HomeMy WebLinkAboutPermit Miscellaneous 1997-4-8
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City of Springfield
225 Fifth $lreel, Springfield, Oregon 97477 - ()evetopme~t services
Date ?~ Application 4-/ 8/ lI:I) 1
Expiration Date:
Property Owner
Address:
1 ~e:.. c..R.e"~~c;rel4 Ccr, ('f)fltlt'l.."
cO '2.7 H, ~PC:~T
Phone: (7($)() 4/\ r; - ':)C:,Q \
City-'E.L.\eGK/lo. State:~Zip .,55'0 '2.
Site Address: ':n-'27L:'7
o UGe
-5775~~
~4#/
;, Springfield, Oregon
Tax Lot: ~400
~QO
la~ Map No: \7 -<:>'2-33-4-\
11 - CL" 3 3~' 1-4-
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o Fill, auantity5~q_J_" ',Source LocationJ~ p..../~~~ I~,.P
Supplier G:;;~ ~~ I ~~~ Materlal.~~~~("_) 6'~~
GRADING, Quantity
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EXCAVATION, Quantity ?"OO c:t.I~O;Dastination: (j~ICN.C1)wt>;)
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SUPPli8r:0~~,' '. 7/Y't:::;: _, Project Supervisor t; Be. l..!.so=:-.....C!Mt~
Address --q-n~ ./Wdff ?7 /' ~~P. j Phone '?2&.....7/~O
SITE PLAN Reql.Jired Data:Quantity of material, Property lines and descrigtions, lax map and
lot number, Site address, Existing contour lines, Proposed contour lines, Existing drainage
ways, ProJ:;)Osed drainage ways, Significant trees and foliage, Ground cover, Soil types,
BI;lildlngs, Septic ~ysterns, Sewers, Areas subject to flooding, Utilities, Areas subjec~ to land
slides, Proposed site improvements. ' I ' , .' i' , /J)J i" 'i
o CROSS SECTIONS, 'i---! / I>- 5-e;.e:. ~..P\~G:.-PL-.b~(A.ttA~:Jr' ( (,I I
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. ~'~OIL~ & GEOLOGY PLAN,. N/ A ~~h IS E2~,~IA.c.. ~ n,w-' ~
.?~ ) J. ".".," " . ,c..::--u D I-OO/t.-' '5:>. ~
0., _Sl~'~RA~,~'JAG~, POLLUTION AND, ERO$ION~ONTROL P.LAN 5J;;,E. ~')~U'1l~JWff/ ~
· ~ REPLANTING PLAN ~.
....
o ADDITIONAL INt::ORMAT10N, :;;: 1-t"lS IS A t'\) GX~r,q;:, 'F".D't"" l~ l-<Jt ~
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COMPANY NAME: F~~ A~ I"rECT'5 1E. P~"~PHONE <5Cl'!1- (.44,. -42.'2.'2_ ~
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PROJECT SUPERVISOR: "" ~ e.~.zr t:::'c.Ao(' in
en
ADDRESS: Go.., J ~ S \V l \ l1"'" ~ CITY_ 'B&.bV&~Iq'j\.Ln__STATE~1C.... ~
COMPANY NAME: 1'1/ ~ _ , PHONE
PROJECT SUPERV~SOR: L~~"~ ~t..4.. <:, ,. I ': :. ~, J
ADDFtESS: S.b(Y")&. AS A"""""VS- CITY STATE
CONIRACTOR NAME; I 0 B.e-... Per~fit('(1l1J.e.o ) , {I ' , !' '.
p.'3g,~sg.!".~.~.EEaVJSQ.R: -PAN (1lC.1 t-f'N P-=- PHONE 54t- C'.I/!;7 -'ZB4-\
. ("~.~R~~.~.~~~!~n N~er; O~N. ~?J 550 , Expiration Date: ~()/ J!,I'C:>-:f'
'-ACH5RESS:....1'"'f.,,/ ~ 'Z!i'2.3 , CITY: ~<;i.&.N~
STATE: C?tz ,ZIP: ~1q.t02 OFFICE PHONE G:.4!n-Z/J!. r11 FAX ,*~.G,{~z.
MOBILE PHONE: c:;.s, - 'Z.a4-t ! EMERGENCY PHONE; <:ea, - 'We4-1
C.w f'-.1'T'1" A,--r.,~ Sb'Y 50 !A~ '$ ~ ~ ~e,~ ' .
By signature, I state and agree. that 1 have carefully examined the completed application and do hereby certify that all
Information herein is true end correct, and I further eertily that any and all work performed shall be done In accordance with
the OrdInanCes of the City of Springfield. applicOIblB City StanOOlr<! specHicOltlons and Drawings, and the laws of the State of
Orogon pertaining to Ihl,l work dQr;cribed herein. I further certify that only contractOrl;; and employees who ere in compliance
with ORS 701.055 will be u$ed on this project.
The City mey ins pact the work sIte described in this permit at any time during a one year period followIng the recolpt by the
CitY of notice of completion of the de5cribed work OInd specify, <'It the City's $ole desecration. any additional restoration worl<
required to return the 6ite to a standard OIcceptable to the City, Tl'le perminea will be notified in writing of any work reQuired
end will have thirty (30) daye from the date of the notice to complete the work. Work not completed at the end of the thirty
days will be performed by the City and the costs will be billed to the permittee. .
I
I fl;lnher agreo tQ anl;ure that all required inspections Bre roquested at tho proper timo, that project address is readilble from
the street, and the epproved Set of plans will re~. o~~ at all timal; during construction.
Slgnaturo ~~~ ~ . . Date 4-/~/ C') J