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HomeMy WebLinkAboutPermit Sidewalk 1992-06-241't/AO I=E,i2Il./tr,N I IAL -t-.()l- ll- ltr,KL,lAL / cuRtsCUJ:'\SPFIINGFIELE, 225 NORTI{ FIFTI{ gTREET gPRlr{GFtELD, OFE60hl 314'11 El.&3 INEERII.I6 D tvtgtohl c|;flcENo.l2b-31>3 lNgPECTlOl.l LINE,'126 - 3169 h, JOB ADDRE99:/, /l/a2Tl/ 5T/ 499E990R9 t'1AP NO.17-q-3g -Zl TAx Lor No.lr@ 9.JBDtVt9lOr.l: ou^lER aAP-A s/NGH ADDRE99:nt s /uo4.TH 57H c'trY,, 9rzfurpQf/{to erArE: Z2p€, a, 47 +77 PHo^rE No. 7+l -.l4tg grDEU.ALt< x' CUR3 grDE - SETtsACK x' CURts-CuT, X REgtDEl.irtAX coi.trlERtcan SECOND DRI\/€IUAY ( gEE TRAFFIC ) REAUI€9 APPLICATIOI.I FOR A 9ECOhlD DRI\€UJAY(T-4.1a) OR A COTJNTY APPLICATIOI.{ FOR FACILITY PERI1IT (C Ab.2@3) DATE OF APPLICATIA{ IF IN THE U6.8. RECEIPT No,0O5Z-(p7 CA41 CHECK L/ *u- CI.iECKED rcR DEL INOJENCIEg SIGNED: L)AI E,. D4 tcf.l: UJORK TO tsE FEFFOFT,IED EY: COT.JTRACTOR * u-'' COT.ITRACTOR ,(REcrerRAIcr.,l No."' a7+7 7 Ol,ll.l=R @/J5T EXPIR=9,,/ra/r- ADDRE99 23 79 /V/*rt?N E0 a2€,Pi.roNE: a87- PROCEDUFE FoR INgFEcTlohl RE@tlE9T' CALL 12b.3163 (RECORDER ) STATE YOUR CITY DE9IGNAT=D JOB NLJHSER, JO3 ADDRESS,TYPE G lNSFEcTlOrl REAUESTED AJ.ID IIHEN YOU ll,JILL B= READY FOR INSFECTIo?.1, CONTRACIaR9 oR Otlhl=RS NA1= At'lD PI]OhIE NI.T"13ER REOUE9T9 RECEI\ED B=FORE 1,OO M IUILL 3E IIADE THE 9A1E DAY, REAU=9'IS #IER IZOO Al"l IUILL tsE I.1ADE THE N=XT IIJOR<I}IG DAY EXIgTII.IG ELIILDING FET'IIT NO.( IF AFPLICAELE )7z osa 3 *YOUR CITY DESIGI.IATED JoB No. tsr 4z-o 679gEE BOOK Y .s6@ / DRI\GUAYYert.{L coNcRETE pAvtNG rutri{tN THE STREET RIGHT OF IUAY, TO BE I1ADE AFTER AL EXCAVATING 19 COMPLETE A{D FOFfi IIJORKAlD 5UB.tsA5E T1ATERIAL 19 IN TLACE r@r APPRoAcH APRor..l:-r#ft FoRrs AE EREcTED tsuT PRIOR TO POuRll'{3 CONCR=TE. r FEE9: glDEllJALKg uil6---cut-t--::-P< Aeazffiz€TUALK X, 11O.OO + tO.l5/LF.( X ) OF UALK rlO.O@+*O.lb/LF.(X)S COi-1I,IERICAL DRI\€UJAY5 5I]ALL HA\G 5'TO A'FLAIRg3'. O'gTA\DARD x' TOTA PEFlllT FEE'1 /o,7' I ;{A\G CAREFIJLLY EXS1INED TI-{= CO!'IPLETED APPLICATIOT.I FOR PEBIIT, A{D DO I{ER=BY CERTIFY TiiAT ALL INFORHATION I-]EREON 15 TR,IE A\D CORR=CT, A\D I FURT|]ER CERTIFY TI-]AT ANY AND ALL ui2R< PERFO lED5ilALL BE DONE IN ACCORDANCE IIJITH TII= ORDINANCE9 G TI..{E CITY tr SPRINC#IELD, AID TI-]= LAI1}3 G TFIE9TAT= d ING TO TFi= IIJOR< D=gCRIBED FiER=IN, AI.{D TiIAT NO OCCUFANCY U,JiLL BE HAD=4 ANY IO,I.I G TI{= BUILDIN6 DIVIgIO}.I I FURTI{ER CERTIFY TI..IAT ONLY CONTRACTORS IA\CE IUITi.{ OR:3 IOIO>> I,TJILL BE USED ON TIII9 PROJECT e-z+-S2- IIHO ARE IN tUITi-{OJT EM6ILIIIL L)Attr EAUIFED INSPECTIOI.IS /\