HomeMy WebLinkAboutPermit Curb Cut 1992-8-21
22" NORTH FIFTI4 !>Tl<EET
. !>f'RIIoIGFIELD. OREc.oN ':>1411
ENGINEERING DIYI!>ION
OFfiCE NO, 126-31,,3
IN!>PECTION LINE, 126-316':>
4
~~I~j;:;I"l1 ,.....1- - '-'VI II
!>IDEWALK I CUReCUT
AF'PLICATloN I PE~IT
SPRINCFIELD
II"""
JOB ADDI"E5&, /5'/0 /J1A12-kET
A!>!>E!>!>OR!\ MAP NO,* (7 - 0:3 .-"25 - '3 '3
&lBDIYI!>ION,
Ij;:;~'-'I""'I- .
-'
TAX LOT NO."* 2. 7/00
RECEIPT NO, CJo<;;o<r3
CA!>I-l
CI-IECK
......--
OUNERo Ct7Y
ADDRE!>!>, 2.2. 5
!>TATE, o;2e,
Or 7/J~//J0FfELD
'5"171 sr, CITYS;>k!./;U0F/Et.D
ZIP, f 74177 PI-lONE NO,
*'
CI-lECKED FOR DELINQJENCIE!> .::::::::
!>IDEUJAl.K. CURB !>IDE _
CURB-CUT, v-- RE!>IDENTIAL _
!lECONP DRIYEWAY (!!>EE TRAFFIC)
REQUIRE!!> APPLICATION FOR A !lECONI:> DRIYEWAn.,.-4.1a)
OR A COUNTY APPLICATION FOR FACILITY PEf<MIT (C ':>8-203)
IF IN TI-lC U6B.
WORK DESCRIPTION.
DATE OF APA..ICATION cP -/2 -"'(2-
WOIO!K TO BE F'E1O!Fv..... u::.D BY.
CONTRACTOR * ~,e '( A, .5411711
ADDRE!>!> t:? ~ )/, t:? 77f '3 T.
!!>ETBACK _
COMMERICAL. ~
!>ICONED,
DATE,
~~
C,-/;t!'-92.
.----
OUNER CONTRACTOR
REGI&TRA TION NO.* 5' ( 48'23
5/~/AJ~FI€UJ 97477
EXPIRE!!>, ~//7Z.
P..1ONE, 747-8'34-3
/
r""",,-,,,,,,,;JFiS FOR IN&R:CTION REGlUEST.
CALL 126-316':> (RECORDER) !!>TATE YOUR CITY DE!!>IGNATED JOB NUMBER. JOB ADDRE!!>!>.T'1'PE OF
IN!!>PECTlON REGlUE!!>TED AND Il.I-IEN YOU WILL BE READY FOR IN!!>PECTION. CONTRACTOR!!> OR OUNER!!> NAME A"<D
PI-IONE NUMBER. REGlUE!!>T!!> RECEIYED B"r~N: 1,00 AM WILL BE MADE TI-IE !!>AME DAY. REQJE!!>T!!> .oFTER 1,00
AM WILL BE MADE TI-IE NEXT UJOf'ilCING DAY
.--
*' !lEE BOOK
EXI!!>TING 6UILDING PEf<MIT NO, ( IF AF'PLICA6LE )
YOUR CITY DE!!>IGNATED JOB NO, ,!!>f '7 2. 0 2:S 34-
&IDEWALK I DRIYEWAY J}1tfAlo/CA-f' ft~.REl v APPROACI-I APRON,
FOR ALL CONCRETE PAYINc;, WITI-IIN AFTER FOf<M!!> ARE ERECTED
Tl-lE !!>TREET RIc;,I-IT OF WAY. TO BE 6UT PRIOR TO POURING
MADE AFTER ALL EXCAYATING CONCRETE,
I!!> COMPLETE AND FORM UJOf'ilC
AND &lB-BA!!>E MATERIAL I!>
IN PLACE
REQUIRED IN&R:CTIONS
D
~Aq;S:::: jfJftVtJ/~ ,eMf? ~
.10.00 + .0.15/LF, ( X) ID" .10.00 + ~.I5ILF. ( X )
OF WALK
FEES.
TOTAL FEF<MIT FEE.
~
/1. 5'0
COMMERICAL DRIYEWAY!> 51-1ALL
I-IAYE ,,' TO e' FLAIR!>
3'.0" !>TA'IDARD
WALK x'
/ ""
I, x' I,
" "
I :-IAYE CAREFULLY ExA'1INED TI-IE COMPLETED AF'PLICATION FOR PE~IT. A'ID DO I-IEREBY CERTIFT TI-IAT ALL
INFOf<MATION I-IEREON I!!> TRUE A'lD CORRECT. A'lD I FURTI-IER CERTIFY TI-IAT A'IT A'ID ALL lOC)RI( PE,.,.~", ,,,D
&HALL BE DONE IN t~~~~A!'oICE Wlil-l TI-IE ORDIN"-'1CE5 OF TI-IE CITY OF 5PRINc;FIELD. AND TI-IE LAl!J5 OF TI-IE
STATE OF OREGON PERTAINING TO TI-IE UJOf'ilC DESCRIBED I-IEREIN. -'ND TI-IAT NO OCCUPA"<CT WILL BE M"-DE
OF "-NT &TRJCTURE WITI-IOJT PE~I&&ION OF TI-IE 6UILDING DIVI51ON. I FURTI-IER CERTIFT TI-IAT ONLT CONTRACTOR!!>
"''1~PLOTEE5 Wl-IO COM ANCE WITI-I OR!!> 101~" WILL BE U5ED ON TI-I15 PROJECT,
/. fr-I'--1"-
&~~ .
DATE