HomeMy WebLinkAboutPermit Land Drainage Alteration 1999-3-26
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1/6i1998
DRAINAGE, 0 Stann, 0 Ditch, 0 Culvert, 0 Natural
WETLANDS, Description ()1JJ;.JZ ..,.
FLOOD PLAIN, Zone: C:-> , FEMA Community Panel No.: 'f/$12{)00:3 A
FLOODWAY, FEMA Community Panel No.: , Date:
PLAN CHECK FEES:
UP TO 100 CUBIC YARDS
t 01 TO 1.000 CUBIC YARDS.
1,001 TO 10,000 CUBIC YARDS
10,000 TO 100.000 CUBIC YARDS
100.001 TO 200.000
200,001 CUBIC YARDS OR MORE
$20.00 ~
$30.00
$40.00
$40.00 For the first 10,000 cubic yards, plus
$20.00 for each additional 10,000 cubic yards or fraction thereof.
$220.00 For the first 100,001 cubic vards. plus
$20.00 for:each additional 10,000 cubic yards or fraction thereof.
$340 For the first 200,001 cubic yards, plus
$6.00 for each additional 10,000 cubic yards or fraction thereof.
GRADING PERMIT FEES:
UP TO 100 CUBIC YARDS
101 TO 1,000 CUBIC YARDS
$30.00
$30.00 For the first 100 cubic yards, plus
$14.00 for each additional100 cubic yards or fraction thereof.
$156.00 For the first 1.000 cubic yards, plus
$12,00 for eaCh additional 1,000 cubic yards or fraction thereof.
$264.00 For the first 10,000 cubic yards, plus
$54.00 for each additional 10,000 cubic yards or fraction thereof.
$750.00 For the first 100,001 cubic yards, plus
$30.00 for each additional 10,000 cubic yards or fraction thereof,
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1.001 TO 10,000 CUBIC YARDS
10,000 TO 100,060 CUBIC YARDS
100,001 TO 260.000
Estimated Volume:
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Date:
Plan Check Fee:
Receipt No: 3)) <to
Date: ) J.l~-f
Received By:
Date:
Grading Permit fee:
Receipt No:
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Date: 4/ZJ/((1
Received by:
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Date:
Date:
Date:
Date
Permit Number
Issued by:
Date:
RACllIlrAd FinAl InApAr.tlnM'
Planning:
Date
DBte ~~<:;:
EnginBBring:
<t!~ L
Building:
Date
Maintenance:
Date:
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Land and Drainage activity as outlined in this permit has been completed in accordance with
the provisions of this permit. . . .
Lllnd and Dralnlloe ac.tivitv as outlined in this permit has not been completed in accordance
WIth the prOvlsl6hs 01 thIS permit. .
Land and Drainage activity was performed prior to application for this permit..
Accepted by:
Date:
,--
, . ../'. .~.' =~. . '~, ~~City of Spl'ingfield'
This Side To Be Filled Out by Applicant
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" This permit is required for any site activity in the flood plain and everywhere site elteration consists of
. fifty (50) cubic yards of material ,or more and/or if a drainageway is affected, within City limits and
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Data of Application ;.3 /? L 199 Permit Expiration Date:
/ - /
Property Owner a';'rlo T\,' .:-R, ,",Cl.\.,j
Address :---!L.n..!Jti~&
Phone: 72 h -qcr~ S
City S 4~1 State:l:}LZipO., tI; FJ
I . -I-L-f D
Site Address: 40:2(")
.s:.~ppT
,Springfield, Oregon
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Tax Lot: S-':-':l8~_..sT
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o UGB Tax Map No: /1 {)2- 3 I lJ-1 f)O \..l. () c...
Journal number applicable Land Use Application
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FILL, Quantity,:STI (!u..t' 7. Sourpe J.;!cation SA
Supplier &"<< t7 {'r7 e Sa..... ,.,I'rc--Y"o"I,Materlal ,~/V
I r . 1
GRADING, Quantity " ~ (+ -- - ," -. =-;!~\ /
EXCAVATION, Quantity, ' ~ ---Destination: ~"'JJII/~ (.,'"00 (l. J \!J .
Supplier: I " ,Project Supervisor r=; r: ,,'v, D ...<;;:;..,. ..../..2"0.-" I. L
Address , Phone '
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SITE PLAN Required Data:Quantity of material, Property lines and descriptions, Tax map and
lot number, Site eddress, Existing contour' lines, Proposed contour lines, Existing drainage
ways, Proposed drainage WaYS, Significant trees and folialle, Ground cover, son types,
Buildings, Septic systems, Sewers, Areas subject to floodIng, Utilities, Areas subject to land
slides, Proposed site improvements. '
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CROSS ~ECTIONS,
SOILS & GEOLOGY PLAN,
DRAINAGE, POLLUTION AND EROSION CONTROL PLAN
REPLANTING PLAN
ADDITIONAL INFORMATION,
COMPANY NAME: /11 /J1ffv /' SO
PROJECT SUPERVISOR: -<'. f' ./?C'J -e
. ADDRESS: '
COMPANY NAME:
PROJECT SUPERVISOR:
ADDRESS:
,PHONE 7V7-0SG g
CITY STATE
, PHONE
CITY STATE
CONTRACTOR NAME: cAIn p
PROJECT SUPERVISOR:
Registration Number:
ADDRESS:
STATE: , ZIP:
MOBILE PHONE:
4. t'lPlJ ~.-'----'
---- -- PHONE
, Expiration Date:
, CITY:
OFFICE PHONE FAX
, EMERGENCY PHONE:
I understand that I. or my successors may hQ,ve future plans for my property which may be anticipated or unanticipated at
this time. I understand that such future plans may require permits and developement approvals from the City of Springfield.
I understand that notwithstanding any approval of this Land and Drainage Alteration Permit (LOAP), that at the time of
application of future permits or approvals the City may review and reconsider all actions which I or my successors have
und~naken persuant to this LOAP. I understand that the City may as a condition of any future app'roval. require the
undoing, changing. or modification of any actions which I have undenaken as 8 result of the City a approval of this LDAP.
By signature, I state and agree. that I have" carefully examined the completed application and do hereby cenify that all
information herein is true and correct, and l further certify that any and all work performed shall be done In accordance
with the Ordinances of the City of Springfield. applicable City Standard specifications and Drawlngs,'and the laws of the
State of Oregon pertaining to the work .described herein. I further certify that only contractors and employees who are in
compliance with ORS 701.056 wlll be used on this project. .
The City may inspect the work site described in this permit at any time during a one year period following the receipt by
the City of notice of completion of the described work and specify. at the City's aole deseaatlon, sny additionsl restoration
work required to return the site to a standard acceptable to the City. The permittee will be notified In writing of any work
required end will heve thirty (30) devs Iro'm the date of the notice to complete the work. Work not completed et the end 01
the thirty days will be performed by the ,C.1ly and the COIU will be billed to the perminee. '
I further agree to ensure that q . d ons are equested at the proper time. that project address is readabla from
.~.. tht? ~t!~t. ~nd the appro s ns will remai the site at all times during constructiOy.. .
Slgnatur '- - ...... ,_-- Date "7 / i~ /fJ ()
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