HomeMy WebLinkAboutPermit Sidewalk 1992-3-14
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SIDEWALK / CUR6CUT
APf'LICATloN / PEI<MIT
SPRINGFIELD
Joe ADDFee&, 2B?4- :f Z87 cD h 6<5 74- C T
ASSES50R5 MAP NO.* /7 -0 "5 _ Z 2. _ '7 IT AX LOT NO."* 0 ID'/O c
5OBDIVISION. he A ~lJ. 1'7 A
ou.NER> CA (Z:C L 1-1 ~L1 e:D
ADDRESS, hi 4 'L rJu:.A.J1?Of", fA.)
STATE. C A ZIP. SO? I '3
WORK DE6CRlPTIONs
SIDE1lJAL.K, ~ CURe SIDE _
CURe-CUT. RESIDENTIAL _
SECOND DRIVEWAY (SEE TRAlTIC )
REQUIRES APPLICATION FOR A SECOND DRIVEWAY("T-4.1.)
OR A COUNrl' APf'LICATION FOR FACILITY PEI<MIT (C ~-203)
IF IN T1-lE U6S.
22!; NORTH FIFTH STREET .
SF'RINGd'IELD, OREGON 0:\1411
ENGINEERING DIVISION
OFFICE NO. 126-31!;3
INSPECTION LINE. 126-3160:\
DATE OF APf'LICATION
.
RECEIPT NO,
CASH
'5"/ '2.. I
CHECK
,~
CITY. LA)<::.c .u..;;~o /->
* .,
CHECKED FOR DELINQ'JENCIES ~
PHONE NO.
SETBACK _
COMMERICAL _
SIc.NED'. A- c _~ .--b -U "-
DATE. ;/!:{;;([}# L
. .,
WORK TO BE r-J:.~ OIO!IIED BY. ou.NER '>C CONTRACTOR
CONTRACTOR* /F-/O ,1l/!4.rr?'( 1Le..c:::rr REGISTRATION NO.*h.'?~~6
ADDRE55 Po l3 1/7~ 4- 6{r~'E:.IA~~ 974-4-0
EXPIRES. 7- z. - Of. ~
P.-IONE,"75 <1- ZtO ~
r-.-.o...=;.J!'e FOR IN&FECTION FeQIJEST.
CALL 126-3160:\ (RECORDER) STATE YOUR CITY DESIGNATED JOB NUMBER. JOB ADDRESS,TYPE OF
INSPECTION REQUESTED AND WHEN YOU WILL BE READY FOR INSPECTION, CONTRACTORS OR ou.NERS NAME A'lD
PHONE NUMBER. REQUESTS RECEIVED Bcr~<= 1,00 AM WILL BE MADE T~E SAME DAY. REQUESTS AFTER 1,00
AM WILL BE MADE THE NEXT WORK!Nc;. DAY
* SEE BOOK
EXIST!Nc;. BUILD!Nc;. PEI<MIT NO. ( IF APf'LICABLE J
YOUR CITY DESIGNATED JOB NO. Isf "3 z... 1/':$ 0
SIDEWALK I DRIVEWAY
FOR ALL CONCRETE PAYINc;, WITHIN
THE STREET RIG;'!T OF WAY. TO BE
MADE AFTER ALL EXCAVAT!Nc;.
IS COMPLETE A'lD FORM WORK
AND 5OB-BASE MATERIAL IS
IN PLACE
FeQUlFeD IN&FECTION5
s
FEES.
SIDEWALKS
.1"'."'''' . tlZl.15/LF. ( X )
OF WALK Z5
TOTAL. r-.:,.. liT FEE. _ S /8,75
D
CURe / APPROACH APRON,
AFTER FORMS ARE ERECTED
BUT ~IOR TO POUR!Nc;.
CONCRETE.
CURB-CUT
.1"'''''''' . tlZl.15/LF. ( X )
WALK x'
/ ""
l x' t
" "
COMMERICAL DRIVEWAYS SHALL
i-JAVE !;' TO 8' FLAIRS
,'- 0" STA'iDARD
I i-JAVE CAREFULLY EXA""1INED T~E COMPLETED APPLICATION FOR PEI<MIT. ':"'lD DO i-JEREB.,.. CERTIF.,.. Ti-JAT ALL
INFO~ATION ~EREON 1& TRUE A'lD CORRECT, A'lD I FURT~ER CERTIFY T~AT A'lY A'iD ALL WOR<; PETS ~..... ,cD
Si-JALL BE DONE IN ACCORDANCEWITi-J THE ORDINA'iCES OF THE CITY OF SPRINGrFIELD, AND T;.IE LAl:J5 OF T;.IE
STATE OF OREc;.oN PERTAINING TO T~E WORK DESCRISED ~EREIN. A"lD T;.IAT NO OCCUPA'iCY WILL SE M4DE
~~Y STRJCTURE WITI40JT PE~I&SION OF Ti-JE BUILDINc;, DIVISION. I FURTi-JER CERTIFY T~AT ONL.,.. CONTRACTORS
~ Wi-JO ARE I::PLIA'lCE WITi-J ORS 101.0:.& WILL BE USED ON T~IS PROJECT.
IGNED t:7 OATE