HomeMy WebLinkAboutPermit Sidewalk 1994-11-19
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~5IDENTIAL - COMMERCIAL
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225 NORTf.I FIFTf.I 5TREET
5PRIN6FIELD, OREC,ON ~'411
ENc.INEERING DIVI510N
OffiCE NO. 12&-3153
IN5PECTION LINE, 12&-31&~
JOB ADDI'iES8. / (){/J(, 1, Of 'I fI1. 0 j ("" >
A55E550R5 MAP NO,*- \-i()":l,i) '7'41 if TAX LOT NO: * 01.01.(1.)
5U6DIVI5ION,
SPRINGFIELD
~
RECEIPT NO, 0 I c;- 4 i I
CA&H
Cf.lECK
o.LNER, H A CS A
ADDRE55, ,100 WI 4a I'V< IIi euJ
5TATE, ()PE ZIP, q7417
--
CIT1', S pJ ( j,
*----
Cf.lECKED FOR DELINQ'JENCIE5 _
Pr-lONE NO.
tl.iOI'<K DE5CRIFTION.
5IDEWALK, V' CURS 51DE -- 5ET6ACK _
CURS-CUT, RE51DENTIAL --- COMMERICAL _
5ECOND DRlYEWA.,... (5EE TRAt:FIC >
REQ'JIRE5 APPLICATION FOR A 5ECOND DRIYEWAYI'T-4.1a)
OR A COUNT1' t.PPLICATION FOR FACILITY PERMIT (C se-203)
IF IN Tl-I: U.c..s, / I Ii
:;lATE Oi' APPLICATION / I > Nj 77
51C,NED,
DATE:
OUNER ~ CONTRACTOR
COAsi, TIJC REC,15TRATION NO,*O 8371
A; .. On w-- + l;?J. ' ); Lh..:f:.vte DIl""
"""-"....l:.....URE FOR IN5FECTION I'iEQUE8;, ' 'I' <77'/-0;)-
UJORK TO BE PE~ IcD BY.
CONTRACTOR* ST A-TOtV
ADDRE55 -:J.q,i'J 4 -J?
&e-T~
Il/! ,>11'4-
:XPIRE5, 3 b;/lS
P,",ONE. L/fc /-Ds-<.J3
CALL 1,&-31&~ (RECORDER) 5TATE YOUR CIT1' D:51C,NAT:D J09 Nu:-1S:R, JOS ADDRE55.TYPE Oi'
IN5PECTION REQU:5TED AND \l.\-1EN YOU WILL S: READY FOR IN5P:CTlON, CONTRACTOR5 OR OUNER5 N/..:'1: AND
Pf.ION: NUMS:R. REQU:5T5 RECEIVED SEFQRE 1.= AM WILL SE MAD: Tf.I: 5A"11: DAY, REQ'JE5T5 AFTER 1,=
AM WILL 6: MADE Tf.I: NEXT UORKINC, DAY
* 5:E SOOK
EXI5TINc. 6UILDINC, PERMIT NO. ( IF APPLICA6LE )
YOUR CIT1' DE51C,NATED J09 NO, 15f c:::r 4-- 17 57
I'iEQUII'iED 1N8Fi:CTIONS
~ 5ID:WALK I DRIVEWAY
FOR ALL CONCRETE PAVINC, WITf.lIN
T!-IE 5TREET RIC,!-IT Oi' WAY. TO SE
MADE AFTER ALL EXCAVATINC,
15 COMPLETE AND FORM UORK
A'lD 5US-6A&: MATERIAL 15
IN PLACE
D
FEES.
SIDEWALKS
110.0'" . .O.l5>/LF. ( X )
OF WALK
CURB-CUT
~ 110.00. 10.15>/LF. ( X )
TOTAL Fi:RMIT FEE.
~
I~>'JO
COMMERICAL DRlVEWAY5 5!-1ALL
!-lAVE 5' TO 8' FLAIR5
3'- O' 5TANDARD
CURS I APPROAC!-I APRON, I
AFTER FORM5 ARE ERECTED I
6UT PRIOR TO POURINC, ,
CONCRETE,
I
WALK x'
/ ""
l x' j.
.,
I ;..lAVE CAREFULLY EX""..,IN:D ,H: COMPLETED APPLICA,ION FOR PERMIT. AND DO ,",ERE6Y CERTIFY THAT ALL
INFORMATION HEREON 15 TRJE ANDCORR:CT. AND I FURTH:R C:RTlFY T,",AT ANY AND ALL WORK PERFORMED
5;";ALL 6: DONE IN ACCORDANC: WIT!-I TH: ORDINANCE5 Oi' THE CIT1' Oi' 5PRINc.FIELD, AND THE LAW5 OF T,",E
STATE Oi' OREC,ON PERTAININC, TO T!-IE WORK DE5CRISED ,",ERE IN, AND ,;";AT NO OCCUPANCY WILL BE MADE
OF ANY 5TR.JCTURE LUIT!-IOJT PERMI5510N OF T,",: 6UILDINc. DIVI51ON. I FL;RTHER CERTIFY ,!-I AT ONLY CON,RACTOR5
"-ND EMPLOYEE5 lUl-IO ARE IN COMPLIANCE WIT!-I 0R5 101.0;'5 LUILL 6E U5ED ON THI5 PROJECT,
~~
51C,NED ~
11/1'1/91./
DATE