HomeMy WebLinkAboutPermit House Move 1997-9-8
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HIGHWAY DIVISION 1r
'tlECIAL TRANSPORTATION .RMIT
FOR HOUSE MOVES'
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PERMIT NO.
SAME
liCLCPHT
UO 143:)
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IP"~~~~~NA;~HOAP BUILDING MOVERS li~;;T344-8833
IAU~;"~ox 2768
IC"~:~:~.~,: OR 97402
I~UlLUCH ;;~~;A IIUN NUM~cH
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AUUHI:::i::i
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30' 27'
UAlc
10/14/97
COMMODITY
Hcl(;iHI *
16'/19'8"
1
2
3
UVcHALL LI:Nli I H
65'
1 1
Wood Frame 2 2
NO, OF SECTIONS 3 3
I-'ILUI VI:HIl.:LI: ~I:UINNINU AUUHI:~
REQUIREMENTS 2 LANE: o NONE []I FRONT IXJREAR
4 LANE; o NONE DIIFRONT IXIREAR 38th and Main
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M17606 YCPJ631
ROUTE
STREET I HIGHWAY FROM MP
1
2
3
UI:::iIINAIIUN AUUHI:~
Main and S 52nd Place
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TO
MP
AGENCY
McKenzie Hwy (15)
38th and Main
4.16
52nd Place and Mair 5.78
Enter onto Main (Hwy 15) at 38th Street, Mf 4.16 fron the South, 90in9 Ea!t on Hwy :5
to 52nd Place, leavi~9 Hwy 15 at MP 5.78 onto South 52nd Place.
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HIGHWAY
TYPE OF
PAVEMENT
WIDTH OF I
PAVEMENT USABLE ROADWAY
Lm.EST
OVERHEAD STRUCTURE
IHAULIf'\IU HUUH::i HI:::iIHIl,;II:U IU
6:45 AM to 7:15 AM
IHAULlSUNO"AV: I "OCTOBER 19, 1997
rp'"A',Uol1'9/97
*SEE REVERSE SIDE OF THIS PERMIT FOR SPECIAL PROVISIONS *
THE PERMITTEE SHALL NOTIFY THE DISTRICT MANAGER. OR THEIR REPRESENTATIVE, OF THE MOVE AT LEAST 24
HOURS PRIOR TO COMMENCEMENT OF THE MOVE.
734-2006 7-90)
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BUILDING MOVING PERMIT '
. COMMUNITY SERVICES' DIVISION
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CITY ASSIGNED JOB NUMBER:
Structure Being Moved Fro~: ~42.:\f\ti l{\ ~ oft.... City:
Lane County 'Reference Number:, ~ ~\~ r ~ Tax' Lot Number:' f)Q~
Structure Being Moved TO:~ 5 ( C\,i\lfl Y;S I
Lane County Reference Number: \f\tfr4. "?J~ -:f\- Tax Lot Number: cx)loC;()
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BUilding~Wner:~~ t" ~~0J.9f.Y
Mailing Address: 2> <6l.g ", .tlo tQ'lNt ~J.....
,City: '-~ ilQ Q.A)
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Moving Contractor: 0~ ~ tD ,,~~ OOGJD Phone Number:
. '. \".. .' 'Illlrv']rf> A 1lC1('j'Q
Con~tructio~ Contractors Registration Number: () [).J (-y\ . . ~xPire~: ~ . 'LQ',,\( )
Mailing Address: l~ \ 1 ~ F:[f"\'W\ \.... ~~}f_" Cell p~~ne Number:
City: f,o~l.ft\' . State:' ' ~~O OtbiP: C\.11O~
Plumbing Contractor: '<' ~~ ~ffil ) Phone Number: .jL\4 '6'63:.\
,Construction contractor~ Registration'Number: 2lLb~C\ Expires: 4 ,t~ c{1
State:
OCQ l\M Zip:
l\
, _Phonei-!umber: 11-10. \9.1~
, , - Ce;; ;~~ne Number: f\ (0-../
Q14-18
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Description of Building to be Moved:
Square Footage: '\ to If
Moving Length:
(,.,s I
Moving Width:
Completion Date of Move:
Lfr;>'
Type of Constr: V N
_ Value ofStructure(s)' \~ f'('{)~
\n '. riJ 8pm
\\00)\ 8pm
Description of Proposed Route (Please attach map with route outlined with directional arrows):
?J<6~ \'\\() \ ~ jL?-0~\- ()'(\ ~ \-.0 51ffiJ'~
()f\ f)~ ~Mt- -\-0 0d-p"
Height on Dolly:
\9 I
'If)"
# of Sections Being Moved:
'.ivino UnitC'. {\ I~
\
Square Footage:
\CJ Jq ,Oil
'\ C'J. \ C\ . C\-l
Beginning at:
Proposed Date of Move:
. Ending at:
"
NOTIFICATION OF MOVE: The Community Services Division will route copies ,of this application to all appropriate divisions,
departments and agencies, However, the applicant must contact property owners if trees are involved in the proposed move, In
addition. the applicant must secure the approval of all appropriate municipal, county and state authorities should the move originate or
terminate outside the City of Springfield, or along any street owned by the state or tl)e county within the Citys boundaries.
PLANS, FEES, AND CHARGES: Prior to receiving a permit to move a building into the City of Springfield, the applicant or their
representative shall:
.. Submit two (2) copies of site or plot plan for new site.
. Submit two (2) copies of the foundation plan for the relocated building
. All applicable permit and system development fees shall be paid prior to any moved
. Any applicable permits and inspections for sanitary sewer cap or septic pump and fill
'\
By my signature below, I certify that the above information is true and correct, that all required contact~ have been made and
authorizations oita.ned. I also understand that the minimum time to process this permit, because of the numbe~ of agencies notified
by the City of ~ leld, i~ leven (7) working days. .' a ____ :t ._(;;--J
"""" {f!lt~ D~ -I () 7 /
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. Moving PennitApproved By: \1. ~ ~W ~ Ii\\~l Date: q 410
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Engineering Division Report: ~wner(s) AND Contractor(s) are both responsible for any damages to private or public property.
Moving Pennit Approved By:
.
~
Date:
9-'-1-97
Traffic Division Report: Contractor is responsible for a safe, efficient relocation operation. All signal systems shall be monitored to
ensure they are functioning properly. Any damage to or malfunctions of the traffic signal system shall be reported immediately to
Gary Weck, Signal Technician, at 343-4902 or Gene Butterfield, Maintenance Supervisor, at 998-3667.
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Date: 10112../ q 7
Moving Pennit Approved By:
, Historical Report:
Moving Pennit Approved By:___
'---"~"- ,.~--..-.
Date:,..___._. ___._,_.
Required Inspeciions: An inspection of the propeI;ly is required at the following indicated stages of this project.
_ Septic Tank Pumped and Filled / Sanitary Sewer Capped ~al Move , :
A Certificate from a bonded! Capped within fjve (5) ;, To be. made once structure has been
registered contractor will meet of the property line with moved from site and all debris has been
this inspection requirement. approved materials. . removed.' , .
To request an inspection, please call 726-3769. Inspections called in before 7 am will be made the same working day, inspections
called in after 7 am will be made the following working day. Please leave your City designated job number, job address, type of
inspection and when you will be ready for inspection.
Zone: W
Flood Plain:
FOR OFFICE USE ONLY
Type of Constr: V AJ
Occy Group:
R0
Application fee
Moving Permit
Sanii3ry Sewer Cap/Septic Pump and Fill
5% State Surcharge
3% Administrative Fee
Subtotal
$ 18.00
$ 60.00
$ 15,00
.75
.45
$ 94.20
$~
$-
$-
$~'W
_ Total Blocks. $.60 per block
TOTAL
(if property does ~ot need ~~itary sewer capped or the septic tank pumped and filled deduct applica e pennit fee)
DatePaid:_ \lJ' \\0 .Cr) _R~ceiptNumber:_' ~ll~C\ _By: . "
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