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Home My WebLink AboutPermit Curb Cut 1996-05-07PERMIT NUMBER:K SIDE DATE ISSUED: iffi c INSPECTION LINE SEE TNSPECTIONS ON APPLICATION DATE: 225 FIFTH STREET SPRINGFIELD, OREGON 97477 ENGINEERING DIVISION oFFtcE TELEPHONE (503) 726-3753 ENCROACHMENT PERMIT NUMBER: LOCATION OF WORK PHONE EXPIRATION DATE PHONE: ztP: 4 7 Lt-7 7 z9{a t 3 ^7 \h PHoNE 7 4,IY PHONE: ZIP: APPLICANT SITE ADDRESS CITY: ADDRESS: TAX MAP TAX LOT: CONTRACTOR: b uul vz\ o rz ADDRESS: CITY:-STATE STArE: O H., SUBDIVISION OWNER: CONTRACTOR REGISTRATION NO PROJECT SUPERVISOR: (.o -^ - REOUESTED PERMITS: ACCOUNT NO:INSPECTIONS REOUIRED: APPLICATIoN FEE / DEPoSIT tr T-l $20.00 /.JVALID FOR SIXTY (60) OAYS FROM OATE OF ISSUANCEI cur srneer E BoRE E oTHER I ousr coNTRoL (TypE oF coNTRoL) E$ fl corusrnucloN, sroRAGE, srAGtNG E$ E$ E$ E$ I ornen trI aseuelr DEpostr...,...,... I amrurer suBEry BoND E suRltTy BoND E CASH / CHECK CURB CUT PERMTT NO:. lNsPEcrtoN: CURB / AppROACH AFIER FT. /1 , E $10.00+$.1s/FT FoBMs ARE eRecreo ilur PRIOR TO POURING CONCRETE,VALIO FOR 180 OAYS FROM DATE OF ISSUANCE. I srcoruo DRtvEWAy (sEE sEeARATE AppLtcA f sroewnLK pERMtr No:FT.E $10.00+$.1s/FTVALID FOR 180 DAYS FROM DATE OF ISSUANCE.ll r.rew ff REMovE / REpAtR E PAVE PLANT srRtp fl srreacx ll CURBSIDE E LENGTH ALL CONCRETE PAVINGINSPF'TION. SIDEWALK / DRIVEWAY FOR WITHIN THE STREET RIGHT OF WAY.,TOBEMADE AFTER ALL EXCAVATING IS COMPLETE, AND FORM WORK AND SUB.BASE MATERIAL IS IN PLACE.tr SANITA.RY SEWER CONNECTTON pERMtT: .,.E $5,00 /VALID FOR SIXTY (60} OAYS FROM DATE OF ISSUANCE I To sTue Q MAIN LINE (EASEMENT-R/W} E oTHER f sronnn sEWER coNNEcrloN pERMtr: VALIO FOR SIXTY (60} DAYS FROM OATE OF ISSUANCE I cnrcH BASTN / BUBBLER E STUB I rrltAtrultrue PROoF OF TNSURANCE: $SOO,OOO MINIMUM I arrncxeo E REoutRED AMouNT Tl $5.00 /U TOTAL DUE: $ TOTAL DUE WITH PERMIT $ DESCRIPTTON OF PROJECT: TYPE OF WORK: CUT: a.1trE. OTHER: DEPTH: BACKFILL MATERIAL: Advance signing and work zone protection to ba in compliance with the Manual on U niform Traffic Control Devices (MUTCD). WORK SHALL CO MPLY WITH 5 OF THECHAPTER X ARTICLE CITY CODE.CONTBACTOB MUTCD.TO COMPLY WITH DESCRIPTION AREA: LENGTH .]WIDTH:HEIGHTT EXISTING SURFACE MATERIAL: BACKFILL MATERIAL TO BE UTILIZED PERIOD OF USE OR TIME OF CONSTRUCTION: tr PLANS (TWo sETS)ATTAcHED FROM DATE: TO DATE: NAME OF OTHER UTILITIES IF THIS IS A JOINT PROJECT WABNING DEVICES TO BE UTILIZED: TIME: TIME: SURFACE REPLACEAiIENT MATERIALS TO BE UTILIZED: TYPE OF DUST CONTROL TO BE UTILIZED: REVtStONS 8t24/95 FORM # 1 16 CITY OF SPRINGF D P{TflIT APPLICATIoN t f erucnoncHMENT pERMtr No: t. PLAN REVIEW COMMENTS / SF-'{AL INSTRUGTIONS: RESTORATTON WOBK SHALL BE !N CONFORMANCE WITH EXISTING CITY CODES ANI.I rN CIIVIPUAruCE WITH CURRENT STANDARD SPECIFICATIONS, EXCEPT AS NOTED BELOW. 001 Backfill with %" minus rock. 002 Compact every 18" loose depth. 003 Requires compaction with a steel rolller. OO4 A.C. to match the greater of existing depth or 4". 005 All cuts sealed for final inspection. 006 Temporary patch may be used at the end of the day. 007 Signing and Zone protection to comply with MUTCD 008 Cut concrete only on score lines or cold joints. 009 Sidewalks and driveways min. 3,000psi. 010 Curbing min 3,500psi / No patchwork less than 3'. 01'l Meet min. requirements on curb cuts, Spfd. code' O12 Restore planted areas, Spfd. code 206'3'05 013 Spec. to Bore / Jack / No A.C. cuts. 014 Mechanical compacting required. 01 5 No patchwork allowed. 0'16 Lateral cuts to have control density fill. 017 Cuts to be polymerizsd crack sealed f or f inal inspection 018 Mininum 2" crushed rock %" minus' 019 o20 021 o22 023 o24 o25 026 o27 o28 029 o30 031 032 033 343 Minumum 4' clearance at any point, swing-away. Concrete minimum 4" depth, 3,OOopsi. Trench to be "T" cut. Needs State / County permit. No above ground enclosings in sidewalk or handicap ramps. Diamond cut A.C./Concrete value boxes to grade. Fresh Oil signs / Graded. Comply with Americans with Disabilities Act, Concrste slabs, 72hrs. curing time, 4500psi. Concrete slabs require joint soal material. Driveway requires dowels every 18". Submit traff ic control plan prior to excavation. Notif y Traffic Division before excavatign. Core drill main line,,insert tee, 2olo min. grade. Must comply with the provisions of OBS 757.541 to 757.571 6" Circular hole/H2O'Vac. Comments: YOU ABE REOUIRED TO CALL THE LANE UTILITIES COORDINATING COUNCIL'S "oNE CALL NUMBER" 1-800-332-2344 48 HOURS BEFORE DIGGING INSPECTIONS: tr cuRB cuT AND STDEWALK INSPECT|ONS CALL 726-3769 (RECORDEB) STATE YOUR DESIGINATED CITY JOB NUMBER/pERrvrrr r.rurraeei. JoB ADDRESS, TYPE oF INSPECTION REQUESTED, AND WHEN YOU WILL BE READY FoR rt.,rbiecrior.r, coNTRAcTon.s on oWNER;S NAME AND PHoNE NUMBER. REOUESTS RECEIVED BEFORE 7:OO A.M. WILL BE MADE THE SAME DAy, nEOUeSTS AFTER 7:00 A.M. WILL BE MADE THE NEXT WORKING DAY. INSPECTIONS ABE To BE CALLED IN AFTER EXCAVATIONS ARE MADE AND FORM WORK IS IN PLACE BUT PRIOR TO POURING CONCRETE. SANITARY SEWER, STORM SEWER, ENCROACHMENT PEBMIT AND OTHER INSPECTIONS CALL CITY MAINTENANCE AT 726-3761.tr SIGNATURE: Bx,8ifl'13\,iL? l,il":3,?S$:Si,"."r lipl,Li?:?..?i'3il![%si1ff:fl [s,f"#,?'s,.',iif3fl'ii'[8t.8iiit"e!3t?Bh%"J'*,n,l^,ir's:8'r5,'""Jl."x'."& 1n. h:%s["'f[:pJffiy,,,1?tnt+[t"*fii.i;*b*u*nr,.it#"*i*,?ffi';l';rs'.1;[: itnn*ls ii?f, o"il'oieon"aff'riii'8813.']%,Yi'{l: project. The Citv mav inspect the work site described in this permit at any time during a one year period lollowing the. receipt bv the citv of ;8f;;'J'';'dJ,i1'Jffi1,:ii"::r."Hjfg1,yu-,nl[',t".'{#, E!'*i*;;'*.. igs Ss,',f,'""d'x*,nntt1l;", -i,",:T;et,:t Hiin"lf;flH5;3 lt,,,, davs (30) from the oatd"JiirL*i6ti,L:""i"o'cliiiiriii'ir,b'i,5rii'W;;I ;;i i"rii5r.i'."'J ii ir,ii iin"o ot1h6 irrirtv davs will be perrormed bv the City and ihe costs will be billed to the permittee' -/-,5) 6 I furthor aoree to ensure that all required i and the ap-proved set of plans will remain adre ble thef rommeatthaddress street,ins project on RECEIVED BY: DATE PAIDAMOUNT RECEIVED RECEIPT NO Signature t Date 1- V 1" VALIDATI I unturuNANcE :-_--- I eenutr tssuED BYi FOR SIDEWALK AND CUBB CUT PERMITS PLACE A COPY (COMPLETED) IN PERMIT DRAWER. DATE:INSPECTION: DATE:woRK rN PROGRESS_ AT TIME OF COMPLETION: DATE: DATE:ELEVENTH MONTH: . INSPECTION: DATE: DATE: f eructrueERtNc REVTEWED BY DATE f, rnnrrtc IEWED BY: DEPOSIT RETURNED DATE DATE: .DATE: CT 'MERCIAL GERTIFIGIT,d OF I]ISUP \GE 5 -9 -96 This certilicate is issued as a matter of informatlon only and conlers no rights upon the certilicate holder. This certificate does not amend, extend or alter the coverage afiorded by the policies shown below. COMPAIIIES PBOVIDI]IG GOUERAGE: 1 TRUCK INSURANCE EXCHANGE g FARMERS INSURANCE EXCHANGE 6 ltllD-CENTURY INSURANCE COMPANY lssue Date (MM/DD/YY) AGENCY Name & Address .VENN VRANAS .FARMERS INSURANCE CO..870 W CENTENNIAL.SPRTNGFIELD OR 97477 ST 73 DIST, 1B AGENT 344 INSURED .JAMES XIARHOS .JBANNE XIARHOS .1833 NORTH IZTH .SPRINGFIELD OR 97477 COMPANY LETTER COMPANY LETTER Name & Address COMPANY LETTEB COMPANY LENEB D GOUERAGES THIS IS TO CERTIFY THAT IHE POLICIES OF |NSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOUIREIUENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUIIENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POTICIES DESCRIBED HEBEIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CIA|TIS- c0. LTR.TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (i/lM/DD/YY) POLICY EXPIRATION DATE (MM/D0|1Y)POLICY LIMITS EXEnil UABTUW COI/l\,lEBCIAL GENERAL LIABILITY _ OCCUBRENCE VEBSION CONTRACIUAL . INCIDENTAL ONLY OWNEBS & CONIRACTOBS PROT PRODUCTS.COMP/OPS AGGREGAIE PERSONAL & ADVERTISING INJURY EACH OCCUflSENCE FIRE DAI\,IAGE (Any one Fire) MEDICAL EXPENSE (Any one person) GENERAL AGGREGATE $ $ $ $ $ $ AUIOMBLE I.IABII.ITY ALL OWNEO COI\4I\,4ERCIAL AUTOS SCHEDULED AUIOS HIRED AUTOS NON-OWNED AUIOS GARAGE LIABILIIY COI\.4BINED SINGLE LIMII BODILY INJUflY PER PENSON) BODILY INJURY (PEB ACCIDENT) PROPERTY DAMAGE GARAGE AGGREGATE $ $ $ $ umBRELtA uAEruTY 3493 8706 3-25-96 L2-27 -9 LIMIT t , ooo, ooo U0RIERS' C0LPEXSITI0X AX0 ETPTOYERS' TIABII,ITY STAIUTIIRY EACH ACCIDENT DISEASE*EACH EMPTOYEE DISEASE_POLICY LI[,IIT $ $ $ DTSCRIPTIOX (lT (lPERATIllXSIVEHICI.ESIRESTRICTI()[S/SPECIAt ITEMS: HOME0I{NER POLCY +1910399462 HAS 100,000 LIABTLITY AND ABOVE UMBRELLA POLICY ]S A ADD]TIONAL 1 , OOO, OOO COVERAGE. .CITT OF SPRTNGFIELD.225 5TH STREET.SPRINGFTELD OR 97477 ' ATTN : IIOBERT KBDDhIIG GATIGETLATIOII SHOULD ANY OF IHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE iHE EXPIRATIr)N DATF THFRFOF IHE ISSUING COMPANY WILL INDEAVOR ]O I'A't 30 DAYS lryBITTIN NOIICI TO NE CrNiirICNir HOiiIid Mlyfp.l0.il-qlEli BUT FATLURE r0. !l4rlsqqH-ryqryE srinLL rn,|posi-r'rt oiaLioniror,r'on LlnsiiirioiANy KIND upoN rHE coMpANy, trs AGENTS on nrpnrsmwnirviS --- @ GEBTIFICATE HOTDER Name & Address 56-2492 4-94 1251 A-95 1301