HomeMy WebLinkAboutPermit Sidewalk 1994-02-23REgIDENTIAL - COHI*IERCIAL
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g=COND DRI\€I,IJAY ( 5EE TRAFIC )
R=aUlREg AFPLICATION FOR A SEcoND DRI\€IIJAY(T-4.1a)
OR A COiJNTY APPLICATION FOR FACILiTY P=R1IT (C 3A-2@3)
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PHONE:
C/+L 12b-3i6A (E,CO@ER ) STATE YOUR CITY DESIGNAT=D JO3 NUXS=R, JOB ADDR=3g;YP= G
iN9P=CTIOhI REAUESTED AND UJi-iEN YOU IUILL B= ,READY FO,R INSPECTIOII, CONTRACTOFE9 OR Oi.tN=R5 NA1.1= ,/.}.lDFiA{= NUi'13ER reaUEgTS R=CEI\€D BEFOE 1:OO A-t LIJILL B= I'1ADE Ti-i= S.slE DAY, REAUES;9 #7]=R ltOoAfi LIJILL B= I.1ADE TI{E NEXT III2R<ING DAY
EXIgTIT.IG BUILD ING PEffiIT NO. ( IF AEEl |CASLE ) .-
*YOUR CITY D=SIGNATED JOB NO. I sr 94 0z(z-5=E BOQK
REAUIRED INSPECTIA{g SIDEUALK / DRI\GI.LJAY
FOR ALL CONCRETE PAVING t].JITi-.iIN
TIIE STREET RIGI{T OF IUAY, TO 5E
I,1ADE AFTER ALL EXCAVATIN6
15 COI,IPLETE AND FOB1 I,]i2R<
AND 5UB.BA5= I'IATERIAL 19
IN PLACE
/
cU@ / APPROACH APRO,hI,
,A=?ER FOg19 Are ERECTED
BUT PRIOR TO POLJRING
CONCRETE.
FEE9' SIDEUJALKS cuRE-cuT I,UAL< X,
ilO.OO + ,O.15/LF.( X )
OF LIJALK
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TOTA FEtrlIT FEE:
COI.IMERICAL DRIVEIIJAYS SHALL
HAVE 5'TO A'FLAIRS
3'- A" STA|.,IDARD
i |.lA\€ CAREFULLY EX,ASINED TI..iE COTPLETED APPLICATION FOR PER',IIT, AND DO HER=BY C=RTIFY 'ii-]AT ALL
INrc3'1ATION I-.IEREON 19 TR.JE A\D CORR=CT, AND I FURTI-.{=R CERTIFY'i}-{AT ANY A\D ALL iJ"R< PE,+OR.1ED
9'1ALL B= DONE IN ACCORDANCE II.JITI] TIIE ORDINANCE' 6 Tl-.]E CITY G 9PRINC,FIELD, AND THE LAIIJS OF TI-IE
STATE G OREGON PERTAINING TO TllE UJORK DESCRISED |IERElN, AND 'l''.1AT No OCCUPA\CY ttJlLL BE |IADE
OF ANY STRJCTURE IUIT}.IOJT P=tr1I99IO}I OF TI{E BUILDING DIVI9ION. I FURTI]ER CERTIFY TI.JAT ONLY CONTRACTOR9
AND EI1PLOTEE9 I.U..IO ARE IN COI.,IPLIANCE UJITI.{ OR' 1O\O>b IJ.JILL BE USED ON TI-.II5 PROJECT,
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5IGNED DATE