HomeMy WebLinkAboutPermit Curb Cut 1992-1-14
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22~ NORTI-4 FIFTI-4 STREET
SPRlt-l:rIFIELD, OREGON '.11411
ENGINEERING DIVISION
OfFICE NO. 12&-31~3
INSPECTION LINE, 12&-31&<;\
.
SIDEWALK I CUR6CUT
APPLICATION I PERl'1IT
RESIDENTIAL - COMMERCIAL
.
SPRINGFIELD
ItI'.lO .
Joe ADDl'ESS: ~73e /?/A'/#'.;7".7:
ASSES501'15 MAP NO.*' I 7 /')?.,.., L ( ~ TAX LOT NO. "* 0' z...t( ('}>)
5U9DIVISION,
O.lNl:R<
ADDRESS,
( /17-:,..,( /t..". -.-(u".
~':'^- CITY, 5?FO
ZIP, 97t./7'tf P'o-lONE NO.7U-#o2-
STATE:
<YO#/I SGI\8iJ
373 <if
oA:
lllORl<. DESCRIPTION:.
SIDEWALK. " V . CURB SIDE _
CURB-CUT, Jf/!!!!! . . RESIDEl-iTIAL _
SECOND DRIVEWAY (SEE TRAlTIC )
REQUIRES APPLICATION FOR A SEC= DRIVEWAYr'T-4.1.)
OR A COJNTY APPLICATION FOR FACILITY PERl'1IT (C '.IS-103) .b
IF IN Tf.IE U.G5. Cl~,v(,. c,I r
DATE OF APP'-'CATlON ~/!r'f)" ~I/:r:
SETBACK _
CO:1h=RICAL _
<!:t;/~
UlORK TO 6E F'E~ORllED e"..:
CONTRACTOR*' tl5tr1- j)~ ~.
9071" A~ I{,l.
Y CONiRACiOR
*'
REGISTRATION NO.
O~R
ADDRESS
1Ii:~
REC::IPT NO, ~1i> IS-
CAS+-!
C;.<::C<
......-
*,.......-
Cl-i::C<:ED FOR DELINQ.!ENCI::S
~.."
~
SIGl.'lED,
':5d~~
/'
DAlE:
::><PIRES,
P;";ONE, k> g 'r -/\("O Y'
r-~" _. "IRE FOR INSR:CTION l'EQUE5T:
CALL 12&-:;1&'.1 (RECORDER) STATE YOUR CITY D::SIGNATED J09 NU:'19::R. J09 A::>DRESS,TYFE OF
INSPECTION REQUESTED A'ID UA-lEN YOU WILL 9E REA::>Y FOR INSPECTION. CONTRACTORS OR O::N::1'15 Nt.."'<E ,1..'0
PI40NE NUM9ER REQUESTS RECEIVED BEFORE 1,= h.., WILL 9E MA::>E ro-lE SA"'<E DAY, REQJ::STS A=TER 1,=
AM WILL BE MADE TI4E NEXT WORKINC. DAY
*' SEE 900K
EXISTIN:;, BUILnlNG. PERl'1IT NO. ( IF APPLICA9LE )
. YOUR CITY DESIGNA~D J09 NO. IS1' ~Ze> 6"2- 7'
REQUIRED IN5FSCTION5
D
SIDEWAL< I DRIVEWAY
FOR ALL CONCRETE PAVING WIT;";IN
TI4E STREET RIGI-4T OF WAY. TO 9E
MADE A-IER ALL EXCAVATINC.
15 COMPLETE h'lD FORl'1 WORK
A'lD 5U9-9A5E MATERIAL IS
IN PLAG::
~
CURS I APPROACI-4 APRON,
A-IER FOR"15 .4~ ERECTED
5UT PRIOR TO PO.JRIN~
CONCREiE.
FEe5, SIDEWALKS CURB-CUT WALK x'
.10.00 . .0.1~/L;:. ( X ) .10.00 . ~.1~/L.t=. ( X ) / ""
OF WALK
co.~ER1CA.L DRIVEWAYS Sr4ALL I, x' I.
_$/~~ I-4AVE ~' TO e' FLAIRS
3'- 011 5T A"lDARD " 30' . ,
TOTAL FCRMIT FEe,
I ;-U..VE C.l.REFULL.,... EXA."1INED T~E COMPLETED AFPLlCATION FOR PER"iIT, ":'''D DO r..;ER:Sl CERTIFY ii-4AT ALL
jN:--o~AilC'N l-1EREON IS TRUE A~D CORRECT, A"{D I FURTl-1ER CERTIFY il-lt.T A'll A'JD ..4LL WOR< FE~O~I=D
S:":ALL BE DONE IN AcCORC>.G.NCE W1Tl-1 Tl-iE ORDlNA"-1CE5 OF Tl-1E CITY OF 5PRrN~lELD. A"ID TI-iE L.AUJ5 OF T;"';E
STATE OF OREGON PERTAINING TO Tl-1E UJOR<. DE5CRI6:D HEREIN, A~D ii-tAT NO OCCUP":"'lC.,.... WiLL BE MhO:
OF At..lY 5iRJCTURE UJITHOWT PE~1551o:-.l OF Tl-1E BUILD1N~ DIVISION. I FURTl-1ER CERlJFl Ii-lAT O~L"'" CONTR,.:..CiOR5
'~yZ~~::~<A'O'.'" ~ ,0=, "" S' _0 ~ ;""~~/ql
51d AyJr ~ . D:./ /' .