HomeMy WebLinkAboutPermit Sidewalk 1994-1-19
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RESIDENTIAL - COMMlrC1AL
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SPRINGFIELD
225 NORTf-I FIFTf-I STREET
SPRINGFIELD, OREGON 'il1411
ENGINEERING DIVISION
OFFICE NO. 126-3153
INSPECTION LINE, 126-316'i1
JOB ADDRE&e. It j. '1 -fJ/ ~J'l-
ASSES!;oRS MAP NO.*' \ 1 _ (''1'1--, - '2-5, '7J'Z-- T AX LOT NO: "* i 4- 'Z..60
SUBDIVISION,
- I/O ( )
~R. ,,~ p (2?Jpe
t.DDRESS, Ie,:l r; ~(~(f-
STATE, Q-( ZIP, 97'177
RECE IPT NO,
\l410
CA5f.I
v
Cf-IECK
CITY, JI')../J
F'f.IONE NO. 7J1t - 7,S'G,l-
"* ./
Cf.IECKED FOR DELINQUENCIES _
ll..IORl< DE5C~IPTION.
S!DEUlALK, 1
CURS-CUT:
CU!'9 SIDE
RESIDENTIAL _
SETBACK _
Co:1MERICAL _
SECOND DRIVEWA.,.. I SEE TRAFFIC)
REQUIRES AF'F'LICATION FOR A SECOND DRIVEWA.,..I"T-4.1a)
OR A COUNTY .4F'F'LICATION FOR FACILIT.,.. PERMIT IC 'iIe-2"3)
IF IN Tf.IE U.c..s.
SIGNED,
12fft1N\
l - \'1. - '14-.
DATE OF AF'F'LICATION
)-19-9 ~
DATE:
WORK TO BE FEFa"u"", ,,::D BY:
CONTR.4CTOR"* dtJj~ C! ::/..- P ll,
ADD!=C:.S:S
Oll.N.ER
V CONTRACTOR
"*
REGISTR.4TION NO. ."i I <+ S<'1i:'
EXPIRES:
PHONE:
r-__....cOURE FOR INet='l:CTION REQUEST.
CALL 1;6-316'i1 lRECORPER ) STATE .,..OUR CITY DESIGNATED JOB Nu:-iBER, JOB ADDRESS,TYPE OF
INSPECTION REQUESTED A'lD UJ;-lEN ""OU WILL BE READ.,.. FOR INSPECTION. CONTR.4CTORS OR OUNERS N.4ME A'ID
Pi-lONE NUMBER. REQUESTS RECEIVED B::rvr= 1,"" .4M WILL BE MADE Tf-I: SA'1E DA.,.., REQ'JESTS -'<'TER 1,00
AM WILL BE MADE Tf-IE NEXT UJOR<ING DA.,..
'" SEE BOOK
EXISTING BUILDING PERMIT NO. I IF AF'F'LICABLE )
.,..OUR CITY DESIGNATED JOB NO. Isf C\4-60.sP,
REQUIRED INSFl:CTIONS
D
SIDEWALK I DRIVEWA.,..
FOR ALL CONCRETE PAViNG WITf.lIN
Tf.lE STREET RIG;.IT OF WA.,.., TO BE
MADE AFTER ALL EXCAVATING
IS =MPLETE AND FORM WORK
A'lD SUB-BASE MATERIAL IS
IN PLACE
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CU!'9 I AF'F'ROACf.I APRON, I
AFTER FORl"1S ARE ERECTED '
BUT PRIOR TO POURING
=NCRETE.
FEES:
SIDEWALKS
.10.00 + .0.15/LF. ( X )
OF WALK
CURB-CUT
.10.00 + ~.15/L.F. ( X )
WALK X'
TOTAL Fl:RMIT FEE:
s
I\~
COMMERICAL DRIVEWA.,..S Sf.lALL
;.lAVE S' TO &' FLAIRS
3'. 0" 5Th"'lDARD
/
t q,l X'
.,
"'"
J.
I f.I"-VE C"-REFULL.,.. EXA'1INED TI-!E COMf"LETED AF'F'L1CATION FOR PERMIT, -"'lD DO ;.IEREB.,.. CERTIF.,.. TI-!"-T -"LL
INFORMATION I-!EREON IS TRUE A"D CORRECT, A'ID I FURT;.IER CERTIF.,.. Tf.I"-T "-".,.. -"'lD -"LL WORK PERFORMED
Sf.lALL BE DONE IN "-CCORDANCE WITf.I Tf.lE ORDIN"-'lCES OF Tf.lE CIT.,.. OF SPRIN""'IELD. -"ND TI-!E LAWS OF Tf.lE
ST"-TE OF OREGON PERTAINING TO Tf.lE WORK DESCRIBED f.lEREIN. h'lD Tf.lAT NO OCCUPA'lC"" WILL BE MhDE
OF h""" STR..!CTURE WITf.lOJT PERMISSION OF TI-!E BUILDING DIVISION. I FURTf.lER CERTIFY T;.IAT ONL.,.. CONTRACTORS
h'lD EMPLOYEES Wf.IO ARE IN COMPLIANCE WITf.I ORS 1"I_S WILL BE USED ON TI-!IS PROJECT.
?/J""40 (}OJ}P~f_
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