HomeMy WebLinkAboutPermit Sidewalk 1994-11-14
-BjiIDENT11~;ALK I :~~ERCIAL
AFf'LICATION I PERMIT.
II~
22S NORT~ FIFT~ STREET
SPRINGFIELD, OREGON <;\1411
ENGINEERING DIVISION
OfT'ICE NO, 12&-3153
INSFECTION LINE, 12&-31&<;\
JOB ADDREe5. 4 '?2-/
ASSESSORS MAF NO.'*'
M1 \AUHor/.
TAX LOT NO: '*'
SUBDIVISION, M-1 V~ LIoN 'lllXlP> Lo'f J
O.1N;;R, <;J,QqC leI ~ ~-riEI AI
ADDRESS, ?IfD7c.r 8/lWrc>J.../ LH CITY, -!!?f Je-P
STATE, tJ L ZIF, 97'17 ~ FrlONE NO. 74/?-OIOO
WORK DE&;RIFTION.
S!D8'1.l.1 K, ~ CUSS 51DE _
CURB-CUT, R:SIDENTIAL _
&ECOND DRlVEWA.,.. (SEE TR,.lJTIC )
R:aJIRES APPLICATION FOR A SECOND DRIV:OWAYI.,.-4.1.)
OR A COUNn- AFf'LICATION FOR FACILITY PERMIT (C '08-203)
IF IN 11-1E U.G.5,
5::leACK
CO:-1MERICAL _
DATE OF AFf'LICATION
/1 /;t.f/~t/
lUQRK TO BE FER!=v"" 11::0 BY.
I~R
SPRINGFIELD
RECEIFT NO, \ 50/\ f)
CA5l-I _
Cl-IECK v-
. '*'
CHECKED FOR DELINQ'JENCIES
51"'NED,
~ I'" p:{/W(-6
/1,1#1/"'1'
DATE:
CONTRAC-;OR
R:"'15TRATION NO,'*'I'?D$'901t., EXFIRES, -z../f /"/5'
FHONE, --zc..f7-0ICO
CONTRACTOR'*' -o-AC%- 1<~S-rEIt-\.
ADDRE55 ~/')"14 'e:.A$~OM L...J--.\.
h~""'''''l:''''URE FOR lN5A:CTION REQUE5T.
CALL 12&-31&<;\ (RECORDER) 5TATE YOUR CITY DESI"'~TED J09 NlJ:'19ER, J09 ADDRESS,TYPE OF
INSPECTION REQUESTED A"D t1\-lEN YOU WILL BE READY FOR INSFECTION, CONTRACTORS OR OU.NERS NAME A"D
FHONE NUM9ER REQUESTS RECEIVED B:rvr= 1,00 "-"1 WILL 9E MADE THE SAME DAY, REQ'JESTS AFTER 1,00
AM WILL BE MADE THE NEXT UJr::>R:::ING DAY
'*' SEE BOoK
YOUR Cln- DESI"'NATED J09 NO. Isf
EXI5T1NG BUILD IN'" PERMIT NO, ( IF APPLlCA9LE )
94173>3
REQUIRED lN5Fl:CTION5
mlDEWALK I DRIVEWAY
FOR ALL CONCRETE FAVIN", WITrllN
THE STREET RI","n OF WAY, TO 9E
MADE AFTER ALL EXCAVATING
IS co;-1FLETE AND FORM UJOR<
A"D 5U9-9t.5E MATERIAL 15
IN PLACE
FEE5.
SIDEWALKS
CURB-CUT
~J0,00 . ~.1:;./LF. ( X )
~10,00 . ~0.1:;./LF. ( X )
OF WALK (P'l.4/' /0.<(.7-
D
CURB I APPROACH AFRON
AFTER FORMS ARE ERECTE
BUT FRIOR TO FOURIN'"
=NCRETE,
WALK X'
/ "'"
l X' I.
" "
TOTAL R:RMIT FEE.
~
2.0 t '-f L
=:1MERICAL DRlVEWAY5 SHALL
HAVE S' TO 8' FLAIRS
3'. O. 5T"-"DARD
I rlAVECAREFuLL Y EXA"1INED T"E COMFLETED APPLICATiON FOR FERMIT, ,'ND DO HEREBY CERTIFY THAT ALL
INFORMATION HEREON IS TRUE A"1D CORRECT, A"1D I FURTf'ER CERTIFY THAT A"1Y ".ND ALL lLOR< PE~ORMED
SHALL BE DONE IN AC=RDANCE WITH THE ORDIN"-'lCES OF THE Cln- OF SFRINc;FIELD. AND THE LAUJ5 OF THE
5TATE OF OREGON FERTAINING TO THE UJr::>R::: DESCRI9ED HEREIN, "-"1D THAT NO OCCUFA'lCY WILL 9E MADE
OF ANY 5TRUCTURE WITrlOUT FERMI5510N OF THE BUILDING DiViSION. I FuRTI-<ER CERTIFY 7HAT OHL Y CONTRACTORS
AND ;MFL27=:; ~~C.s:; ~) 101.055 WILL BE USED ON THIS FROJ:T'_ I'V -,7'7'
51"'NED
DATE