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Permit Curb Cut 1994-12-16
!:/~O -'DENT~I~;.l.L=-'C~~E~AL ,l.PPL ICA TION I PER-lIT n" NORTH FIFTH 5TREET 5FRINGflELD, OREGON ':11411 ENGINEERINCi DIVISION DrrICE NO. 176 -3153 INSPECTION LINE. 116-316':1 JOB ADDRE55. /Lf 72 me PherSoN A5sEsSOR5 MA~ NO,*" /1 03 2. 1 4- 2.- TAX LOT NO:"* / DO SUBDIVI510N, RECEIPT NO, CA5H CHECK OUNER. HAc s A ADDREs5. .:?no UJ, l::;"alr-vr'I~I') STAr::., OtE&-o/'J ZIP, q-74T7 U)()fq( DE5CRIFTION. SPAINCFIEl..O ! 577?- ~ I CiTY'51)I-;~i.e.l J P~ONE NO, o87~7) '" '?---- CHECKED FOR DELlNOJENCI=5 _ 5IDau.<J.K, CURS SIDE _ CURS-CUT. ~ RE5IDENTI-'-L _ 5ECOND DRIVE:.:Jt.Y (5EE TR,L..,;:::;:IC ) FC.QJIRE.5 APFLICAil~ i=-OR ~ &ECO:-":P DRIy:w,t."((rr-..::.lo) OR A COJNT'T" t..PPLICAOION FOR FACILITY P'.:.~IT IC ~.)03) I~ IN THE U.u5, ;:::i5AC< _ CO:--f."1=~lCAL Dt..iE ~ APPLICATION 1;)./tSjcl~ SIGNEDl Dt...iE: UlORK: TO BE PE~1'<J It::D BY, 'If /"'r-:A '- IJ CO:-;,RACTOR ,') I. 10 t..DDREss ;),'137"1 ~R )L Ot!J~R CO~T~C'70R roy\-,T, TYlL. A i_tpQ)o-'t 'Rd. ,,,,,-,,-EDURE FOR IN&PECTION REaJE&T. REGISTRATION *" NO, 033 7 I 9l4D.1 . E461P; o~~ ~ . b;t;:ld IZ/Iv!-i/ EXPIREs..?/;).t!~) . . P;';ONE, ~!o-Oo~ C.l.LL 1J6-316':1 lRECOR:>ER ) sT-'-TE YOUR CITY DEsIG~"-ED J09 N'.J;";5ER, J09 ADDREs5,TYPE ~ INSPECTION REO'J:5iED ~o...:::> 1,lh..i:::N IOU CJILL 5: R.E..!..:;'Y FOR INSPECTlo:-.l, CONT:<.ACTOR5 OR OLl..NER5 N.L...~E J...."-lD P;..k)N:: NU"1!3ER REO:JESiS RECEJVED 9E:"FORE 1:00 ~""i 1lll!..L 5E MAD: i;..;: 5~"1: PAY, REa-JESTS ..:..FTER 1:00 AM lJJILL SE MADE il-lE NEXT l1OR<.INC; Dt. Y EXISTING ::.UI!..D1NC, P::~IT ~:C'. ~ Ii=- AF'PLICASLE ) * 5EE BOO< YO~R CITY DE5IG~"- 'ED J09 ",0, 1St C{'-f 112...-/ REaJlRED 1N5PECTION5 D SIDEWALK I DRIY::!jt..:y FOR ALL CO~CREr= PAVINC; lJJITr-.lIN H--l::; SiREET Rlu~T or= U);.i. TO B: H.!D:: t.r--rER .L.LL EXC.:..vt. ilNG 15 COi'"'iPLETE A"lD FO~ l1OR.'< t....~D SU!3-5t...5: Mt.TERIAL 15 IN PLACE [R1 FEE5, SIDEWALKS 110.00 . IZ>,I::./LF. ( x ), 0;= llJALK CUR9-CUT 110,00 . 10.1::' IL.F , ( x ) 1ft; TOTAL PE~IT FEE. t CO","ERICAL DRlVEWAY5 5H"-LL :-U..YE 5' TO 8' FL.t..IRS 3'- 0" sr t.,.0...:::>4R:D /?",qO , I CURS I APPRO,l.CH APRON, Ar-.ER FOR-l5 ARE ERECiED BUT PRIOR TO POJRNG CONCR.:TE. WALK x' / "" I. x' I " , r ;"U..YE CAR:PJLLl' EX":""'1NED 7;":: Co."1FLETED t.,PFLlC.c.. ilO~ FOR PEF<7iii, ..:...o...:D DO ;"";ERE9Y CERTIFY 7~.!. T ":'LL !:-;~~ATION HEREON 15 TRJ'.:. ,l."D CORRECT, "-'<D I FURT~ER CEROIFY TH-'-T -'-"Y "-"D ':'LL ~R< PEf<l'O~ED 5~ALL 5E DONE IN ':"CCORDANC:: lJJJT~ Tl-i= OROIN":''JCES OF T;"";E Clll or SPRJ!'-Jcr.=IELD. ..:.,t-..lD T~E L~c..'5 OF Tl-iE sr':-'TE or: OREGON PERT':'INING TO TM: \!.io?R< DESCRIBED !-;:R:l~, .:..o...:D rf-.:.!.T NO OCC:JP~t-.JCI lJJlLL 9E M":"D: ~ t..NY 5TRJCTURE WIOHOJT PEWdssIO; '.::f THE BUILDING DIVISION, I Fl8T'-'ER CERTIFY THAT O"L Y CONTRACTOR5 "'-'<D EMPLOYEES U!-<O';'RE IN CO;-1PL'.",::= WITH ORs 101.05; WILL 9E USED ON T;";15 PROJECT. JL-j//t<Jt4/ Q, A~ ~IUNED ~ / ;llltl f7{/ D~TE