HomeMy WebLinkAboutPermit Curb Cut 1993-08-13il/ao F<gIDENTIAL -COI1IIF?CIAL
SIDEIUAK / C;URE€;UT
APPLICATIO?.I / FERI-IIT
SPFIi|GFTELE,
225 NORTH FIFTH gTREET
gPRlhk3F |ELD, oRE60r{ 314'1'1
Et l6lNEERlhl6 D IVtItOt{otrtcE No. 12b-31>3
IN9PECTION LINE: 126-3163
Jots ADDRE86,7 !8 ,Aa, /
A99E990R9 t1AP NO./7 -o;-7i -zl TAX LOT NO.i44@
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ADDRE99'g tUt:' / 977{cmr,.)//7/-tAFl&{>
5TATE,4€,ZlPt ?7477 Pr{oNE No. '/14:-?177
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CURts gIDE
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gETEACK
-REgIDENTIAL
-
COIIMERICAL
-
9ECOhID DRIVEUJAY ( gEE TRAFFIC )
REaUIRE9 APPLlCATlol.l FOR A 9ECOIlD DRI\€[UAY(T-4.1a)
OR A COI.INTY AFPLICATIOT.I FOR FACILITY PERI.IIT (C Ab-2O))
tF tN Tl{E U6.8.
DATE OF APPLICATIOI{Z
RECETpT No, 7<=i
cHECK
*-'
CI-{ECKED rcR DEL ]NAUENCIES
9tGt{ED:
DATE:
t-,
TIjOFK DEOCRIPTIOT.I,
IIDFK TO EE FEFFFI'GD BY;-1*rurRAcroROTINER* ,44/&ic,4/L/Q?bC, fu fi7&atsrRAlohl No.x sfiaga,EXprFEe: r/A'l/+Z
4qDFEse ,144 fr ,l/rl Kt i,t'l Pr{oNE:
-72G- 8 577'
PffiEDUFE FoR lNgFEcTloN REcLlEOT,
CALL 12b-3163 (RECORDER ) STATE YOIJR CITY DE9IGNATED JOB NLII-IBER, JOB ADDRE99,TYPE OF
IN9PECTIOI.I REAUESTED AlD II}.{EN YOU IUILL BE READY FOR INSPECTIAN, COhITRACTORS ON OTNEES NAHE AID
PI-]ONE NUHtsER REOI]E9TS RECEI\GD BEFORE 1,O@ *l IUILL BE T,1ADE TI-{E 5AF1E DAY, RE6[JE9T9 /fTERlZ@@
AH IIJILL BE I1ADE THE NEXT IIJORKIT.IG DAY
EXIgTII.IG BUILD IT.{6 PEFrIIT NO. T F AFPLICABLE )
*YOTJR CITY DES JoB No. tef ?zrz oB5EE BOOK
REAUIFED INSFECTIOI.Ig SIDEIUALK / DRI\GIJJAY
FOR ALL CONCRETE PAVING TUITF]IN
THE gTREET RIGHT OF IIJAY, TO BE
HADE AFTER ALL EXCAVATING
19 COI-IPLETE AID FORH IJJOFK
AID gTJB.BA,gE I'IATERIAL 19
IN FLACE
/ AffiOACFI APROT{'
AFTER FOFMg ARE ERECTED
BIJT TRIOR TO POURI}.IG
CA{CRETE.
FEE9: 9IDEIUALK9 IZ TUALK X,
rlA.OO + iO.lb/LF.( X )
OF TUALK
(@ +.t5 ()
ToTAL FEffllT FEEr i /0,oo
COHI'IEF?ICAL DRI\EIUAYS SI.IAL
HA\E 5' TO A'FLAIRg3'. A'STADARD
I HAVE CAREFULLY EXAI'1INED THE COHPLETED AFPLICATION FOR PERIIIT, A}.ID DO HEREBY CERTIFY THAT ALLNrcRHATIC)f'I I{EREON 19 TRIJE AND CORRECT, Al.lD I FURTI.]ER CERTIFY TI]AT ANY AID ALL uJoRK PEFFoF,.IEDgHALL BE DONE IN ACCORDANCE IUITH THE ORDINACES 6 THE CITY OF 9PRINGFIELD, AID THE LAITB OF TI..IEgTATE OF OREGON PERTAINING TO THE TIJORK DE9CRIBEP HEREIN, AND TI-.IAT NO OCCUPANCY IUILL BE HADEOF ANY gTRLICTURE IUIT}.IOUT PERI'1ISgION OF TI.{E BUILDING DIVISION. I FURTT-]ER CERTIFY THAT oNLY coNTRAcToRSA}{D EI'1PLOYEEg IUHO ARE IN COI'IPLIANCE IUITH OW IOIO>9 UJILL BE USED ON TI{I9 PROJEC,T.
DATE
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