HomeMy WebLinkAboutPermit Sidewalk 1999-10-13
225 FIFTH STREET .....'NQ..... .
SPRINGFIELD, OREGON 97477 ~
ENGINEERING DIVISION A!.
OFFICE TELEPHONE (503) 726-3753 IlJiIIJ' .
APPLICATION DATE: I'" 1/3/ertf
PERMIT NUMBER:
DATE ISSUED:
'1 '1l 4<::> 2-
10/13/'17
SITE INFORMATION:
LOCATION 0~ORK:-t::;7 ~q frrlrl!.A.,.:.,-"d--
APPLICANT,M ,,vr;u=i.\A.e f I rJ
ADDRESS:q~D iI~..._ 9fAI
,-. cf
CITY: f:'d'f_ STATE: r0//_ . ZIP: '111(0;)
. v "r7 /I ~) (PtAT SSZ)
SUBDIVISION: th,,,,... 7,.".. K :r-/,rD" .LoT /0
U
~., ('/iI. A
~ -
ADDRESS: ~IID ti,1/
1/
PHONE Cl/,J .Of''> J,C
TAX MAP:
1~-02-o4-//
4-700
TAX LOT:
~.'
OWNER: 1//7"....
PHONE:
C?g--RJ?91
zIP:0L~r?~
~J.
~
CITY:~_
STATE: ().
REQUESTED PERMITS:
01 DRIVEWAY ICURs-CUT ISIDEWALK: ..................~.:.............................. ....... ........... $ 60.00
AMMOUNT OF SIDEWALK IN EXCESS OF 90FT, @$0,06 SF. $
o SIDEWALK REPAIR: ....",..............."..,.......................................,..".........",,$ 10.00,
('pO ,00
o ADDITIONAL DRIVEWAY:
..,...........,.,...,....,.....,.'..".,..,..,..,.,..,..",.".,..,.$ 30.00
o PROOF OF INSURANCE: $500,000 MINIMUM IF WORK IS DONE BY PROPERTYOWNER
TOTAL DUE WITH PERMIT $
"0 , 00
CONTRACTOR INFORMATION:
CONTRACTOR:,..J3~ ( J ).,) rfr)'A- ..
ADDRESS: 'to 1f'1Y ~ 1,t/t})1! EL.{
CONTRACTOR REGISTRATION NO: r'? nl,tql7 . (J
PROJECT SUPERVISOR:
PHONE:
EXPIRATION DATE: "7 /.;)/ /'Or1
PHONE: ~/d..:r:;A>f/__
. ; i
INSPECTIONS:
AN INSPECTION REQUEST SHOULD BE MADE PRIOR TO POURING CONCRETE, AFTER THE PROPOSED WORK HAS BEEN FORMED
AND MADE READY TO POUR.
CURB CUT AND SIDEWALK INSPECTIONS CALL 726-3769 (RECORDER) STATE YOUR DESIGINATED CITY JOB NUMBER/PERMIT
NUMBER, JOB ADDRESS, TYPE OF INSPECTION REQUESTED, AND WHEN YOU WILL BE READY FOR INSPECTION, CONTRACTOR'S
OR OWNER'S NAME AND PHONE NUMBER. REQUESTS RECEIVED BEFORE 7:00 AM. WILL BE MADE THE
SAME DAY, REQUESTS AFTER 7:00 AM. WILL BE MADE THE NEXT WORKING DAY. INSPECTIONS ARE TO BE CALLED IN
AFTER EXCAVATIONS ARE MADE AND FORM WORK IS IN PLACE BUT PRIOR TO POURING CONCRETE,
YOU ARE REQUIRED TO CALL
THE LANE UTILITIES .cOORDINATING COUNCIL'S
"ONE CALL NUMBER" 1-800-332-2344
48 HOURS BEFORE DIGGING
SIGNATURE:
AMOUNT RECEIVED:
RECEIPT NO:
1> 6CJ !EE
0~'.>-lS"~4-
DATE PAID:
RECEIVED BY:
10/(3/99
F.>tG-T~
, 0
By signature, I state and agree, that I have carefully examined the completed application and do hereby certify thpt all information herein
is tru~ and ~orrect and I further certify that any and all work performed shall be done in accordance With the Ordlnanc~s of
the CI!y of Spnngfield, applicable City Standara specifications and Drawings, and the laws of the State of OreJl.on p'ertaoning to the work
descr,ibed ~erein, I further certify that only contractors and employees who are in compliance with ORS 701.055 will be used
on thiS proJect.
The City may inspect the work sile described in this permit at any time during a one year period following the receipt by the City of notic,
of completion of the described work and specify, at the City's sole descression, any additional restoration work reguireil to return the sitE
to a standard acceptable tQ the City, The permitlee will be notified in writing of any work required and will have thirty days (30) from the
date 91 the notice to cOl"{1plete !he work. Work ~ot completed at the end olthe thirty days WIll be performed by
the City and the costs w!1I be billed to the permittee. .
I furthor agree to ensure that all required inspections are requested at the proper time, that project address is readable from the
street, ana the approve,fset of plans will ~emain on the site at all times during construction,
Signaturel~!;~L~..
Date r1J//? /99-
I /
.
,.
..
J
.-
City of Sppi~gfield
225 Fifth St,peet
Sp~ingTield, OR S7~77
(503) 726-3753
Tpa~sactio~ ~umbep 035864
Octobep i3, i595 11:02 AM
Received fpem: P.J.C. LLC
Co~t,pact/O~~ CPNTRACTOR
Addpess: 940 H~Y 59 N.
City: EUGENE St: OR Zip: 97402
-Bl1ilding-
Job .: 997402
Descpiptio~
Fee
Amt
Total:
Received:
Check t:
~
~.l~tI/\
60.00 . (2- f~r--" .
60.00 Ch ' . pO
,e~ fOP- \
J1 /J \ 4P -V-
Tha~k you, Bob T. K ~ <q "\ t>!J
t!.. t.r~C IJIRO ? 1"" \ 1"t"".w-
f, . p!J1 ~ ':(;//'1
fJP fC,(1
?
60.00
Side~alk
1200