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HomeMy WebLinkAboutPermit Sidewalk 1995-4-18 1I~ ::. ,.. reSIDENTIAL - COMMERCIAL ...., . SIDEWALK I CURBCUT ~ , '.- APPLICATION I FERt1IT ~ 225 NORTH FIFTH STREET. .' SPRINGFIELD. OREGON ~'411 ENGINEERING DIVISION . on=lCE NO. '26~3153 INSPECTION LINE: 126-316<3 . ,\ , .",. '.' SPRINGFIELD " JOB ADDREe5: tf '7?~ P If I 6 t/, ' ASSESSORS MAP NO.* I, ~ b 1J.~ ~ 2... </3 TAX LOT NO: W6C SUSDIVISION: RECEIPT NO: If e;/760~ CA5l-1 CHECK ~ STATE: ~'1INILf- ~~ 4>?Lf "D~I.s'( D~ ZIP: Of7l./7tI. It}((L~q! CITY: tt;pf!..t.,NbR.JfzJL PI-lONE NO'7/f 1-14;!rk *" ./ CHECKED FOR DELINQUENCl:::S ~ O'J.NER: ADDRESS: - - UJORK DESCRIPTION: ... ! . ~ SIDEWALK: ~ CUSS SID:::. i CUR;3-CUT: ,/ RESIDENTIAL i SECOND DRIVEWAY (SEE TRATTIC ) REQUIRES APFLICATlo--l FOR A SECOND DRIY:::WAy(rr.4.1a) ~ 1/ R A COUNTY APPLICATION FOR FACILITY Pl::~IT (C ~.2lZl3) L? L ~ IN THE U.G5. -... . SIGNED: -P'Y DATEOFAPeb.IC~o--l q-I'-fb ~_~-I~4S X'" .~~F \. y ~--V- --.....-- -- ~ ~ WORK TO 6E FE~D 6)": Ou.N::R v' CONTRACTOR /"#2<1- CONTRACTOR* ~..>()-t'S V tJ-(...U6..(/ fhl-(~ REGISTRATION No.*9~b73 :::XPIRES: ADDRESS / 5'" q to /). Lo&..t2 Wo (li? /Z.U t5-E::U"1'" "'7 q.() <.t 5:::TBACK CO~ERICAL '-- .~~ REQUIRED 1N5~CTfON5 .~ ----""- . ......-"'- -/\.. eLl I 126-316<3 (RECORDER) STATE YOUR CITY D:::SIGNAT:::D J05 NUM5:::R, J05 ADDRESS,TYPE OF INSPECTION REQUESTED A"JD Uh-IEN YOU WILL BE READY FOR INSPECTlo--l, CONTRACTORS OR OUNERS NAM::: A"JD PI-!ONE NUM5ER REQU:::STS RECEIVED B:::FORE 1:00 AI"'! WILL BE MADE THE SAME DAY, REQUESTS AFTER 1:lZ>lZ> AM WILL BE MADE THE NEXT WOR<.ING DAY tJ~~t7 EXISTING BUILDING PE~IT ~ICABLE ) YOUR CITY DESIGNATED J'a NO. Isf 9'.~6c.,tP0 ) I ., __~ \....-- _ "--'" __ j SIDEWALK I DRIVEWAY f /:-~ I Arrro:.OACH APRON FOR ALL CONCRETE PAVING WITI-lIN V AFTER FORt1S ARE ERECTE THE STREET RIGHT or: WAY, TO 5E BUT PRIOR TO PO;.JRING MADE AC=TER ALL EXCAVATING CONCRETE. IS COMPLETE AND FORt1 WORK AND SUB-BASE MATERIAL IS IN PLACE * SEE &>oK. FEE5: 51DEWALK5 CURB-CUT WALK X' " ~1@.@@ + ~@.15;LF. ( X ) '" - OF WALK /()..I(../>.,./. ~c) ~(O TOTAL FERMIT FEE: ~ 2h. 6 D ~1@.@@ + Y.2?.15/LF. ( X ) =:1(.fO /O~ .If"::: '.1 ~i~~ COMMERICAL DRIVEWAYS SHALL HAVE 5' TO 8' FLAIRS 3'- lZl" ST A"JDARD / ~ , 'I X' 1 I I-lAVE .c.i.REt-LJLL Y EXA"1IN:D T~E COMPLETED AFPLICATION FOR PERMIT, A"JD DO HEREBY CERTIFY THAT ALL lNrORMATION HEREON IS TRUE AND CORRECT, A'ID I FURT;";ER CERTIFY THAT ANY ~'1D ALL WOR<. PER5"ORMED S;.lALL BE DONE IN ACCORDANCE WITH THE ORDrNA'ICES or: THE CITY or: SPRINGFIELD, AND THE LAUJ5 or: THE STATE or: OREGON PERTAINING TO THE WOR<. DESCRIB:D HEREIN, AND THAT NO OCCUPANCY WILL BE MADE or: ANY STRUCTURE W!Tl-lOUT PERMISSlo:-.l or: THE BUIJ...DI~~ Drv!SI01-t I FURTHER CERTIFY THAT ONLY CONTRACTOR5 AND EMPLOYEES WHO ARE IN COMPLIANCE WITH ORS '01-"'55 WILL BE USED ON THIS PROJECT. 51CJ4~ /;; ~~~ . DAlE ,~k .