HomeMy WebLinkAboutPermit Sidewalk 1994-11-14
Il~
1j6IDENTIAL - COMME~CIAL
SIDEWALK I CUReCUT .
-. APPLICATION I PER'1IT
225 NORTJ.1 FIFTJ.1 STREET
SPRIN6FIELD. OREGON '01411
ENGINEERING DIVISION
Oi'FICE NO. 12('-31!;3
INSPECTION LINE, 12&-31&'0
JOB ADDRE55. /0 S- LU. 01'1 M () j (~
ASSESSOR5 MAP NO.*' \ 'l0 ?'~'\4 \
SPRINCFIELD
TAX LOT NO. *D~olO()
RECEIPT NO, D I S-4i 3
CA5J.1
5U6DIVISION,
CHECK
Oll.NER, H fI C S it
ADDRESS, ~OO Uh
STATE, <Dee
......--
-
CITY, S f~/d.
"*
CJ.1ECKED FOR DELlNQJENCI:S ...:::::...
Fai~LI;eLJ
ZIP, q7411
PJ.1ONE NO.
UJORK DEOCRIPTI~.
V
CURS SIDE v/
RESIDENTIAL v/
SIDEUJALK,
SETBACK
CURS-CUT,
SECOND DRIVEWAY I SEE TRAFFIC)
REQUIRES APPLICATION FOR A SECOND DRIY:WAYI'T-4.1.)
OR A CO'JNiY ,G,FPLICATION FOR FACILITY PER'1IT IC ~-2"3)
IF IN TJ.1E U.c;.9.
CO:-1;-J:RICAL _
SIGNED,
DATE,
DATE OF APPLICATION
WORK TO BE FERf=u"", It::D BY:
CONTRACTOR"* STA-+6n COY1:\t, rV1 C
ADDRESS (lq:?q'l-!? AivoOJ-t N .
~ONTRACTOR
REGISTRATION NO.* 03 37/
ELtlrtle OrfF C!f740"1..-
O"-NER
~ T-.A---
H/i S/94-
EXPIRES. 3/ dl/fiS-
PHONE, L/.I" 1-6S4 <
,.-..'->=.....URE FOR lN5Ff:CTI~ REGllJEST.
CALL 12&-31&'0 (RECORDER) STATE YOUR CITY D:SIGNATED JOB NUl'1B:R. J06 ADDRESS.TYP: Of'
INSPECTION REQUESTED A'lD ~EN YOU WILL BE READY FOR INSP:CTlON. CONTRACTORS OR OlLNERS NA"1E A'ID
PJ.1ONE NUl'16ER. R:OUESTS R:CEIVED B=r-ORE 1,0" .<.M WILL 6E MAD: TJ.1: SA"'tE DAY. REG>JESTS .<.FTER 1,00
AM WILL 6E MADE TJ.1E NEXT UIORKING DAY
* SEE 600K
EXISTINC: eulLDING PER'1IT NO. ( IF ,G,F'F'L1CABLE )
YOUR CliY D:SIGNATED JOB NO. 151' '9 4-li5"G:,
REQUIRED lN5R:CTJ~S
IT
SIDEWALK I DRIY:WAY
FOR ALL CONCRETE PAViNG WITJ.1IN
TJ.1E STREET RIGHT Of' WAY. TO BE
MADE AFTER ALL EXCAVATING
15 ca1PLETE A'ID FOR'1 UIOR<
A'lD SUB- BAS: M,G, TERIAL 15
IN PLACE
D
FEES:
SIDEWALKS
CUREl-CUT
$10.00 + $0.15/LF. ( X) s:;;l..... $10-"'0 + ~.15/LF. ( X )
OF WALK
TOTAL R:RMIT FEE.
~
(I.BO
COMMERICAL DRIVEWAYS SJ.1ALL
J.1AVE !;' TO 8' FLAIRS
3'- 0" STA'IDARD
CURB I AF'PROACJ.1 APRON,
At-,ER FOR'1S ARE ERECTED
BUT PRIOR TO POURING
CONCR:TE.
WALK x'
/ ""
l x' j.
"
I J.1AYE CAREFULLY EXA"1INED TJ-l: COMPLETED APPLICATION FOR PER'1IT, A'ID DO ...EREBY CERTIFY TJ.1'" TALL
1~-o~ATION J.1EREON 15 TRUE ,G,'1D COl'i1RECT. A'ID I FURT!-~ER C:RTIFY TJ.1"'T "''I'''' ,.l.'lD ,.l.LL UOR< PE!<l=O~ED
SJ.1ALL BE DONE IN ACCORDANCE WITJ.1. T~E ORDIN4'lCES Of' TJ.1E CITY Of' SPRINc.FIELD. AND TJ.1E LAUIS Of' TJ.1E
STATE Of' OREGON PERTAINING TO TJ.1E UIOR< DESCRIB:D J.1EREIN, 4'1D TJ.1AT NO OCCUPA'lC.,.. WILL BE M"'DE
Of' .l.N.,.. STRUCTURE WIT...OJT PERMISSION Of' TJ.1E euILDINC: DiViSION. I FURTJ.1ER CERTIFY TJ.1AT ONL Y CONTRACTOR5
.l.ND EMPLOYEES UIJ.10 ARE IN COMPLIA'ICE WITJ.1 ORS 1"I.osS WILL BE US:D ON THIS PROJECT.
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SIGNEb~ ~ DATE