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HomeMy WebLinkAboutPermit Sidewalk 1992-03-26i\/ao I=E,i, ll-lE,l\ I I AL - t-2\)l - ll - lE l=1./ IAL 9IDEUJALK / CURBCUT APPL ICATIOI.I / PEEIIT SPRINGFIELO 225 NORTH FIFTI{ gTREET 9FR|hI3FIELD, OREGON 91411 El.l6 lNEERll.l6 D lvl I lol.,l ffitcENo.126-11>3 lNgPECTlOt,l LINE: 126 -3']69 h, JOO ADDRE99T I ll s AeeESsoRs rlAF No.* if ol ->S z?-TAX LOT NO.6 ts56D 9tlBDlYl9lOtl: REcErPr No3 OO *Dq--' cA${ CHECK x */ CHECKED FOR DELNAJENCIES 9I6NED: DATE,j - uto:1 z Otl^lER: n1 k ADDRE9g: I O I STATET F ZIP:7 L CITY: FHONE No.7L/jos/ TIJOFK IJOFK TO EE PEFFOFT1ED EY: cot,lrRAcroR* CO}.ITRACTOR REGISTRATIOhI NO.* x OtU..lER EXPlRi9' SIDEIIALI<: CURS gIDE - SETEACK - CuRg-CuT: FEgtDE}.iTlAL Y cotf;lERlcAl - 9ECOND DRI\EII,IAY ( gEE TRAT+IC ) R=AUIRE9 AFPLICATION FOR A SECot'lD DRt\€tUAy(T-4.ta) OR A COUNTY APPLICATIO?'I rcR FACILITY P=Ri-1IT (C AO.2@)) IF IN THE U.6.E. '5'Lt , -77-'DATE.OF APFLICATIO'hI ADDRE9g PHONE: 12b-3169 RE@IIE9T: ) STATE YOUR CITY DESIGNATED JOB NtJ'i.19=R, JO3 ADDRESg,TYPE trD AJ.ID [T.H=N YOIJ IUILL B= READY FOR IN9PE CTlOfl, CCtITRACTOR9 oR OtJ.t.lERg N+1E Ar.lDP}.IO,{E NLMBER R=AUEgTg RECEI\€D BEFOFE 1,OO Nl UILL BE HADE TI{= 9A1E DAY, FEOJEST9 AFTER liOOAH U,,ILL BE T,IADE TI]E NEXT IUORKING DAY EXIgTII.{G ELIILDIN6 PER'IIT NO. ( IF APPLICABLE ) *YOUR CITY TED JOE NO.,ef a'zo +1qsEE BOOK 9IDEIUALK / DRI\EII.JAY FOR ALL CONCRETE PAVING IUITTIN THE STREET RIGHT OF IUAY, TO 3E MADE AFTER ALL EXCAVATIN6 15 COI'IPLETE AID FORI1 IIJORK AID sUB.BA,gE HATERIAL 19 IN PLACE CU@ / APPROACH APROI.I: AFTER FORF1s AE EECTED BUT PRIOR TO POIJRING CONCRETE. FEE9: SIDEIUALK9 cuRts-cuT lu.lALK x' ;IO.OO + t@.19/LF.( X ) OF I.IJALK jlO.OO+t@.|>/LF.(X) COiII-IERICAL DRI!€UAYs SHALL HA\G 5'TO A'FLAIRS3'. O'STADARD tC $*oTOTA PERI'IIT FEE: I iA\€ CAREFULLY EXAYINED TH= COI1PLETED APPLICATION FOR PEBIIT, A{D DO HER=BY C=RTIFY THAT ALLiNTSIATIOI.I I]EREON 15 TRUE A\D CORECT , A\D I FURTI-.IER CERTIFY ]'I]AT A\Y A\D ALL Ui2R< PE=O31=Dg;ALL 3E DOh,IE IN ACCORDANCE I.iJIiII Tit=ORDINA\CEg OF TI{E CITY G SPRINr.#IELD, A\D Tr.lE LAII,9 C THESTATE OF OREGON PERTAINING TO TI.1E IIJOR< DESCRIB=D IiER=IN, AND TiIAT NO OCCUPA\CY UILL 9E IIAD=G A.IY STR.JCTURE IUIT|]OJT PEB1 r99lo,i! 6 THE BUtLDtN6 Dtvtgtof{ I FURTI{ER CERTIFY THAT ONLY CONTR,ACTORS TI{I3 PROJECTA\D [J+{O COI'1PL|A\ICE IUITH ORg lolg>> tUtLL BE U5ED Ot{ DATE 3 ,Zl- 7a_- FEAUIRED tNgPECTICt.Ig