HomeMy WebLinkAboutPermit Curb Cut 1994-12-8
_~lbENTIAL - COMME~IAL
____ SIDEWALK I CUR!3CUT ,
APPLICATION I FE~IT
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225 NORTH FIFTH STREET
SFRINC>FIELD. OREGON ~14"
ENGINEERING DIVISION
OFFICE NO. 126-'15'
INSFi:CTION LINE, '26-"6~
J06 ADDREe5. ~W'f)~ic:
ASSESSOR!> MAF NO. II (;) ~ ?'1 4/
SUBDIVISION.
ou.Ni:R> HAc s A
ADDRESS, _:( D.n UJ Fa...... vt' el"
STATE, OfE6-OI1J ZIF, q7477
UJORK DEe.cRIFTION.
l!JORK TO BE FE~D BY:
CON7RACTOR* STATokJ r.o~f, TVlC.
ADDRESS ;JJI.FN ~l? Ai "por-t....BJ.
r~.....EDURE FOR IN&FECTION REQUEST,
SPRI""CFIEl..O
',*
TAX LOT NO. 1,,7DD
RECEIFT NO, 1~t<>q5'"
CASH
CHECK
v
CIT'r\~{'J-;"J;f~~
F;..IONE NO,
CHECKED FOR DELlNCl'JENCIES'* /
5;:;T9ACK
CO'1:'1ERICAL
SIGNEDI
DATE:
OUN.:R
x..
CONT~CiOR
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EXFIRES,.? /J.I / qS-
-. .
F;..IONE, ffa./ -Oo~
C4LL '2&-~'&~ (RECORDi:R J STATE YOUR CITY DESIC,NATED J08 N~8ER. J08 ADDRESS.TYFE or
IN5PE.CTI~ REQUE57ED t...""lD ~EN YOU l:JILL 9: RE""'::;''''' FOR IN5PECTI~. CONT~CjO::;;!:5 OR ou..N.ERS N.l.ME .L.."ID
Pr40NE NUM5ER R:aJE5T5 RECEIVED 8EFORE 1:0:2> 4"1 WILL 5E MADE Tr.4:: 5,L,,"""iE DAY, REOJESTS ~TER 1100
AM WILL BE MADE THi: NEXT UJOR<INC, DAY
SIDi:WAL!<::.. CURS SIDE _
CURS-CUT, ~ RESIDENTIAL _
SECOND DRIVE::JAY (SEE TRAM'IC )
RECl'JIRES APPLICATION FOR A SECOND DRIVEWAYI'T-4.1a)
OR A COUNTl' .l.FP....ICA7I0N FOR FACILITY FE~IT (C ~,20'J
IF IN THE U.c.,S, I
DATE OF AFl"LICATlON I ;J./c,/CJtj
REGISTRATION
'*
NO. 0337/
C(7'f01-
E"'(61P;
O&:!,
'* SEi: BOOK
Exr5TI~ etJILDINC, PE~IT NO. ( IF APPLICABLE)
'1'11"15'1
YOUR CITY DESIC,N4TED J08 tiO, ,sf
SIDEWALK I DRIVEt:JAY
FOR 4LL CONCR!:TE FAVltiC, WIT~IN
T~:: STREET ~IG~T OF WAY, TO BE
M-'D: klER ~L EXCAYt.iIN~
IS =l'1FLETE A'lD FO~ UJOR<
A'lD sue-BASE MATERIAL IS
IN FLACE
REQUIRED INSPECTIONS
D
FEES:
&IDEWALK&
110,00 . 10.1:;./LF. ( X )
0;= I.!JALK
TOTAL PERMIT FEE.
s /4. $ 0
[gl
CURB-CUT
r1... 110,00 + S0,I:;./L.F, ( X ) 3~
CO:--1MERICAL DRIVEWAYS SMALL
;..I4VE 5' TO 8' FLAIRS
3'. 0" STt..~DARD
CURS I APPROACH AFRON,
Ar-""TER FO~S ARE ERECTED
BUT PRIOR TO FOURINC,
=NCRETE,
WALK Xl
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! i-l.t.VE CARE:R.JLL.,.. EX":""1NED i~E COMPLETED .4PFLJCAjIO~ FOR PER'11T, "':"''lD DO ~EREe..,.. CERTIFY 71-:~T ':"'LL
'tiFO~ATION HEREON IS TR:.JE A'lD COR~CT. A'lD I FURT;..IER CERTIFY TH4T ':''lY -'-'lD ':'LL ~R< Fi:RfO~ED
S;..IALL BE DONE IN .l.CCORDANCE WITH THE ORDIN':''lCES or T~E CITY or SFRNUFIELD. .:.ND T~E LAU-'5 or T"E
STATE OF OREGON PERT.t...INING TO TI-lE u.JOR<. DESeRtS:::D I-iER:I~. ~~D T;";':"'T NO OCCUP':'NCY UJ1LL BE M.!..DE
or -'-NY STR'JCTURi: WIT""OJT Fi:~ISSION or THE BUILDINC, DIYISICN, I FliRT"ER CERTIFY T"AT ONL Y CONTRACTOR!>
A'lD EMFLOYEES ~O ARE IN COMFLlANCE WITH ORS '01.0,,5 WILL BE USED ON THIS FROJECT,
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DATE