HomeMy WebLinkAboutPermit Sidewalk 1995-6-15
Ii~O
..r=SIDENT~I~;ALK I ~~~~RCfAL
APPLICATION I PER:'11T ..
22:' I~ORTf< FIFTf< ~TR::ET
~PRINGFIELD, OREGON ~1411
ENGINEERING DIVI~ION
o:TlCE NO. 126-~1:,~
IN~P"CTlON LIN", 126-~16~
JOB ADDRE55,
I '-f Z<(
fJ?~ 1?LUE.i? 'SOI-i
T~X LOT NO: '*
10D
REC"IPT NO, /7 gtHI
CASH
Cl-i"C< ~
..!..SSES50RS nt.p NO.*"
1/ D~ 2.'147-
SU3DIVI~ION,
O.:t-ER 1-1 A 5L. A
=D!'<:'~~, 300 \/J.
57AT:, oR-
WOR< DEe.cRIPTI~,
51:>~;<'~
CJR9.CU'T:
(i7J2../IJ./-I ~/.J A I"'t:lZ... ')
t===-A I~V I ~AFJ C!71', 6>f'elf..u:..F/frJJ
ZIP, er1Lf71 Pi-lON: NO.
*-
CH"C<=D FOR D"L1NOJ:NCI,,5
l.
CU:;S 51:>" _
R.ESID~il.!..L _
==re/.:.C~ _
CO,'C ERICA!.
SECOND DR1V'Ell.lt. Y (SEE ~IC )
!'<:'GlUI!'<:'S APPLICATION FOR A S=COND DRIV=WA"'I'T-~.I.1
OR A COUNTY '!'PPLICATlON FOR FACILITY PE~IT IC <;JB..21D~1
I" IN Tl-<" UG.5.
:::>AT: O? APPLlCA710N ~_/<j..--1C:;-
.SIG~::;:
DATE:
WORK TO BE FERFv"", IcD BY,
~ONT;<AC70R
'*
!'<:'Cd57:<ATICN NO. ~"'.., I
O~R
CON7:<AC70R'* -'7'IA'f04
=DR:55 2.9 5?q IS
r .M..L~-tf!.vctlf!)/J
A I ?PCJllf .eel.
SPRINCFIELD
150 i? Ie..
I/; -/<;'-'?~
"X?1!'<:'5"~-2./ - 96
P;":'ON"'~"I. OS ~
PROCEDURE FOR IN5A:CTI~ REQUEST,
C.t.LL 126-:;16~ lRECOR:::>ER ) STAT: YO'JR CITY D,,51C,NAED J05 N'J:"'13=:R J03 ADDRE~5" ; p= O?
IN~PECTION R=:au=:57ED A'4D tU-reN YOU WILL 5: !'<:'ADY FOR INSP"C7ION, CONTRACTORS OR 0l:NE~ N~=: A'<D
Pf<ONE NUM3:R. R=:OU=:~7S R=:CEIVED 5=FOR=: 1,00 .<.'1 WILL 5=: MAD=: Tf<" SAME DAY, R=:OJ=:S7S ":"=7ER ',00
A.~ WILL 6E MADE T!-lE NEXT ~1NC, DAY
TOTAL !"l::RMIT FEE,
I' /
I :.-l.c.VE.CA~~LL"" EXA~INED T~E COMPLETED APPLICATION FOR F'E~IT. ":"""lD DO ~EREe.,.. CE!=i!:Tlrl 71-Ll..T ALL
INrO~ATION. I-!EREON IS ~E A"U) CORR:CT, A"lD I RJRTi-:ER CERTIFY T~AT A~Y ~"'D ~L lLOR< FE;""'.r.......;-O::" Il:;:D
5;..lALL 5E DONE IN .t.ccORDA'4CE WITH Tf<=: ORDIN"''<CES OF Tf<E CITY OF SPRINCf.'IELD, AND T;..l=: L= O? Tf<E
STATE OF OREGON P"RTAINING TO THE WOR< DESC!'<IBED H=:R=:IN, A'<D T;..lAT NO OCCUPANCY WILL 5E M"'DE
or .l::...~y ST~CTU~ lllIT:ooI0JT PE~IS51~ OF Tl-lE BUILD!NC, DI\'15101'4.. I Fu'R7l-l::.R CERTIFY' T~.J.T OOL y COS!RACiO~5
.t.ND EMPLOYEES WHO ARE IN COMPLIA'<CE WITf< O~ ''''1.05>:' WILL BE U~"D ON THIS PROJECT.
EXISTING 5t!ILDINC:J P:~IT NO. ( IF APPLICABLE)
'" 5== =~
...._~
.,..ou~ CITY DESIGNATED J09 SO. Isf
t7 ->1 tJ(", 7
,
REQUIRED INSFECTI~S
[[f
SID=:WALK I DRIYEWA Y
FOR ALL CONCRETE PAVINc= WITf<IN
Tl-lE STREET RIGf<T OF WAY, TO 5E
H.4DE t...=TER AlL EXCAYATNC::
IS COi""iPLETE AND FORM WO~
A"'lD SU9-6.t..5E Ht..TERIAL IS
IN PLACE
D
FEES,
SIDEWALKS
CURS-CUT
~10.00 . @.15/LF. ( X )
~10.00 . SOJ5/LF. ( X )
or WALK
s
r
COMM"RICA!. DRIVEWAY~ Sf<ALL
HAVE :,' TO e' FLAIRS
3'. O. 5TA'lDARD
~16NED
DATE
.- CUR5 I APPRCACf< APRO
A=TER FOR:'1S ARE ER=:C7'
BUT PRIOR TO pOJ!'<ING
CONCRETE.
Wt.L< X'
/ ""
I. X' I.
"'i "