HomeMy WebLinkAboutPermit Curb Cut 1996-05-28I Da D1 T
DATE ISSUED:
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0PERMIT NUMBER:INSPECTION LINE SEE INSPECTIONS ON BACK SIDE
APPLICATION DATE:
225 FIFTH STREET
ENCBOACHMENT PERMTT
NUMBER:
SPRINGFIELD, OREGON 97477
ENGINEEBING DIVISION
oFFtcE TELEPHONE (503) 726-3753
LOCATION OF WORK
PHONE
EXPIRATION DATE:
PHONE:
o
ZIP:
|: r/-,.
7'
04 ryf?ZT
DD
PHONE:
PHONE:
ZIP:
n/(
'7-ff
CITY STATE:
APPLICANT
STATE
CONTRACTOR
ADDRESS
TAX MAP:
TAX LOT:
SITE A
CITY;
SUBDIVISION
OWNER:
CONTRACTOB BEGISTRATION NO
PROJECT SUPERVISOR:
REOUESTED PERMlTS:
INSPECTIONS FEOUIRED:APPLICATION FEE / OEPOSIT ACCOUNT NO:
CITYOFSPRINGF P ITA ICATION
f erucnoacH[/tENT pERMtr No: .....
VALIO FOR SIXTY {60I OAYS FROM DATE OF ISSUANCE
I ousr coNrRoL (TypE oF coNTRoL)
I corusrnucloN, sroRAGE, srAGtNG
I orxen
I aseHelr DEpostr
TYPE OF SECURITY DEPOSIT
BLANKET SURETY BoND E SURIITY BoND E cASH / cHEcK
CURB C'UT PERMIT NO:FT . )L/
earod ro pouRtNGlNsPEcrroNr CURB / APPROACH AFTEB FORMS ARE ERECTED BUT
E $20.00 /
E$
tr
tr
tr
E$
$
$
$
VALID FOR 180 OAYS FBOM OATE OF ISSUANCE.tr SECOND DBIVEWAY (SEE SEPARATE APPLICATION)
I sroewnLK pERMtr No:.................... FT.
VALIO FOR 180 OAYS FROM DATE OF ISSUANCE.
[ rurw l] REMovE / REpAtR fl PAVE PLANT srRtp
Q serencx ll cURBSIDE
CONCRETE.
WTHIN THE STREET RIGHT OF WAY, TO BE
FROM DATE:
TO DATE:
E 910.00+$.1s/FT.4
E $1o.OO+$.1s/FT
NsPF.rrnN. SIDEWAIK / ORtVEWAy FOB
E LENGTH
ALL CONCFETE PAVINGMAOE AFTER ALL EXCAVATING IS COMPLETE, ANO FORM WORK ANO SUB.EASE MATERIAL IS IN PLACE.tr SANITARY SEWER CONNECTION PERMIT:
VALID FOR SIXTY (60I OAYS FROM OATE OF ISSUANCE
I ro srus E MAtN L|NE (EASEMENT-R/W)
f sronu sEWER coNNEcloN pERMtr:
E oTHER
VALIO FOR SIXTY (60) OAYS FROM DATE OF ISSUANCE
Q carcH BASTN / BUBBLER E STUB E MA|NL|NE
PRooF oF INSURANCE: $5OO,OOO MtNtMUM
Q erracxeo E REoUIRED AMouNT
DESCRIPTION OF PROJECT
PERIOD OF USE OR TIME OF CONSTRUCTION:
tr PLANS (TWo sETS) ATTAcHED.
Tl $5.O0 /.l
Tl ss.oo /U
TOTAL DUE: $
TOTAL DUE WITH PERMIT $ fi
TIME:
TIME:
DEPTH:HEIGHT
AREA: LENGTH TWIDTH:
TYPE OF WORK: CUT; e.roE.
OTHER:
EXISTING SURFACE MATERIAL:
BACKFILL MATERIAL TO BE UTILIZED:
SURFACE REPLACEN4TNT MATERIALS TO BE UTILIZED:
TYPE OF DUST CONTROL TO BE UTILIZED:
NAME OF OTHER UTILITIES IF THIS IS A JOINT PROJECT:
WARNING DEVICES TO BE UTILIZED:
Advanco signing end work zone piotoction to bs in compliance with the Menual on Uniform Traffic Control D€vices (MUTCD).DESCRIPTION:
WORK SHALL COMPLY WITH CHAPTER X ARTICLE 5 OF THE CITY CODE. CONTRACTOB TO
REVTSTONS 8t24195 FoRM
'
il6
COMPLY WITH MUTCD .
?74:7
ADDRESS:
PLAN REVIEW COMMENTS /SPE^!qL INSTRUCTIONS:
8FiL"rl{J'##P'tr^'#d^h5,'f*'8.89XJ[S#B'8.[8IU'
Backfill with 7r" minus rock.
Compact every 1 8' loose depth'
Requires compaction with a stoel rolller'
A.C. to match the graater of existing depth or 4"'
All cuts sealed for final inspection.
Temporary patch may be used at the end of the day'
Signing and Zone protection to comply with MUTCD
Cut concrete only on score linas or cold ioints'
Sidewalks and driveways min' 3,000psi'
Curbing min 3,500psi / No patchwork less than 3"
Mest min. requiraments on curb cuts, Spfd' code'
Restore planted areas, Spfd. code 206'3'O5
Spec. to Bore / Jack / No A.C. cuts'
Mechanical comPacting required'
No patchwork allowed.
Lateral cuts to havs control density fill'
Cuts to be polymerized crack sealed lor final inspection
Mininum 2" crushed rock %" minus'
EXIST]NG CITY CODES ANL . CI]IVIPTIANCE WITH CURRENT
001
002
003
004
005
006
007
008
009
010
011
012
013
014
015
016
017
018
019
o20
021
o22
023
024
025
026
o27
o28
o29
030
031
032
033
343
Minumum 4' clearance at any point, swing"away'
Concreta minimum 4" depth, 3,000psi'
Tronch to be "T" cut.
Needs Stato / County Permit.
No abovo ground enclosings in sidewalk ol handicap ramps'
Diamond cut A.C./Concrete value boxes to grade'
Fresh Oil signs / Graded'
Comply with Americans with Disabilities Act'
Concrete slabs, 72hrs' curing time, 4500psi'
Concrote slabs require joint seal material'
Driveway requires dowels every 18"'
Submit traffic control plan prior to excavatron'
Notify Tralfic Division before excavati5rn'
Core drill main line, insert tee, 2olo min' grade'
Must comply with the provisions of ORS 757 541 ro 757 571
6" Circular hole/H2O-Vac.
Comments:
THE LANE UTIL
"ONE CAL
YOU ABE REOUIRED TO CALL
ff iES"-Co-6 R Di N ATt ru-c- -c Q u N c I L' s
L' ruUNt-eER" 1 -8oo-3 32-2344
48 HOURS BEFORE DIGGING
INSPECTIONS:
SANITARY SEWER, STORM SEWER, ENCROACHMENT PEBMIT AND OTHER INSPECTIONS CALL CITY MAINTENANCE AT
726-3761tr
7:00
BNAEDTJCITYRYOUESIGDDBERTSTEoNSo7CALL(REC26-3769INSPECTIALKSANDIDEWRBCUCUT RREADFUBEENWIYOULLDWHDANESTENREOUoINSPECTIoFTYPEADESSDRTUMNBJOBMBER/PEBM ER,NU BWILL EMABEoF7RE00EIVEDRECOUREESTSEPHONUNMBERER'S AMEN NDARSoORWNoNTRACTCoSPEINCTION,qN AR oT EBANSPECTUWORKTGINDDEMAETHEXNALLBEM.AFTEBESTSREOUDAEMADETHSAME BNC TEERIPOUCNGnEUTRPRIOoTRKINSPLACFORMANDWOASDEREMAEXAFTERCATIONALCADLEN
SIGNATURE
RL3ifl'13\yt? ::l':"#33-:gl,Ti tli$Li3:?,i?i'sil;[%silH:fi [s,f "pT,q's,"i'q{38'it'[3?.s# ii"e:3t?!h%T'iiY,iii!'81[,'""J['.!""& 1n.
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project.
I furthor aoree to ensure that all required inspections are requested a.t th9 qro^q.ql1ime, that project address is readable from the street'
;;A i6; "p"pro;v;!;;iii dtin! witiiemiin ori the site at all times durins construction'
DateSignature
/U
(
,9-&9- "6
RECEIVED BY
DATE PAIDAMOUNT RECEIVED
RECEIPT NO:
VALIDATION:
'f
eenrutr tssuED BYi
FOR SIDEWALK AND CURE CIJT PERMITS PLACE A COPY (COMPLETED) IN PERMIT DRAWER
WORK IN PROGRESS
AT TIME OF COMPLETION:
ELEVENTH MONTH:
f-I rnnrrtc REVI
ff rrucrrueERlNG
EWED BY:
REVIEWED BY:
I n,tntrureNANCE
INSPECTION:
DEPOSIT RETURNED
DATE:
DATE:
DATE:
DATE:
DATE:
DATE:
INSPECTION:
I
DATE:
DATE:
DATE:
DATE:
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