HomeMy WebLinkAboutPermit Curb Cut 1998-05-19D I
DATE ISSUED:
aPitlaortILD
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PERMIT NUMBER:INSPECTION LINE SEE TNSPECTIONS ON BACK SIDE '
APPLI9ATION DATE:
226 NFTH STREET
ENCROACHMENT PERMIT
NUMBER:
SPRINOFIELD, OREGON 97477
ENGINEERING DTVISION
oFFtcE TELEPHONE t503) 726-3753
.LOCATION OF WORK
STATE:1r;{
PHONE:
EXPIRATION.DATE:
sr
OA
''t "'^
-PHONE:
/70 2_ l? ztSITE ADDRESS:&
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ON:
il. €a
CIW:
TAX MAP:
APPLICANT
CONTRACTOR:
ADDRESS:
ZP 77q77 TAXLOT:
OWNER: 3 rt
--
, PHONE:
STATE:
-
I ZIPI
CONTRACTOR BEGISTRATTON
PROJECT SUPERVISOR:
REOUESTED PERMTTS:SaSPtCnOlrt nEOUnlDr A?tuc^Ttoil ru roEPoSIf ACCOUMT NOrI erucnoAcHMENT pERMtr No! ............................... n g r2o.oo IvAtD FOn Stxry tcol oAyt tRoM oAT! ot lau l€!
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Q ousr coNrBoL (wpE oF coNTRou
Q orxea
-
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Elr
Er
Elr
flesnrur oEpostr
TYPE OF SECURTTY DEPOSIT
Q aurxer suRery BoND E
I
klcuna
suR[wBoND ECASH'CHECK
CUT PERMIT NO: ....................Fr._ tr_IJT tepS To touflNo cor{cREra E 010.00+t.lE/FT.€oIUIEECIIQ&, CUE8
' ^PPf,O^CH
AFIER FORM8 ATt IRESrIO
VALD FOR Tto DAYS fROM OATE OF EEUANCI.tr SECONO ORIVEWAY ISEE SEPARATE APruCATIOMI snrwaLK pERMtr No!..........FT.
-
El t1o.0o+0.1E/FT.VALD FOi tlo OAYS FROM OAT! OF E3UANCE
O new E BEMovE, REpAtR O pAvE pr.ANT srntp
Qierarcx Ecunasroe OI"ENoTHlN(B.YlnN. ttoEwALX
'
ORVEWAY FOR All coNcim t^vhto WTHIN THT 8?BEET ArcHT OF WAY, rO OE
ANO aulBAS: lt^Ttnt L I fi rucE.MADE AFTER ALL EXCAVATINO 8 COM?LITE , ANO FOnil WoBxtrSANITARY SEWER CONNECTION PERMIT:E 05.do /VAID FIOA tlXTY ttot OAYS fnOU DAT! Ot BEU fiE!
Q ro srua e MarN UNE (EASEMENTR/W
fl srcinrvr sEWER coNNEcnoN pERMlr:
O orHER
tl E C5.oo /VALO toi StxTy tcot o^yr ?iolt oArt ot EluAr€t
Q cercx BAsIN , auBBrER El sruE 0 MANuNE
PRooF oF INSURANCE: CE00,0OO MINIMUM
Q rrmcxeo O REOUTRED AMOUNT TOTALDUE: 0
'o
I TOTAL DUE wlTH PERMIT C
DESCRIPTION OF PROJECT:
PERIOD OF USE OR TIME OF CONSTBUCTION:
Q rnxs ffwo sETSt ATTAcHED
FROM DATE:
TO DATE:
TIME:
TIME:
AREA: LENGTH:WIDTH:DEPTHI
TYPEOFWORK: CUT: SohE:
OTHER:
BACKFILL MATERIAL TO BE UTILIZED:
SURFACE REPLACEMTNT MATERIALS TO BE UTILIZED:
HEIGHT:
TYPE OF DUST CONTROL TO BE UTI
NAME OF OTHER UTILITIES IF THIS IS A JOINT PROJ
WARNING OEVICES TO BE UTILIZED:
Adv.nc. rlgnlng rnd work rgnc p.ot.6lon to b. ln oomplhnct wltlr thr Mrnurl on Unlform Tnlllc Drvlcu IMUTCDI.DESCBIPTION
WOBK SHALI COMPLY WrrH CHAPTER X ARTTCLE 6
iEvrsroNE u2m0 FonM , tt!
OF TTIE CTTY CODE COTITBACTOB TO COMPLY WIT}I MUTCD.
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COMMENTS /CTIONS:
E9il,BmB'#Jtg1dhlrtffi,'5l8r9?Xr ,,rtf#[crEeydffi.ErcTrNo
cnv coDEs AND rN ctmpuancE wrrH cuRRENr
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002
00il
oqt
0or
006
007
008
008
0r0
011
ot2
ot3
014
0rc
0r0
017
'018
Erclflll wlth I'mlnw rocl.
Comprd lvcry 18'loor drpth.
Rrgulnr comprotlon wlth r rta.l ,olllat.
A.C. to mttoh th. gr..t., o, .xltthe dlpth or 4'.
Al our t..lrd lor tln l ln ilotlon.
Trmponry p.toh mry br ut.d .t th. ..1d ol thr d!y.
Slgnlng rnd Zonr'protoalm to compty wlth MUTCD
Cut ooncror only.on rcorr lhct ot sold lolntt.
Sldrmlkr .nd drlvfw.ya r{n 3.0O0prL
Cudlne mln 3,tOOpd I No pdahwort hr thrn 3'.
Mcit mh. rcquhrmcnr on curt outr,Spld. codr.
Errton phntcd.rrcrl, Spld. codr 20C.3.0e
Spcc. to Borr / Jrcl / No A.C. otr.
Mrchrnlcel cwrprctlng ngulnd.
No p.tchwort rllowrd.
bt.r.l out. to hrv. cootrol d.illty rlll.
Cur to b. polymcrlrd cruck .!!lrd lor llnrl lnrpcctlon.
Mlnlnum 2'cruhcd rock I'mlnur.
0r9
020
021
o22
o23
02tl
026
020
o27
028
020
030
03r
032
933
343
Mlnunrrn 4' chlrrncr .t rny polnt. rwing.lwry.
Concl.t. mlnlmum 4' drpth. 3,oooprl.
Tnnolr to br T'out. t
N..dt 8t.t. / iounti prmlt.
Nc rbovr gtound andoalng. ln .ld.wtlh o, h.ndlc.p rrmgt.
Dlrmond arl AC./Conarcr vcluc box.t to gr!d..
Frorh Oll rlgnr I Orudrd.
Comply wlth Arnrrlcrm tylth Oltlbllllltt Act.
Corcotr dobr, 72ho. curlne tlrnc. 460opcl.
Concrrtr rhbr nguln lolnt ..!l mttrtlrl.
Ddvrwry ngdnr dowrlr rvcry 18'.
Submlt tnlflo control phn prlor to cxcrvltlon.
Notlly Tntllo Dlvblon bctorc rxcrvatijn.
Con ddll mrln llnr. lnr.rt t!r, 2tl mln. grcdr.
Murt comply wlth th. provlrlonr ot ORS 767.541 to 767.671
C' Clrculrr holr/H2GVrc.
Comments:
YOU ARE REOUIRED TO CALL
THEr=ANEUTT-LITIE$_q_O_QRDtNA:r_tN_c_.CQUN_C!L',S"oNE CALL NUMBER" 1-900-332-2344
48 HOURS BEFORE DIGGING
INSPECTIONS:
'E cuna curano sIDEWALK rNspEcnors cALL 726a7as BEcoRDEntsrATE youn DEsIGINATED ctw JoB
NUMBER/PERMIT NUMBER, JOB ADDRESS, TYPE OF INSPECTION REOUESTED, AND WHEN YOU WILL BE READY FOR
INSPECTION, CONTRACTOR'S OR OWNER'S NAME ANO PHONE NUMBER. REOUESTS RECEIVED BEFORE 7:00 A.M. wlLL BE
MADE THE SAME DAY, REOUESTS AFTER 7:OO A.M. WILL BE MADE THE NEXT WORKING DAY. INSPECTIONS ARE TO BE
CALLED ]N AFTER EXCAVATIONS ARE MADE AND FORM WOBK tS tN PLACE BUT pRtOR TO POURING CONCRETE.
I sarureRy sEwER, sronM sEwER, ENcRoAcHMENT pERMrr AND orHER lNSpEcnoNS cALL ctry MATNTENANcE AT72487A1,
SIGNATURE:
! lun[gr ag|gc to.onqulg th6t alt [gqutrcd lnrpgctlops arc qpqu&te$ a.t the prop8r !ime, that project address ls readable from the streot,tno lno approveo 8et or prant wlll romarn on mc $tc at all tames during construction.
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and
DateSlgnature
10 7.7 7-
and
thlc ofayoar
at
not 8ny
tho
I have and do
RECEIVED BY:
AMOUNT BECEIVED:
RECE]PT NO:
i
DATE PAID:
VALIDATION:
I naerrurENANCE:
I nennar rssUED BY:
,
FOB SIDEWALK AND CURB CW PENMITS PLACE A COPY (COMPLETED) IN PERMIT DRAWER.
INSPECTION:
I
INSPECTION:
. WORK IN PROGRESS DATE:
ATTTME OF COMPLETION: DATE:
ELEVEilTTI MONTH: DATEI
I
DATE:
I eruatrueERrNc REVTEWED BY:
I rnernc REVTEwED BY:
OEPOSIT RETURNED:DATE:
DATE:
DATE:
DATE:
DATE:
I the
on
SPFlIIIGFIELO
PUBLIC WORKS DEPARTM ENT
ADMINISTRATION
ENGINEERING DIVISION
MAINTENANCE
225 FIFTH STREET
SPRINGFIELD, OR 97477
OF SPRINGFIELD, OREGON
APPLICATION FOR A SECOND DRIVEWAY / OVERWIDTH DRIVEWAY
DA -a
AppLrcANT (pRopERTy OWr.ren): c-h r rS De- Lgcn
ADDRESS OF PROPERTY FOR DRIVEWAY "80 OKTzl zt
APPLICANTS TELEPHONE ?a
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 tines, road
intersections and bordering driveways. (See attachment for an example.)
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DAittS L,
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tfut
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t : ?,{lo )0 I32ry
ALL APPUCANONS OUTSIDE THE CITY UMITS OF SPRTNGFIELD THAT ARE WITH]N THE URBAN
GROWTH BOUNDARY REQUTRE A I.ANE COUNTY PERMIT. '
Note: The City of Springfield will not grant a second driveway permit on an Arterial or Colleclor Street.
TJ'
ADMINIS'|RAT|ON/ENGINEERtNG (50s) 726.s753 FAX (50s) 726 3689
t\/IAlNTENANCE (503) 726 3761 FAX (503) 726 3621
7
t.
$o t
n
1. Property type: Single Family Residen." X' Duplex Other_
2. The proposed driveway will take access from which street A) , -?ard-
3. The distance from the edge of the driveway to the nearest corner (measured to the curb return) is_ feet.
'{. The second driveway will give access to: _garage_ carport{ side yard_ other_
5. The distance from the property line to the garage, carport, fence, wall, or other, (where the vehicle isto be parked) is _ feet.
6. Will the proposed parking / storage area create a vision obstruction to adjacent property driveways orto any vehicular movement on a public street? (See vision clearance attichmeniy__p,.6___
Applicant hercby agEes to install the rcquested driveuay to City of Springrfnld standards. The appticant furoreragrces to have 6- of conctete in the sidewatk area (adiacent to the driveGy), and to pave the arca behind theback edge of tlp siderryalt<, or driveway aprcn, with a minimum depth of 3'asphaltic concrcte or 6', of portlandcement concrete. The area behind the sidermtk sha[ be paved a mhimum of 1g feet
The applixnt agEes that if he/she does not pave the area behind the sidevnatk within 30 days of cutting thecurb opening, he City of Spdngrfnld has the authority to ctose the drivenray access by rcmoval of the curb cr.rtAll hcuned costs shall be assumed by the applicant and il unpaid, said colt shalt beiome a tien of the propefty.
When this application is approved by the City, the applicant must obtain a curbcuUdriveway permit from lhePublic Works Department, Engineering Division.
CurUcut t Orivewav p
a. on an improved street (existing curb): $1o.oo 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
_*rPROPERTY OWNER'S SIG
APPROVED BY
CTRAFF|C DtVtStON
BUILDING PERMIT NO.: nartr
TRA 9-1
ATTACHMENT: Msion Clearance, Example #1
E-'AMPLE +I
APPLTCATION FOR A SECOND DRTVEWAY / OVERWIDTH DRIVEWAY
DATE:-
APPLTCANT (PROPERTY
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 property lines, road
intersections and bordering (See attachment for an examPle.)
STREET NAME 12:t5'2st+t'
tletcuW4s
Hovse
o
-.1ts
rao
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7n
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ALL APPUCATIONS OUTSIDE THE CITY UMTTS OF SPRINGT|ITO THAT ARE WITHIN THE URBAN
GROWTH BOUNDARY REQUTRE A IANE COUNTY PERMIT.
f,3\
RfuPoo
Dn,rven{ryi
=o
(,)
rq
ExtsTtN6
DRIYEWAY
Note: The City of Springfield will not grant a second driveway permit on an Arterial or Collector Street.
v IJl\,,lt u-LtrArlANutr
,.'
a
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a
3, AtsOVE CUBB t-
2'ABOV E CUF
o+
25'FOR COHNER LOTS
1s'FOB LOTS AT ALLEY
1O' FOR DHIVE\^/AYS
II.I ALL DISTBICTS
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-2-11:
STFEET OR ALLEY
THIS DII/TENSION:
INTERSECTIO}.IS
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