HomeMy WebLinkAboutPermit Curb Cut 1997-07-14D
PERMIT NUMBER: O; , ZV,
DATE ISSUED:
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INSPECTION LINE SEE TNSPECTIONS ON BACK SIDE
APPLICATION DATE:
ENCROACHMENT PERMIT
NUMBER:
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SPRINGFIELD, OREGON 97477
ENGINEERING DIVISION
oFFtcE TELEPHONE (503) 726-3753
225 FIFTH
.LOCATION OF WORK
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"ADDRESS:
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PROJECT SU PERVISOR:
ADDRESS:
PHONE
TAX MAP:
TAX LOT:
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SUBDIVISION:
OWNERT
}APPLICANT
r4lTE ADDRE
: ZIP:
INSPECTIONS FEOUIREO:APPLICATION FEE / DEPOSTT ACCOUNT NO:
REOUESTED
Q erucnoAcHMENT pERMtr No:E $20.00 /VALIO FOR SIXTYI cur srneer
(60I OAYS FROM OATE OF ISSUANCE
E BoRE E oTHER E$Q ousr coNTBoL (TypE oF coNTRoL,
Q corusrnucroN, sroRAGE. srAGtNc E$Q orxen
E$Q asrrllr DEpostr..........E$TYPF OF SECURITY DFPOSIT
Q euruxer sunEry BoND e sunttrv eoruo E cASH / cHEcK n9-ffiuns cuT pERMrr No:. Fr. /2 n q<T6.oo+ $.1s/Fr.IiISPECTION. CURB / APPROACH AFTER FORMS AR E _E^EcrE o eur piEi-EEIi]G
DAYS FROM OATE OF ISSUANCE.
CONCRETE.o
v^Lto FoR rEoaSECONO ORIVEWAY (SEE SEPARATE APPLICATION)tr fl $10.00+$.1s/FT
\A/AY, TO BEtrPLACE.
D $5.0o /
tr E $s.oo /
rorAl oUfi' s
TOTAL DUE WTH PERMIT O
PROJECT:DES CRIPTI oON F
IT APPLICATION
PERIOD
Q er_a
AREA: LENGTH:
TYPE OF WORK: CUT:
OTHER:
BACKFILL MATERIAL TO BE UTILIZED:
OF USE OR TIME OF CONSTRUCTION:
NS (TWO SETS)ATTACHED
FROM DATE:
TO DATE:
TIME:
TIME:__- WIDTH:DEPTHI
BACKFILL MATERIAL:
SURFACE REPLACEI\4tNT MATERIALS TO BE UTtLtZEDT
TYPE OF DUST CONTROL TO BE UTILIZED:
NAME OF OTHER UTILITIES IF THIS IS A JOINT PROJECT
WARNING DEVICES TO BE UTILIZED:
DESCRIPTION
WORK SHALL COMPLY WITH CHAPTER
and zone protoctlon to bo in complianc6 wlth tho Manurl on Uniform Traffic Control Dovicos
X ARTICLE 5
REVISIONS 8t24t95 FORM ,116
OF THE CITY COD E.CONTRACTOR TO COMPLY WITH MUTCD .
(MUTCD'
L
)
PERMITS:
EXISTING SURFACE MATERIAL:
REVIEW COMMENTS / SPET .. INSTBUCTIONS:
SFilBmB"dFltsP'ffoiffi*'5,'r'*'8'B?[l'#'E[d[il
IEXISTING C ITY CODES AT\ID
--I)MPLIANCE
WITH CURRENT
OOl Backflll with *" mlnuo rock.
OO2 ComPact every 18' loose doPth'
OO3 Requires compaction with a stsol rolller'
OO4 A.C. to match ths greatsr of exlsting dopth or 4"'
OOE All cuts soaled lor tlnal lnspoction'
OOB Temporary patch may be used 8t the snd of th6 day'
OO7 Slgning and Zoni protection to comply with MUTCD
OO8 Cut concrete only. on score lines or cold ioints'
OOg Sldewalks and drlveways min' 3,OoOpsl'
01O Curblng min 3,6OOpsl / No patchwork less than 3"
011 M6ot min. rsquiromBnts.on curb cuts, Spfd' code'
012 Rostoro plantsd aroas, Spfd' code 206'3'05
013 Spoc, to Bore / Jack / No A'C' cuts'
014 Mochanlcalcompactingroqulred'
016 No Patchwork allowed,
016 Lateral cuts to havo control density fill'
017 Cuts to bs polymerized crack sealed lor linal inspection
019 Minumum 4' clsarance at any point, swing"away'
O2O Concrete minimum 4' depth, 3,OOOpsi'
021 Tronch to be 'T' cut.
O22 NoBds StEto / CountV Permit'
O23 No abovs grgund cncloslngs in sidswalk or handicap ramps'
O24 Oiamond cut A.C./Concroto vslua boxes to grade'
O25 Fresh Oil slgns / Groded.
026 Comply with Americans with Oisabilities Act'
O27 Concrets slabs. 72hrs. curing time, 4SOOpsi'
O28 Concrsto slobs require ioint oesl material'
029 Driveway requires dowels every 18''
O3O Submit traffic control plan prior to excavation'
031 Notity Trolfic Division belore excavatign'
032 Core drill main line. insert toE, 27o min' grade'
033 Must comply with the provisions of ORS 757'541 to 757'571
1a
6" Circular hole/H2O'Vac. t a
018 Mininum 2" crushed rock X' minus'
Comments:
THE LANE UTIL
"ONE CAL
YOU ARE BEOUIRED TO CALL
r r[ES"-C'b-o ribi fuATt N-q Q q U N -c I L' s
L'tullMegR"- t -8oo -332-2344
48 HOURS BEFORE DIGGING
INSPECTIONS:
SANITARY SEWER, STORM SEWER, ENCROACHMENT PEBMIT AND OTHER INSPECTIONS CALL CITY MAINTENANCE AT
726-3761
tr
tr
, ANO WHEN YOU
OUESTS RECEIVED
AYDAY
VATIONS
JOBCITYTEDESIGINABDSTTEAYOU7(BECORDER)26.3769CALLPECTIONSINSALKSIDEW BANDoDYFREARBCUCUTBEWILLTEDESEOURSNPECTIONFoTYPEESS,AD DBJOB BELNUMBER,MA.WILUMNER/PERMITB EFOBEB :0O7RENMBERUDPHNoEENAMANOWNER'SoRSTRACTOR'TO BEloNcoNSloNARENSPECTDPECTNSTNTHEEXWORKINGMADEBELLwlA.M:00AFTER7ESTSREOUETHEDESAM ETCR E.MA GURIN coNRPOTOPRIEBUTSINPLACFRMWoANEoRKDMADAREEXCAINAFTERCALLED
SIGNATURE:
Signature
pidli$itfufift1',Ff,",;.lliltfi.gtffiHir'3-qlj:fffi$filrj;*lllitlilti,l,ffe'ln'i:j.I:4e,t'}"til"'Ett$lt**t"
project.
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that proiect address is readabre trom the street'
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AMOUNT RECEIVED
RECEIVED BY:
DATE PAID:
RECEIPT NO:
VALIDATION:
E rnnrrtc REVIEwED BY:
E ruotrueEnlNc REVIEWED BY:
I uatrureNANcE l
I nrnutr lssuED BYi -
AND CURB C'JT PERMITS PLACE A COPY rcOMPLETED) IN PERMIT DRAWER'
ir rrvrE oF coMPLETIoN:
FOR SIDEWALK
DATE:
DATE:
DEPOSIT BETURNED:
ELEVENTH MONTH
WORK IN PROGRESS
DATE:
DATE:
DATE:
DATE:
DATEI
DATE:
DATE:
DATE:
INSPECTION:
INSPECTION:
{
SPR FIELE}
,,btgAF,225 FIFTH STREET
SPRINGFIELD OR 97477
PU BLIC WO R KS DEPARTMENT
ADMINISTRATION
ENG/NEE8/NG DIVISION
lt|,\!l'.!TEIiANCE
APPL]CATION FOR A SECOND DRIVEWAY / OVERWIDTH DRIVEWAY
DATE: 6*,2 "l' cj'7
APPLTCANT (PROPERTY OWNER)f rrr/e n
:,p{elADDRESS OF PROPERTY FOR DRIVEWAY PE A tSZ O+. S+
APPLICANTS TELEPHONE NUMBER .7 4 b-.OS b 9
Please sketch the proposed driv'eway. lnclude the following applicable items: house or building, proposed
driveway, existing driveway, and street names. lnclude dimensions and measurements to property lines, road
intersections and bordering driveways. (See attachment for an example.)
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ALL APPUCANONS OUTSIDE THE CITY UMITS OF SPRINGFTELD THAT ARE WITHIN THE URBAN
GROWTH BOUNDARY REQUIRE A LANE COUNTY PERMIT.
Note: The City of Springfield will not grant a second driveway permit on an Arteriat or Collector Street.
AD\VtNISTRAIION/Er\Gr\FEAilvG OA3) 726'3753 FAX (503) 726 3689
^IAtNrENANCE
(503) 726-s761 FAX (503) 726-3621
I
Other
2. The proposed driveway will take access from which street h*"qT
3. The distance from the edge of the driveway to the nearest corner (measured to the curb return) is
_ feet.
4. The second driveway will give access to: .garage- carPort- side yardll Other-
5. The distance from the property line to the garage, carport. fence, wall, or other, (where the vehicle is
to be parked) is
-
feet.
6. tM[ the proposed parking / storage area create a vision obstruction to adjacent property driveways or
to any vehicular movement on a public street? (See vision clearance attachment)34-
Applcant hereby agrees to instatl the requested driveway to City of SpringfreH standards. The applicant fur$er
"ir."" to have
-6'of
conc;.te in the sidewalk area (a{acent to the drirreway), and to pave the are,a behind the
back edge of the sidewalk, or driveway apron, with a minimum depth of 3" asphaltic concrete or 6'of portland
cement concrete. The area behind the sidewalk shall be paved a minimum of 18 feeL
The appll=nt agrees that if he/she does not pave the area behind the sidewalk within 30 days of cutting the
curb opening, Oe CitV of Springfeld has the authority to ctose the driveway access by removal of the curb cut
All hcuned ios6 shall be issumed by the applicant and if unpaid, said cost shall become a l'en of the prop'erty.
When this application is approved by the City, the applicant must obtain a curbcuVdriveway permit from the
Public Works Department, Engineering Division.
1. Property type: Single Family Reside n"" /' Duplex
Curbcut / Drivewav Permit Fee
a. On an improved street (existing curb): $1O.OO plus S.15 per lineal foot of curb cut.
b. On an unimproved street (no curb): $12.00
c. on currently unimproved streets that are under construction: $12.00
TE: L,*4r7-77PROPERTY OWNER'S SIGNA
APPROVED
BUILDING PERMIT NO
TRA 9-1
ATTACHMENT: Msion Clearance, Example #1
7
DIVISION
r XAMTLE +I
eppucaflou ron a s
APPLTCANT (PROPERTY OWNE
ADDRESS OF PROPERTY FOR DRIVEWAY PERMI
APPLICANT'S TELEPHONE NUMB
Please sketch the proposed driv'eway. lnclude the following applicabte items: house or building, proposed
driveway, existing driveway, and street names. lnclude dimensions and measurements to propefi lines, road
intersections and bordering (See attachment for an example.)
STREET NAME H.tt l5l L5t
Ner cuw{s
HousE
o-l,o
rn
CI
{
77
3
frl
8o,
ALL APPUCATIONS OUTSTDE THE CITY UMITS OF SPRINGFIELD THAT ARE WTTHIN THE URBAN
GROWTH BOUNDARY REOUIRE A I-ANE COUNTY PERMIT.
Note: The City of Springfield will not grant a second driveway permit on an Arterial or Collector Street.
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ExtsrrN6
DRIVEWAY
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S.AtsOVE CURE
--Z-1 2' AB OVE CUR
STNEET OR ALLEY
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11
THIS DII/TENSION:25'FOR COHNER LOTS
1s'FOR LOTS AT ALLEY
1O'FOR DRIVE\TAYS
II.I ALL DISTHICTS
INTERSECTIOT.iS
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