HomeMy WebLinkAboutPermit Miscellaneous 1999-5-25
0;:';,.. " ". : :'" . <J'City of Sprhlgfi~ld~:
This Side To Be Filled Out by ApPlicant
'P!~op~ :IJII ' ' '
This permit is required for allY ,ite activity in'the'flood plain and overYY>'hore site alteration consists of
~ fifty (50) cubic yards of mat",;al or more andlor if, a drainagew'ay is affected, within City limits and
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Date of Application .s= z.. ~ -7' j
Permit 'Expiration Date': .-
Property Owner fln/KFrR Z i JC<<'A- C. Si!..rr
Address: t2.7V2. ..(.nCuSr oS..-
Phone; .5Y1. 7Y? - a-~s-j.
Cit~.",.... State:".c ZiJil'7f??
Site Address: //>72- 1)e-'-t'ase:- M.
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. Springfield, Oregon
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UGB Tax Map No: l7,o3-2:J.litf .~ / JiIlIl...
Journal number applicable Land Use Application '
Tax Lot: 0/7DO
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FILL, Quantite'! ,;l.~- '77I7'f~ource Location ' '=~ i!.7</lr .s;;;,..,.;o ) C;,4AVU-
Supplier E /A G "'~ Sth-tl> ,Material C~"-S'f ~ ~
GRADING, Quantity
EXCAVATION, Quantity)go C Y Destination: -IrPor1f-e72- lor- &fi '71hsr;vc)
Supplier: c"Aft;~ ~e" 'n,l~ Project Supervisor, S'"",,,,"..)) 'mp--,c:;,qdf21<
Address .;12'" tJ. S'" ~ E:u9c'.ve'l'f, 97/''''v ,Phone 3</S-/ !;'c1'
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SITE PLAN Required Dat,,:Quantity of matElrial; Property linElB and dElscri!,tions, Tax map and
lot number, Site addruss, Existing contour linEls. 'Proposed contour lines, Existinf/ drainage
ways, Proposed drainage ways, Significant trees and foliage, Ground cover, 501 types,
Buildings, Septic systems, Sewers, Areas subjElct to floodll1g" Utilities, Areas subject to land
slides, Proposed site improvements. ' . ,
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CROSS SECTIONS,
SOILS &'GEOLOGY PLAN.
DRAINAGE, POLLUTION AND EROSION CQNTROL PLAN
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REPLANTING PLAN
ADDIT.IONAL INFORMATION.
COMPANY NAME: CAf.U-i/4) ,ex" /f-vAflN(;, /A.-e., . PHONE 3vJ:-/SoS-
PROJECT SUPERVISOR: 5 V- EA/l) ''1>1_, .;/.d,.e-t2-
,ADDRESS: l../ 2.-i'o W. j-n, m/e- CITY
COMPANY NAME:' r/LB 1>~i9~ .:I'u<..t.s.N4t'f7C71
PROJECT SUPERVISOR: 71 A4 ,,' & 5: ~,
ADDRESS: /7'11.-- ' Z>E:L~S E" Jl-VC
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FUCc.~ STATE
. PHON E '7/{, ~371 ~
CITy..'S.f''''-'~tt7 U.L>
STATE &L.
CONTRACTOR NAME: K~r-i:::rrr J. .
PROJECT SUPERVISOR: I.
Registration Number:
ADDRESS:.:Z7V2-- l(Jc.~J.s.., Sj-
STATE: D..Y! , ZIP: '17'1'77
MOBILE PHONE: S-V - ~& 30
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PHONE 7'/(, - jj rs;J.
, Expiration Date:
, CiTY::~~'(/"F/<:~
OFFICE PHONE l/h Y 7./,~ FAX Y!~-3/ 9/
'. EMER,GENCY PHONE: '3 V:z.. -.21 S- I
I understand that I or my succos:,nr:-; may have future plena for my property which mey bo anticipated or unanticipated at
this time. I understand that such luture plans may require permits ~nd del/elopement approvals from the City of Springfield.
I understand that notwithstanding any approval of this ls'nd and" Drainage Alteration Permit (LOAPI, that at the time of
application of future permits or approvals the City may fevJew 8I')d,rec.onsider all actlon~ which I or my successors have
undertaken persuant to this lOAP. I understand that the City may 118 8 condltlon.of anY.future approval, require the
undoing, changing, or modification of af)Y actions which I have un~ertaken as a result ~1 the City's approval of this LDAP.
By signature, I state and agree. that I hav~ carefully examined the completed applicatio'n ~nd do hereby certify that all
infnrmntion horoin ill. lruo nnel r.nll"l:l, nnd I furthn'r certify that any and all work performncl shJlII be done in accordance
with tl1u OrdilUlllc.:US ul tho City 01 ~;pdilgfleld, tipplicable City Standard sp6clflc.:lltIO~8 aruJ Urewlngs, and the ltiwt/. 01 tho
St8te of Oregon pertaining to tho work described hereln..J further certify that only contractors and employees who are in
compliance with QAS 701.055 WIll hu used on this project.
The City may inspect the work sill: doscribed in this peu:mlt at. any time during a one'year period following the receipt by
the City of notice of completion of the ~escribed work. and. 8pecify,' at the City's sole de,secration, any additional restoration
work required to return the site to a standard acceptable to the CIty,. The permittee will.be notified in writing of any work
required and will have thirty 130) days from the date of the notice to complata the'work. Work not completed at the and of
tha thirty days will ba performed by the 'City end the cost. will ba billed to tha permltta~.
I further agree to ensur that all required inspections are requested ~t the proper time: that project address is readable from
the street. and t proved set#~,~ romai on ttae sit,e at all times during cpnstruction.
Signature . _ : ~~" ~ ~ . . Date ..,r- 2 r~"
J;;~,'Adb:",.,.lqq~{f)51f)P2/iP.;;,.IJtrhL.: .s:.ZS'.qq 1JJ~t/;k~
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1/6/1998
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DRAINAGE, 0 Stonn, 0 Ditch, 0 Culvert. 0 Natural
WETLANDS, Description
FLOOD 'PLAIN, Zone: ,'B
, FEMA Community Panel No.:~ ''511 t7570r:...
FLOODWAY, FEMA Community Panel No.:
, Date:
PLAN CHECK FEES:
UP TO 100 CUBIC VARDS
101 TO 1.000 CUBIC V ARDS
1,001 TO 10.000 CUBIC YARDS
10.000 TO 100.000 CUBIC YAROS
$20.00
$30.00
$40.00
$40.00 For tho Iil~~l 10,000 cubic yards. plus
,,$20.00 for each :ulditionall0.000 cubic yards or fraction thereof.
$220.00 For thn 1i,:;1 100,001 cubic yards. plus
$20.00 for each additional 10,000 cubic yards or fraction thereof.
. $340 For the first 200,001 cubic yards. plus
$6.00 for e8ch additional 10,000 cubie yards or fraction thereof.
100.001 TO 200.000
200.001 CUBIC YARDS OR MORE,
GRADING PERMIT FEES:
UP TO 100 CUBIC YARDS
101 TO 1.000 CUBIC YARDS
1.001 TO 10.000 CUBIC YARDS
$30.00
$30.00 For the first 100 cubic yards. plus
$14.00 for ea.ch additional 100 cubic yards or fraction thereof.
$156.00 For the fir::;t 1,000 cubic yards, plus
$, 2.00 tor each additional 1.000 cubic yards or fraction thereof.
. $264.00 For the filsl 10,000 cubic yards, plus
$54.00 for each additional 10,000 cubic yards or fraction thereof.
$750.00 For the first 100,001 cubic yards, plus
$30.00 for each additional 10,000 cubic yards or fraction thereof.
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10.000 TO 100,000 CUBIC YARDS
100.001 TO 200.000
Estimated Volume: 2 ~ m
J::..hr'l-,-. {,
Plan Check Fee: -.v:::::t/
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Receipt N034174
Date: S/;es-155
Receipt No: 0345'~ Date: tLJll gj 't Ci
Date: 5/2Sffl
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Received By:
Grading Permit fee: 11 L/~CJc)
Received by:~A-1 I.Uo K"rl.
Date:
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0 Plannino Date:
0 Engineering Date:
0 Building: Date:
0 Maintenance: Date
Permit Number
Issued by:
Date:
Rp.qllin~ri Fi'~~1 lnc::npt"'tinns:
Planning:
Date _
Engineering:
Date
Building:
Date
Maintenance:
Date:
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Land. and Drainage activity as outlined in this permit has been completed in accordance with
the provisions of this perin it. , '
land' and Drein~lle 8~tlvltv a8 outlined in this permit has not been completed in accordance
With. tne. prOVISIC1hS of ~hlS permit.
land and Drainage activity was, performed prior 10 application for this permit.
Accepted by:
Date: