HomeMy WebLinkAboutPermit Curb Cut 1997-07-14D I a
DATE ISSUED:
TPFINOTTELO rr L
fl
PERMIT NUMBER:INSPECTION LINE SEE INSPECTTONS ON BACK SIDE
APPLtgATtoN DATE:
oFFtcE TELEPHONE (503) 726-3753 ENCROACHMENT PERMIT
NUMBER:
226 FFT,I STREET
SPRINGFIELD, OREGON 97477
ENGINEERING DIVISION
'LOCATION OF WORK
STATE:ztp: ?2,4,? ? TAX LOT:
-e75
PROJECT SUPERVTSORT PHONE:
7tP:
74
SITE ADDRESS:
OWNER:d-dz- t
A
2o7 {,94
CONTRACTOR BEGISTRATION NO: (4I3 ' €O Z -EXPIRATION
CITY:STATE: @R
PHONE:
APPLICANT
ADDRESS
o23/lCr.V:@
SUBDIVISION://
TAX MAP: / 7
REOUESTED PERMITS:
ACCOUNT NO:INSPECTIONS REOUIREo: AppLtCATtoN FEE / OEPOSTT
I erucnoAcHMENT pERMrr No: .........
VALID FOR SIXTY 160I OAYS FROM OATE OF ISSUANCE
Q cur srneer O BOnE E oTHER _
tr- g sio.oo r
E$
Q ousr coNTRoL (wpE oF coNTRoLt
Q corusrnucloN, sroRAGE, srAGtNG tr tr
tr
tr
$
I orxln tr $
Q asnxllr oEpostr.,......,.
TYPE OF SECURITY DEPOSIT
Q aururer suREw BoNo e sunttrv eoruo E cASH / cHEcK
$
ffi cuna cur pERMtr No: .... FT.
Es_
-
NSPECNON.CURB / APPROACH AFTER FORMS ARE ERECTEO BUT Q $10.00+$.1s/FT ,,5()
VALIO FOR I8O OAYS FROM OAIE
PRIOR TO POURING CONCRETE.
OF ISSUANCE.tr SECONO ORIVEWAY (SEE SEPARATE APPLICA'tr STDEWALK PERMTT NO:.................... FT.
VALIO FOR I80 OAYS FROM OATE OF ISSUANCE.E $1o.o0+$.1S/FT.
Q Hew D REMoVE / REPAIR E PAVE PLANT STRIP
Q seraacx I cunasroe E LENGTH
INSPF'TION. SIOEWALK / ORIVEWAY FOR ALL CONCRETE PAVING WTHIN THE STREET RI6HT OF WAY, TO BEMADE AFTER ALL EXCAVATING IS COMPLETE , AND FORM WORK ANO SUB.BASE MATERIAL IS IN PLACE,tr SANITARY SEWER CONNECTION PERMTT:r-l $5.OO /.JVALIO FOR SIXTY 160' OAYS FROM DATE OF ISSUANCE
Q ro srua e MAIN LINE (EASEMENT-R/IvI E oTHEB
I sronrvr sEwER coNNEcrtoN pERMtr tr E $s.oo /vAlro FoR stxw t8o) oAys FRoM oATE OF TSSUANCE
Q clrcx BAstN / BUBBLEB E STUB e uAtt[true
PRooF OF INSURANCE: $SOO,OOO MtNtMUM
Q rrrecueo I neoutneo AMouNT TOTAL DUE: $
TOTAL DUE WITH PERMTT $
DESCRIPTION OF PROJECT:
PERIOD OF USE OR TIME OF CONSTRUCTTON:
tr PLANS (TWo sETS)ATTAcHED
BACKFILL MATERIAL TO BE UTILIZED:
suRFAcE REpLACEt\rtNT MATERTALS To BE ulLrzED
FROM DATE:
TO DATE:
TIME:
TIME:
AREA: LENGTH:TWIDTH:
TYPEOFWORK: CUT: e6atr.
OTHER:
EXISTING SURFACE MATERIAL:
DEPTH:HEIGHT:
BACKFILL MATERIAL:
NAME OF OTHER UTILITIES IF THIS IS A JOINT PROJECT
WARNING DEVTCES TO BE UTIL|ZEDT
TYPE OF DUST CONTROL TO BE UTILIZED:
DESCRIPTION:
WORK SHALL COMPLY WITH
Adv!nco and work zono protectlon to bc in compliance wlth th6 Manual on Uniform Tru ffic Control Oevices (MUTCO),
CHAPTER X ARTTCLE 5 OF THE
REvrsroNs 8t24t95 FoRM ' 116
CITY CODE.CONTRACTOR TO COMPLY WITH MUTCD .
OF SPf
/6
REVIEW COMMENTS / SPET .. INSTRUCTIONS:
B?iigHJgE#Bffo!ffi tb,'f*'8'B?[ffi"".YI#.EXISTING CITY CODES IHO.-,bTuPLIANCE WITH CURRENT
OO'l Backfill with il" minus rock.
OO2 Compact every 18'loose dePth.
OO3 Roqulres compaction with I steol rolller.
OO4 A.C' to mstch tho groator of sxisting depth or 4"'
OO5 All cuts saaled for final lnspoction.
OOO Temporory patch may be'ussd at the end of tho day'
OO7 Slgnlng and Zono'protectlon to comply with MUTCO
OO8 Cut concretB only. on gco[o linos or cold ioints'
OOg Sldswalke and drivoways min. 3,000ps1.
OlO Glrblng min 3,6OOpai / No patchwork less than 3"
011 Meet min, roqulremente.on curb cuts, Sptd. codo.
012 Rostore plantod areag, Spfd' code 206.3'05
O13 Spsc. to Boro / Jack / No A.C' cuts.
014 Mechanlcalcompactlngrequired'
016 No patchwork allowed.
016 Leteral cuts to hsve control donsity fill'
017 Cuts to be polymerized crack sealed for final inspection'
018 Minlnum 2n crushed rock l(' minus,
019
020
021
o22
023
024
025
o26
o27
028
029
030
031
032
033
343
Minumum 4' cloarance at any point, swing'away' ''
Concreto mlnlmum 4' dePth, 3,000Psi.
Trench to ba 'T' cut.
N8ods Stato / CountY Permit'
No abovo ground snclosings in sidewalk or handicap ramps'
DiEmond cut A.C./Concrete value boxos to grade'
Fresh Oil slgns / Gradad.
Comply with Amoricans with Oisabilities Act.
Concrete slabs. 72hrs. curing timo, 4500psi.
Concrete slabs require ioint seal matorial.
Driveway requiros dowels every 18".
Submit tralfic control plan prior to oxcavation.
Notify Traffic Division belore excavatign'
Core drill main line, inssrt toe, 2% min' grade.
Must comply with ths provisions of ORS 757.541 to 757'571
6" Circular hole/H2O.Vac.
Comments: -
YOU ARE REOUIRED TO CALL
THE LANE UTILITIES COORDINATING_ .CQU N9lL',S
'oNE GALL NUMBER" 1-800-332-2344
48 HOURS BEFORE DIGGING
INSPECTIONS:.N CURB CUT AND SIDEWALK INSPECTIONS CALL 726.3769 (BECORDEB) STATE YOUR DESIGINATED CITY JOB
- ruUMaeilpeRrrmnurrlaen, JoB ADDRESS, TypE oF tNSpEcloN REoUESTED, AND wHEN You wlLL BE READY FoR
iIIspeCfioT.I, CoNThAcTon,s on oWNER,S NAME AND PHONE NUMBER. REOUESTS RECEIVED BEFORE 7:OO A.M, WILL BE
MeoE Tne SAUE oeY, REoUESTS AFTER 7:Oo A.M. WILL BE MADE THE NEXT WORKING DAY. INSPECTIONS ARE TO BE
CALLED IN AFTER EXCAVATIONS ARE MADE AND FORM WORK IS IN PLACE BUT PRIOB TO POURING CONCRETE.
SANITARY SEWER, STORM SEWER, ENCROACHMENT PERMIT AND OTHER INSPECTIONS CALL CITY MAINTENANCE AT
726-3761.tr
SIGNATURE:
Bv sionaturs, lstate and aqree, that lhave carefully examined the completed application.and.do hereby certify.that all information
Edreif iiiiui ina-ii,riijct. End litirth-eiieitilv inat'ani ano allwork peiformed'shall be dgne in accordancs with the ordinances of the
Ciiv'ijt'i;oririqiieiO, appiii'a5ie Ciiv.SiihdiiA ipecifications and Drawings, and the laws of the Stat6 ojplejpqpgrtainipg to the work
rje's'cribed heiein. l'ftjrther certify that only cohtractors and employees who are in compliance with oRS 7o1.o55 will be used on thrs
project,
The Citv mav insoect the work sito described in this permit at any time during a on.e year period Jollo.wing the.receipt.by the City of
notice cif corholetion of the described work and specify, at the City's sole descresslon, any sdclational restoratlon wor.k requrred to.
iblirii *ie s-ite-io-a ltinrjriia-aCCepl-abte io the Ciiv. Tlid permittee'will be notified in writing.of-any work required.and will.have thirty.
davs (30) from the date of the notico to complete the work. Work not completed at the encl ot the thlrty days wlll 0e perlormeo oy Ine
City and ihe costs will be billed to the pormittee.
I furthor aqree to ensure that all required inspections are requested a.t the proper time, that project address is readable from the Street,
and the ap-proved set of plans will remain on the site at aU times during constructlon.
b
DateSignature
7
RECEIVED BY:
DATE PAID:AMOUNT RECEIVED:
RECEIPT NO:
VALIDATION:
f, untrureNANcE,
f, eentr,ttr tssuED BYi
FOfr SIDEWALK AND CURB CUT PERMITS PLACE A COPY (COMPLETED) IN PERMIT DRAWER.
INSPECTION: - DATE:
ELEVENTH MONTH
INSPECTION:
f rnerrtc REVTEWED BY:
DATE:
DEPOSIT RETURNED:DATE:
DATE:
DATE:
DATE:
DATE:
DATE:
f, eirctrurERlNc REVTEWED BY:
.. WORK IN PROGRESS
nf rtrtnE OF COMPLETION:
DATE:
PUBLIC WORKS OEPARTMENT
ADt\4INISTRATION
ENG! I'I EER I NG DIVISI ON
I',4AII,ITEIiANC€
SP. JFIELE}
225 FIFTH STREET
SPRINGFIELD, OR 97477
APPLICATION FOR A SECOND DRIVEWAY / OVERWIDTH DRIVEWAY
DA
AP
ADDRESS OF PROPERTY FOR DRIVEWAY J
APPLICANTS TELEPHONE
Please sketch the proposed driv'eway. lnclude the following applicable items: house or building, proposed
driveway, existng 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 APPUCATIONS OUTSIDE THE CITY LIMITS OF SPRINGFIELD THAT ARE WITHIN THE URBAN
GROWTH BOUNDARY REQUIRE 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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ADMilN|STRAT|ON/ENGiNEERtNG (5A3) 726 3753 FAX (503) 726-3689
i\tAtNTENANCE (50-1) 726 3761 FAX (503) 726 3621
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1. Property type: Single Family Reside n"" u/ Duplex other-
2. The proposed driveway will take access from which street Offa
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 yard_ Other___L y'_
thed;D carport, fence, wall, or other, (where the vehicle is5. The distance from the property line to
to be parked) is _ feet.
6. \Mll the proposed parking / storage area create a vision obslruction to adjacent
to any vehicular movement on a public street? (See vision clearance attachmer
property driveways ornt) ilo
Applicant hereby agrces to install the rcquested driveway to Gity of Springrfreld standards. The appticant further
agrces to haw 6'of concrete in the sidewalk area (adjacent to the driverirlay), and to pave ttre area behind the
back edge of the sidewal( or driveraay apron, with a minimum depth of 3'asphattic concrete or 6" of porthnd
cement concrcte. The area behind the sidewalk shall be paved a minimum of 18 feet
The applicant agrces that if he/she does not parre the area behind the sidewalk within 30 days of cufting the
curb opening, the City of Springfreld has the authority to ctose the driveway access by removal of the curb cut
All incuned costs shall be assumed by the applicant and if unpaid, said cost shalt become a lien of the property.
When this application is approved by the City, the applicant must obtain a curbcuUdriveway permit from the
Public Works Department, Engineering Division.
CurUcut I Orivewav p
a. on an improved street (existing curb): $10.00 plus $.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
PROPERTY OWNER'S SIGNA
a*@ 361 1**4,
APPROVED TE
2
)t 17
rlhv\ Batnu* CTRAFFIC DlVlSloN
BUILDING PERMIT NO.: DATE:_
TRA 9-1
ATTACHMENT: Msion Clearance, Example #1