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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