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