HomeMy WebLinkAboutPermit House Move 1997-7-11
CITY ASSIGNED JOB NUMBER:
225 FIFTH STREET
SPRINGFIELD. OR 97477'
(541) 726,3753
FAX (541) 726,3689
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BUILDING MOVING PERMIT
, COMMUNITY SERVICES DIVISION '.
Structure Being Moved From: ~$o ~i') .::::::;..
Lane County Reference Number: \1()l-:J.A-~ A-
Structure Being Moved To:_/,b14~~,", ~.
Lane County Reference Number: \ '\ \\'d->:,t?A-
Tax Lot Number:
. City:~. -""l.c,,=,~
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, Tax Lot Number:'
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Building owner:~ k ~Ul""- ~C1' ~-=..::!.
Mailing Address: {~'7:::J!r ~~
Phone Number~ ()~. "'f?Rt
Cell Phone Number:
,City:_/ ..-.>:>-r....J>. ~ =- ~J"",,-
State: oR...
Zip:
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Moving contractor:~ 'IY{ L1J? I':Jt JArflA""n" f7 ~..,- \ ~~
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Phone Number: '3{--::",~~~
State:
Expires: 7 .I c:;,
Cell Phone Number: 'ff' ~:::; -0
Zip: q 1t4-n
Construction Contractors Registration Number:
Mailing Address:"'? O.~ (t7(dI-
City:~,.,...."\=
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Plumbing contractor:~ ~-1'~
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Phone Number: '
. Construction Contractors Registration Number:
Expires:
Description of Building to be Moved:
Square Footage: I \ '\4
Height on Dolly: \.q' {n"
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Moving Length: {..,L.-
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Moving Width: ~
lPOvP
Type ofConstr:"'p~' =.
# of Sections Being Moved:
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Square Footage: (I A-"'\, Living Units:
Proposed Date of Move: { J I '=> /=t '7
,
Completion Date of Move: 7 (I ~ /q-:
Value of Structure(s):
B ,. ~ 1: DQ.Q.- JB.-- a.
egmnmg at: ~.. - '. ~~
Ending at: \ \ ; CSD ~m
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Description of Proposed Route (Please attach map with route outlined with directional arrows):
~-r ~ ~~It' ~ ,= ,~
NOTIFICA TION OF MOVE: The Community Services Division will route copies ,of this application to all appropriate divisions,
departments and agencies. However, the applicant must contact property owners if trees are involved in the proposed move. In
addition, the applicant must secure the approval of all appropriate municipal, county and state authorities should the move originate or
terminate outside the City of Springfield, or along any street owned by the state or the county within the Citys boundaries,
PLANS, FEES, AND CHARGES: Prior to receiving a permit to move a building into the City of Springfield, the applicant or their
representative shall:
0, Submit two (2) copies of site or plot plan for new site.
o Submit two (2) copies of the foundation plan for the relocated building
o All applicable penn it and system development fees shall be paid prior to any moved
I. Any applicable permits and inspections for sanitary sewer cap or septic pump and fill
By my signature below, I certify that the above infonnation is true and correct, that all required contacts have been made and
authorizations obtained. I 5understand that the minimum time to process this penn it, because of the numbe\ of agencies notified
by the City of Springfield, s ven (7) working days.
Signature: ~~, ___ . Date: 7 - 1\ . Q.7 '
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';!~~:i~an ~::~\~~ ~:::: ~. Foun~:::umber:
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Moving Permit Approved By:
/
Date:
'1.\o.en
Engineering Division Report: Owner(s) AND Contractor(s) are both responsible for any damages to private or public property.
Moving Permit Approved By:
f).,
~
Date:
7-Z-97
Traffic Division Report: Contractor is responsible for a safe, efficient relocation operation. All signal systems shall be monitored to
ensure they are functioning properly. Any damage to or malfunctions of the traffic signal system shall be reported immediately to
Gary Weck, Signal Technician, at 343-4902 or Gene Butterfield, Maintenance Supervisor, at 998-3667,
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Moving Permit Approved By:
t..,O.
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Date:
7/7/17
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. Historical Report:
Moving Permit Approved By:
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Date:
-
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Required Inspections: An inspection of the property is required at the following indicated stages of this project.
_ Septic Tank Pumped and Filled ~anitary Sewer Capped V;:;:al Move
A Certificate from a bonded! Capped within five (5) To be made once structure has been
registered contractor will meet of the property line with moved from site and all debris has been
this inspection requirement. approved materials. removed.
)
To request an inspection, please call 726-3769, Inspections called in before 7 am will be made the same working day, inspections
called in after 7 am will be made the following working day. Please leave your City designated job number, job address, type of '
inspection and when you will be ready for inspection.
Zone: \~ ~~ ~ Flood Plain:
FOR OFFICE USE ONLY
Type ofConstr: \J ~
Occy Group:
~3
Application fee
Moving Permit
Sanitary Sewer Cap/Septic Pump and Fill
5% State Surcharge
3% Administrative Fee
Subtotal
$ 18,00
$ 60.00
$ 15.00
.75
.45
$ 94.20
$-
$-
$
$~ill
_ Total Blocks. $.60 per block
TOTAL
(if property does not need the sanitary sewer capped or the septic tank ,umped and filled, dedu~t applicable permit fee)
Date Paid: l\\\'c\''\ ReceiPtNumber:_~Q.o"'.J Bv: ~\J::O\ \,
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[~QW ~J,<yjor-b B,W ~J\. '
6149 Main SLreet
Sp'.r,)~,~ie 1 ell' Df<.. 9!"~/.~1i1'l'---
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5.687-4701
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SPECIAL TRANSPORTATION PERMIT
FOR HOUSE MOVES
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KEN MARQUARDT
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PO Bo~ 11764
5A!lO Main StreeL
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Eugene, OR
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138998 YCRC176!
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HOUTE
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9747A
114990
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McKenzie Hiqhway
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from 58th St
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MUST BE OFF HIGHWAY flY 8:00 AM
.__L SUNlJAY, July 13, 1997
*SEE REVERSE S/lJE OF THIS PERMIT FOR SPECIAL PROVISIONS *
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HOUSING INSPECTION APPLICATION
/7025'/32Cm'ttJo
~
CITY OP SPRINGFIELD
BUILDING DIVISION
:::::====~~{\(l~==\12:~\(j(~~=========~=============:::=:::::::=()If\~~
ADDRESS OF INSPECTION: f\ ~~C) \ ffiC\ Q. (\ rn Q 0 t-
OIlNER: ~ dv ~ij\~\
OIlNER'S ADDRESS: \C\~0A \
APPLICANT: ~Jl)'{\~ ~
./ . ~P,:HONE NUMBER:
J ~ \\ 8 \0 V\O_ 'I ~
APPLICANT'S ADDRESS:
FOR ACCESS TO PROPERTY - TELEPHONE NUMBER: U,40 -. (J/t~':b I.. f' U . ~
==============================================================================e=
A $35.00 INSPECTION FEE IS REQUIRED AT THE TIME OF APPLICATION
THIS APPLICATION FORM MUST BE SIGNED BY THE OIlNER OF THE PROPERTY TO BE
INS CTED; ----
~,~
UKe OF PROY~KIY OI/NER
--------------------------------------------------------------------------------
FOR OFFICE USE ONLY
--------------------------------------------------------------------------------
DATE PAID:
\ 0 .\t~1
RECEIPT NUMBER: 6ll()\ l{>-. ~
DATE OF REPORT:
DATE' OF INSPECTION:
DATE OF CERTIFICATE OF COMPLIANCE:
COMMENTS:
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