HomeMy WebLinkAboutPermit Sidewalk 1995-6-15
..r=SIDENTIAL - COMMERCIAL
;~~.o.;~~ ~~T.
275 NORTI-l FIFTI-l STREET
5PRINGFIELD, OR!:GON 91411
ENGINEERING DIVISION
Ofi'ICE NO. 126-3153
INSPECTION UN:: i16~316e
li~O
J09 ADDRE55,
":'55E550RS MAP NO.'*'
IC-IZ1 tvrt' Pr4L~ N
17 6? 7.-'~?......- Tt.XLOTNO:* /{lU
5USDIVISION,
O.:N:R, J-l A SC A
=D1'<:S5, 300 vJ,
5,A,=, oR-
WOR< DE5CRIFTI~,
S!DEWALK ~
(f?7Z-1 IJ-/-./ .<!,I.! A F€lZ... '>
r::;AI~VI~ ClOy, 13>f'e/~('P/frJ?
ZIP, <r1Lf71 P;.ION: NO.
CUSS S!D: _
~5ID8'TI.!-L _
=::T8.AC<. _
c.JRS -Cl.JT:
co,~r. ERlCt.-L
S:=ND DRIv:WAY I SE: TRtJTIC )
R:OUIR:S APFLICAOION ~R A SECOND DRIV:WA.,-I'T-4J4)
OR A COUNTY J..PP'_ICATION ~OR FACILITY PE~IT IC '38-2"'3)
I~ IN THE UG.9.
D,t.. TE 0;: APPLlCA lION
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SPRINCFIELD
REC:IPT NO, /1866
CASH
Ci-i:C< ~
*
C;-;:C<:D ~OR D:LINQ~:NCI:S
.51C::.~:::::
DA"i"'::::
WO;;;K TO BE FERrv"", It:D BY: O;lNER
CQN,RAC,OR "* ~ A '10 J--I r ~'\I,.L<;-tt!.vC:11 oAl
=DR:055 2-'1~?qf$ AIF'F'CJl1.'1'.eeI.
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R:C,15TRATI0>-l NO.' ~"'7 I
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P;..;=:,~rcl- os <',I~
'~'-t:vURI: FOR IN5FECTION REGlUEST,
CALL 126-3169 IR:CORDER ) STATE YOJR CITY D:51C,NAT:D .!OS N'J:'1S:R. JOB ADDR:55,TYP: ~
INSPECTION R:auE5TED A'jD ~EN YOU WILL BE 1'<:ADY FOR INSP:CTION, CONTRACTO~S O~ 0i:NE~ Nt.,",: ';"ND
P~ NUMBER. R:OJ:5TS R:CElvED B:rv= 1,= ';"'1 WILL B: MAD: Ti-!E SAJ"IE DAY, R:Q;]:5TS ~TER 1,,*,
A.'1 WILL BE MADE TME NEX1 l1.iOR<.lNG DAY
EXISTING 5:.!ILD~ P::RMIT NO. (' rr AFPLlCABLE )
C?9~01
"* s== =~
--~
YO..JR CITY DE516NAlED J09 NO. ISr
Rf:GlUIRED INSF'ECTJ~S
[Ef
SID:WALK I DRIv:WA Y
FOR ALL CONCR:TE PAYING WITi-!IN
TI-lE STR:ET R1G!-IT ~-UJAY, TO BE
Mt.DE h=TER ALL EXCAVATINC:l
IS CO;-;PLETE AND CO~ WO~
A'jD SUB-SASE MATERIAL IS
IN PLACi:
FEES:
SIDEWALKS
~1@.0@ + ~.15/LF. ( X )
0;: WALK
CUR!3-CUT
~1@.@@ + ~.1:;/LF. ( X )
D
s
ff
=MMERICAL DRlv:WAYS SI-lALL
I-lAvE 5' TO 8' FLAIRS
3'. "'. STA'jDARD
TOTAL PERMIT FEE,
I i-!AVE .CAR:"'FuLL Y EXA.'1INED TI-'I COMPLETED APFUCATlON FOR PE~IT, "''jD DO I-lER:BY C:ROI"Y TI-lJ.. TALL
1~~ATION l-{ER.E:ON 15 TRUE A~ CORR::CT. A'lD I RJRTi...t:::R CERTIFY 71-t'.T A"f'( ~""'D AlL WOR< PE~~~ IcD
5;-lALL BE DONE IN ACCORDA'jCE WITI-l n"E ORDINA'jCE5 ~ mE CITY ~ SPRIN~IELD, AND TM: LACJ5 ~ TI-lE
STATE ~ 0R:60>-l Pi:RTAINING TO TI-lE WOR< DE5CRI9:D H:REIN, AND TI-lAT NO OCCUPA'jCY WILL 9: M-'-D:
OF ,t..,,-:y STRUCTU~ Ullit~OJT f=lE~1551(7.\l O? THE !3UILD~G DIYlsIOt../.. I R.1R7~=R CERTIFl' 71-l...lT OOL Y Co--..,RACiO~5
AND EMPLOYEES ~O AR: IN COMPLIA'jCE WITI-l ORS 101.0:>5 WILL BE US:D ON T...IS PROJECT.
51GNED
DATE
.- CURS I APPROACI-l APRO
Ar>ER FO~ ARE ER:CT'
BUT PRIOR TO PO;]RINC,
CO~CR:TE.
WAL< x'
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