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HomeMy WebLinkAboutPermit Curb Cut 1994-7-1 ,..-..... _RESIDENTIAL - COMM~CIAL _SIDEWALK I CUR6CUT _ APPLICATION I PEf<t1IT SPRINGFIELD II~" . 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 I'] ()'Z..;;z,Cf q/ .* 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 . - ,.-. ,.". ",," ./ / I .I / . " .',," .~ . " ,..... ..'.' , .~~,: . . .; ,~..:: ::1. . ..;. ... .' '.'.:::::f,:~~';' .... City of Sprj.I'yfleld 225 Fifth Str.eci, Springfield: DR 97477 (t:".....,..., "JU"; } 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 ~~. n,'." ..... , ,-- . '. I~, ." "~'-.~ ~,'" :to.lS . ..... ;o''"7/-/'" .~ I "t-/I fc(.:.~ ill. iO~ is ......,:1.';...1"\ ., ' .', ' '. ..,'.. """;'. . ..' '...:' .....\'. .?" , .. , .':,-! .;' ,,\ " .~:.- . ':: .\.,.' i., .-.i:-..-. . -.. ~ ,.~,. .' "