HomeMy WebLinkAboutPermit Curb Cut 1997-11-17I I tI DI t
PERMIT NUMBER:
DATE ISSUED:
Itittao?ttt.D
v
226 FIFTH STREET
INSPECTION LINE SEE INSPECNONS ON BACK SIDE '
APPLIOATION DATE:
ENCROACHMENT PERMTT
NUMBER:
-7
SPRINGFIELD, OREGON 97477
ENGINEERING DIVISION
oFFtcE TELEPHONE (5031 726.3763
.LOCATION OF WORK
PHONE
PHONE:
rrHorue:
4 T
2
ZlPz o
ZIPz
PHONE:
6
T,C- O(+eN
Yz- /4 4/
STATE: 0/--
ADDRESS:
TION.DATE:
ADDRESS:
APPLICANT
TAX MAP:
TAX LOT:
.-€ONTRACTOR REGTSTRATTON NO:
?FOJECT SUPERVISOR:
SUBDIVISION:
OWNER:
CITY:
SITE ADDRESS:
REOUESTED PERMTTS:f\BPCgnONS nEOUIREOT APPUCATIOT{ FEt / oEPOS|T ACCO(,NT NOIQ erucnoAcHMENT pERMtr No:g rio.oo IVATP R)R SIXTY ('O} DAYS;ROM DAT! OF E8UANCE
Q cur srneer O aone EI oTHER %_Er
Q ousr coNrRoL (wpE oF coNTRou
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tr
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Q asexllr DEpostr............................i.....a....................
TYPE OF SECURIY NEPOSIT
Q aunrer suRETy BoNo e sunttw aolo E cAsH / cHEcK Ef
E q{to,oo*t.16/Fr.-60
tr [ 010.00+0.1s/FT.
El New 0 REMovE / BEpAtB O pave pLANT srRtp
Q'serarcr OcURBstoE OulorxlNsPF."roN. i|DEWALX
'
OR|VEWAY FOR A[t coNcrEll ?AV|NO WTI{IN THE STREET RIOI{T OF WAY. TO BE
ANO SUBSAEE MATERIAL 18 IN PIACE.MADE AFTER ALI EXCAVATINO B COMPLETE , ANO FOBU VrrORxI sarureny sEwER coNNEcloN rEBM
v^t D FOB StXTy tCO, OAYS r80M DA?E OF ISSUANe!
Q ro srue E MA|N UNE (EASEMENT-RM
I srcinrvr sEwER coNNEcloN pERMtr:
IT:E S5.o'o /
E oTHER
vAlD;oR axw t80t oAyt FeoM OAr! Of ESUA!{C!
E cercx BAstN , BuBBrrR O srua El MANUNE
PRooF oF INSURANCE: $EOO,OOO MINIMUM
E r5.0o /
I rrmcxeo E REOUTRED AMOUNT TOTALDUE: CI TOTAL DUE WITH PERMIT I
DESCRIPTION OF PROJECT:
PERIOD OF USE OB TIME OF CONSTBUCTION:
Q rmns fiwo sETst ATTAcHED
AREA: LENGTH:IA'IDTH:
TYPE OF WOBK: CUT:
OTHER:
EXISTING SURFACE MATEBIAL:
BACKFILL MATERIAL TO BE UTILIZED:
SURFACE REPLACEI\4tNT MATERIALS TO BE UTILIZED:
FROM DATE:
TO DATE:
TIME;
TIME:
DEPTH:
BORE:
BACKFILL MATERIALI
HEIGHT:
TYPE OF DUST CONTROL TO BE
NAME OF OTHER UTILITIES IF THIS IS A JOTNT PROJECT
WABNING OEVICES TO BE UTILTZED:
DESCRIPTION:
WORK SHALL COMPLY WITH
Advrnc. algnlng.nd work ronc protoctlon to ba ln compllrnct wlth lhr Mrnurl on Unlform Tnllc Control D.vlcc! lMUTCol.
CHAPTER X ABNCLE 6 OF THE CrrY
REVTSONS Ct21t06 FoAM
' ll!
CODE. COIITRACTOR TO COMPLY WTH MUTCD.
El_
E-
CURB CUT PERMIT NOI ...................,
REVIEW COMMENTS / SPECIAL INSTRUCTIONS:
giilBtrtB'#l8P'f'r^ifdfr t,'5l8dF?t*.8H['E[dff .
O(ISTINO CITY CODES AND\{"|,bMPUANCE WITH CURRENT
ool
002
003
004
00t
006
007
008
009
010
011
012
or3
014
010
or0
017
018
Comments:
Bccktlll wlth I'mlnur rcck.
Comprct cvcty 1 8' loor drpth.
Rcqulrrr compratlon wlth a fi..i tollltr.
A.9. to mltch thr grcr&r ol rxlrtlng drpth ot 4'.
All outt rrrlcd lor lln.l lmptotlon.
Trmporury pllch mly bl urcd lt th. ltrd ol thr dry.
Slgnlng rnd Zoncr protcctlon to oomply wlth MUTCO
Cut oanotcta only. on rcorc llncr or cold lolntl.
Sldcwclkr tnd ddv.rvlya mln. 3,00opd.
Curblng mln 3,600pr1 / No Prtchworl lrrr thrn 3'.
Mcct mh. rcqulrrmtntl on ctlb ct tt, Spld. aodt.
8ldort plonttd.arcu, Sptd. codr 206.3.05
Sp.c. to Borc / Jrck / No A.C. cut!.
Mcchrnlccl comptctlng roqulrod.
No pltahwork rllowtd.
Llttr.l outr to htv. oonttol dtnrtty flll.
Cutt to bc polymcrlrrd crcok ulcd lor flnal lnrpectlon.
Mlnlnum 2' crurh.d rock l'mlnut.
0r9
020
021
o22
023
o24
026
o26
o27
028
029
030
03r
032
033
343
Mlnumun,l' chlrrnct .t lny polnt, rwing'rway.
Concrtr mlnlmrrn 4' drpth. 3.0OOPrl.
Trrnoh to ba 'T' out. l
N.rd. stlt. / Count, p.tmlt.
No rbovr ground rnclodngr ln rldcwalk or hlndlcap rrmpr.
Dhmond ogl r\C.lConcrcr valuc boxcr to gndc.
Forh Oll rlgnr I Qrudcd.
Comply wlth Am.rlctil wlth Oltlbllllit! Act.
Concnr rlrbr, 72h0. curlng tlmr. tl600pcl.
Concntr drbr nqulrr lolnt rrrl mtttrltl.
Drlvrwry rrqdnr dowrlt rvrrY 18'.
Submlt tnlflo cintrol pltn prlor to cxccvrtion.
Notlly Trrlllo Dlvlrlon bctorc cxcrvltlrn'
Con drlll mtln llnl, lnt.rt tac, 2ll mln. gradr.
Murt comply whh th. provblonr ol ORS 757.541 to 757.671.
C' Clrculrr hoh/H2O.Vrc.
I
YOU ARE REOUIRED TO CALL
THE LANE UTILITIES COORDINATING COUNCIL'S
"oNE CALL NUMBER" 1-800-332-2344
48 HOURS BEFORE DIGGING
INSPECTIONS:
.N
CUNS CUT AND SIDEWALK INSPECTIONS CALL 726€769 (BECOBDER} STATE YOUR DESIGINATED CITY JOB
NUMBER/PERMIT NUMBEB, JOB ADDBESS, TYPE OF INSPECTION REOUESTED, AND WHEN YOU WILL BE READY FOB
INSPECTION, CONTRACTOR,S OR OWNER,S NAME AND PHONE NUMBER. REOUESTS RECEIVED BEFORE 7:OO A.M. WILL BE
MADE THE SAME DAY, REOUESTS AFTER 7:00 A.M. WILL BE MADE THE NEXT WORKING DAY. INSPECTIONS ARE To BE
CALLED IN AFTER EXCAVAT]ONS ARE MADE AND FORM WOBK IS IN PLACE BUT PRIOR TO POURING CONCRETE.
I sarureRy sEwER, sToRM sEwER, ENCRoACHMENT pERMrr AND oTHER tNSpEcTloNs CALL clrY MAINTENANCE AT
726.3781,
SIGNATURE:
Bv slonature. I state and aoree. that !have carefullv examined the comoleted apolication and do herebv cortifv that all information
h6reifi is truC and correct. 6nd I further c€rtifv that bnv and all work oeiformed'shall be donc ln accordince with tho Ordinances of the
Citv of Sorinofield. aoolic'able Cltv Standard doecifications and Drawinqs. and ths lawg of thr Stato of Oreson pertainino to the work
des.crlbod heieln. Iftjrther certifylhat only cohtractors and employees-who are ln compliance with ORS 7O1.055 willbd used on this
project.
The Cltv mav lnsoect the work slte deacrlbcd ln thlg permlt atianv tlme durino ! ono vEar perlod followlns the receipt by the Citv of
notice cif.corholetion of tho doscribed work and aoecifv. at the Citv'r cole deicression. anV additionalresforation wbrk iequired to
return the sltito a rtandard accaotablc to tho Citv. Ttid oermlttec-wlll be notified in Wdtin-o of anv work reouired and will'have thirtv
Sifrfft,{!"g1$r";}filt3tllilo",tilf;.,Br.,fi,.1ltl"#'sc w6rk. work not complsted at thc cna or thb thlru davs will be perrormed bv the
I funhor aoreo to snsuro that alt reoulred lnroectlons are reou&ted at the orooer time.
and the ap'proved set of plans will r'or.nain ori the site at all times during cohstruction.'
Signature Date
that project address ls readable from the stre6t,
AMOUNT RECEIVED:
RECEIPT NO:RECEIVED BY:
I
DATE PAID:
VALIDATION:
I eenur rssuED BYi
FOR SIDEWALK AND CURB CW PEBMITS PLACE A COPY (COMPLETED) IN PEBMIT DRAWER.
DATE:
I
DATE:
AT TIME OF COMPLETION: DAT!:
DATE:
E uerrureNANCE :
I eruatrueERrNc REVTEWED BY:
I rnnrrrc REVTEwED BY:
DATE:
DATE:
DATEI
DATE:
DATE:
INSPECTION:
. INSPECTION:
WORK IN PROGRESS
ADDENDUM City of Springfield
To:
From:
Date:
Subject:
PermiteeAJtility Installer/tJtility Company
Mike Koivula, City Survey Dep't.-
April9,1.997
City Specifications, Survey Monumentation, State Law
PAGE 1 OF 2
All permittees under our "Encroachment Permit" program should be particularly aware of their
responsibilities as noted under the section "PLAN REVIEW COMMENTS/SPECIAL
INSTRUCTIONS" on the reverse side of the permit form which refers to the current city
specifications document.
Besides the full gamut of construction standards the document also has specific provisions relating
to the protection and preservation of survey monuments. (1) In addition, there are Oregon State
laws that deal with the same subject.(2)
For a general overview of survey monuments, please see the following page.
For general information regarding city specifications and the permit process, please call our office
at (541) 726-3753. For specific assistance with survey monumentation please call me directly at
(s41) 726-3679.
(l) City of Springfield Standard Specifications, 1993 section 105-l0 "Protection of Survey
Monuments"
(2) OREGON REVISBD STATUTE 209.150 *REMOVAL AND DESTRUCTION OF
MONT'MENTS..''
ADDENDUM City of Springfield
PAGE 2 OF 2
TYPICAL MONUMENT CONFIGTJRATIONS CAN INCLUDE:
l) Property corners
Thbse usually are a piece of steel reinforcing rod (rebar) of ll4 to 1 inch diameter or lengths of
iron pipe with diameters of ll2 to 4 incheS. They may or may not have tags or caps of brass,
aluminum or plastic with identifuing letters, numbers or combinations of the two. They are
typically found at recognizqd property occupation limits, fence corner areas, hedge rows and
between utility services like water meters. Along road right-of ways, they can be found ll2 to eight
feet behind the back of sidewalk , and may be found at typical "occupation" lines as delineated
above and also at areas where roads make angular changes, curye or change in width.
2) Roadway centerline markers
In asphalt or concrete streets, these are typically nails of various types, sometimes with
identifuing tags or washers. They can also be "rebars" or iron pipes as delineated above. They can
be found typically at the intersections ofroads, on the center ofboth roads, and on the center of
one and the right-of-way of the other. They may also be found at angles and curves of road
alignment or at changes in roadway width. In unimproved dirt or gravel roads, they are typically
"rebars" or pipes set below the driving surface.
3) Road Reference Monuments and Benchmarks
These are typically small nails.set in concrete curbs in the vicinity of road centerline markers.
They also can be brass caps of ll2 to 2 inches in diameter. Benchmarks.(vertical control
monuments) can also be squares chiseled in to the curb concrete. A system of federally installed
precise benchmarks comprises iron rods set into aluminum "valve-{rpe" cases at South A st in the
vicinity of 14th st_and along Main St. in the vicinities of 24th st, 33rd st (at house no. 185 -N
33rd), s 41st st, 59th st, and 64th st.
4) Government Control Monuments
These typically comprise brass caps set in concrete monuments , railroad spikes set in paving
and various types of monuments set in "valve-f/pe" cases. Their location varies with the type of
monument and does not follow any typical location pattern. Often there are warning signs in the
vicinity or survey sfakes and colorful ribbon to alert you to these monuments.
SPF.INGFIELE)
225 FIFTH STREET
SPRINGFIELD, OR 97477
PU BLIC WORKS DEPARTMENT
ADMINISTRATION
ENGINEERING DIVISION
A4AINTENANCE
APPLICATION FOR A SECOND DRIVEWAY / OVERWIDTH DRIVEWAY
APPLTCANT (PROPERTY :--)'T"
ADDRESS OF PROPERTY FOR DRIVEWAY PERMI
APPLICANTS TELEPHONE 1t
Please sketch the proposed driv'eway. lnclude the following app[cable items: house or building, proposed
driveway, existing driveway, and street names. lnclude dimensions and measurements to property lines, road
intersections and bordering driveways. (See attachment for an example.)
- i(,{ ,4/ . / /4=
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ALL APPUCATIONS OUTSIDE THE CITY UMITS OF SPRTNGFIELD THAT ARE WtTHtN THE URBAN
GROWTH BOUNDARY REAUIRE A I.ANE COUNTY PERMIT.
Note: The City of Springfield will not grant a second driveway permil on an Arterial or Collector Street.
ADM t N t STRATI ON / E NG t N EE Rt NG (50s) 726-3753 FAX (503) 726'3689
MATNTENANCE (50s) 726-s761 FAX (503) 726-s621
a
DATE: ,'//trl- Li'/
LXAMPLE +I
f,3s
r.tAfuPoru
Io
a
rrl
ExtSTti.l6
DRIYE}VAY
applrcanoru ron a s
DATE:-
APPLTCANT (PROPERTY OWNER):
ADDRESS OF PROPERTY FOR DRIVEWAY PERMIT:
APPLICANT'S TELEPHONE NUMBE
Please sketch the proposed driv'eway. lnclude the following applicable items: house or building, proposed
driveway, existing driveway, and street names. lnclude dimensions and measurements to property lines, road
intersections and bordering driveways (See attachment for an example.)
STR€ET NAME I t5'25t+-l'tt
Ner cuWPs
llotts?.
o
-{,!
rn
CI
{
77
7
fa
Eo,
ALLAPPUCATTONS OUTSIDE THE CITY UMITS OF SPRTNGFIELD THAT ARE WITHTN THE URBAN
GROWTH BOUNDARY REOUIRE A I-ANE COUNTY PERMIT.
Note: The City of Springfield will not grant a second driveway permit on an Arterial or Collector Street.