HomeMy WebLinkAboutPermit Building 1997-07-22ATTOF
SPFTNGFIELD
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BUILDING MOVING PERMIT
COMMLINITY SERVICES DIVISION
225 FIFTH SIBEFI
SPRINGFIELD, OR 97477
(s41 ) 726-37s3
FAX (541) 726_368s
\1CITY ASSICNED JOB NUMBEIT:t
Tax Lot Number:
Tax Lot Number:
*
\a
C ity
Lane County Ref'erence N
Structure Being Moved To:
Lane County Reference Number:
Structure Being Moved From:
Building Owner:Phone Number:
Mailing Address:Cell Phone Num c)@6
City state: & zip'
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7
State:City
I
Expires
Cell Phone Num
Phone Num
Ex
zip
o.
Construction Contractors Registration Number:
PlLrmbing Contractor:Phone Number:
Mailing Address
Construction Contractors Registration Number:
Moving Contractor:
Description of Proposed Route (Please attach map with route outlined with directional arrows)
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Moving width: AAi t^,
Square Footage Value of Structure(s):s t..:# ofSections Being Moved:
Living Un I
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!-t^Ul-f
Moving Length
Proposed Date of Move:Beginning
Qoo
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Description of Building to be Moved
Square Footage 4oo
Type of Constr: @&D f€ktl€Ileight on Dolly llt br
Completion Date of Ending at:
4f,l! ':r
NOTIFICATION OF MOVE: The Community Services Division will route copies of this application to all appropriate divisions,
departments and agencies. However, the applicant must contact property owners if trees are involved in the proposed move. In
addition, the applicant must secure the approval of all appropriate municipal, county and state authorities should the move originate or
terminate- outside the City of Springfield, or along any street owned by the state or the county within the Citys boundaries.
PLANS, FEES, AND CFIARGES: Prior to receiving a permit to move a building into the City of Springfield, the applicant or their
representative shall:. Submit two (2) copies of site or plot plan for new site.. Submit two (2) copies of the foundation plan for the relocated building
. All applicable permit and system development fees shall be paid prior to any moved
. Any applicable permits and inspections for sanitary sewer cap or septic pump and fill
By my signature below, I certify that the above information is true and correct, that all required contacts have besn made and
authorizationsobtained. lalsounderstandthattheminimumtimetoprocessthispermit,becauseofthenumberofagenciesnotified
by the City
Signature
t
is seven (7) working days.
Date: 7 ?a q
ut 7:7o ^6fu^
Community Services Division Report
Foundation/Site Plan Sdbmitted??_Foundation Perm it
n
V l'A
o +q1Moving Permit Approved Date:n ,4.
Engineering Division Report: owner(s) AND Contractor(s) are both responsible for any damages to private or public properfy.
Moving Permit Approved By:7- z+-17
o,; ft4aa"r f*zQcl, /'42
Traffic Division Report: Contractor is responsible for a safe, efficient relocation operation. All signal systems shall be monitored to
ensure they are functioning properly. Any damage to or malfunctions of the taffic signal system shall bereported immediately toGary Weck, Signal Technician, at 343-4902 or Gene Butterfield, Maintenance Supervisor, at99g-3667.
Moving Permit Approved By:3 1z
Historical
Moving Permit Approved
Required Inspections: An inspection of the property is required at the following indicated stages of this project.
_ Septic Tank Pumped and Filled
. A Certificate from a bonded/
registered contactor will meet
this inspection requirement.
L Sanitary Sewer Capped
Capped within five (5)
of the property line with
approved materials.
L'-Final Move
' To be made once structure has been
moved from site and all debris has been
removed.
To request an inspection, please call726'3769. Inspections called in before 7 am will be made the same working day, inspectionscalled in aftet 7 am will be made the following working day. Please leave your City designated job number, job address, type ofinspection and when you will be ready for inspection.
FOR OFFICE USE ONLY
Zone;Flood Plain:_ Type of Constr:J Occy
Application fee
Moving Permit
Sanitary Sewer CaplSeptic Pump and Fill
5% State Surcharge
3% Administrative Fee
-5 Total Blocks. $.60 per block
Subtotal
$ 18.00
s 60.00
$ 15.00
.75
.45
$94.20$ie
$_
$
TOTAL $91 1)o
applicable permit fee)(ifproperty sewer capped or the septic tank pumped and
Date
does not need the
Receipt Number:
\
I,/ECIALTRANSPORTATION :RMIT
FOR.HOUSE MOVES
PERMIT NO.
N: 0021 07
KEl{ MARQUARDT s41 ) 345-630s
OWNER NAME
SA!.IE
I ELTPHUNE
()
ADDRESS
P0 Box 11764
ADOFESS
ctrr,sm[F.zP
Eugene, 0R 97440
(;IIY,SIAIE,ZIP
-^.
BUILDER REGISIRAT ION NUMBEH IJAIE
071301e7
PERMIT INSPECIION DEPOSI I PERMIT FEE
$8.00
crE)K NUMBER- 10056
@MMODITY
llood frame
NO. OF SECTIONS 1
LENGTH *,
35'
wrDrH *'
26'
HHGHr *'
14'60
OVIHALL LENGTH
65'
1
2
3
1
2
3
1
2
3
1
2
3
PI.OTVEHICLE
REOTJIREMENTS 2 LANE:
4 LANE:
E HOHE
fi rcrue
ErnoNr
hrnor.n
EREAR
D neas
11th St & l{ain
Spri ngfi eI d
Uts I INA I IUN AUUHESS
6th St & Garfield
Eugene
ffi
1974 Kenworth Dump Truck
ID NO.
138998
PUO NO.
YCRC126
LI(;ENI'L NU.U{JM}" N(J.
ROUTE
l{cKenzie Hwy (15)
Pacific t{est (11{)
House ilove Route:
HIGHWAY LOWEST
REVERSE SIDE OF THIS PERMIT FOR SPECIAL PROVISIONS *
THE PERMITTEE SHALL NOTIFY THE DISTRICT MANAGER, OR THEIR REPRESENTATIVE, OF THE MOVE AT LEAST 24
9:*sgg
Junction ulith 1l'|
6th & Garfield
on l{ain to Frankl
t{est on Cross in
in;
eld
2.20
1 25.81
0.00
122.26
t{est on
Iene.
llth & l,lain
Junction of
Hwy 15 & 1l{
leginning at 11th and
5th Street, North on (
JVhHHtrAU D IFTUU II
WIDTH OF
PAVEMENT USABLEROADWAY
TYPE OF
PAVEMENT
EXPIRATION DATE
08103197[8'tutt"offun SUNDAY August 3, 1997to 9:30 AM.5
734-2006 (4-94)
CEMENTOF THEHOURS
tsEUINNINq AUUHEN
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