HomeMy WebLinkAboutPermit Sidewalk 1995-11-9
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, P"~5IDENTIAL - COMHF~CIAL.
-,
, ^ OR ~'.."....,.
-~
5IDE\llALK I CURBGUT
AFFLlCATION I PE~IT
SPRINGFIELD
225 NORT~ FIFT~ STREET
5PRINGFIELD, OREGON '31411
ENGINEERING DIVI510N
O:=;=ICE NO. 126-3153
INSPECTiON LINE, 126-316'3
JOB ADDRESS:
A5S::S50RS .MAP NO,*'
,
'e 9'1etf:fi.- 'f ~J}lp , tL/Il> ~'
"*
J 7.. () ;j .. ~-/ i.J. T AX LOT NO. ~10f\
RECEIPT ~747
CASI-i
5USDIVI510N, -',-
CHECK
OJNER:
MICLJ~
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(' , f7lJ(LFSJ
CITY:
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CHECKED FOR DELINQCJENCI::S ~
ADD:;;::::S5:
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~l_j:::-;
ZIP:
PHON:: NO.
u.J(;)R< DE5CRIPTION:
S!D::wALK,
CUR;3 5!DE
S::TBACK
---
,CURB-CUT: /' RESIDENTIAL
S::COND DRIVEWAY (SEE TRA,:"-IC )
REQUIRES APPLlCATI~ FOR A S:::COND DRIVEWAY(-T-4.1a)
, OR A COJNT'r APPLICATION FOR FACILITY F::~IT (C ~-203)
IF IN THo: U.G.5.
CV, ,I. I:=RICAL
DATE 0;= APPLlCATI~
DATE:
~L__
//-945
. f ,
SIG~D:
UJ:::)~ TO BE FE~ It::D 6"(: OUJ-ER
* L '
CONTRACTOR' "PAJlf), Sv~7
ADDRESS I S-.s=z-. ,At} 11 Y WtXJ 0
FRQl..,.cvUF:E FOR lNeFECTION REQUEST:
CALL 126-3169 (RECORDER) STATE YOUR CITY DESIG!-o1ATED JOB Nu:-iBER, JOB ADDRESS,li ,= 0;=
INSF::CTION REQUESTED A~D ~EN YOU WILL B:: READY FOR INSPECTI~, CONTRACTORS OR 0UN::R5 NAM:: AND
Pl-lONE NUMBER REQUE:5TS RECEIVED BE:FORE 1:00 A"1 WILL BE MADE THE SAME DAY, REQCJE:STS :..FTER 1:00
A'1 WILL BE MADE THE NEXT l.l.ORKlNG DAY
CONTRACTOR
*'
REGI5TRATION NO. ~r
~~b -f1?k;Y
EXPiRES: 6=7.C/h
P~ONE: ~xK-3/~
EXISTING 5tJILDING F::~IT NO. ( IF APPLICABLE)
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'* S"'''' "":.-.,...,...
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YOUR CITY DESIGNATED JOB NO. ISf-
9~!'17?
REQUIRED INSFt:CTIONS
I ~EWALK I DRIVEWAY ,
~ ~R ALL CONCRETE PAVING WITHIN
. THE STREET RIGHT OF WAY, TO BE
M.4D:::: AFTER ALL EXCAVATING
IS COMPLETE AND FORM WOR<.
AND SUB.BASE MATERIAL IS
IN PLACE
, ~ A,n",OACH APRO:-
. ~ AFTER FORMS ARE ERECTI
BUT PRIOR TO POURING
CONCRETE,
FEES:
SIDEWALKS
CURB-CUT
WALK X'
COMMERICAL DRIVEWA Y5 SHALL
~' /} ~ HAVE :;,' TO 8' FLAIRS ,
So ,.....,/ 3'- 0" STANDARD '
TOTAL PERS1IT H:t:
I HAVE CAREFULLY EXA""~~~L1CATiON FOR PER!1IT, AND DO HEREBY CERTIFY 7H.L.T ALL
INFO~ATION HEREON IS T, ' CT, A"lD I FURTt-JER CERTIFY THAT A"lY .A"lD ALL WOR<. PE!'O"O~ED
SHALL BE DONE IN ACCORDANCE WITH THE ORDINA"lCES OF THE CITY 0;= SPRINGFIELD, AND THE LAWS 0;= THE
STATE 0;= OREGON PERTAINING TO THE WORK DESCRIBED H::REIN, AND THAT NO OCCUPANCY WILL BE MADE
OF A"lY STRJCTUR::; UJITl-lOUT PER:'1ISSION 0;= THE BUILD!NG DIY151Qt-l. I FURTHER CERTIFY THAT ONL -r CO)',iTRACTORS
M~EMIPl~~~ 1~1D55 WILL BE USED ~ mISt';;Ej tf \
SIGNED+--'" ~ ,. t,.;..-'"- .. > DATE ' t '..,
~10.00 + ~0.l5/LF. ( X ;,--
or WALK II. 2 )
~10.00 + ~.l5/L.F. ( X )
/
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