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Home My WebLink AboutPermit Sidewalk 2019-04-29Driveway/Sidewa I k Perm it Appl ication City ofSpingfield Application Date: Permit Number lssue Date: 225 Fifth Street, Springfieid, Oregon 97477 Transportation & Engineering Section, Public Work Department Phone: 541 726-3753 \ NGFIELD STTE INFORMATION Location of Work:?l s,'q Applicant: Address: City: ,non,@2lz1 State:ZIP: Tax Map Tax Lot Subdivision Owner: Address: City: Phone: State:ZIP: REQUESTED PERMITS: f Sidewalk Amountofsidewalkinexcessof9Ofeet f Sidewalk Repair f,ffirbCuVDriveway: NumberofDriveways 2 f tvtultiple Permit Discount each: (Maximum 2) Multi permit discount good for one site and one site inspection only applies to 2nd and 3rd permits only. Not sidewalk repairs f 5%Technoiogyfee ll Proof of lnsurance: 5500,000 Minimum if work is done by property owner. F Facility Meets 201 1 PROWAG For ADA Compliance Fees '121.00 @s0.1 1 sF 512l.00 1stCut X 565 2nd Cut Totai due with permit 5 CONTRACTOR'S INFORMATION Name: Address: City: Contractor state'O(L ze w enonez{q/ -S3ar 9z-77 2 /q*rRegExpiration date: Project Supervisor Phone: INSPECTION5: An inspection request should be made prior to pouring concrete, after the proposed work has been formed and made ready to pour. Curbcutandsidewalkinspectionscall:541 726-3769(recording)StateyourdesignatedCtyjobnumber/permitnumber,jobaddress, typeofinspectionrequested,andwhenyouwillbereadyforinspection,Contractor'sorOwner'sname,andphonenumber. Requests received before 7O0 am will be made the same day, requests after 7:00 am will be made the next working day. lnspections are to be called in after excavations are made and form work is in place, but prior to pouring concrete. are to Lane 1 -800-332-2344, 48 hours digging. SIGNATURE: Amount Received: Receipt No. Date Paid: Received By: By signature, lstate and agree that I have carefully examined the completed application and do here by certify that all information herein is true and correct, and I further certifo that any and all work performed shall be done in accordance with the Ordinances ofthe City of Springfield applicable City Standard specifications and drawings and the laws ofthe State ofOregon pertaining to the workdescribed herein, I further certify that only contractors and employees who are in compliance with ORS 701 .055 will be used. The City may inspect the work site described in this permit at any time during a one year period following receipt by the City of notice of completion of the described work and specify, at the City's sole discretion, 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 days (30) from the date of the notice to complete the work not completed at the end of the thirty days will be performed by the C:ty and the costs will be billed to the permittee. I further agree to ensure that all required are requested at the proper time that project address is readable from the street and the approved set of plans will rema Signature times during construction. Date:/-Jr/F \'--o?\.t + r/) N \n erl( )-\9a? IL - no fiotl Ch.,rt )9t {.rf t r)e $4 $ ,l ;r{ aL \ AEti 4\,arA ?ro,,il'eil forBiS \'t{>c'fsir .h(SF-L. lll.l. Y'dl''r Second/Overwidth Driveway Apptication Development and Public Works Departmentringfleld 225 Fifth Street Springfi eld, Oregon 97 477 Current Development Division Phone (541)726-3753 This is not a Permit lf the application is approved, a permitwill be issued OREGON Step 1 : Location of Work Who is filling out the application? ll_!f,t-'_ '-_"q!igl,-v_s.v-yj ll need to identify the Applicant and location of driveway. Site Address or Location Applicant (Property Owner) Add ress (Property Owner): st Buiiding Permit Number: Received by:Receipt #: EmailAddress:-?Phone: Step 2: Check list A site plan will be required (see sketch example on paqe 2 of application.) please use the check iist below to ensure that all necessary information is included on your site plan. Any applications lacking the required minimum information will be deemed incomplete and will not be accepted. t:Copy of approved P.l.P. plan sheet if applicable (new subdivision) Faciliry Meets 20'11 P.R.O.W.A.G. For A.D.A. Compliance.r - Provide existing and proposed driveway J- Show all street trees' location [ Show all property boundaries a show all drainage structures including'- weep holes at the curb l- Show all utilities a show any other below or above ground - site features along property frontage Step 3: Property description Note: The City of Springfield will not grant a second driveway permit on an Arterial or Collector Street. Over Width driveways less than 30ft. proposed to the transportation planning staff must demonstrate compliance with all applicable codes, policies and previous land use decisions. Driveways over 30ft. in width require a Land Use Decision and are not handled on this application. (Contact the Planning Department) The application fee is non refundable. 1. Property type: ffAngtuFamily Dwelling l- Duplex ll other Project Description 2. The proposed driveway will take access from which street?9I 3. The distance from the edge of the driveway to the property corner is ft. and the distance from the ft.edge of the driveway to the nearest intersection corner (measured to the curb return is) 4. The additional driveway will give access to: T- Garage l- Carport l- Side yard l- Other 5. Distance from the property line to the garage, carport, fence, wall or other (where the vehicle is to be parked) is.5- t!t. 6. Will the proposed parking area creatq a vision obstruction to adjacent properly d movement on a public street? (see vision clearance standard development See other side for additional information code) or to any vehicular W*J lnformation A permit will require that the applicant meets City standards, specifications and codes. The area behind the sidewalk shail be surfaced to the property line and also a minimum of 18ft. behind the property line per Springfield Development Code. lf this application is approved by the City, the applicant must obtain a curbcut/driveway permit from Development and Public Works within 60 days. Any approvals given by this application will expire in 60 days if a curbcut/driveway permit is not obtained. Fee Secondary/Over Width Driveway application S0S.OO -A 5% fechnology Fee will be appiied to the total cost for processing the application. Fees that may apply -Additionalfees may be required upon approvalof this application (i.e. sidewalk permits, SDC's, building permits, etc.) Step 4: Signature Signature of owner Signature of App (Transportation a&"e tulL-L StaffComm ---r ati *r h" Date: Date: -2q-11 f-eq - tq no 1405r fvt usl th u" €t y'-n l9'f,,+, enil,h) 7ol" r"fo*' dl oraabl ii)"uqll' itt a A> or'o,- Example Diagram Property line 6arag€ Main lpuse Driveway Feet Trees Weep lines 26FLWide-tA lt 15 feet llr You are required to call: The Lane Utilities Coordinating Council's "One Call Number" Sl 1, 48 hours before before digging. --'....-.