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HomeMy WebLinkAboutPermit Sidewalk 1994-6-3 III'*:> RESIDENTIAL - COMMER.CIAL . :~~~~C~~;T 2250 NORT~ FIFT~ 5TREET 5PRINGFIELD, OREGON "11411 ENGINEERING. DIVI510N OiTICE NO. 12&-31503 IN5PECTION LINE, 12&-31&"1 JOB ADD~se. tJ? A55E550R5 MAP NO."* ~t1L MAIN \1 t)Z- ~<-f '3? CA5H RECEIPT NO, TAX LOT NO:"* !;{ 0 5UBDIVI5ION, C~ECK OU.NERo ADDRE55, "!!?co-r-r '37 S5"' oIL 'P n e:, ~ 11...[$ 'E;M~eALD'E:,7 CITY, i2:f)~"L zlP,QfZttfos PHONE NO'v;<{7;'<:&f:, 7 '>if C~ECKED FOR DELINQJENCIE5 5TATE, llJORI< DESCRIPTION. : ----- I 5IDEWALK, - CURB 51DE - I CURB-CUT, RE51DENTIAL _ I SECOND DRIVEWAY (SEE TRAFi'IC ) I REQUlRE5 AFPLlCATlON FOR A 5ECOND DRIVEWAn'T-4.1.) I OR A COUNTY ,l,PPLICAiION FOR FACILliY PE~li (C "lIl-203) IF IN THE U.6.B. SEiBACK _ COMMERICAL _ 5IGNED, DATE OF APPLICAilON DA. TE: WORK TO BE FE~D BY. OIlN!:R CONiR.4CiOR'>if \N 4L IS CDf4C.f2.~.:1,t;=- ADDRE55 qLfS- N. ?~ tit ~ v---- CONiRACiOR "* REGI5iR.4iION NO. /J()'2.S"C> SPRINGFIELD I,?I(, g ~Ifr * 13:,g~ b /'?-/ClLj EXPIRES, / / ho/c?4 P;.lONE, "14c'--3!i'a73 r~c"".JRE FOR INSPECTION ~QUE&T. CALL 12&-31&"1 (RECORDER) 5iAiE YOUR CliY DESIG~iED JOB NLJ:"1BER. JOB ADDRESS.TYPE OF IN5PECTION REQJESTED A'"D WHEN YOU WILL BE RE,l,DY FOR INSPECiION, CONiR.4CiORS OR OIlN!:RS N.L."lE A,"D P~E NUMBER. REQUE5iS RECEIVED BEFORE 1,00 A'1 WILL BE MADE THE S""'1E DAY, REQJE5iS -'FTER 1,00 AM WILL BE MADE iHE NEXT 1lJC>!iil<1NG. DAY "* 5EE BOOK EXI5ilNG: BUILDING. PE~li NO. ( IF APPLICABLE) YOUR CITY DESIGNATED JOB NO. Isf ~QlJI~D IN&FECTJON& ~5IDEWALK I DRIVEWAY FOR ALL CONCRETE PAVING WliHIN il-lE 5iREEi RIGl-li OF WAY. iO BE MADE AFTER ALL EXCAVATING IS COMPLEiE AND FO~ WO!<!< AND 5UB-BA5E M,l,TERI,l,L IS IN PLACE D FEE&: SIDEWALKS .1"'."'''' + ."'.1!;/LF. ( X ) OF WALK CURB-CUT .1"'."'''' + ~.1:;/LF. ( X ) TOTAL FEI't1IT FEE. NO f~ PeJL ~ s 5"0. ~ ~I~ttf COMMERICAL DRlVEWAY5 S~ALL HAVE 5>' iO 8' FLAIR5 3'- Oh 5T A'lDA~ 940<66s qLl6M~ CURB I ,l,FPRO,l,CI-I APRON, AFTER FO~S ARE ERECTED BUT PRIOR TO POURING CONCRETE. WALK X' / l ., '" X' J. I HAVE CAREFULLY EXA"lINED TI-IE COMPLETED AFPLICAilON FOR PE~li. "'ND DO I-IEREBY CERTIFY 7H"-T ALL INFO~ATION HEREON IS T"'-'E A"D"CORRECT, A'"D I FURTI-IER CERTIFY TH"-T ANY "'ND ALL WO!<!< PERFORMED 5HALL BE DONE IN ACCORDANCE WITH. TI-IE ORDIN"-,"CES OF il-lE CITY OF SPRINGFIELD, AND TI-IE LAW5 OF i"E STATE OF OREGON PERTAINING TO TI-IE WO!<!< DE5CR/BED "ERE/N, AND THAT NO OCCUPANCY WILL BE M"-DE OF A"Y ST"'-'CTURE WITHOUT PE~ISSION OF TI-IE BUILDING: DIVI51ON. I FURTHER CERTIFY 71-1AT ONLY CONiRACTORS .<.ND EM~5 Wl-IO ARE IN ~PLIANCE WITI-I ORS 10'-'*5> WILL BE U5ED ON il-l15 PROJECT. /~~h~V ~ 6hfci.t/- SIGNED_______ ". DAiE' ,