HomeMy WebLinkAboutPermit Sidewalk 1995-6-15
~5IDENTIAL - COMMERCIAL
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Iireo
"5 NORTl-l FIFTI-I STR:ET
SPRINGFIELD. OR:GON ~1411
ENGINEERING DIVISION
OfTICE NO. 17"'-3153
INSPECTION LINE, 17"'-31"'<3
J09 ADDRE55, h(:fl W t)U(,v(J.<..-r'
':'SSES50R5MAPNO.* 17-D'3-7.7- q"L.. i':'X lOT NO: * /,,1')
5U9DIVISION,
O.:NER, 1-1 A 5t:. A
ADDRESS, 300 vi.
5iA,=, oR-
iJ..iOR<: DESCRIPTION,
SIDE'.!JAUC, ~
CURS-CUT:
( f?:712../ JJ.J./ ...:,/-J A ~t:rz... ')
'::;AIe..\L1..@IJ Cln', 6f'e/~t..f/P,dl
ZIP, "f1L171 ",;..lONE NO.
CU:;S SIDE _
~5IDESi].!.L _
==B.LC<
co, r. ERICAL
SECOND DRIVEWAY I SEE TRAFi'IC )
REQUIRES APPLICATION i'OR A SECOND DRIVEWA"-I'T-<.1.)
OR A COUNTY .l.PPLICATlON FOR F,t.CILITY F::~IT IC '38-7"'3)
IF IN THE UC.9. .
~ATE O? APPLICATIa-.l
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SPRINCFIELD
RECEI",T NO, 17300
CAS';
CHEC':::
~
4;
CHEC"ED FOR DELINQ:.i~CIES' !:.
5IC:~:;:
DAT::
WORK TO BE FEF<rv"", lcD BY,
O~R
~~C'jOR
*
REC:ISTRATION NO. '3:>,7 I
CON7RACTOR* -?-rA-rOJ.-j
A:>DR::S5 2fi '$?4,1S
r fl~<:,'ft>.vCt( OJJ
A I PPt'J1i!.7 eel.
t50 f? Ie
to-/r-" ,.
EXPIRES'f??-2.l- 96
P;";OSE'L/fc/. os 9'5
""""^"'c.....URE FOR IN5Fl:CTlON REQUEST,
c.AL1. 126-:;'6~ (R:CORDER ) STATE 10'JR ell"( D::SIC::~T=D J09 N'J:"'i9:R. J09 ADDR.:55,1 T p:; 0;:
INSF::CTION R:QUESTED A'iD UT.-IEN YOU WILL BE RE,t.DY FOR INSPECTION. CONTRACTORS OR OCNER5 NA.""E '<''iD
PHONE NUM9ER R:G'JESTS R:CEIVED B:rvr= 1,= ..<..., WILL BE MADE TI-IE 5AJ-1E DAY. R:QJESTS ..<..=TER 1,00
A., WILL BE MADE THE NEXT Uk:lRKING DAY
* SEE WOK
YOU~ CITY DE51GNATED J03 NO. Isf
EXISTING e.t.J1LDING P::~IT NO. ( rr= APFUCA9U:: )
q,~/~
REQUIRED INSPECTIONS
[f
51DEWALK f DRIVEWAY
FOR ALL CONCR!;iE PAVING WIT~IN
THE STR:ET RIC:4i OF WAY. TO SE
M.t.D:;: .l..=TER ALL EXCAYATINC:I
15 COo'1PLETE AND FORM 1lk:>R<:
A"J.D SU9-9.t..5E MATERIAL IS
IN PLACE
FEES:
SIDEWALKS
~10,00 . ~.I5/LF. ( X )
OF WALK
CUR9-CUT
~10,00 . l-0.1:;/LF. ( X )
s
ft
COO1MERICAL DRIVEWAYS SHALL
I-lAYE 5' TO 8' FLAIRS
3'- "'" STA~DARD
TOTAL PERMIT FEE,
I ~..!.VECAR:"R.iLL Y EXA.,INED 4E COMPLETED APPLICATiON FOR PERMIT. "'-'iD DO HER:BY CERTICY 71-1'<'T ALL
INrORMATION HER:ON 15 TFaJ,,r;:"ID CORRECT. A"ID I AJRTHER CERTIFY THAT A'iY ""'iD ALL u.oR<: PERrORMED
S~ALL BE DONE IN ACCORDA'iCE WITH TI-IE ORDIN-'-'iCES OF THE Cln- OF 5PRINC:FIELD. AND THE LACJS OF THE
STATE OF OREGON PERTAINING TO THE 1lk:>R<: DE5CRISED HEREIN. A~D THAT NO OCCUPANCY WilL SE M-'-DE
OF ,J::..SY STF3.JCTU~ UlITI~OJT PERi1IS51~ OF THE BUILD!Nc; DIV1510t.t. I FUR71-l:R CERTIPr' ~H,j.T ~L ";" Co-..IRACTO~5
.eND EMPLOYEES UJI-lO ARE IN COMPLIA~CE WITH 0R5 10'"*5 WilL BE USED ON THIS PROJECT.
SI6NED
D
DATE
.- CURS I APFRO'<'CI-I APRO
A=-r;:R FOR:1S ARC ER.:Ci:
BUT PRIOR TO POJRING
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