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 - . ~