HomeMy WebLinkAboutPermit Land Drainage Alteration 1999-05-27Thls Slde To Be Filled Out by Applicant ,:.
This permit is required for any site activity in the flood plain and everywhere site alteration consists offifty (60) cublc yards of material or more and/or if a dralnageway ls affected, wlthln Clty llmits and
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Permit Expiration Date: ''
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Property Owner
City
Date'of Appllcation
Address :
Site Address:Sprlngfiold, Oregon
Zipq4&
Phone:
Journal number applicable Land Use Appl
Tax Lot:2y'oo
ication
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EXCAVATION, Ouantity em 1t l-<- Destinatlon
Source Location
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FILL, Oua
GRADING, Oua
Supplier
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Phone
Supplier:
Address
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cRoss sEcTtolts,
SOILS & GEOLOGY PLAN,
DRAINAGE, POLLUTION AND EROSION CONTROL PLAN
ADDITIONAL INFORMAT]ON,
and
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BEPLANTING PLAN
PHONE
CITY STA
PHONE
STATCITY
COMPAMY NAM
COMPANY NAME:
PROJECT SUPEBVISOR
ADDRESS:
PROJECT SUPERVISOR:
ADDRESS:
ztP: a " " 37 oFFtcE pHoNE3jH6 L?
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CITY: O^a uo- I l)'sC),oy Zo+
FAX s
EMERGENCY PHONE: 46 7
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Expiratlon Date
MOBILE PHONE
STATE:
ADDRESS:
CONTRACTOR NAME:
PHONPROJECT SUPERVISOB:
Registration Number:
I understand that l'or mv succo8sors may have future_plane for.my proporty whlch may bc anticipated or unantlcipated atthis timo' I understand thariuitr-tritu;,iljl,iiii-,nlviequire permits'aho iivitopement_aiprovaiiiiom ttre city of Sprinsfield.I understand that notwithstandins any a'ppiovat o? ihii-L;,ia-;;A-d;il.se Xiappricaiiln'ot iri,'ii il'i"it'.o-r alplolarS-t'ne c'iry- ,n"y reviow and iCC;;io;ItifitlH,f;lTh[tPi5]';?t:rT*".ii,Tiii;undertakon persuant io ttrts.loeFli unairi-iano ihit th" iiti rni;;;;;il'iuil;6;i'fi;'iil,'ililairi'.ib;;;';;,y',,EiiLi.I'irni;r, ii,i,i,hii'n-,iffigT,3lrr'i[lllTt,ilPJ";X;*:,,l,.,lllSrr^,
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fli.1,'g:tl"1td,:l"ti? ilI1""tl3t;"t}3L',1'"',;i,i1'*[:11, examined the completcd-applcatlon rnd. do hereby ."rtiry tr,.t .rrwith the Ordinancos of thsi;i;;id,"1,ffi;-q,",!;r$:$"::-$rfti":,r*rrtif,lliilii:lll*#kh*1"[ifl{#i*fi111'##lffiT:q;
comptiance wirh ORS 70i.06E wil Or ucid on tntr prcjsct,
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IJ}'f,lty:nv-]1999t tnc work ttto dsccribed tn thts pormtrtn€ srry or nouc! ot complrtlon of the deccrlbeO woik-Cni'yg1!, 11cu i r9o to return rtie iif,i- to a iia noaiil-i.-.iot. or. to
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$i1B! [i,!lTliT: ll?ffi:t.work not oomprilio it]rr,r iii or
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DRAINAGE, EStorm,0D itc , E Culvert, Cl Natural
WETLANDS,
FLOODWAY, FEMA Community Panel No.:
FLOOD PLAIN, Zona;FEMA Community Panel No.:
$20.00
$30.00
$40.00
S40.00 For the first 10,000 cubic yards. plus
$2O.OO for each additional 10,000 cubic yards or fraction thereof.
$220.00 For tho'first 100,001 cubic yards, plus
$2O.OO for each additional 10,000 cubic yards or fraction thereof,
$340 For th€ first 200,001 cubic yardc, plus
96,0O for each additional 1O,OOO cubid yards or fraction thereof.
930.OO
130,00 For the first 100 oublo yrrdr, plut
$14.00 for each additlonal 100 cubic yards or fraction theteof.
e156.OO For the firct 1,0O0 oublo yardt, pluo
4t2.00 lor..oh.ddltlon.l l,0OO oublo yerdr or tt.otlon thar.of,
t264,00 For the first 19,000 gublc y.rdt, plur
it1.00 lot eaeh eddltlonal 10,000 cublc yards or tractlon thtruof ,
$750.00 For the first 100,001 oubic yards, plus
a3O.OO tor ..oh rddlrlon.l tO,OOO oublc y.rd. or ft.otlon th.r.or,
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Receipt No.!i4-257
Date
Receipt No:oV,tbbf o"t",blL+q1
Received By
50c
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2OO,OO1 CUBIC YARDS OR MORE
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Received by:
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Estlmated Volume:
Giading Permit fee:
Plan Check Fee:
PLAN CHECK FEES:
UP TO lOO CUBIC YARDS
101 TO 1,000 CUBIC YARDS
1,001 TO 10,000 cuBlc YARDS
.10,000 To 100,000 cuBlc YARDS
100,001 To 200,000
GRADING PERMIT FEES:
UP TO lOO CUBIC YABDS
101 T0 1,000 cuBlc YARDS
1,001 TO 10,OOO CUBIC YARDS
1o,o0o T0 100,000 cuBlc YABDS
10o,oo1 To 20o,oo0
ng:
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tr Maintenance:
Engineering
Date:
Date
Date:
Date:
{ Plannin
Date:
Date:lssued by
Date
ReqJrired Final lnsf'eetions'
Permit Number
Planning:
Engineoring:
Building:
Date
Date
O tf3.rfly"Br,iiTfinir"Hi,H,i:
outlined in this permit has beon completed in accordance with
tr ufil$,1{tdfr53[p"q.".%?tiyigf3,3..y,,]i"ed
in this permit has not been completed in accordance
tr Land and Drainage activity was performed prior to application for this permit.
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't16/1998
Sicle To IJe Fil By City Staff'
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