HomeMy WebLinkAboutPermit Curb Cut 1994-09-07RESIDENTIAL - COII}-IERCIAL
sID=UJALK / CURBCUT
APPLICATIOT{ / PERJ-1IT
SPRlNGFIELO
22> NORTH FIFT|{ gTREET
gPRll.lcFtELD, OREGOhI 9-14'l-1
EN6 lNEERll.{6 D lvl9 lOt,lffitcE No. ]26-31>3
IN9PECTION L lNE,'126 -3169
JOB ADDRE99:
A95E550R9 tlAP NO.
S'UBDlVl9lON,
TAX LOT NO.
ori.i,iER,
ADDRE99,(/r
ZI?,
CITY:
PHO}{E NO,
.JJOFK
9lDEllALK: CURB 9lDE
-
$=TBAC< _
CUR3.CUT; JZ RESIDEI.iTIAL
-
COI-IMER|CAL
-
gECOI.ID DRI\GUAY ( SEE TRAFIC )
EAJIE9 APPLICATIONT FOR A SECOND DRI\€II.]AY(T.4,IA)
OR A COIJNTY APPL|CATION FOR FACILiTY P=R-1IT (C AA.2O3)
DAl= G APPLICATION q -? -{4
RECEIPT NO'
CA9+{
CHECK //, zo
+ €F17 *
CHECKED FOR DEL INOJENCIE9
9IGNED,
DATE'
ISTRATION
ADDR=99
I,,IJORK 10 OE PEFFOFIGD DYZ OUI=R,Z,-'?/CONT,RAC;OR
tA/i a (j t(,
Pi-.ioNE:
PROCEDUFE FOR IN9PECTIOhI RE@t]E9T;
3AJ-L 12b-liba (re.CO@ER ) STATE YOUR CITY D=9ICNAT=D JO3 NLJi.iS=R Jo3 ADDRESSJYFE oF
INgP=CIICI.I REAUESTED AND u.X-|EN YOU UJILL 3= R=A?Y FOR INSPECTIOII, CONTRACTORg OR OuJ{=Rg NAi.1= AND
F,I-](,,\IE NL[-l3ER R=AUEgT3 RECEI\€D BErcRE \OO N TJJILL B= I.1ADE THE 5A1E DAY, REAUEgTg /fTER 1,OO
A}'1 IIJILL 3E T,1ADE THE N=XT I,Ir?R<|NG DAY
EXI9TIhIG BUILDING PE, 1IT NO. ( IF APPLICAtsLE )
*.YOUR CITY DESIGNATED JoB No. rsr qq / 37 b9== Wd.
9IDEIIJALK / DRI\GII]AY
FOR ALL CONCRETE PA\/NG IUITi-.IIN
THE STREET RIGHT OF WAY,iO 9=
fiAD= AFIER AL EXCAVATING
19 COHPLETE AND FORI1 IiJOR<
AlD sUB-BAgE T1ATERIAL 15
IN PLACE
/ A?trOACF.l APROr|l,
AFTER FORI1g AE EREC'IED
BUT PRIOR TO POJRING
CONCRETE.
FEE9: SIDEUJALKS CURB-CUT IIJAL< X
rlO.OO + tO.lb/LF.( X )
OF I]JALK '1O.OO+,O.1>/LF.(X)
TOTAL FEFi'1IT FEE,
COil,I.1ERICAL DRIVEI.IJAYS 9i-.{ALL
HA'r'i-,9'TO A'FLAiR9
3.. O'STADARD
I '1A\€ CAREFULLY EX/-,J'1INED THE COTFLETED APPLICAT|ON FOR FEB,IIT, AND DO I-.IEREBY CERTIFY TI-.{^Z.T ALLiNFO, IATIAN HER=ON 19 TR.JE A\D CORRECT, A'.ID I FURTH=R CERTIFY 'I'1-1AT ANY AND ALL ui2R< PERFOE.IED9i]ALL BE DONE IN ACCORDANCE IIJITI..I TIIE ORDINA\CEi G THE CITY 4 SPRINC#IELD, AID TI.]E LAUS tr TI]E
STATE ff OREGON PERTAININC TO THE UJORK DESCRIS=D HER=IN, AND TI-]AT NO OCCUPANCY UILL 3E HADEG ANY gTRLICTU,RE IUITI-{OJT PEB1I9SION OF THE tsUILDING DIYIgION. I FURT}IER CERTIFY TI..]AT ONLY CONTRACTORS
A)'lD =iIPLOYEE5 tIJilO ARE lN COI'IPLIANCE tulTi{ ORg 1@lO>> UJILL tsE USED ot{ THlg PRoJECT.
*
DATE
IF IN THE IJ.G9,
FEAdIRED IN9PECTIChI9