HomeMy WebLinkAboutPermit Curb Cut 1994-7-1
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_RESIDENTIAL - COMM~CIAL
_SIDEWALK I CUR6CUT _
APPLICATION I PEf<t1IT
SPRINGFIELD
II~"
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22!; NORTf-l FIFTf-l STREET
SPRINGFIELD, OREGON <;\1411
ENGINEERING DIVISION
OFFICE NO. 12&-3153
INSPECTION LINE, 12&-31&<;\
J06 ADDI'S65,
ASSES50RS MAP NO.*
0??6 Mtl-rH -;0-f
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TAX LOT NO. (/l"7{')()
RECEIPT NO, 0/3747
~
SIDEWALK. CURS SIDE _
CU~-~T: ~ RESIDENTIAL _
SECOND DRIVEWAY (SEE TRAFFIC)
R!:QUIRES APPLICATION FOR A SECOND DRIVEWAYC'r-4.1a)
OR A COUNT'!' I.PPLICATION FOR FACILITY PEf<t1IT (C ea-2"3)
IF IN THE U.G.B. ! . /
DATE OF APPLICATION I /1 _9'-1
SUBDIVISION,
OIlNER,
ADDRESS,
\'ffy I"L
(o7QO
oK-
i" J?.Ae:;..t~
f-ul A-l J-f S1
ZIP, <J74'?(
STATE,
UJORK DESCRIPTION.
WORK TO BE FERf'v"", ,eD 6Y,
CONTRACTOR* ~-rA~ W L 'f4Cl-t-
-:v:tao C (.-, ~ s-t
ADDR!:SS
CA5!-I
C,",ECK
crry, 5Pr()
Ff<ONE NO, "7 q{" -4>Cfs1
*
CJ.;ECKED FOR DELINQJENCIES _
SETSACK _
COMMERICAL _
*
SIGNED, r'E::oO ~
7//Ncf
DATE,
OUNER
CONTRACTOR ,. /
R!:GISTRATION NO.* 5Z5f7
EXPIRES, &:,); /cJS-
P;.!ONE, "7~ - c:'Y'!:) I
4 r'1=-t[)
(')fL-
f"Rv,,"'.....UI"!E FOR lN5FECTION I'SQUE5T.
CALL 1,&-31&<;\ (RECORDER) STATE YOUR CITY DESIGNATED '>OB NUMBER. '>OB ADDRESS,TYF'E OF
INSPECTION REQUESTED A"D WHEN YOU WILL BE READY FOR INSPECTION, CONTRACTORS OR OIlNERS NI.ME I."D
Pl-lONE NUMBER REQUESTS RECEIVED b<;r~"", 1,"" AI1 WILL BE MADE T~E SA'"lE DAY, REQUESTS I.FTER 1,=
AM WILL BE MADE Tf-lE NEXT IlIOIi!<ING DAY
*' &EE BOOK.
EXISTING: BUILDING PEf<t1IT NO. ( IF APPLICABLE)
YOUR CIT'!' DESIGNATED '>06 1-<0. I$,*
c; q () 8:;;c
q L( {)f3~ L-
SIDEWALK I DRIVEWAY
FOR ALL CONCRETE PAVING WIT~IN
T~E STREET RIG~T OF WAY, TO BE
MI.DE AFTER ALL EXCAVATING
IS cOMPLETE AND FORM WORK
AND SUB-BASE MATERIAL IS
IN PLACE
I'SGlUII'SD lN5FECTION5
D
FEE5.
SIDEWALKS
$10.00 + $0.15/LF. ( X )
OF WALK
~ /0 ~ 6-
TOTAL FEI'MIT FEE,
G- CURB I AF'PROACf-l APRON,
AFTER FORMS ARE ERECTED
BUT PRIOR TO POJRING
CONCRETE.
CURB-CUT
$10.00 + $0.15/LF. ( X )
WALK X'
/ ""
l x' t
"
COMMERICAL DRIVEWAYS 5I-lALL
~AVE 5' TO 8' FLAIRS
3'. 0- 5T '(';"'iDARD
I ~AVE CI.REFULL Y EXA'-1INED T~E COMPLETED APPLICATION FOR PEf<t1IT, ""-"D DO ~EREBY CERTIFY T~I.T ALL
IN:"-QRMATION ~EREON IS TFaJE A"D CORRECT, A"D I FURT~ER CERTIFY T~AT A"Y A"D 4LL u;oRK PER!"Of<t1ED
S~ALL BE DONE IN ACCORDANCE WITH T~E ORDINA"CES OF T~E CITY OF SPRINGFIELD. AND T~E LAWS OF T~E
STATE OF OREGON PERTAINING TO T~E WORK DESCRIBED ~EREIN, AND T~AT NO OCCUPA"CY WILL BE MI.DE
OF ANY STFaJCTURE WITHOUT PEf<t1ISSION OF T~E BUILDING: DIVISION. I FURT~ER CERTIFY T~AT ONLY CONTRACTORS
AND E~;~~C;;IAZ?;<<"1~5 WILL BE USED ON T~IS PRO'>;} /f'~
SIGNED" , ' I
DATE
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City of Sprj.I'yfleld
225 Fifth Str.eci,
Springfield: DR 97477
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72b-3733
Tr.;:ms;.It:'~,ian nUlllbf~l" Gt~i'?4'?
..1111)' 01, :1.354 4.:; 2i F'N
Received fr~jJlh~ SHIFL~~' ~.Y{~CH
Contract/O~r' : CONTRACTOR
Addr.ess: b790 Hf~IN ST
City~ SPRINGFIELD
St, OR hr.':
-S'.i'lldirlY-
,lab 'I: 34.08c,2.
nescr.ip+.ion
Cur.bcu-i;
To-t,Dl~
Am~, RCCC1Vpd~
Thank YOlJ, Bob ~~.
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