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HomeMy WebLinkAboutPermit Sidewalk 1995-6-15 ~SIDENT~I~;AL:-1 ~~MMERCIAL APPLICATION I PE~IT.' . . """..0 225 NORTl-; FIFTI-I 5TREET 5PRINGFIELD, o.RE6ON '31411 ENGINEERING DIVI510N OFrICE NO. 126-31,,3 IN5PECTlo.N LINE, 126-316'3 JOB ADDRESS, /4'(;0 /Yff'1PH-~(UJ "-5SE550R5MAPNO.* 17t)-; 2742... T"-XLOTNO:* /60 5U3DIVI5ION, o..:NER, i-l A 5C II ADDRE5S, ~ vJ. 5TATE, 6 rc.... lUOR<: DE5CRIFTION, 5!~S!.l.4Li<.: ~ CLlRS-c...'T: ( M!A /J-/-./ -,,?M A 1"€lZ.... '> ':::AIE:-VltfVJJ CITY, 6Pe/~t-F/frJ? ZIP, ef1~7 7 P;.lONE NO. CUSS 5!DE _ ~S'DEl'iIAL _ 5-ETeACK _ Co:-MERICAL 5ECOND DRIVEWt. Y (5EE TR,L.;=;=IC ) REQUlRE5 APFLICATI~;=OR A SECOND DRIVEWAY('T-4.1a) 0.1'1 A COUNTY ,l,PFUCATlON ;=OR F,L.CILlTY PE~IT (C '38-203) 1;= IN Tl-;E UG.5. D,L.TE OP APPLICA7ION ti. -/S-fr;' SPRINCFIEl.O RECEIPT NO, 17S00 CAOJ-; Cl-IEC< ~ .;; CI-IEC<ED Po.R DELlNOJENCIE5" .!: ~ .SIG!\E::::;: ;:50 f? Ie.. 4, - /"--,?<;' D.42: UJORK TO BE FERf'v"" 11::D BY: O:.J.N:R ~~TR.ACiOR *' REGI5TRATION NO. '3","" I CONTR-'-CTo.R* ~A--rOJ...l =!:>RE55 2..~ '$'1ij ,; r'/JIJ.<7P..va't OIJ AIF'P()~-r- eel. EXPIRE5,?-Z-I- 96 PI-IONE,qfcl_ OS ~~ ,,,,,,",,--l::v:.Jl<E FOR INe.F!:CTION REQ.JEST, c.t.J....L '26~3'6~ (R:COR'DER ) STATE YOUR CIT'r D=SIG~TED J05 N....C..'i9=R. JOS ADDR2SS,T"i""'P: 0:= 1N5PECTION REQUE5TED A~D Ilh-IEN YOU WILL 9E REt.OY FOR IN5PECTION, CONTRACTOR5 O;i! o.UNER5 NA,",E "'~D PI-Io.-E NlJM3ER REO'JE5T5 RECEIVED 5=FORE 1,= -'-'1 WILL 5E MADE TI-IE 5AME DAY, REOJE5T5 '<"=TER 1,00 A~ WILL BE MAD: T!-lE NEXT ~I~ DAY *' ~== o~ ~--~ YOU~ CITl D::SIGNA"7"'ED J03 SO. 1St EXISTING BLlIL:;)ING PS~lT NO. (' rr= APPLICABLE) 9'7'/t1t,:::, R!:QUIR!:D INSPECTIONS [f 51DEWALK I DRIVEWAY PaR ALL CONCRETE PAVING WITI-IIN me 5TREET RlG4T OF WAY, TO 9E M.4.DE t..==iER AlL E::'<CA Y Ai rNU 15 ccmPLETE AND ;=ORM = A"lD sue..SA&: Mt.TERIAL IS IN PLACE D .~ CURS I APPROt.C1-I AFRO A-"'/ER FO~ ARE EREC7: BUT PRlo.R TO FOJRING CONCRETE. FEES, SIDEWALKS CURB-CUT WALK x' ~10,00 . ~.1S/LF. ( X ) ~10.00 . ~.1SILF. ( X ) / ~ 0;= WALK Jf Co...-V"ERICAL DRlVEWAY5 51-1ALL I. x' I. I-IAVE 5' TO. 8' FLAIR5 ~ 3'- O. 5TA~DARD " " TOTAL PERMIT FEE: , I I-I.l.VECAR:-'FuLL Y EXA'1INED THE COMPLETED APPLICATiON FOR PERMIT, A~D DO I-IEREBY CERTt;=Y 7H.l.T ALL INrO~ATION ~EREON IS TRUE A"'ID CORR::CT, A'U) I RJRT;";ER CERTIFY T~AT A!'-JY ~~D ALL WOR< FE~Ri1ED 51-1ALL BE DONE IN .4CCORDA~CE WITI-! THE ORDIN-'-~CE5 0;= TI-!E CITY OP 5FRN6PIELD, AND THE LAU15 OP TI-IE 5TATE OP o.REGo.N PERTAINING TO. TI-!E WORK DE5CRI9ED I-IEREIN, A~D TI-IAT NO OCCUPANCY WILL 9E MADE or: .t.SY 5TF1JCTURE lllrT;40JT PE~155100 OF T~E BUILD!NC:. DIV1S10t-l I FUR71-l!:.R CERTIF"Y" 7~~T ONL.,... C~I~CTO~5 .<.ND EMPLOYEE5 WI-IO ARE IN COMPLIA~CE WITI-I o.RS 101-<*" WILL BE U5ED ON T"'15 PROJECT. 51GN;:D DATE