HomeMy WebLinkAboutPermit Sidewalk 2009-7-20
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:':'~ .;; DRIVEWAY/SIDEWALK: . ; ......:.~: PERMITAPPLlCATION:......::.':::r~t:
225 FIFfH STREET
SPRINGFIELD, OREGON 97477
ENGINEERING OMSION
OFFICE TELEPHONE (503) 726-3753
APPLICATION DATE: ?j J. 0/ 0 '{
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PERMIT NUMBER: CO,.., 01- (; 10 9- b
DATE ISSUED: 7/J./J/ Of(
SITE INFORMATION:
lOCATlONOFOORK:.).~).. M.:-
onpT
1.114 Ii. .5t
C+./O~IJ.(' /\. Mf' 3,lS-~3.J.<l. tIorf~ .iJ<-
/ ,. -, .
PHONE (j-~(f) 74 'f - forO;' 0
TAX MAP: '703 J'!f( oUO'O
APPliCANT
ADDRESS:
OW S;>r;~(."..\J
SUSQMSION:
C>DUI
STATE:
()t(
ZIP:
q7477
TAX LOT: IOOl?: If~ IJ..Ol>/ (300
OWNER:
PHONE:
ADDRESS:
ClTY:
STATE:
ZIP:
REQUESTED PERMITS:
o SIDEWALK: .................... ........................ ................................... $88.00 ......................... ~ $
AMOUNT OF SIDEWAlK IN EXCESS OF 90fT. @$O.08 SF. = $
.tlil; SIDEWALK REPAIR: ..................................,........................................ $15.50 ........."................ ~ $
~'b.-
q. ~12-
o CURB CUT/DRIVEWAY: NUMBER OF DRIVEWAYS
X...".."............. $88.00 1st Cut = $
o MULTIPLE PERMIT DISCOUNT EA: .........(MAX 2)......... .....$30.00
(MULTI PERMIT DISCOUNT GOOD FOR ONE SITE AND ONE SITE INSPECTION..!lliLt
/ APPUES TO 2nd AND 3rd PERMITS ONLY. NOT SIDEWALK REPAlRt
51 5% Technology Fee $ ~. C;" TOTAL DUE 'MTH PERMIT $
o PROOF OF INSURANCE: $500,000 MINIMUM IF WORK IS DONE BY PROPERTYOWNER
2nd Cut ~U'
=$
1-
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CONTRACTOR INFORMATION:
CONT~TOR: f'o1'G~o""'C".JrQc.-h".-~ Lie..
ADOREss:1. $./w::I3..{ r..~J.,;~.... OR
cClNTPACTOR REGISTRATION NO: I.,,\",q?cb .. ,
PROJECT SUPERVISOR: .1>0..... A.""'~_^-(I.-r
,
EXPlRATIONOATE:
AI
PHONE: .!L'lfl" ~......:.
q-IJ. -/u
PHONE: 7Q", S~t.O
97'11<1
INSPECTIONS:
MlINSPECTlON AEOLEST SHOULD BE MADE PRIOR TO POURING CONCRcrE, AFTER THE PROPOSED WORK HAS BEEN Fa RMED AND MADE READY TO
POUR. CURB CUT AND SIDEWAlK INSPECTIONS CALL 720.3769 (RECOROE.R) STATE YOUR OESIGINATED CITY..oB
NUMBER/PERMlT NUMBER, JOB ADDRESS, TYPE OF INSPECTJOI'.l REOUESTED, AND \r'vHEN YOU Will BE READY FOR INS PECTtON, CONTRACTOR'S OR
O'NNEA'S NAA1E AND PHONE NUMBER. REQUESTS RECEIVED BEFORE 7:00 A.M. Will BE MADE THE
SAME DAY, REOUESTS AFTER 7:00A.M. Vv1ll BE MADE THE NEXT WORKING DAY. INSPECTIONS ARE TO BE CALLED IN
AFTER EXCAVATIONS ARE MADE AND FOAM WORK IS IN Pl..ACE BUT PRIOR TO POURING CONCRETE.
YOU ARE REO~REO TO CALL
THE LANE UTILITIES COORDINATING COUNCIL'S
"ONE CALL NUMBER" 1-800-332-2344
48 HOURS BEFORE DIGGING
SIGNATURE:
AMOUNT RECEIVED: .-It;, 0,) .
RECEIPT NO: ~)CV''''-
3<-
"'V'L
DATE PAID:
RECEIVED BY;
'(.;}C
t:l;'u.J
. C C',
By siglature. I stale and agee thaI I have ca.-eful!y examined the cOOlpleted appkalion 8l1d do he reby certify thai al inlamation herein is !tue
and cOO"ect and I further cet"tiIVtha\ af!r' and all work performed shall ~ dene in accordance with the Ordinances or , .
the CilV 01 ~Pijngrjeld, aPfllica6le Cily Slandatd spealicalions and nra....;flQs. and the laws oIlne Slale 01 Oragoo perla.nirlg 10 the v.ork described herell1. I further
cerlify that .only conlraClors and employees who are in canpliance 'Mlh OAS 701.055 'Mn be used
onlhlsp-olect.
The City may il1specllhe work sHe described in this permil at,any lime duting a one yeal period 10 nOwillg the receipt by the City 01 notice 01 can~elion oIlhe
descflbed...,.ark and speoty, .!lIthe Oty's sole discrelicn any addilional resloll::I!ion work required 10 fetUln lh_e sile to a slandard accep'!able 10 the Cl . The
permlnee WIll be notified in 'Nfi.1ing 01 any work required <ind.,.,..;1I have thirty c1ays (30) from Ihe date 04 the nollce 10 COI"fl)Iele the work Work not can eled allhe end
of lhe Ihlrty days WIU be per!()(rneo by ttie City and Ihe cosls wil be billed 10 ltie perTTlltlee. .
I further agree 10 ensure Ihat all req d lI1spechons are requesled .!Illhe pfOper lime. Ihal pl"ol eel ado-ess IS readable hem the
;;;:~j"J:O'- ;:::;7~'- G 7-~O-69
22,5'Fifth Street
..;:,.'
Springf.eld, Oregon 97477
541-726-3759 Phone .
Job/Journal Number
COM2009-0 I 046
COM2009-0 I 046
Payments:
Type of Payment
CreditCard
cReceintl
RECEIPT #:
Description
Sidewalk Permit
+ 5% Technology Fee
Paid By
STATE OF OREGON ODaT
".,~~_l~G."'.~:~....:,.:,.: :)..'
t 4.. 'pi:Ii
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City of Springfield Official Receipt
Development Services Department
Public Works Department
Ii
3200900000000000542
Date: On!0/2009
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
CTM 042614 In Person
Payment Total:
I;
Page 1 of]
10:42:54AM
Amount Due
97.92
4.90
$102,82
Amount Paid
$102.82
$102,82
7/20/2009
~Var,
1,3' To 7.3'
r 18" Curb and r;utter
. (See drg. no. RD700J
5 - - --
. P. C. cone. sidewalk
Thkn. - 4"
(See drr;. nos.
MHMAC wearing course-----. RD720 & RD750J
~~;:" ~k!:: ~?se R=3"\' / Exlr;. surfacing
Extg. surfacing, 7"L\~sl.2% __1____
_L ~.
51. var, :7 I" ~ Saw cui
Saw cui 1:6 To 1:8 ~'~
I 1'( . Aggrer;ate base
~1'1-- Nom. compo thkn. - 16"
ANr;r;rer;ate baths: _ 4" Subgrade geotextile
om. compo .n.
---
SIDEWALK CONStRUCTION
JUL 27 2009
~: \ODOT _DA T A \Projec t s\ARCH1VE \ORl26-Main_Street _Sidewal k_lmprovements_Springfiel d\sprgfl d_sidewolk. pll 7/27 /2009 8:0~: 15 AM
TYPE SSa-l
r Seam stitch shall be no
-'. Less than 1" and no
I Greater than 1/12"
'-T I.
"FLAT" OR "PRAYER" SEAM SSa-l
42V-146
TYPE SSd-l
TYPE SSn-l
1"
r
'~f
1"
r
-fr
"BlITTERFL Y" SEAM SSd-l
"J" SEAM SSn-l
=:a----....I'
:: ! :
=)I~jLI_il
STITCH TYPE 301
-----,
~
STITCH TYPE 401
GEOTEXTILE ST1TC~ING
RENEWS: 12-31-2009
hwye30s
NOTE, .
Side-slopes are s/lo'Nn as vert. to OOr1'z
r . OREGQN DEPAR.tM~NTOF TRAN~PORtAT10N
Fi~~I()N:2 TI;CHCENifE;Fi
.' OR126iIlAINISTliEET 0 lIiP. 3:27
SIDEWAlKo; IIIPROVEIIENTS (SPRINGFIELD) SEe,
. . .c..., ., MCKENZI( HIGHWAY' -
LANE COUNTY
Oesioned By - Bruce Eblil'lQ
OroHftd By - D. Centner--Oay
D ETA I:L 8
S>€H
NO.
2
1:02~O - 2