HomeMy WebLinkAboutPermit Sidewalk 1998-04-16DATE ISSUED:
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TNSPECNON LINE SEE INSPECNONS ON BACK SIDE '
APPLI9ATION DATE:U
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
ENGINEERING DIVISION
oFFtcE TELEPHONE (503) 726-3763 ENCROACHMENT PERMIT
NUMBER:
.LOCATION OF WORK South 35th Street a te1 300 feet
3700
PHONE:
PHONE:
E
SITEADDRESS: 530 South 35th Street
Terry Stamo s
Road
OR
Ztpz 97 477
ADDRESS: 975 I^Ii1laeillesoie CIW:_Euqene STATE:
CONTMCTOB: C-2 Utilitv Cont. TnADDRESSI 3698 Franklln 81 vd.. Eusene^
PHONE:
CONTRACTOR REGISTRATION NO: 47346
PROJECT SUPERVISOR:
OWNER:Earl McElhany
TAX MAP:
TAX LOT:
Orognn I ZlPi
AppgCANT Earl MeElhany
EXPIRATION.DATE:' 2-28-gg
CtTy: Springf ield STATE: Oregon
SUBDIVIS;ON. Lilac Meadows
REOUESTED PEBMITS }6?ECTK)Nt ntountDt AtrucATtor{ Ft!, oEroSrT ACCOtlt{I NOrI erucnoAcHMENT pERMtr No:dro.oo IvALp FOi &XTY tcol o^yt tRoM oATt OF BTUANC!
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TYPE OF SECURIW DEPOSIT I
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OF BSUA}TG.
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wTt{JN ?l.G STAEET RrOHT OF WAy. TO BE
ANO IUBSASE MAT:Rnt n rr anc.tr SANITARY SEWER CONNECTION PERMIT:E $5.0'0 /VALD FOR axw tsot o^y8 tRoM DATE Ot ttsu ilc!
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PRooF oF INSIIRANCF: CEOO,OOO MINIMUM, flrrrecxeo OnrounroAMouNT_TOTALDUE: 01 TOTAL DUE WIT}I PERMIT T
DESCRTPTION OF PROJECT:
OF SP RTN RMIT APPLIG ATION
PERIOD OF USE OR TIME OF CONSTRUCTION:
E[ purus fiwo sETS) ATTAcHED
FROM DATE:
TO DATE:
ri7 27 t9 TIMEI
TIME:May 1, 19
DEPTH: aporov 3r HEIGHTI
AREA:LENGTH: 45, bcr oss 35th I/[IDTH:
TYPE OF WORK: CUT:BORE; Across 35th and er
OTHER:
EXISTINGSURFACEMATERIAL: SidEWAIK/CONCTEtC BACKFILLMATER}AL:
BACKFILL MATER]AL TO BE UTILIZED:
SURFACE REPLACEIUTNT MATERIALS
TYPE OF DUST CbNTROL TO BE
NAME OF OTHEB UTILITIES IF THIS IS A JOINT PROJECT:
WARNING OEVICES TO BE UTILIZED:
TO BE UT;LIZED: Concrere cir ofS 1d standard for s idewalk t
Advrncr rlgnlng a,td wo,L tono
DESCRIpTION: Contractor to sawcut and remove
b. ln oomplhnc. wlfh tfrr on Unltorm Trroc Conrol Dlvlcil fiuTcot.k on the east side cif 35th Street a
prot.ctlon to I
sidewal t ointsone or two ec ti
u er 35 h Str lt
and install 4"dia c e sleev es ere i SUB to -luater s ce. t fi11.
WORK SHATL COMPLY X ARNCLE 6 OF THE CITY
REVISK)NS !nrn!
ir.
FO8M ' ttC
install
TO COMPLY WM{MUTCD.
PERMIT NUMBER: Stpe"u*c4_ 4(Ot Zlqq
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013 Spra. to Bon / Jrct / No A.C. cur.
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Ol6 No $tahwork rllowrd.
010 bt.r.l out. to hrvr control d.ilW tlll.01, Cutr to b! polymcrlrrd cruct ulrd lor lhal lnrpcctlon.
018 Mlnlnum 2' crurhcd rock I'mlnut.
Comments:
IUNUS
EO8NNG CrrY CODES AND lt, .rMpLtiANCE WTH CUBRENT +
S*- {, chrrrncr ll rny polnt, twing.rwoy.
lonc'.rt. mlnknur .1. d.pth. B,OOOprt.Tnndr to b. T. our. ;N.!dr 8trt. / Counti ptrmlt.
I:-:lr-rj^?py{ rnctortngr tn rtdowrtk or handtcap rrmpr.uramond Anl rt.C./Concrcta valua boxl to grrdc.Fnrh Oll rlgnr I Gndod.
Comply wlth Arntrlcrnr rvrth Ot.!bt,rr,., Acr.
Concrrtr dtbt, 72ht* ourlng tlnrt. 46ooprt.
Concntr rlrbr rrquln folnt roal mrtcdrl.
Ddvrwry nqukrr dow.lr rvrry t8'.
Submlt tnfllo contrgl plrn prlor to cxcrvrtlon.
Notlly Tolflo Dlvldon bclorc rxcavctljn,
Murt comply wlth thr grovlrlonr o, ORS 757.541 to 767.671.
6' Orcuht holr/H2OVro.
l.
rHE LANE unLdiE6^Ub"8HbifuthNc couNcrL's"oNE CALL NUMBER" 1-800-332-2344
48 HOURS BEFOBE DIGGING
INSPECTIONS:
'O cuna cdr aHo stDEwALK tNspEcnoNs cALL zzs.s76g (REcoRDERI srATE youn DESTcINATED crry JoB
NUMBER/PERMIT NUMBER, JOB ADDBESS, TYPE OF INSPECTION REOUESTED, AND WHEN YOU WILL BE BEADY FOR
INSPECTION, CONTRACTOR,S OR OWNER,S NAME AND PHONE NUMBER. REOUESTS RECEIVED BEFORE 7:OO A.M. WILL BEI MADE THE SAME DAY, REOUESTS AFTER 7:OO A.M. WILL BE MADE THE NEXT WORKING DAY. INSPECTIONS ARE TO BE
CALLED lN AFTER EXCAVATIONS ARE MADE AND FORM *98K. rS rN PLACE BUT PRIOR TO POURING CONCRETE.
I sarureRy sEwER, sronM sEwER, ENcRoAcHMENT pERMtr AND orHER tNSpEcIoNs cALL ctry MATNTENANcE AT
728,a781.
are requ&ted al the propar tims, that prolect address ls readable from th6 street,
at all tim6s durlng cohstruction.'
SIGNATURE:
I have
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thlc
,.
Slgnature,
the and
to
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tnvthi
RECEIVED BY:
I furthor rorcc to on8urc
and the ap-proved set of
Date
AMOUNT RECEIVED:
RECEIPT NO:
F
DATE PAID:
F4'
VALIDATION:fl-fl
E penrur tssuED BYi
FOB SIDEWALK AND CUBB CW PERMITS PLACE A COPY (COMPLETED) IN PERMIT DMWER.
AT TIME OF COMPLETION:
--DATE:
U
I
I
I uerrurENANCE :
I rNarrueERrNG REVTEWED BY:
I rnarnc REVTEWED BY:
ELEVENIH
OEPOSIT BETURNED:DATE:
DATE:
DATE:
DATE:
DATE:
INSPECTION:
' tttspEcloN:
DATEI
WORK IN PROGRESS
0r9
020
02r
o22
023
o24
026
02A
o27
028
02s
030
03r
032
933
343