HomeMy WebLinkAboutPermit Sidewalk 1991-12-18
RESIDENTIAL - COMMERCIAL
. SIDEWALK I CURBCUT .
APPLICATION I R:R'1IT
liI90
225 NORTH FIFTH STREET
SPRINGfiELD, OREGON <:1,4"
ENGtN:ERINGr DIVISION
Off'IC!: NO, ,2&.3,53
INSR:CTION LINE, ,2&-3,&<:1
.'
J03 ADDRESS, 702-- ~LO i:ls tS I e..-h, n 4::>Y---
ASS!:S50RS MAP NO,* /7032/2,-/ T"-X LOT 1010,"* Ot.{qw
&uSDiVI5ION:
O~R. Tf'iAVt /U.1,~ - / j)ClJLt1vrMA/) ft
ADDRESS'-?D 2- Sz 0 fIE.-, 6 I eJ1YJ CIT'l',~cl
STAT:, ()12-- ZIP, q7 477 Pi-ION!: NO'''74'/ zyfb
lJ.JORK DE5CRIFTION,
SID8''-'-' K, ~ CURS SIDE _
CURS-CUT, ~ R!:SID!:NTIAL _
&!:COND DRIvEWAY (S!:!: TRA'TIC)
R!:Gl'JIR!:S APPLICATION FOR A &!:COND DRlvEWAY('T-4.1.)
OR A COolNTY APPLICATION FOR FACILITY F'ER'1IT (C ~-"03)
IF IN Ti-2 U.G.5,
&E'iS.4CK _
CO, ~~:=RICAL. _
DAT: "" A.9"LICATION
17;/741
~
SPRINGFIELD
REC!:IPT NO, 334,0
C~ _
CI-i!:CK ~
"*
CI-l!:C,::ED FOR DELINGl'J!:NCI!:S' V
&IC:NEO:
f1vv.~ n
12.--I~ J-n
:J,AiE:
v' CONTRACTOR
REGIS7RATlo.-I NO,* (-R &4y 7EXPIR!:S, '3-.7-92
UlORK TO BE F'ER!=u~ I~D BY, O:LN!:R
CONTRAC7OR * h Dzx;;/ e V\ Ho--vvt"S6Yl
ADDRESS /4 L/ I ~JJ~ it q !\.J
t
,..,.. -, ,UJq; FOR IN5I"'ECTION REQUEST.
CALL ,2&.3,&<:1 (R!:CORD!:R) STATE YOUR CITY D!:SIGNAT:D J05 IoI:.J:'15!:R, JOS oODR!:SS,TrP!: OF
INSF'EC7Io.-I R!:QU!:STED AND UJi..!!:N YOU WILL S!: R!:ADY FOR INSR:CTION, CONTRAC70RS OR O:LN!:RS N,l,"'l!: A'lD
PI-lo.oE NUMS!:R REGl'JESTS REC!:lvED S:r-OR!: ,,= A'1 WILL 5E MoO!: TH: SAME DAY, R!:aJESTS AFTER ,,=
AM WILL s: MADE THE NEXT IlORKINGl DAY
PMONE,
* &!:: 900K
!:XISTING SUILDINGl F'ER'11T NO, ( IF APPLICASLE I
YOUR CITY D:SIG.'1A: :D JOS NO, IS'f 01 I J L-f 0 h
REQUIRED INSPECTIONS
8j
SID!:WALK I DRIvEWAY
FOR ALL CONCR!:T: PAVING WITHIN
T!-/E STREET RIC::l-IT OF WAY. TO BE
MAD!: Ar-IER ALL !:XCAVATING
IS COMPLETE A'O FOR'1 ~
A'ID 5US-SA5: MATERIAL IS
IN PLAC:
==S,
SIDEWALKS
~10,00 + ~.15/L;:, ( X )
or WALK '1.3'.:::. 11,'15
~ 2'-l.~D
CURB-CUT
~i0.00 + ~,i:;/Lr. ( X )
Iq I =,l~ ,86
Q
CURS I APPROACf-l ':'PRON,
A-IER FOR'1S ARE ER!:CT:D
SUT PRIOR TO pOURING
CONCR!:TE.
WALl< X'
/ ""
.l- X' I.
1
TOTAL PEF<MIT FEE,
CO:-1ME~ICAL DRlYELUA '(5 5t-iALL
i-4AYE 5' TO e' FL'!"I~5
,3'- 011 5T ~'l!:>,L.~
I :-:k\!E Ct.RE:=JLL'( EXA"1INED Tl-lE COMPLETED A.FF'L1CATI~ FOR PE~JT. :"~D DO i-!ERE9Y CERTIFY TI-IAT "':'LL
i~'=OR:t1ATla-.: ;";EREON 15 TRUE A~D CORRECT, A'lD I PJRT!-;ER CERTIFY 7~kT A"-lY :"'lD~L WOR< PER=O~ED
S:"":.!..LL 5E D~E IN 4CCOROI..."JCE WITl-! Tl-lE ORDlNA'JCES OF T;..;E CliY 0:: SPRINGFIELP. ~~D T;...;E L~ OF T~E
::..:.72 OF OREGON FERTAJNIN~ TO T;..;E WORl< DESCRI5ED ;"!EREIN, ~"'D 7i-lt.T NO OCC:..JPA'JC"( WiLL 5E Mt..D:
0:= :"~Y Si~C7URE LUITl-iOJT PE~15SI~ OF T~E BUILDING DIYI51~ 1 ~":RT;";ER CERTIFY ii-l.!.T O~L Y" CONTRACTORS
':"''-':J EMPLCiEES ~O ARE IN COMPL1;tl,NCE WITt-4 OR5 101.055 WILL 5: ~SED ON T!-lIS PROJECT.
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