HomeMy WebLinkAboutPermit Curb Cut 1997-08-18225 FIFTH STREET
SPRINGFIELD, OBEGON 97 477
ENGINEERING DIVISION
oFFtcE TELEPHONE (503) 726-3753
SPEIIf OTIELD
INSPECTION LINE SEE INSPECTIONS ON BACK SIDE
APPLICATION DATE:August 15, 1997
'LOCATION OF WORK
APPLICANT Kay A. Renken
ENCROACHMENT PERMIT
NUMBER:
PERMIT NUMBER:c(-
DATE ISSUED:
pHoNE H:72 -59 9ti
SITE ADDRESS: 304 16 Th S T TCC T 14x y4p.See attached
TAX LoT: /-(o>'? ZG zsi AZIOCITY:STATE ztP
SUBDIVISION
Da Di TElTJTfrOF SPRINGFI PEXJITA CATION
OWNER:as above
ADDRESS CITY
f, ervcnoacHrvrENT PERMTT No: ......tr
VALID FOR SIXTY (60} DAYS FROM OATE OF ISSUANCE
Q cur srnrrr E BoRE E orHER tr
Q ousr coNTBoL (TYPE oF coNrRoL)
Q corusrnucroN, sroRAGE, srAGrNG
Q orHen
D ASPHATT DEPosrr.,.... ....
TYPE OF SECURITY DEPOSIT
Q elaruxer sunEry BoND E sURilTy BOND
I cuna cur PERMTT No:
fl CASH / CHECK
INSpECTION: CURB / APPROACH AFTER FORMS ARE ERECTEO BUT PFIOP Ta PCURiT'ic CONCRETE.
VALIO FOR 180 OAYS FROM DATE OF ISSUANCE.
I secor.ro DBrvEwAy (sEE sEeARATE AppLtcATtoN)_
I stoewalK pERMrr No:.... .,..... FT.
VALID FOR 180 DAYS FROM OATE OF ISSUANCE.
tr
Q ruew E REMovE / REpAtR fl PAVE PLANT sTRtp
I seraacr l] cURBSTDE I lerucrx
INSPF'TINN' SIDEWALK / DRIVEWAY FOR ALL CONCRETE PAVING WITHIN THE STREET RIGHT OF WAY, TO BE
MADE AFTER ALL EXCAVATING IS COMPLETE , AND FORM WORK ANO SUB.BASE MATERIAL IS IN PLACE.
f sarurrnny sEWER coNNECTtoN eERMtr tr
VALIO FOR SIXTY (601 OAYS FROM DATE OF ISSUANCE
I ro srua O MAtN LtNE (EASEMENT-R/w)
f sronu sEWER coNNEcloN PERMIT:
VALIO FOR SIXTY (60} DAYS FROM DATE OF ISSUANCE
tr
Q cercH BASTN / BUBBLER O STUB D MAINLINE
PROOF OF INSURANCE: $500,000 MINtMUM
fl arracreo E REoUIRED AMoUNT
PHONE:
STATE:ztP.o*r.o. oBo*m u,rg" n;:76flr pHofff+ L - 6 Bg - 3 37 9
coNTBACToR REGISTRATION No: 4337 3 EXPTRATION DATE f>o.?7
PROJECTSUPEBVISoR: Rogwer Kennedy PHoNE: 54L-689-3379
REOUESTED PERMITS:INSPECTIONS REOUIREO: APPLICATION FEE / DEPOSIT ACCOUNT NOr
E 520.00 /
E$
$
$
$
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tr
tr
tr
tr
FT 10'tr
E$
q4-to.oo+ $,1s/FT
E $1o.oo+$.1s/FT
0 t,t,
f.I oTHER
E $5.00 /
ri $5.00 /
TOTAL DUE: $
TOTAL DUE WITH PERMIT $
DEPTH:
DESCRIPTION OF PROJECT
PEBIOD OF USE OR TIME OF CONSTBUCTION
B PLANS (TWo SETS) ATTACHED
AREA: LENGTH:
TYPE OF WORK: CUT:
OTHER:
EXISTING SURFACE MATERIAL:
BACKFILL MATERIAL TO BE UTILIZED
FROM DATE
TO DATE
TIME:
TIME:
WIDTH HEIGHT:
BORE:
BACKFILL MATERIAL:
SURFACE REPLACEN4TNT MATERIALS TO BE UTILIZED
TYPE OF DUST CONTROL TO BE UTILIZED
NAME OF OTHER UTILITIES IF THIS IS A JOINT PROJECT:
WARNING DEVICES TO BE UTILIZED:
Advance signing and work zone protection 1o bo in complianc€ with the Manual on Uniform Traftic Control Oevices {MUTCD)
DESCRIPTION
WORK SHALL COMPLY WITH CHAPTER X ARTICLE 5 OF THE CITY CODE. CONTRACTOR TO COMPLY W
REVTSTONS 8t24195 FORM ' 116
ITH MUTCD
PLAN REVIEW COMMENTS / S-CIAL INSTRUCTIONS:
RESTORATION WORK SHALL BE IN CUNFORMANCE WITH EXISTING CITY CODES AND IN C1CIVIPIINruCE WITH CURRENT
STANDARD SPECIFICATIONS, EXCEPT AS NOTED BELOW.
001
oo2
oo3
oo4
oo5
006
007
008
009
010
01 1
012
013
014
015
016
o17
018
Comments
Backfill with %" minus rock.
Compact every 1 8" loose depth.
Requires compaction with a steel rolller.
A.C. to match the greater of existing depth or 4".
All cuts sealed for final inspection.
Temporary patch may be used at the end of the day.
Signing and Zone protection to comply with MUTCD
Cut concrete only on score lines or cold joints.
Sidewalks and driveways min. 3,O0opsi.
Curbing min 3,SOOpsi / No patchwork less than 3'.
Meet min. requirements on curb cuts, Spfd. code,
Restore planted areas, Spfd. code 206.3.05
Spec. to Bore / Jack / No A.C. cuts.
Mechanical compacting required.
No patchwork allowed.
Lateral cuts to have control density fill.
Cuts to be polymerized crack sealed for final inspection
Mininum 2" crushed rock %" minus.
019
020
021
o22
023
024
025
o26
o2t
028
029
030
031
032
033
343
Minumum 4' clearance at any point, swing-away.
Concrete minimum 4" depth, 3,000psi.
Trench to be "T" cut.
Needs State / County permit.
No above ground enclosings in sidewalk or handicap ramps.
Diamond cut A.C./Concrete value boxes to grade.
Fresh Oil signs / Graded.
Comply with Americans with Disabilities Act.
Concrete slabs, 72hrs. curing time, 4500psi.
Concrete slabs require joint seal material.
Driveway requires dowels every 18".
Submit traf f ic control plan prior to excavation,
Notily Traffic Division before excavatiprr.
Core drill main line, insert tee, 2o/o min. gtade.
Must comply with the provisions of ORS 757.541 ro 757.571
6" Circular hole/H2O-Vac.
rHE LANE unlt+iE6'UbtHbiflrX'frNc couNctl,s"oNE CALL NUMBER" 1-800_332_n44 - -
48 HOURS BEFORE DIGGING
lNSPECTIONS:
tr 9yI.B-9-UIAND_sIDEWALK tNspEcnoNs cALLZIG-37S&IRECoRDER) srArE youR DESTcTNATED crry JoBNUMBER/PERMIT NUMBER, JOB ADDRESS, TYPE.-OFINSFRTION REOUESTED-, AND WHEN YoU WILL BE READY FoRINSPECTION, CONTRACTOR'S OR OWNER'S NAMEAND PHONE NUMBER. nebUeSrS RECETVED BEFORE 7:00 A.M, WTLLBEMADE THE SAME DAY, REOUES.TS AFTER 7:OO A.M. WILL BE MADE THE NEXT WORKING DAY, INSPECTIONS ARE To BECALLED.IN AFTER EXCAVATIONS ABE MADE AND FORM WORK IS IN PLACE BUT PRIOR TO POURING CONCRETE.
tr 94ry1^T4IY sEwER, sroRM sEWER, ENcRoACHMENT pEBwrr AND orHER TNSpECTToNS cALL crry MATNTENANCE AT726-3761.
SIGNATURE:
py sigr'1ature, I state and agree, that I have caref ully examined the completed application and do hereby certify that all inf ormationherern rs true and correct, and I f urther certify that any and all work peif ormeo ihilt-oJ oone in aCioiJ6ncei *hA'ti,e oiOi"jijiliti tf,.
3l:l.,ilffillpJisll
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project.
The Citv mav insoect the work site described in this permit at any time during a one year period following the receipt by the City of
l.1l:,iri#[o]3tf3.3LJ!:o'ru,"$vi*erdl"f* 3;,*##iff,1"",3n1i:.il;*lii}',i{:hv;,ilji.T:itit#xlj,.jf;iir;s,In,,"davs (3o) from the date of the notiCeto Comolete'tne w5*. W;-r.[;;i i"riiir"i,iiui ir,lj'"."al't'tri6 ifiIitv'a'i'vf ir"iriijE plii?"i.?iE+'oir'ir,"City and the costs will be billed to the peimit[ee.
lfurthor aoree to ensure that all required insoections are requested at the proper time, that project address is readable from the street,and the ap-proved set of ptans *itiiemiin oiitlx;;ii;;i;lt il;; driins constructron.
//,70
a7 /ob
/ ff -v7
Signature Date
RECEIVED BY
DATE PAIDAMOUNT RECEIVED
RECEIPT NO:
VALIDATION:
FOR SIDEWALK AND CURB CUT PERMITS PLACE A COPY (COMPLETED) IN PERMIT DRAWER.
INSPECTION: DATE
IINSPECTION: DATE
WORK IN PROGRESS ONTT
AT TIME OF COMPLETION: DATE
DEPOSIT RETURNED: DATE:
f ernurr rssuED BY
f rnnrrrc REVTEWED By
ELEVENTH MONTH:DATE:
DATE:
DATE:
DATE:
DATE:
I erucrrueERtNc REVTEWED By
f, rvnrrureNANCE :
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AREA CALCUI.ATIONS SUMfuIARY
Ares Name dtArec Slze Totalr
UVING AREA CALCUIATIONS
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Shop
1043.25
765.00
140.00
504.00
5l I .00
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1045.e5
76r.00
140.00
1015.00
2&.00
14.00
18.50
1.00
52.50
28.50
' 8.50
28.50
14.50
6.00
20.00
1.50
s.5b
Breekdown suLtotsts
399.00
658.25
6.00
650.00
42.75
72.25OIH
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Plat Map
CAIIL GOSCHIE I ASSOCIATES