HomeMy WebLinkAboutPermit Sidewalk 1994-12-29
II~
. ~IDENTIAL - COMMEiclAL
..:-w SIDEWALK I CURBCUT
A~L1CATION I FERl1IT .
225 NORTe! FIFTe! STREET
SPRINGFIELD. OREGON <;\1411
ENGINEERING DIYISION
OffiCE NO. 126-3153
INSPECTION LINE, 126-316<;\
JOB ADDREe5: 42~7 //111-/J.J Sy;
ASSESSORS MAP NO.* /7-02-32. -31
SPRINGFIELD
~~
TAX LOT NO: *300:>
RECEIPT NO, \W77
CA5l-l
5USDIYISION,
CHECK
O.1.NER, ~TG'U2;;' ..(?tJ{.G'
ADDRESS, 25"0 5(JU!7f 1-3RD
STATE, ol2E, ZIP, 174-78
lJ..IOF:l< DE5CRIPTI~:
I J/"
SIDEWALK,
,/
cm-, 7/RIIJ~/cLf)
Pf./ON: NO, 7;z&-ZICb
'*
CHECKED FOR DELINQJ:NCI::S
--
CUSS SID::
5:T9AC< _
CUREl-CUT,"/ RESIDENTIAL _ CO:-r.1::RICAL .A-
5:COND DRIVEWAY (SEE iRtJTIC )
REQUIRES A~L1CATIO,ool FOR A S::COND DRIV::WAYI'T-4J.!
OR A COUNTY t.FFLICATlON FOR FACILITY F::Rl1IT (C <;lB-2/Zl3!
IF IN TJ.1E U.c.,S,
DATE OP A~L1CATIO,ool I?-/Z-:tdf-
.SIGNED,
DATE:
WORK TO BE FERFv"", IcD BY: OUNER
CONTRt.CTOR'* f"fRItMIO COJvSTJ2U~Tlt)N
,
~~ E' ::.-r:. 5,PrE(lJ~rt'eC-D
x
CONTRACTOR
*
NO. 5~~
REc.lSTRATION
ADDRESS
~
~A4-
r2./2-~ 4-
::XPIRES, f(/'2-/9S"
PHONE, 7~-cr~
,""'-"-c....URl: FOR INSR:CTI~ l'SQUEeT.
CALL 126-316<;\ (RECORDER! STATE YOUR CITY D::Slc.NATED JOEl NU:1ElER, JOEl APDRESS,TYPE OP
INSFECTlON REQUESTED A'lD Ul-lEN YOU WILL BE READY FOR INSPECTIoN, CONTRt.CTO!'15 OR OUNERS Nt.ME t.'lD
PI-lONE NUMElER REQUESTS RECEIVED BEFORE 1;/Zl/Zl t..'1 WILL ElE MAPE Tf./E SAME DAY. REQUESTS AFTER 1,=
A'1 WILL BE MAPE THE NEXT WOR<:INc. DAY
'* SEE B()oK
EXISTING: SUILDINc. FERl1IT NO. ( IF A~LICABLE !
YOUR CITY D::Slc.NA TED JOEl NO, Isf q 4 1 q 7 (
~S(~tl\ (!..HA/JtEE- CURB-CUT pallle-tVA+- CUI28-<6T RP1'.oe.+ ff~).
- oveR FRPIII EXISTlICko :f A~~ T~,~ Pe-,e;nrrref) WALK x
110.00 . ~0.15(LF. ( X )PRIIICtII4-hI0.00 . ~.r;Jf!PrMj{"J:: e:>POT / "-
OF WALK 3~ '" 'M "-
l x' I.
'I '.
l'SGlUIl'SD lNeFl:CTl~e
~DEWAL!il.- I DRIVEWAY
!'VI'< ",,-"C CONCRETE PAYINc. WITHIN
TH:: STREET Rlc.HT OP WAY, TO ElE
MADE A"TER ALL EXCAYATINc.
IS COMPLETE AND FORl1 WORK
A>oJD SUEl-ElI.5E MATERIAL IS
IN PLACE
D
[K]
FEEe.
TOTAL Fl:Rt1IT FEE:
$
I~Z5
COMM::RICAL DRIV::WAYS SHALL
HAVE ,,' TO 8' FLAIRS
3'. 0" 5TA'lDARD
CURS I APPROACH APRON
AFTER FORl1S ARE ERECTE
BUT PRIOR TO POURINc.
CONCRETE.
I r-l.t.\I'E .CAR:::."i=uLL Y EXA'1INED Ts-lE COMPLETED APPLICATION FOR PERMIT, ~'lD DO t-/EREBY CERTIFY Tt-l,l.T ALL
1N"'.-oRl1ATION HEREON IS TRJE A><D CORRECT, A'lD I FURTHER CERTIFY THAT A>oJY ""'lD ALL WOR<: PE!'l'O~D
SHALL BE DONE IN ACCORDANCE WITe! THE ORDIN"-'lCES OF THE CITY OF SFRINc.rIELD, AND TH:: LAWS OP THE
STATE OF OREGON PERTAINING TO TI-lE llJC>RJ<. DE5CRI9ED HEREIN, A""lO TI-lAT NO OCCUPA"'lC.,.... WILL 9E M.L.DE
OF .ANY STRJCTlJRE WITHOUT PERMISSIoN OP TH:: BUILDING: DIVISION. I PJRTH::R CERTIFY 7H"-T ONL Y CONTRACTORS
AND EMPLOYEES WHO ARE IN COMPLIA>oJCE WITH ORS 1"'1~" WILL ElE USED ON THIS PROJECT.
Jiu~ alA ~ j),,-;)..Y-9f//
SIGNED' DATE