HomeMy WebLinkAboutPermit Land Drainage Alteration 1999-07-27Thls permit ls required for any slte actlvity in the flood pfifty (50) cubic yards of materiar or more and/or if a drair
laln and everywhere site alteration conslsts of
nageway is affected, within City limits and
This Side To Be Filled Out by Appticant
Permlt Explration Date:
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Date of Applicatlon
Phone:
Sito Address:Sprlngfiold, Oregon
Proparty O
Address : .
Tax Lot:5m/
Journal number applicable Land Use Appllcation
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Phone
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Source Location
Destination:
Project Supervisor
Supplier
Address
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DRAINAGE, POLLUTION AND EROSION CONTROL PLAN
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CROSS SECTIONS,
SOILS & GEOLOGY PLAN,
ADD]TIONAL TNFORMATION,
REPLANTING PLAN
COMPANY NAME: ,
PHON
CITY STATE
PHONE
CITY STAT
1f,).r1 .}COMPANY NAME:
PROJECT SUPERVISOR:
ADDRESS:
PROJECT SUPERVISOR:
ADDRESS:
Registration Number: ZZ*1/ ,
, CITY:
MOBILE PHONE:-, EMERGENCY PHONE:
ZlP:
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Expiration Date:
PHONEPROJECT SUPERVISOR:
CONTRACTOR NAME:
ADDRESS:
STATE:
l.understand that l.or my succossors may.have future p_lans for.my property which may ba anticipat€d or unanticipated atthis timo. I understand that suc-h future plans may require permits and devClopement aiprovals fiom tho City of Sprinsfield.I understand that notwithstanding any approval of this Land and Drainage Altbratlon Pdrmlt (LDAP), that at ihe tirire oiapplication of future permits.or-approvals the City may reviow and reconsidsr all actions which loi'my successors have
undortaken porsuant to this LDAP. I understand that the City may as I condition of any future approvbl, require thoundoing, changing, or modification of any actions which I hivo uhdertaken as I result bf the City's appiovai of this LDAP,
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By signature., I stat-e and agree, that I have carefully ex-amined the completed application and do hereby cortlfy that allinformation herein is truo and_ corr-ect, and I further'ceriify that any and all work'performed shall be Ooie tniicorJinJewlth the ordinances of the Clty of Springfield, applicable'City Standard specifications and orawinss, inO inJiawJ oi ttroStato.of Oregon p-o!!i!['g to_the.work described herein. I fuither certify that only contractors ana-e'mptoyiee wnL aid incompliance with ORS 701.055 will be used on this project.
The City may inspect tho wotk site described in this permit at any timo during a ons yoar perlod followins the receiot bvthe City of notlce ol completion of tho described worlt and specify, at the City'a sole'desicratlon, any ad-ditional reitordtionwork required to return the site to a standard acc€ptable to the City. The perrirlttee will be notlfied ln'writino of anv work
required and will have thi(y (30! days from the date of tho notice to complete tho work. Work not complet6'd at th'e end ofthe thirty days will ba performed by ths City and the costs will be billed t6 the pormittee.
aro roquested at the propor timo, that proiect address ls readable fromon th6 sito at all timos durlnE constructioh,
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DRAINAGE, E Storm,E Ditch, E Culvert, O Natural
WETLANDS, Doscription
FLOOD PLAIN, Zone:
--T--FLOODWAY, FEMA Community Panel No.:
X , FEMA community Panel No.:
s30.o0
930.O0 For tho first 1OO cubic yards, plus
$1 4.OO for each additional 1 0O cubic yards or fraction thereof.
$156.00 For tho first 1,000 cubic yards, plus
$1 2.OO for oach additional 1,000 cubic yards or fraction thereof.
$264.00 For ths first 10,000 cubic yards, plus
$54.00 for each additional 1 0,000 cubic yards or fraction thereof.
$750.00 For the first 100,001 cubic yards, plus
$30.OO for each additional 1 0,000 cubic yards or fraction thereof.
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Date:
Yn Date:
-tffiReceipt r,to, O b 5Z{Loutu g
Received
100,001 To 200,000
2OO,OO1 CUBIC YARDS OR MORE
Estimated Volume:
Plan Check Fee:
Grading Permit fee:
Received by:
Receipt No:_
Date:
PLAN CHECK FEES:
UP TO 1OO CUBIC YARDS
1O.t TO l,OOO CUBIC YARDS
1,001 TO 10,000 cuBlc YARDS
1 0,000 To 100,000 cuBlc YARDS
GRADING PERMIT FEES:
UP TO lOO CUBIC YARDS
101 TO l,OOO CUBIC YARDS
1,001 TO 10,000 cuBlc YARDS
1o,ooo To l oo,ooo cuBlc YARDS
roo,ool To 200,000
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Maintenance:
Building:
Engineering
Planni
Date:
Date
Date: n-Z-: r/1
-Date:lssued by:
Date:
Perm it Number
Required Final lnspeetions'
Maintenance:
Date,
Date
Planning:
Engineering:
Building:
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5 Land and Dralnage activlty.as outllnsd ln thla permit has been complotsd ln accordanco wlth
the provieiona olthie perririt.
hr1#,111.p%ilgp"q.,tr%?,lyll,Jf&ffy,,li"ed in this permit has not been completed in accordance
tr Land and Drainago activity was performed prior to application for this permit.
Accepted by:--- Date:
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AMBLESIDD MEADOWS SUBD.
This property is located in an area ofheavy clay
soils (expansive clays). A licenscd cngineer shall
vcrify the stability ofthe soils in the proposed
building arca and make any recommendations
ncccssary to assurc tltc continued stability ofthe
soil. A copy ofthe cnginccr's report shall be
submittcd to the Iluilding OIficial prior to
bcginning construction of thc structurc.
1/6/1998
$20.00
$30.00
$40.00
$40.00 For the first 1O,000 cubic yards, pfus
$'2O.OO for each additional 1O,O0O cubic yards or fraction thereof .
$220.00 For the first 100,001 cubic yards, plus
920.OO for each additional 1 0,000 cubic yards or fraction thor€of'
$340 For the first 200.001 cubic vards, plus
$6.00 for each additional 1O,OO0 cubid yards or fraction th€r€of.
:
ide To Be By lity
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