HomeMy WebLinkAboutPermit Curb Cut 1996-03-18L
225 FIFTH STREET
SPRINGFIELD, OBEGON 97477
ENGINEERING DIVISION
oFFlcE TELEPHONE (503) 726-375s
9PRI}IGFIELD
INSPECTION LINE SEE INSPECTIONS ON BACK SIDE
APPLICATION DATE:
ENCROACHMENT PERMIT
NUMBER:
PERMIT NUMBER:
DATE ISSUED:
,LI,,,-D t I,
SUBDIVISION:
PBOJECT SUPERVISORi PHONE:
LL-PHONE
ZIP:STATE
PHONE
EXPIRATION DATE
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ZIP
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LOCATION OF WORK
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STATE:
ADDRESS:
CONTRACIOR REGISTRATION NO
OLSITE ADDRESS:
APPLICANT
CITY:
OWNER
CONTRACTOR
TAX MAP
TAX LOT:
flFo pnoNr, Hl-oASlADDRESS: tft/vl'L' cfiY
REOUESTED PERMITS:INSPECTIONS REOUIBED: APPLICATION FEE / DEPOSIT ACCOUNT NOr
f encnoacHMENT PERMIT No: .......
VALID FOB SIXTY (60) DAYS FBOM DATE OF ISSUANCE
E $20.00 /
I cur srneer E BoRE E orHER tr E$
I ousr coNTRoL (TYPE oF coNTRoL) .
Q corusrnucrtoN, sroRAGE, srAGlNG tr
tr
tr
$
$
$
E ornen
fl esexrur DEpostr....,............,
TYPE OF SECURITY DEPOSIT
I amrurer suREry BoND E suRllrY BoND fl casH / cHEcK E$
(cuna cur PERMIT No:.......
lilseEcllotrli cuRB / APPRoACH AFroE?iiixj
FT tr E $10.00+$.1s/FT o
ARE ERECTEO BUT PRIOR TO POURING CONCRETE,
DAYS FROM DATE OF ISSUANCE.
I secouo DRIvEWAY (sEE SEPARATE APPLIcATIoN)-
fl stoewalK PERMIT No:.,...,
VALIO FOR I80 OAYS FROM DATE OF ISSUANCE.
FT,E $1O.0O + $.1 s/FT.
I r.rew E REMovE / REPAIR E PAVE PLANT srRlP
Q serercr E CURBSIDE E LENGTH
INSEECBON:SIOEWALK / ORIVEWAY FOR ALL CONCRETE PAVING WITHIN THE STREET RIGHT OF WAY, TO 8E
MAOE AFTEB ALL EXCAVATING IS COMPLETE , AND FORM WORK ANO SUB,BASE MATERIAL IS IN PLACE.
f snrurrany sEWER coNNEcrtoN PERMIT:
VALID FOR SIXTY (60) OAYS FROM OATE OF ISSUANCE
tr Ti s5.00 /
I ro srua E MAIN LINE (EASEMENT-R/W) E orHER
I sronrvr sEWER coNNEcnoN PERMIT:
VALIO FOR SIXTY (60) OAYS FROM DATE OF ISSUANCE
I caror BASTN / BUBBLEn E sruB E MAINLINE
PRooF oF INSURANCE: $500,000 MINIMUM
Tl $5.00 i
I arracHeo tr REOUIRED AMOUNT TOTAL DUE: $
TOTAL DUE WITH PERMIT $
DESCRIPTION OF PROJECT:
Advanca signing and wolk zone protection lo be in complianco with ths Manual on Uniform Traffic Control Devicos (MUTCD)
WORK SHALL COMPLY W]TH X ARTICLE 5 OF THE CITY CONTBACTOB TO COMPLY WITH MUTCD .
BACKFILL MATERIAL TO BE UTILIZED
WARNING DEVICES TO BE UTILIZED:
NAME OF OTHER UTILITIES IF THIS IS A JOINT PROJECT:
TO DATE:
EXISTING SURFACE MATERIAL:BACKFILL MATERIAL:
DESCRIPTION
.WIDTH DEPTH:HEIGHT:
PER]OD OF USE OR TIME OF CONSTRUCTION FROM DATE
TYPE OF WORK: CUT
OTHER:
BORE:
tr PLANS (TWo sETS) ATTAcHED
AREA: LENGTH:
SURFACE REPLACEIVTTNT MATERIALS TO BE UTILIZED
TYPE OF DUST CONTROL TO BE UTILIZED:
TIME:
TIME:
REVTSTONS 8t24t95 FORM f 116
I
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PLAN REVIEW COMMENTS /INSTRUCTIONS
RESToRATIoN woRK SHALL BE IN Cor. IRMANCE WITH EXISTING CITY CODES AND IN CTIVIPTIAruCE WITH CURRENT
STANDARD SPECIFICI\TIONS, EXCEPT AS NOTED BELOW.
oo1
002
oo3
004
o05
006
007
oo8
oo9
010
01 1
012
013
ol4
015
016
o17
018
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,OOOpsi.
Curbing min 3,500psi / No patchwork less than 3,.
Meet min. requirements on curb cuts, Spfd. code.
Restore planted areas, Spfd. code 206.3.O5
Spec. to Bora / 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
o27
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 Stat€ / County permit. I
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 Oisabilities Act.
Concrete slabs, 72hrs, curing time, 4500psi.
Concrete slabs require joint seal material.
Driveway requires dowels evary 1g',.
Submit traffic control plan prior to excavation.
Notify Traffic Division before excavatign.
Core drill main line, insert tee, 2o/o min. grade.
Must comply with the provisions of ORS 7S7.54 1 to 757.5:-1
6" Circular hole/H2O-Vac.
Comments:
rH E r=a NE u rru +ifl6'ffit'h'tifuttr"ONE CALL NUIVIBER"_ T.6b'd48 HOURS BEFORE DIGGING
NG COUNCIL'S-332-2344
INSPECTIONS:
CURB CUT AND SIDEWALK INSPECT]ONS CALL726-3769 (RECORDER) STATE YOUR DESIGINAT]NUMBEB/PERMlr NUMBER,-.JpB-4\D-DRESS, TYPE or rrvsiedrror,r niouesrED, AND wHEN you l
INSPECTION, coNTRACTOR'S oR owNER;s NAME arrro pnor,rE'Nunreen. REouESTS RECEtvEDMADE THE SAME DAY, REQUESTS AFTER i:oo A.M. Wrr-r- eE rraabe rHE NEXT woRKlNc DAy. ICALLED lN AFTER EXCAVATIONS ARE MADE AND ronrrn wonr'i5 rru placr BUT pntoR To pou
f sarvtraRY .EWER, sroRM
'EWER,
EN.R'A.HMENT pEBMtr AND .THER TNS'ECTT'NS .ALL crry TMATNTENANCE AT726-3761.
ED CITY JOB
WILL BE READY FOR
BEFORE 7:00 A.M, W|LL BE
NSPECTIONS ARE TO BE
RING CONCRETE. I
By signature' lstate and agree, that lhave carefully examined the comp.leted gnplication.and.do hereby certify that all informationherein is true and correct, End ifuither;;rtiiv ih;i'a;i;;A';ii w6r[ieirormedih;it-#ddnJiqaccorda_nce with the ordinances of the3:'.'.3["'f"]!PJisli'f#fi'"7!!:,fi[i^',1;:iui5Ee",t#%xiTgffJiyi!';;s[1JH .1H.,3,"[,,%'i,iA"Ji:q&,{.fdk1.Y;E ?sl}:'ftli["
prolect,
Ii.t:.? _Yl r":ru?ifl3st""tfiisi[iJil:"$:;vTlfe$1n tnis permit at anv time dulrs-e-gre vear ner5olf,,tooi:iy::?",,.:?rJf,.fl3lno..r":l?,.g,I""t
;ptiii,i_tde,itei;'l"i'tIna;io
"",i:1'pt,,irlii"ifilj_ti$it-i*;1|.,[13trv;i i!!djjil:"qa:1"*,inir1, any work required ano wrrr have thirtv8i,rr'Jfool,{'."3}:i,.,f,f,iist iffir1T,,i{Ti1,frotiie'inb'il5i[]'wb"'I i',jt ;;;;r;i;i ;i th;t;'d"oriii6 ifrl'iv i"Jyl'i',lrii# ;t;ii;iiEd'ulr'in.
that all reouired insoections are requested at the^proper.time, thatproject address is readable trom the street,plans will r'emain ori the site itait t-imes'du;;g constructron.
SIGNATURE:
Signature r/r (
RECEIVED BY
DATE PAID:
Date
AMOUNT RECEIVED
RECEIPT NO:
I furthor agree to ensure
and the approved set of
fu4--,
VAL!DATION:
FOR SIDEWALK AND CURB CUT PERMITS PLACE A COPY (COMPLETED) IN PERMIT DRAWER.
WORK IN PROGRESS DATE
AT TIME OF COMPLETION: DATE
ELEVENTH MoNTH,
--oore
2
RAFFIC REVIEWED BY
DEPOSIT RETURNED:DATE:
DATE:
DATE:
DATE:
DATE:
INSPECTION
INSPECTION
DATE:
DATE:
fl eenurr tsSUED By:
Flrc r r.r eERt NG REVI EWED By :
f ,rraerrureNANCE :
,FIINGT'€L()
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TJ B LI C IYO R KS D EPART AI EN T
.4IfA4lN/s/ /iAI/ON
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^I,AINIEI'IANCE
ADh4filtstRAftON/ENGtNEERING (5O3) 726 3753 t-AX (503) 7?6 36g9
efr,225 Ftrt u st rig/r/i//rtGf/llI D ( )t j :)
APPI I CAtI NF OR A StrCOND NR \/tr W ^Y ' OVtrR\^/IDT H nRtvFl /AY
DAT
APPUCANT (PROPERTY OWNER)P,.a/)D baer'
ADDRESS OF PROPERTY FOR DRIVEWAY PERh4 /+q I (.%?,-
APPLICAI.ITS TEI.EPHONE I.IUI"4 BER:2a_
Please skelch the proposed driv'ervay. lnclude the following applicable ilems: house or building. proposed
driveway. erisling driveway. and slreet names- lnclude dilnensions and measuremenls lo ptoperly lines. road
intersections and bordering driveways. (See altachment for an example.)
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N LL APPUCATIONS OUTSIDE TI{E CITY UIVIITS OF SPRINGFIELD TI{AT ARE TryITI{IN TIJE URBAN
GROWTI{ aOUI,IDARY IIEQUIRE n L-llrlE COU,{TY PERhflT.
l.lote: I'he City of Springfield will not granl a second drivcwal,permil on an ArleriaJ or Collcclor Slreel
A,lAt\lTfAlAl\l/-C /aaAl ,.a a:a1 rAw /.^.\ 1-E 1c-.
B/
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1. Property lypc: Single Fanrily Residence Duplex Other
2. The proprosed driveway will take access frorn which stteel ///
3. Tho dl{nc e lrorn lhe edge ol lhe driveway lo lho ncarest corrrcr (rneasurcd lo llre cuttr return) is
fect
ya,d / ott\e.(. The second driveway will givo access lo: garage- carporl- side
5. The dislance from tlre dto,Derty line lo. tlte .garage. carport. fence. wall. o. other. (vrlrere the vchicle is
to be parked) ;s O- 3 teet. N in
6. Will t|e propbied parking / slorage area creale a.vision obstruciio.n lo adjacenl Properly f.ryewaYs or.
lo any vehicular movemenl on a public slreet? (See vision cleatance attachment) '
v ( -
agrees to have 6- of concrete in the sidewatk area (adjacent to the driveway). and lo pave the area behind Ule
back edge of tle sidewalk or driveway apron, with a minimum depth of 3- asphattic concrete or 6- of portland
cement concrete. The area behind the sidewalk slra[ be paved a minimum df 18 {eeL
The applicant agrees Urat il he/she does not pave ttre area behind tlre sidewalk within 30 days of cutting the
curb opening. Ure City of Springrfreld has the authority to close the drivewzy access by removal ol tlre curb ctrL
All incurred cosG shall Ue assumed by tlre applicant and if unpaid. said cost shall become a l'ren of the property'
l^y'hen lhis app[cation is approved by the City. lhe applicant musl oblain a curbcuUdriveway permit from the
Pubfic Works Deparlment. Engineering Division.
Curbcul / Drivervav Permil Fee
a. on an imptoved street (exisling curb): s1o.oo plus S.15 per lineal loot of curb cut
b. On an unimproved sl.eet (no curb): Sl2'00
c.oncurrentlyunimprovedstreetslhatareunderconstruction:S12.00
DA
\/ts/r e
PROPERTY OWNER'S SIGNATURE
D/rTE:.4
APPROVED B
StONFIC
DATE
AUILDII.IG PERIIIT NO
TRA 9.1
ATTACI'll,,1ENT: Msion Clearance, Exarnple #l
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