ch /J~4<:--r~R. -Un,,;. /DE/LI7/~-/';:::;<; ~ A-f "'---' L1 ~ 6 ../.f ) t6. 'V ----;;; L1----r rJ'7.4j/" I(.M> '7 THE' P.e.E,eJ S .--, a T S I DC. ~A.J/ I/J /.-J);=<e;,- .<:5'R?//l/9,AL~{j:J /1-//<; A-S 4/'I.J/=<;T4R/j,Nl::.D /::::?H hL' / ED. CONDITIONS: WORK SHALL COMPLY WITH CHAPTER X ARTICLE 5 OF THE CITY CODE, CONTRACTOR TO COMPLY WITH MUTCD ( MANUAL ON UNIFORM TRAFFIC CONTROL DEVICES 1 AND THE OREGON SUPPLlMENTS, h" ;:? Llr:~n h)f TH/A) &,.:;Pr=:-'u/.U.;_F'I"J 41.1 , ~ ,2 C /5~ ,-, ""/ r, ~ J ,r:; Y' /7'i"::; /1, IA >---<( . ~c /:::k.-t/A'L<'1bE ~d 1-/4. /-F ./?-?//s r < /-;;(~, n"h:J,A)$J <seD 6'i?.4S5 oe OTNEP,. ~""J-' u."r ':.~.~ ,,~ ~/2r==d <: . n?//<,'( ,c:; ;::'=1'/, A )?, 7C, /, ' REVISIONS 9/6/95 ! ~ORM # 128 " FEES: . fLAI\I ~"'~~K FEES' o UP TO 100 CUBIC yARDS''''''','''''''''''''''''''''''''':' 6-'101 TO 1,000 CUBIC YARDS """,,,,,,,,,,,,,__,,,__,,,, o 1,001 TO 10,OOO'CUBIC yARDS""",,,,,,,,,,,,,,,,,,,, o 10,000 TO 100,000 CUBIC YARDS"",,,__,,,,,,,,,,,,, o 100,001 TO 200,000 ",,,,,,,:,, ,,,,,,,,,,,,,,,,,,,,-,,,,,,,, ::. - . '~... .... , o 200,001 CUBIC YARDS OR,MORE "",,"'" , ....,l -T' .... ' GRADING PFRM'T F~~1>;. o UP TO 100 CUBIC YARDS ":"",,,,,,,,,,,,,,,,,,,,,,,,,,,, ~1 TO 1,000 CUBIC YARDS """":":""'''''''''''''' o 1,001 TO ,10,000 CUBIC yARDS""""""""",,,,,,,, o o 10,000 TO 100,000 CUBIC yARDS'",,,,,'''''''''''''''' 'I '. .......'\ ". 100,001 TO 200,000 ",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,__,,,,, \ ,. I . . ~'. . '.... \ -_.'W ",'.~.- E.STIMATEI2 'vOtUME'OF "I,LL:" ., \ ,........;"", ". ,.,;~;'.... I- _III, $20,00 $30,00 $40,00 $40,00 For the first 10,000 cubic yards, plus $20.00 for each additional 10,000 cubic yards or fraction thereof. $220,00 For the first 100,001 cubic yards, plus $20.00 for each addttjon_a~ 1 O;OOO'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, $30,00 $30,00 For the first 100 cubic yards, plus $14.00 for each additional 100 cubic yards or fraction the~~of. $156,00 For the first 1,OOO,cubic yards, plus ' $ 1,2,00 far,each additional ,1 ,000 c'ubic ,yards,ar fraction thereof. ';....i ..'i':'. I'~."""w 1 ~. I:; "_~' '..~"-~. $264,00 For thidirst 10,000 cubic yards,'plus ,,', ". , $54.00 for each additioriall0!OOO cubic Ya.r9s;;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 .~, . ,. _ '.0.1 " ~ ~'. .- 1 - ',f .. ..; ~I'''-' .. ",'r..,.~..;,-~ -"'_... :"::! ,\~'" ...~ ~'.. .... ..' c;2 1(:; c c/ ;.;9IJ,,\~:~,,~ .. c:::; ....., \, ..;: ~ i\.,'" .:i\~~ .......~-...\,..:.\ \ , " A final inspection 'will be required after work is completed. Please call the Inspection Line at (503) 726-3769 and allow two business days advance notice of the date Y,?u wish inspection. . . . o Engineering Final Site inspection by: o Planning Final inspection by: o Building Final inspection by:' PLAN CHECK FEE: GRADING PERMIT FEE: TOTAL DUE: PAID WI APPLICATION BALANCE DUE '?r'I, () 0 iJ:..f.o () 71://0 "7./i " $ $ $ $ $ RECEIPT'NO, REOUIRED INSPECTIONS:, COMMENTS: CHEC~ N9, CHECK NO, :! '27/7/ -...-;1., / -? I RECEIPT NO, . RECEIPT NO," /9/7.6 /?(7~ DATE: , DATE RECEIPT NO, CHECK NO, Date' , Date: " Date: v'ALlDATION: ' ,',- , ,.j signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all information . rein is true and correc( and I furthor certify that any and all work performed shall be done in accordance with the Ordinances of the y of Springfield, and and the laws of the State of Oregon pertaining to the work described herein. I furthor certify that only contractors and employees who are in compliance with ORS 701,055 will be used on this project. . 1 furthor agree to ensure that all required inspections are requested at the proper time, that project address is readable from the street, and the approved set or-plans will remain on the site at all times during construction. Signatur~ O/~~ ~ ------- ,I?at~ /0 - J~ C(r fN(:; --0' ~~' <'//, J-orlJ...-::r - '''X//,- p,,~\ ' , ;J)r/.. ~Ov.... " '~l 'I ..,...., " S-)O-:J"V~, I , "'-4';.' <? <l- .... 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