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HomeMy WebLinkAboutPermit Sidewalk 1992-09-29iino I=E,gll-lE,l\ I IAL - r-,tJl- ll - lE,l=r.-,lAL 9IDEI,IJAK / c/JREc]')7 APPLICATIOhI / PER-IIT SPFIINGFlELc, 225 NORTH FIFTI{ gTFEET gPRlt{3FlELD, ORE60hl 3'14'I'1 ENGINEERI\I3 D lvlSlOl',l otrtcENo. 12b-91b1 IN9PECTIOi{ LINE:'126 -3163 JoB ADDFE99,6*Z++ Ol,) AeeEeeoRe FIAF No.* lr 07 a3 vl TAX LOT NO.100 9tBDtVt9tofl: OIINER CITY: sTArE: O(1 ata. I.IJoRK TO BE PEFFOFI,IED EY: Pi{ohl= No. OiU.lER COhITRACTOR*Sc+rusz Gff X cohrrRAcroR REGI9TRATIOII NO.* 9qer4 ExPlRE9,%r CURB-CLT: FE9IDENTIAL - coifiERlCAL 9ECcr.lD DRI\EIUAY ( 5EE TRAFFIC ) REaLllREg APPLlcATlotl rcR A 9EcOtlD DRI\€tlJAY(T-4.la) OR A COIJNTY APPLICATION FOR FACILITY PEF?.1IT (C AO.2O3) IF IN Tl{E U6.8. DATE oF APPLrcAro?.r 7 /-Z 'l z 9IDEIIJALK cuRB gtDE _9EI3ACK _ C++ECRED FOR DEL INAJ=NCI=g *z+< 1^zn L- * 00bNO:IFT CA9+1 cliEcK 9I6NED: ))All:z ADDRE59 4<ya tfusnl Eerrt- -1-P rHoNE: -72/L- A,57= PROCEDUFE FOR tNgFEcTloN REGIIE9T' C)TL 12b.316A (reCO@ER ) STATE YOUR CITY DE9ICNATED JOB NI.JI'13=R, JO? AgDFE.gg,TYFE OF IN9FECTIA{ REAUEgTED AlD u}{EN YOIJ IIJILL BE READY F.OR INgPECTIOII, CANTN4.CTOR9 OR OIIAIER9 NAI,1= AID PIIOhIE NL[1tsER REAUEgTS RECEI\€D B=FOre \OO ,LIl IUILL BE HADE TI{E 5AI1E DAY, REAUE9T9 lfTER 1,OO AI'1 IUILL tsE I1ADE THE NEXT IIJORKI}.I3 DAY if' EXIgTING BIJILDIhr3 PERi1IT NO, ( IF APPLICAELE ) ro,R cr'' oes. ,.,Eo tooNo. E! n'?lQ / - |sE tsOot< gIDEIIJALK / DRI\EIUAY FOR ALL CONCRETE PAVING IUITi]IN THE STREET RIGHT OF IIJAY, TO BE FIADE AFTER AL EXCAVATING 19 COI.IPLETE A}.ID FORfI u,lORK AID sUB-BA,E F1ATERIAL 19 IN PLACE C,U@ / APFROACH APROhI, AFTER rcRi1s AE ER=CED BUT PRIOR TO POJRING CONCRETE. FEE9:SIDEIUALKS OF TUALK TOTAL FERI,IIT FEE'i + *O.lb/LF.( X )rlOOO+tO.lb/LF.(X) COI.IIIERICAL DRI\EI'AYg 5i]ALL AA\G >'TO A'FLAIRg 3'. OU STA\DARD CURB.CUT .35 IJJAL< x /> I i{A\G CAREFULLY Exl$llNED Tl-iE COIIPLETED APPLICAI-IaN rcR PEt"ilT,;\*.lD DO I]EREBY CERTIFY TI-{AT ALL INFOR'1AT|O}I1 HEREON 19 TRLIE AND CORR=CT, A\D I F\.,lRTlr=R C=RTIFY'I-HAT ANY AND ALL UIOR< PESOB1ED 5i-lALL BE DONE lN ACCORDANCE tlJlTH TH= ORDINA\Ca, G:r{E CITY G gPRlNr.rFlELD, AID Ti.l= LAUS OF T+iEgTATE OF OREGON PERTAINING iO TI.IE UJOR< DESCRIS=D I.i=EIN, AND Ti..{AT NO OCCUPA\CY UILL B= I.1AD=d ANY STRTICTURE IIJIT}.IOUT PEB1IS9ION G THE BUILDING DIYISIO\I I FURTHER CERTIFY T}.1AT ONLY CONTR,ACTORSA\D EtlPLo]EEs uJ+1o AR= tN coHpLtANcE rrJirr{ oRg loto>> t![-L tsE ugED ohl ri{ls pRoJECT. REOTJIRED IN9PECTICI.I9 )