HomeMy WebLinkAboutPermit Sidewalk 1995-6-28
225 NORTl-l FIFTl-l STR:ET
SPRINGFIELD. OREGON ~1411
ENGINEERING DIVISION
cm=ICE NO. 126-3153
INSPECTION LINE, 116-316~
tr=SIDENTIAL - COMMERCIAL
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SPRINCFIELD
IifO'...o
JOB ADDRESS, ~21 I')(J /^-ILlc..-r
':'SSESSORS M"-P NO.'*' I? D 2, ? _.., ~'L. T "-x LOT NO: +. / () c.:>
SUSDIVISION,
REC:IPT NO, I! tf9s
CASH
CH:C< ~
O.:N:R 1-1 A sc. A
ADDRESS, 300 vi.
S,AT:, olC.
ll.OR< DE5CRIPTICiN,
5!D="1I.'...., ~
( f7P.../ IN-I ~J-j A 1"t:lZ..- '>
~JlIe...V/I'VJJ CITY, GPe/~t-FlfrJ)
ZIP, "f1Q71 PHONE NO.
CM::CKED F=OR D:LINQJ:NC;::S
~
1-
cuss SDE
==BAC<. _
c.JRS.CUT: ~SrD~i]AL _
S:=ND DRIV=l!J.!. Y I S:E 7R.!.M'IC )
REQUIFCS APPLlCATION;'OR A s:C= DRIV=UJA':'I'T-4.1.)
OR A COUNrr "-PPUCATION FOR FACILITY PE~IT IC ~-2"'3)
IF IN THE UL:,.9.
=,CERIC.!.L
~A TE 0:= APPLiCA ria-.!
_yz/l. 7!r~
5IC=N:.:;:
150 I? Ie..
to -2..Y-PS-
DA'i'::
WORK TO BE F'E~1'<J IcD BY: O~R
CONTR.'-C70R *' .,::;rrA'10J.-l t'""/\^'-t::.71?J.Jc:t/Ojj
A::>DRESS 2-'7 ~?q ~ A / PPt>Rf J?c/
f-,..-. .. -. -UR!: FOR IN5PECTlCiN REQUEST:
CALL 126-316~ lRECORDER ) STATE YOJR CIT'!' DESIC:~TED .!OS Nu:-i3:!'!. JOB ADDRESS.TTPE 0.=
INSPECTION REQU:5TED A"lD lU-EN YOU WILL 50: R:AOY FOR IN5P=CTI~. CONTRACTO~ O~ Ol:.NE~ N.L:""::: .l..'ID
pf..lONE NUMBER. REQU:STS FCCEIVED B:FOFC 1,0'" .l.'1 WILL B: MADE Tl-lE SAnE DAY. REOJ:STS "-=TER 1,00
..0..'1 WILL B: MAD: THE NEXT lLOR<:lNC: DA.,..
~~TRACTOR:
+.
REGISTRATION NO. "3:';7 I
EXPIFCS,,?-Zl- 9"
P;';=.E'Lffol- CJ5 ~~
EXISTIN0 ~!ILD~ P:::~IT NO. ( IF APFLICA9LE )
+. 5== o~
-- ...............
YOU~ CITY D:::5IGNATED J09 so. ,sf
7'71 d ~o
REQUIRED INSFl:CTICiNS
[0'
SIDEWALK / DRlveWA.,..
FOR .!.LL CONCR:TE PAVINe. WITl-lIN
THE STREET RIG4T OFWA.,.., TO BE
M.4DE ~=rER AlL EXCAYAi~
IS COi"'iPLETE AND rO~ UJO~
A"lD SU9-BASE M"-TCRIAL IS
IN PLACE
D
.- CURS I APPROACl-l APRO
AFTER FO~S ARE EREC7'
BUT PRIOR TO POUR IN'"
CO~CR:iE.
FEES:
SIDEWALKS
CURB-CUT
TOTAL Fl:RHIT FEE:
s /1.'5"6
=o-1MERIC.!.L DRlVEWA.,..S Sl-lALL
I4AVE 5' TO 8' FLAIRS
3'- O' ST"-"lDARD
WAU<' x'
/ ""
I. x' I.
.,
H@.@@ . ~.IS/LF. ( X )
or WALK
~1@_@@ . Y.2>.I5/LF. ( X )
I ~lVE .CAR=-i=uLL Y EXA""1IN.!:D TJ-!E COMPLETED APPLICATION FOR PERMIT, ':..'''.JD DO l-IER:ey CE!"<!:TIFY 7"':..l..T AlL
INi=O~ATlON I4ER.:ON 15 TR1.JE A"ID CORRECT, A"lD I RJRT~:R CERTIFY T~AT A"lY ~~D ~L lLOR< PE~RnEO
SI4ALL BE DONE IN ACCORDA"lCE WITI4 TI4E ORDIN':''JCES OF Tl-lE CITY OF SPRINC:F1ELD. AND Tl-lE LAC.!S 0.= TI4E
STATE OF OREGON PERTAINING. TO Tl-lE ll.\?R<: DESCRIBED .....EREIN. A"lD TI4AT NO OCCUPA"lC"" WILL BE M-'.!:>E
OF J:..NY 5TAJCTU~ ll117;40UT PE~15Sla-l or Tl-IE 9UILDrNC:i DIV1510t-t 1 FVR:7i--l~R CERTIlr ":"1-I,j.T o:-...ll'T" C~'TRACTOR5
.<ND EMPLOYEES WHO ARE IN COMPLIA"lCE wlm ORS 1"1.055 WILL BE USED ON mls PROJECT.
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