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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. ~~. ~ II/ttj/qij SIGNEb~ ~ DATE