HomeMy WebLinkAboutPermit Sidewalk 1993-09-10ll/zo F=gIDENTIAL - COIIIIF:CIAL
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APPLICATIOhI / PERHIT
SPRINGFIELE,
225 NORTH FIFTI{ gTREET
9PR|I.{GF IELD, ORE60r.l 3141'I
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IN9PECTION LINE:'126-3'169
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RECEIPT NO:.ls8l
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CHECK 4
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C+{ECK,ED FOR DEL NAUENCIEg
9lGl.lED:
DATE'
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4 li=
IIJOFK DEOCRIPTI6I:
gIDEI.IJALKT CURE SIDE
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CURB.CIJTI _4 RE9IDENTIA 4 COF1FIERICAL
-
9ECOhID DRIVEII,IAY ( gEE TRAFFIC )
REaUIRE9 AFPLlCATlotl FOR A SECOND DRt\Gr!Ay(T-4.1.)
OR A COLNTY APPLICATIOT.I FOR FACILITY FEFHIT G AA.2O1)
IF IN THE UG"B.
DATE oF AppLrcAror.r 4u4, t4 ,49V
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EXPIRE9'
ADDRES9 PI-IONE:
P@EDUFE FoR tNgFEcTloN RE6[lE9Tr
CTLL 12e--1169 (RECORDER ) STATE YOI,,F CITY DESIGNATED JOts NIJT1BER, JOB ADDRE99,TYPE OFINgPEcrloh,l REouEgrED AlD IIHEN You u,lLL BE READr FoR lNgpEclotl, ciT.lrRAcroRg oe ouNens NAME AIDPl-iot'lE NtHBER- REaUEgTg RECEI\GD BEFoRE 1,oo kl tUlLL tsE IIADE THE 9A1E DAy, REaUEgTg AFIERlzal@Al'l UILL BE MADE THE NEXT II,loRKI}.IG DAY
EXl9TltlG tsr,llLDll.lc PERtltT NO. ( IF APFLICABLE
.il(YOIIR DESIGNATED JOB rer -#4ffi?gEE tsOOK
REAUIFED IN9PECT]ONS 9IDEIUALK / DRIVEIUAY
FOR ALL CONCRETE FAVING I,UITI{IN
THE STREET RIGHT OF IUAY, TO tsE
MADE AFTER ALL EXCAVATI}{6
19 COI,IPLETE A]D FORT1 IIJOFK
AI.ID gUB-BAgE I1ATERIAL 19
IN PLACE
A)RE / APFRoACI{ APROtt,
AFIER FOFTIS ARE ERECTED
BUT FRIOR TO POURII.IG
COI.ICRETE.
FEE9' gIDEtUALKg
IUALK X,
TOTAL PEFI'IIT FEEr i /3,oo
)IO.OO+$O.]r9/LF.(X)
OF IUALK
+JO.\,/LF.(X)Za
COI-II"1ERICAL DRIVEIUAY9 9HAL
HA\G 5' TO A'FLAIRS
3'- @'STAIDARD
cuRB-CUT
I HAVE CAREFULLY EXAFIINED THE COI.IPLETED APF,LICA TIOI.I FOR FEFHIT, A}.ID DO HEREBY CERTIFY THAT ALLINFORI.IATIOhI HEREON 19 TRIIE AND CORRECT,, AlD I FURTI]ER CERTIFY THAT At.lY AID ALL IIOFK PEFFORI1ED5I]ALL BE DONE IN ACCORDANCE IUITI-.I THE ORDINAICES OF TI]E CITY OF SPRINC#IELD, AD TI{E LAI,I3 OF TI{EgTATE OF OREGON PERTAINING TO TI]E UTCRK PS96RIBED HEREIN, AND T,HAT NO OCCUPANCY IUILL BE HADEOF ANY gTRLICTURE IUTTHOUT PERI1I59 lor.l oF THE BU|LDINC DtvtgtoN. I FURTI{ER CERTIFY TI]AT ONLY CONTRACTOR9
USED ON TI]I3 PROJECT
7-to*7
A}.]D EHPLOYEES I.U-.IO ARE IN col"lpLlANcE tutTH ore 1@to>> u]tLL BE
DATE
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