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
)