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HomeMy WebLinkAboutPermit Curb Cut 1994-12-16 !:/~O ~bENT~I~;AL=-/ c;~~ERj~AL t.f'PLiCt. TlON / PER"1IT n!; NORT~ FIFT~ STREET SPRINGFIELD, OREC;ON >;\1411 ENUINEERINU DIYISION on=lCE NO. 17&.31!;3 INSPECTION LINE. 17&.31&>;\ JOB ADDRE58, 4B/ ASSES50RS MAP NO.*' Q><.JillarT II I'J?;' ? '7 L./ I .* TAX LOT NO. /0 I RECEIPT NO, I 5"777- CASH C~ECK ~ 5U6DIYISION, OUNER> HAc. s A t.DDRESS. _~ 0 n LV STt.TE. OR. EfrON t!.lORK DEecRIPTI~: SID:uJt.LK, CUR9-CUT. X I:'a" i-' v/ r~_L() ZIP, 47477 c:TY,r ~'''_II L>f1' . 1..lOll' P...ON: NO. i?;7-.'1ms- C~:CKED FOR DELlNOJ:NCI:S* J CU~ SID: _ 5ET5ASK _ R:SID:NTfAL _ CO:--r.-1:::RICAL 5ECOND DRlVE~~"'" (SEE TR..~.;;:;:IC ) R:QJIRE5 APFLICAjl~ i=OR ~ S::CO~P !:>RIV::UJA"""('T.~.1~) OR A COJNTY t.PP'~ICA710N FOR FACILITY P:!'<:'1IT rc 'O3-?0;) IF IN TH: Uc..9. SIC;N:D, DATE OF Af'PLiCt.TION p/I):!rtf D,.~.:i=: WI':K TO BE PEF<Fu"" It:D BY, x.. OlU'ER CO~i~C:OR CON7RACTO~ * 5'1 A To JJ AD::>RESS ;J.93'1<I -R .,,",C;ISTRA TION '* NO. 03.'? 7/ 9.J.::f..Q. :J... (:r)I11>T. TYlc. A~,~ C VCi.t:ll e. 01Y.~ I ' ~~d;j - J2.!irPi EXPIRE S.. 1'/.:;./ / qS- -. . P...ONE, 'f:fa.1"OS~ PROCEDURE FOR rNe.FECTI~ REQUE5T, C4LL '2c,-~1&9 (R2CORO::R ) ST~TE YOUR CITY D::Slc,~A:::D JOB N~=::R, JOB APDR.::SS..YP: or: [NSPECTION REQU::S'iED ..:..-...:::> ~EN YOLJ ~ILL 5E REt.::;'Y FOR lNSF'::CiIO'-l, CONT~C'70RS OR oc..N::RS N.L...""'!:: ,l.."o,/D Pi40~E NUM9ER REQJ::SiS RECEIVED B::i=OR.: 1:0" ..!..""i llJl!..L 9E MAD: it-;: S~"'I: DAY, REQ..JESTS ..:..FTER 1:00 AM UlILL 5E MADE il-l: NEXT liOR<ING Dt. '( E:'<ISTINC:s ~UILDISS P:R"iIT ~O, ( Ii= "!'PFLICABLE ) '*~""=~ ~--~ YO~~ CITY ::>:Slc;~"-7:D J09 NO. ISf- 9~z.7- REQUIRED rN5PECTI~S D S[DEWALK I DRIVEI.:JA'r i=OR ALL CO~CR:TE FAVlr.;c, IlJlT;...HN T~= SiR:.ET RIGHT or UJ~Y, 10 5: t"'i.!DE kIER.c..LL =;,(C~Vt.i[~G 15 COi"iF'LETE A~D FO~ U1OR<: t...~D 5US.5t...5E t"",.t..TER:1AL IS IN PL"-CE ~ FEES, SIDEWALKS 110.00 . 10.15/LF. ( >< ) 0;= I.!JALK CURB-CUT ,10.00 . >0.15/L.F. ( >< ) l(p TOTAL PERMIT FEE, ~ /'J.t.f() CO:-r.-1ERICAL DRIVEUJA,YS 5r-lALL i-lt.VE :.' TO 8' FLAIRS 3'. 0" 5Tt.."o,/~.t..R:D CURS / Af'PROAC~ APRON, At-,:R FOR'1S ARE ERECTED 6UT PRIOR TO PQ;JRINC; GONCR.: TE. WALK X' / I. "\ X' J 1 ~AVE CLR:;PJLL Y EX":""1NED il-!E COi"1PLETED "':'F'PLlC~ i[O:-': i=OR PER1i1', "':"-"':0 DO ;"';:::RE5Y CERTlrY 71-\,.!.T ~LL !S:=O~ATION j..lEREON IS TRJE t..-"':D CORRECT, .A"lD I FL.:RT;"';:.R CS:RilrY TI-\":' T ...:.....:.,... ":'~D ":'LL \1..OR<:. F'ERfO~ED S;..!ALL BE DONE IN t.CCOR:DANCS WITj..l TI-I: OR:DI~~'lCES OF- Ti-::: CITY or 5PR1~cr.=I:L~ ~"-lD T;.....lS L..:.t:..'5 OF Ti-:E ST":'TE OF OREC,O:-J PERT":"INING '70 Ti-iE: UJOR<. DE5CRI5::D ~ER:I~, :""\.:D T;..:..!.T NO OCC:.JP":''''lCY ~tLL 5E M~~: 0;: .:..NY 5TR'..JCTU~ UJI~;"';O..JT PE~ISSIO;\l OF TI-IE BU[LDING DIVISIO~. I FL:R:7i-:ER CERTIFY '7t.:":'T O~L'" CONTRACTOR5 "-'1D EMPLOYEES ''''''0 "-RE IN CO"'PLIA~CE WITH ORS 1"'1.0~!; WILL 9E US:D ON THIS PROJECT. SIC;N~ &; ~ /,;2./4/pfL O":'TE