HomeMy WebLinkAboutPermit Curb Cut 1991-8-15
RESIDENTIAL - COMMERCIAL
. SIDEWALK I CURBCUT r )
AF'l"LICATION I PER1IT \_~
lll%)
225 NORiH FIFTH STREET
SPRiNGfiELD, OREGON <314,1
ENGINEERING DIVISION
o:TlCE NO. 126-3,53
INSPECTION LINE, '26-3'6<;!
JO:3 ADDF:i:55: 3&"7 1/14//../ ST.
ASSESSORS MAP NO.*' /7 - 0 Z .- 3/ - d-2-
TAx LOT NO. '* 4701
5'J9DIVISI0~,
OJNER: tJ/G5TrA/R A-?~c 1A-7.s5
ADDRESS, P.O, I30x 4-S-c. cm", SjPIZIAI~fcx..f)
STATE, Cl2-E". ZIP, 974-77P'HONENO'74--7-4~(
:!lORK DESCRIPTION.
SIDEWALK., CURS SIDE _ SET9ACK _
CURS-CUT, --X- RESIDENTIAL _ COMMERICAL _
~=,..~'..., """"V="'LY (SEE TRA'-,-IC )'+'pj7,tU>/ietJ '-"r ~ /J/.SII<:'(D
REQJIRES AF'f'LICATION FOR A SECOND DRIVEWAn'T-4.1.)
OR A COJNTY APPLICATION FOR FACILITY PER1IT (C ~-203)
IF IN ni: U.G.9.
DATE OF AF'F"~ICATIO~ ff//~/1(
:.;:oR!<. TO BE F'ERru"", I1:D SY'.
CONTRACTOR *'
x
Ou.NER CONTRA.CiOR
*'
REGISTRATION NO.
ADDRESS
SPRINGFIELD
R:C!:IPT NO:
8. ~O~ l
C~
CH=C<
~
*.--
CI-I=CKED FOR DELINQU:NCIES
*
~t!/r
o/t~/ ir
SIGNED,
DATE,
EXPIRES,
PMONE,
PROCEDURE FOR IN&FECTION l"5QUEST.
CALL ,26-3,6<3 (RECORDER) STATE YOUR CITY DESIGNATED J09 NUM9ER, J09 ADDRESS,TYPE OF
INSPECTION REQUESTED A'lD UJ;.IEN YOU WILL BE READY FOR INSPECTION, CONTRACTORS OR OLLNERS NAME A'lD
PHONE NUM9ER REQJESTS RECEIVED 9=r~= 1,<i:>O A"1 WILL 9E MADE THE SAME DAY, REQJ=STS AFTER ',<i:>O
A"1 WILL 9E MADE THE NEXT UO!Ol<IN!O DAY
*' SEE !3OOK
EXISTING BUILDIN!O PER1IT NO. ( IF AFF'L1CABLE )
YOUR CITY DESIGrNA~D J09 NO. IS'!" q f 0 q ~7
REGlUIl"5D IN&FECTION5
D
SIDEWALK ~IVEWAO
FOR ALL C()NL;'""" It: r'AVING WITHIN
THE STREET RIG"T OF WAY, TO BE
MADE AFTER ALL EXCAVATING
IS COMPLETE A'lD FOR1 UO!Ol<
A"iD &US-BA.&: M..t..TERIAL IS
IN PLACE
:-:::5.
&ID=UJALK&
~10.00 + ~0.i:;/L';=. ( X )
or= WALK
CURa-CUT
~i0.00 + ~.i:;/LF. ( X )
~
CURS I APPROACH APRON,
A-iER FO~5 ARE ERECTED
SUT PRIOR TO POURI~G
CONCREiE.
WALK X'
/ -",
I, Z4' I
x'
, ~ -
TOTAL FE~IT FEE. _ S /3. {PO
COMMERICAL DRIVEWAYS SHALL
"AVE 5' TO 8' FLAIRS
3'- O' 5TA'lDARD
I ;..;,t.,VE CAREFULL.,.... EXA."1INED i~= Co:--iPLETED ~PPLICATION FOR PER!'1IT, ~"-lp DO ~ER:9Y CERTIFY TI-IA.T ":"LL
:~:=ORMAT1ON l-1EREON 15 TRUE 4"'D CORRECT, t.."-lD I FURTI-lER CERTIFY Tl-IAT .4"'Y A"-JD ALL UOR< FE~O~ED
S~4LL 6E.DO~E IN .4CCORD4~CE WITl-l T;..lE ORDINt.."-lCE5 OF Tl-IE CITY OF 5FR1N~lELD, ':"'~D T!-!E LAt:J.5 OF T;";E
ST4TE OF OREGON PERTAININ~ TO il-lE U)ORl< DE&cRIBED MERE IN, .L."ID Ti...tAT NO OCCUP":"'lCY UJiLL 5E M4.DE:
:.:;.:= ~~Y 5TRJCTURE Wli:";O;JT PE~ISS1ON OF il-lE 6UILDING: DIVISION.. I FU~Tl-1ER CERTifY i;";~ T O--:L Y CONTRACTO~5
":",,,-:p EMPLOYEES UJ;-.!O ARE IN COMPLIA"-lCE wIn..; ORe iOl..oe.~ WilL BE USED ON Tl-lIS PROJECT.
~~l~
DATE
~!b-j?/
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