HomeMy WebLinkAboutPermit Curb Cut 1992-10-9
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SIDEWALK I CURBCUT
APPLICATION I PEF<:'1IT
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SPRINGFIELD
22S NORTH FIFTH S~ET
SPRINGFIELD. OREGON 'a1411
ENGINEERING DIY1SION
OffiCE NO, 126-31S3
INSPECTION LINE, 126-316'a
.
JOB ADDI"!!:&&. /.0.0/ /114-11/ "sT,
ASSESSORS MAP NO.*" I r; ()3 ,~~l
SU6DIVISION.
TAX LOT NO, '*m-:zrn)
-'-~_.-
OUNER.
&/'/2.//JM=/CUJ UTILlT'(' 6r:7l/tYJ
/J1If-IN 5T, crn', S/,~I(;~(~
ZIP. 974-77 PHONE NO, 72.4>-23'1'5
ADDRESS, / .(/,0 /
STATE, t?',eE,
UJOfO!K DESCRIPTiONs
SIDEWALK. CURe SIDE ......- SETBACK _
CURe-CUT, RESIDENTIAL _ COMMERICAL _
SECOND DRIVEWAY (SEE TRAfFIC) J)/t/VC/,(Jlty <-- _
REaJlRES APPLICATION FOR A SECOND DRIVEWAn.,.-4.1.) ~
OR A COJNTT APPLICATION FOR FACILITT PEF<:'1IT (C ~-2"'3) Ik>P#-Il-LT
IF IN T1-lE U6.6. / III/PI C~,</C.
DATE OF APPLICATION /~-.P
WORK TO BE r-",~ ,,,,D BY.
CONTRACTOR*" S~~/~ct./)
ADDRESS / POI /I1M,(j
.,......... OUNER --- CONTRACTOR
A~O '*
I?'"' vREGISTRATION NO.
V77C/r'(
GT,
.
RECEIPT NO.
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~ 4-SO
CASH
CHECK
*"
CHECKED FOR DELINQUENCIES
-
/
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SIGNED,
DATE,
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/0/97<1''2.-
EXPIRES.
PHONE. 7~-Z3'7<y
r--..."""""JlOiS FOR IN&FECTION REQUEST.
CAlL 126-316'a (RECOROER) STATE YOUR CITT DESIGNATED J06 NUMSER. J06 ADDRESS.TTFE OF
INSPECTION REQUESTED AND l1A-lEN YOU WILL 6: READY FOR INSPECTION. CONTRACTORS OR OUNERS NAME A"lD
PHONE NUM6ER. REQUESTS RECEIVED 68'ORE 1"2>0 AM WILL 6E MAD: TH: SAME DAY. REaJ:STS AFTER 1.00
AM WILL 6: MADE THE: NEXT UJORKING DAY
*" SE: 600K
EXISTING 6UILDING PEF<:'1IT NO, ( IF APPLICAaLE )
YOUR CITT DESI"''iATED J06 NO, 1St CP2 (42/
REGlUIRED IN&FECTIONS
m u
SID:WAL~IVEWAY ~
' FOR ALL f'E'FE , A ING WITHIN
THE STREET RIG4T OF WAY, TO 6:
MADE AFTER ALL EXCAVATING
15 COMPLETE A'iD FOI<l1 UJORK
A"lD SU6-6ASE MATERIAL 15
IN PLACE
D
CURS I APPROACH APRON.
AFTER FOF<:'1S ARE ERECTED
6UT PRIOR TO POURING
CONCRETE,
FEES. &IDEWALK& CURe-CUT WALK x'
.10,00 . .0.1&/LF. ( X ) .10,00 . ~.I&/LF, ( X ),% I / ~
OF WALK PR/I/e<<JA'r ~/J!E,tIT
COMMERICAL DRlYEWAY5 5I-IALL l x' I,
4AVE S' TO 8' FLAIRS
S /5' ,4-0 3'. O. STA'iDARD " 1
TOTAL FEI"t1IT FEE.
I 4AVE CAREFULLY EXA..,INED T4: COMPLET:D APPLICATION FOR FEF<:'1IT. "'''D DO HERE6"- CERTIFY TH"-T ALL
IN?OF<:'1ATION HEREON 15 TRU: A"lD CORRECT, A'iD I FURT4ER CERTIF'r THAT A'll' A'iD ALL lOCll<K PE""~,,, 'o:D
S4ALL B: DONE IN ACCOROANC: WITH T4E ORDINA"CE5 OF THE CITT OF 5PRINGFIELD. AND TH: LAWS OF T4E
STATE OF OREGON PERTAINING TO TH: UJORK DE&cRIBED HEREIN, A"D T4AT NO OCCUPA"C"- WILL B: MADE
OF ANY 5TRJCTURE Wm-lOUT PEF<:'11551ON OF TH: 6UILD'ING DiViSION. I FURTI--I:R C:RTIF.,- THAT ONLY CONTRACTORS
A"D :MPLO'l'EE5 WHO ARE IN COMPLIANCE WIn-l ORS lOI.05S WILL B: U5:D ON THIS PROJECT.
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SIGNED
DATE
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