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HomeMy WebLinkAboutPermit Sidewalk 1994-11-22 !i/~O ~5IDENTIAL - COMMERC::I~L _. SIDEWALK I CURflCUT . - AFf'LiCA TION I PERMIT . 22:' NORTI-l FIFTI-l STREET SPRINGFIELD. OREGON ':>1411 ENGINEERING DIVISION OFFICE NO. 126.'1:" INSPECTION LINE, 126.'16':> JOB ADDRE55. /40.S ASSES50RS MAP NO.*' 17 SUBDIVISION, (YIe PVtelt-SON 0'3> 27 #1- CA5I-l CI-lECK TAX LOT NO: *' J D 0 RECEIPT NO, 1 S-~bl:f- OUNER, H A (. S A ADDRESS, .:( 0 () UJ STATE, Of.I=. frotJ ll.IOFK DESCRIPTION. ...-- C'TY'S"f;-;" Ji.e.lJ PrlONE NO.~ *' CHECKED FOR DELINQJENCIES ,/ Falr-v/c:ul ZIP, W7477 SIDEWALK, CURS SIDE _ CURS-CUT, /' RESIDENTIAL _ SECOND DRIYEt:JAY (SEE TRAffiC) REQUIRES APFLICA,ION FOR A SECOND DRIYEWAY('T.4.1.) OR A CO\JN7Y APP'~ICA71ON FOR FACILITY PERMIT (C ~.20') IF IN TI-l= Uc,.9. 5:::TeACK _ CO:-r.-ERICAL SIGNED, DATE: DATE OF AFf'LICA71ON II ftJ./qLJ lLIOf'K TO BE FERrvl'Q .:D BY, CON,RACTO;=;!*' srATolJ CuASt. TI'lc.. ADDRESS ~Cf39<f ~J? Ai "por-t 'Rd.. PROCEDURE FOR IN&FECTION REaJE5T. 'X... CONT~C70R OUN..:R REGIS,RATlON * NO. 03371 '{l.!::fQ:1 ' E''''{EMP; OEr. J3d~ I' - zZ~9";/ =XPlRES,.? /;).,1 q.'J- . . P;";ONE, ~"-os~ Ct..LL 12b~~ib~ (RECORDER ) ~)TATE YOUR CITY D::5Iu~AT::D Joe Nw:-19:R, .J05 ADDRESS,TYPE OF INSPECTION REQUESTED "'''D WHEN YOU t:JILL 6E READY FOR INSPECTI0<. CONTRAC,ORS OR OUNERS NAI'1E "'''D . P~E Nu."15ER. R:Q'JESTS R:CEIVED BEFORE 1:"~ t..""'i WILL 5: MADE it--I= SA""'i: DAY, REQUESTS ~TER 1:0" AM WILL SE MADE ,HE NEXT WORKING DAY '" SEE BOOK EXISTING SUILDINc:.. PER:'1IT NO. ( IF APPLICA6LE ) YOUR CITY DESIGNA,ED JOS NO. Isf q 41 7~5 D mURS I APPROACI-l APRON, AFTER FORMS ARE ERECTED BUT PRIOR TO POURING CONCRETE. REQUIRED 1N5FECTION5 SIDEWALK I DRIYEt:JAY FOR ALL CONCRETE PAVING WITHIN TI-lE S,REET RIGI-lT OF WAY, ,0 SE MADE AFTER ALL EXCAYA71NG IS COMPLETE A"D FORM WO;:;!K AND SUEl-SA5= Mt.TERIAL IS IN PLACE FEE5, SIDEWALKS 110.00 . 10.1!:>/LF. ( X ) 0;= l!JALK CURB-CUT liO.OO + lO.i!:>/L.F. ( X )I(P TOTAL FE~IT FEE. ~ /':).'-10 GO:'1MERICAL DRlYEWAYS SHALL Ht.YE !;' TO 8' FLAIRS ,'. O. ST"'''DARD WALK x' / J X' "" I- " ! i-IA\IE CAREFULL.,... EX~"1NED T~E COMPLETED '!"FPLlC~ i'10!'-l FOR F'ERM1T, ":"'JD DO i-IERE6Y CERTIFy 7l-1.!. T ":;'LL !N;:O~ATION l-lEREON IS TRJE A~D CORRECT, A'JD I FURTH::R CERTIFY Tr--I.L.T "=""'1" ~~D ':"LL lliOR<. PE~O~ED S,"ALL BE DONE IN ACCORDANCE WITI-l THE ORDN-'-,"CES OF THE CITY OF SPRI,"GFIELD, "-ND TrlE LAU.S OF THE STATE OF OREGON PERTAINING TO Tl-lE WO~ DE5CRI9ED p.;EREN, :"'\!D Tt-lAT NO OCCUP.t..NCY WILL 5E M.!..DE OF ANY STRJCTURE WITHOJT PERMISSION OF THE BUILDING DIVISION. I Fl;'R,:";ER CERTIFY ,HAT o.-IL Y CON,RACTORS ,~ ~~=:: .~'~o, "" - ,.,~, "" "' "''" ~ '"D1SAPRTE O~~C;~ ~ / () J SIGNED - . ~