HomeMy WebLinkAboutPermit Sidewalk 1993-3-17
225 NORTf4 FIFTf4 5TREET
5PRINGFIELD, OREGON <:11411
ENGINEERING DIVI510N
OA'ICE NO. 126-3153
1N5PECTION LINE, 126-316<:1
~5IDENT~I~~ALK I :~~Effl_AL
APPLICATION I PERMIT
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J06 ADDf<E6e/ c10i /" /9 U ;"..{/ A L r
A55E550I':5MAPNO.* (I O~ 2f/? cf-I TAXLOTNO'*./S:"1()Q
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OUNER, .J2 lh cui! ~aU P 4 r'..:" -' ,-;>
ADDRE55'/),9 ? ~ ;A'~:JL I - crTY,
5TAM.4./l_ I /)f. ZIP, 97 t; 77 F'I-lONE NO-7Uh (.;//9
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RECEIPT NX--
CA51-1 _
Cf4ECK _
* V
CHECKED FOR DELINGlUENCIE6 _
51DEUJALI<, CURB 51DE _
CURB~CUT. RE51DENTIAL _
5ECOND DRIVEWAY (5EE TRAfl'IC )
REGlUlRE5 APPLICATION FOR A 5ECOND DRIVEwAnor-4.1.)
OR A COJNTY AF'PLICATION FOR FACILITY PERMIT (C <:l8-2""3)
IF IN Tf.IE U.c..B.
5ETBACK _
COMMERICAL _
WORK. TO 6E F'E~ leD 6Y.
CONTRACTOR*P\ 12cu f=Rn
ADDRES8 '0.0 ."BOY '0 "7
OUNER
5IGNED.
DATE.
'f- CONTRACTOR
REGI5TRATION NO.* 71)3'6/
~
'3 - \"l - '1 ~
'"
DATE OF AF'PLICATION
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EXPIRE5.
-
'D~ f c:;: ,e... _ OR
PHONE,
f-...........cwUl'<E FOR IN&FECTION f<EQUEST.
CALL 126-316<:1 (RECORDER) 5TATE YOUR CITY DE51GNATED J06 NUM6ER, J06 ADDRE55,T'!"PE OF
1N5PECTION REGlUE5TED AND llA-lEN YOU WILL 6E READY FOR 1N5PECTION, CONTRACTORll OR OUNERll NAME AND
F'I-lONE NUM6ER. REGlUE5T5 RECEIVED 6EFORE 1,,,,,,", AM WILL 6E MADE TI-IE 5AME DAY. REGlUE5T5 AFTER 1,""'"'
AM WILL 6E MADE Tf4E NEXT WORKING DAY
* 5EE ElOOI<
EXI5TING 6UILDINC. PERMIT NO. ( IF APPLICABLE)
YOUR CITY DE51GNATED J06 NO. 15'f' q ~ 0 ""?:. ~ <
f<EQJIf<ED INsPECTIONS
~
51DEWALK I DRIVEWAY
FOR ALL CONCRETE PAVING WITf4IN
Tf4E 5TREET RIGf4T OF WAY, TO 6E
MADE AFTER ALL EXCAVATING
IS COMPLETE AND FORM WORK
AND llU6-6A5E MATERIAL 15
IN PLACE
D
CURB I AF'PROACf4 APRON,
AFTER FORM5 ARE ERECTED
6UT PRIOR TO POURING
CONCRETE.
FEES, 5IDEWALK& CURe-CUT WALK x'
.10.00 . W.l5/LF. ( X ) .10.00 . W.l5/LF. ( X ) / ""
OF WALK 40\
COMMERICAL DRIVEWA Y5 5HALL J x' I,
\eo.OO HAVE 5' TO B' FLAI1':5
. 3'- "". 5TANDARD , .
TOT AL ,J:~ ,IT FEE.
I f4AVE CARERJLL Y EXAMINED Tf4E COMPLETED APPLICATION FOR PERMIT, AND DO f4ERE6Y CERTIFY Tf4AT ALL
INFORMATION f4EREON 15 TRUE AND CORRECT, AND I RJRTf4ER CERTIFY Tf4AT ANY AND ALL WORK PEf<FORMED
5HALL 6E DONE IN .6,CCORDANCE WITf4 Tf4E ORDINANCE5 OF THE CITY OF 5PRINGFIELD, AND Tf4E LAW5 OF Tf4E
STATE OF OREGON PERTAINING TO Tf4E WORK DESCRI6ED HEREIN, AND Tf4AT NO OCCUPANCY WILL 6E MADE
OF ANy 5TRUCTURE WITf40UT PERMI5510N OF Tf4E 6UILDING DIVISION. I RJRTf4ER CERTIFY Tf4AT ONLy CONTRACTOR5
~;PL1?::~: IN COMPLIANCE WITf4 01':5 1""1~5 WILL 6E USED ON Tf415 J:~T~ _ ~ 5
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