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HomeMy WebLinkAboutPermit Sidewalk 1997-05-27DATE ISSUED: DD tr I o tPntxoFtELO Z ?? o PERMIT NUMBER:INSPECTION LINE SEE INSPECTIONS ON BACK SIDE APPLtgATtoN DATE: 225 FIFTH STREET ENCROACHMENT PERMTT NUMBER: S/RINGFIELD, OREGON 97477 ENGINEERING DIVISION oFFtcE TELEPHONE (503) 726-3753 -o PHONE: PHONE rL o 0 ZIP: q 7471 ADDBESS:lll!4l-a695Q-urto 4/zJ-4EXPIBATION DATE: : Er tL6<{,L STATE:ADDRESS: 'LOCATION OF WORK APPLICANT SITE ADDRESS: CITY:STATE: aA-_ PHONE: PHONE: ZIP: TAX MAP: TAX LOT: CONTRACTOR REGISTRATION NO: PROJECT SUPERVISORT SUBDIVISION: OWNER: CONTRACTOR: \/ Il.lliPECTDNS REOUIRED:APPLICATION FEE / OEPOSIT ACCOUNT NO: REOUESTED PERMITS: CITY,OF SPRING LD IT APPLICATION f, erucnoAcHMENT pERMtr No: ....... VALIO FOR SIXTY 160I OAYS FROM OATE OF ISSUANCEI cur srnerr E BoBE E orxEa Q ousr coNTRoL (TypE oF coNTRoLt p corusrnucloN, sroRAGE, srAGtNG p orxen I asnxalr DEpostr.......... TYPE OF SECURITY DEPOSIT Q auaxxer sunEry BoND e sunttw aoruo e casH / cHEcK E cune cur pERMrr No: .... FT INSFECTION. CURE / APPROACH AFTER FORMS ARE ERECTED 8UT PRIOR TO POURINGVATID FOR T8O OAY6 FROM OATE OF ISSUANCE. E $2o.oo / E$ fl s10.oo+ $.16/Fr. [ $10.00+ $.1s/FT. E $5.0o / E $5.oo / TOTAL DUi;...i TOTAL DUE WITH PERMTT S TIME: TIME: DEPTH:HEIGHT: BACKFILL MATERIAL: tr tr tr Es I $ $ ---E secoN'of[ sroewelr ORIVEWAY (SEE SEPARATE APPUCA PERMIT NO:.................... FT VALID FOR I80 oaYsJEOM OATE OF tssuANcE. ffielaove / REpAtR A tr S,ANITARY SEWER CONNECTION vALto FoR stxTy t6o) oAys FaoM DATE oF tsSuANcE I ro srue E MAIN L|NE (EASEMENT-R/w) f, sronnn sEWER coNNEcnoN pERMtr: VALIO FOR SIXrY (60I OAYS FROM OATE OF ISSUANCE Q rurw PAVE PLANT STBIP Q srreacx E cuRBstDE a LENGTH lNspFaTtoN. stoEwALK /DRIVEWAY FOR ALL CONCRETE PAVINGMAOE AFTER ALL EXCAVATING IS COMPLETE ANO FORM WORK BACKFILL MATERIAL TO BE UTILIZED: S URFACE REPLACET\4tNT MATERIALS TO BE UTILIZED: WTHIN THE STREET BIGHT OF WAY. TO BEANO SUE.BASE MATERIAL IS IN PLACE. I orHrn fl crrcn BASTN / BUBBLER e srua E MAINLINE PROOF OF INSURANCE: $SOO,OOO MINIMUM Q arrrcxeo E REOUTRED AMOUNT DESCRIPTION OF PROJECT: PERIOD OF USE OR TIME OF CONSTRUCTION: tr PLANS (TWo sETS)ATTAcHED 6 FROM DATE: TO DATE: AREA: LENGTH:.WIDTH: TYPE OF WORK: CUT: eAatrr OTHER: EXISTING SUBFACE MATERIAL: TYPE OF DUST CONTBOL TO BE UTILIZED NAME OF OTHER UTILITIES IF THIS IS A JOINT PROJECT: WARNING DEVICES TO BE UTILIZED: Advance signing and work zone protoctlon to bo ln complianco with tha Manull on Uniform TrslJic Control Devices (MUTCD),DESCRIPTION: WORK SHALL COMPLY WITH CHAPTER X ARTICLE 5 BEVTS|ONS 8124195 FORM ' 116 OF THE CITY CO CONTRACTOR TO COMPLY WITH MUTCD. .i, f, ... n n REVIEW COMMENTS / SPEC'.I. INSTRUCTIONS: 8Fil,BmB'S#P'ff^iTd$!l %t*'8JF?[bi8#[tE Yd[U. ExrsrrN G crrY co DES AND ._ JCTUPUANCE WITH CURRENT. Minumum 4' clearance at gny point, swing'away' Concrotc mlnlmum 4" depth, 3,000psi' Tronch to be 'T' cut. N6eds Stato / County Psrmit. No above ground oncloslngs in sidowalk or handicap ramps' Diamond cut A.C./Concrete value boxes to grade' Fresh Oil slgns / Graded. Comply with Americans with Disabilitigs Act' Concratc rlabs, 72hrs. cuting timo, 4500psi' Concrete slabs rcquire loint saal matsrial' Driveway rcqulrea dowels every 18n. Submit traffic control plan prior to oxcavation' Notily Traflic Dlvision bafore excavatign' Core drill main line, inssrt to6, 2% min' grade' Must comply with the provisions of OFS 757'541 to 757'571' 6" Circular hole/H2O'Vac. 001 002 003 004 006 006 o07 008 009 010 011 012 013 014 015 016 017 018 Backfill wlth J(' minus rock. Compact every 18' loose dePth. Requlres compactlon with a steel rolller. A,C. to match tho'groltor ol exlsting dspth or 4'' All cuts gealed lor final ln3pectlon. Temporary pstch may be used 8t th6 end of tho dEy' Slgnlng and Zoni protection to comply wlth MUTCO Cut concrete only on score lines or cold loint3' Sldewalks and drlVewaya mln. 3,OoOpal' Curblng min 3,6OOpsl / No patchwork leea than 3" M6at min. roquiremento on qurb ctts, Spfd' cods' Rostore planted areas, Spfd' code 206'3'05 Spec. to Bore / Jack / No A.C. cuta. Mechanlcal comPactlng requlred. No patchwork allowed. L.t.rll cut. tg h.vr control d.ntlty fill. Cut8 to bo polymerlzed crack soalcd lor llnrl lnspectlon' Minlnum 2' crushed rock l('minus. THE LANE UTI "ONE CA YOU ARE REOUIRED TO CALL iLrTl lis"co-o nol NAr! N-G- Ca u N I I L' s lL- NUMeEn" 1 -800-332-2344 48 HOURS BEFORE DIGGING 019 020 021 o22 023 024 o25 026 o27 028 029 030 031 032 033I Comments: NS: tr ;l3r5f;rl sEwER, sroRM sEwER, ENcRoAcHMENT PERM EB IT AND OTHER INSPECTIONS CALL CITY MAINTENANCE AT irrsisji!""?lil:,i'i;iliq'El{*fr,.$F[iHi{'3i[iliftr"*$flnilir#*ffi:d}[1ii,e,r.ffii,]ii.,i:4fri;{t$'{i;,fd$ti};t**t' 3:Y"fflfffl39Ji35'ftproject. g,gfi,t*lurllfi*t34p1;$.p'H"{!:tiftli fldn!$.ttt{flflffi'"'l,iffftrukdfi'*" SIGNATURE: I furthor and the €l 7k7/o . {() ensurs that all requlred lnspections set of plans will remain on the site 8re reouested at the Proper time, lliimes during construction. Date /, RECEIVED BY: DATE PAID:AMOUNT RECEIVED: that project address is readable from the street, RECEIPT NO: VALIDATION: f, rnnrrtc REVIEWED BY: I ultrureNANcE , I eenur lssuED BYi INSPECTION: DATE: AT T]ME OF COMPLETION: ELEVENTH IN PROGRESS. WORK DATE: DATE: DATE: DEPOSIT RETURNED:DATE: DATE: DATE: DATE: DATE: DATE: E eructrueERlNc REVIEWED BY: : INSPECTION: CUBB JOB ARE AND SIDEWALK MADE THE CALLED IN AFTER , FOR SIDEWALK AND CURB CUT PERMITS PLACE A COPY (COMPLETED) IN PERMIT DRAWER. I