HomeMy WebLinkAboutPermit Sidewalk 1992-08-03l<tr,i2ltrEN I IAL - L,L4-ll'IEl<L'lAL
SIDEIUAK / CURBCTIT
APPLICATIOhI / PEBIIT
SPRINGFIELE,
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INSFECTION LINE:126' 3'163
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1r.-liA CITY:i^l
STATE:o zr, q1q 7e)Pr{oNE Na74L 11ryJ
IIJOFK DE9CRIPTI6I:
I.DFK TO tsE FERfuFIIED EY:OIII{ER CA{TRACTOR
CURB-CIJT: t---- RE9IDENTIAL :' cotrmERtCAL
9EC6ID DRI\GII,AY ( 9EE TRAFFIC )
REAUIRES Af'PLICATIOhI FOR A 9ECOhID DRI\GIUAY(T-4.IA)
OR A COLNTY AFTLICATIOI{ FOR FACILITY FERrIm (C AA.2O3)IF IN THE UG.3.
SIDEIIJALT<
DAG, OF APFLICATIOI..I
CURB gIDE
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CHECK=D FOR DELNAUENCIES !/-
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DATE'a
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PFOCEDUFE FOR IN9FECTIOI.I REGI,IE9TI
REcreTRATrohl No.* 5eZ \- 7 EXPTRES: I - 93
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aAJL 12b-31b9 (re,co@ER ) STATE YOUR Ctr.r DE9TGNATED JOB NrJMS=B Jo3 ADDREgs,TrpE OFIN9PECTION REauEsrED AlD u.[.{EN Yotl tutLL BE READy rcR NgpEcir&, conrinaEroes oR oLl^lERs NAI'1E AIDPHOhIE NIJIltsER R=OI.IEST9 RECEI\GD BEF.ORE 1I@@ Nl IUILL BE IIADE TI{E 9A1E DAY, REOJ=gTg /i1ER,1@@AI"1 IIJILL BE I.1ADE THE NEXT ujORKII.IG DAY
EXI9TI}.IG ELJILDING FER!-1 IT NO. ( IF APPLICABL.E)
*CITY JOAgEE tsOOK
9IDEII'ALK / DRI\GIUAY
FOR ALL CONCRETE PAVING IUITI]IN
THE STREET RIGHT OF IUAY, TO BE
I1ADE AFTER AL EXCAVATING
19 COFIPLETE AI'ID FOtr1 uJORt<
IU.ID g,1Jts-BAgE MATERIAL 15
IN PI.ACE
CU@ / APPROACI] APROI..I.
AFTER rcRr1g ARE ERECTED
BUT FRIOR TO POURNG
CONCRETE.
r
FEE9:9IDEUJALKS cuRB-CUT
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rlo.Oo + iO.l>/LF. ( X ) +'
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CO|i.IIIERICAL DRI\€IUAYg SHALL
HAVE 5'TO A'FLAIRS3'- @'STA\DARD
TUALK X,
I ,/ oTOTA FERI.IIT FEE:Z
I )AG CAREFULLY EXS1INED TI-.{E COI'IPLETED APPL ICATION FOR PEB1IT AND DO I-]ER=BY CERTIFY TI-.IAT ALL
T ANY AND ALL u.,OR< pERFOBIEDINrcR-IATION HEREON I5 TRUE AI{D CORR=CT, A\D I FURTI-]ER CERTIFY THA'9iJALL BE DONE IN ACCORDANCE IIJITH THE ORDINANCE9 OF T}.]E CITY G SFRINCTFIELD, A}.lD Tl{E LAttlg OF Tt{EgTATE OF ORECON PERTAINING TO TIl= IIIORK DESCRISED HERE IN, AND T,{..{AT NO OCCUPANCY tUiLL 3E T1ADE4 ANY gTR"ICTURE UJITI-IOUT PER.,1I59ICI.I OF TI]E BUILDING DIVI9 lot\l" I FURTI]ER CERTIFY TI-]AT ONLYAND ET1PLOYEE9 I]Ji.IO ARE USED ON Ti{I9 PROJECT.IN COT1PLIANCE IUITH O# 1OI.@5> IIJILL BE
DATE
CON]R.ACTORS
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REaIIRED lNgFECTlc,t lg