HomeMy WebLinkAboutPermit Sidewalk 1997-7-24
22& NORTH FIFTH S~ET
SPRINGFIELD, OREGON <;\1411
ENGINEERING DIVISION
OiTICE NO. 126-31&3
INSPECTION LINE. 126-316<;\
~Olvt:r'lIIAL- - L..-VI-II-It:to::.L..-IAL-,
SIDEWALl< I ~T
AFR.ICATloN I PERMIT
SPRINGFIELD
1I~
.
.
JOB ADDI"iE&e. /4/ (0 nE'-A -S 4 .u T
ASSE''''~,"", MAP 100'0,* /7-0"'3' 7- S' - 3' '2-
SU13DIVISION.
OUNER> '"5 ~61T' $" '5 (/<; <41{ 1 f ~ /"> l? A l-r-o "u
ADD~SS. /41/r> RD4SAJ{), <5/ CIT'!'.c:s.PF'LT7
STATE. C>e:.... ZIP, 9747'7 PHONENO'74~-Sq.04
CbT
, '*
TAX LOT NO, OGq.oO
~CEIPT NO.
CA&H
<5~8 S"
Ct-lECK
...--
.. ~
Ct-lECKED FOR DEL INQ'JENCIES v'"
WOi"!K DEec~IPTION.
&IDEUJAl.l<, -l.::::::::. CURe &IDE _
CURe-CUT. ~&IDENTIAL _
!lECOND DRIY!:WAY (&EE TRA'TIC )
~aul~& APPLICATION FOR A !lECOND DRIVEWAyr.,.-4J.)
OR A COJNT'!' AFR.ICATION FOR FACILIT'!' PERMIT rc 'il8-21Z>3)
IF IN TI-lE U.a.a,
DATE OF APPLICATION 7,/2.4/92-
SETaACl< _
COMMERICAL _
&1G.'lED,
DATE,
~J-"~
, 7/t4-li:?7
, I
WORK TO BE F!:1O!f...,..... Il:D BY.
CONTRACTOR*
ADD~&S
x
OUNER _ CONTRACTOR
*
~GI&TRATION NO,
EXPI~&.
PHONE,
r-.-...........UF<E FOR INSFECTION REGlUEST.
CALL 126-316<;\ (~COFIt>ER) &TATE YOUR CIT'!' DE&IGNATED JOEl NUM5ER, JOEl ADD~&&,TTf'E OF
IN&PECTION ~auE&TED AND ll.\.lEN YOU WILL 13E ~ADY FOR IN&PECTlo.-l, CONTRACTOR& OR OUNER& NAME A'lD
PHONE NUMaER ~QUE&T& ~CEIY!:D I3EFORE 1,= t.I1 WILL 13E MADE T.e SAME DAY, ~QUEST& toFTER 1,=
t.I1 WILL 13E MADE T.e NEXT WOl'il<ING DAY
* !lEE BOOK
EXI&TING ElUILDING PERMIT NO, r IF AFR.ICA6LE )
YOUR CIT'!' DE&IGNATED JOEl NO, 1&1' 92. / 6 J h
REQUIRED INSPECTIONS
o
SIDEWALK I DRIVEWAY
FOR ALL CONC~TE PAViNG WITt-lIN
TI-lE ST~ET RlGf.lT OF WAY, TO 13E
MADE AFTER ALL EXCAVATINCO
1& COMPLETE AND FORM WOl'il<
AloID &U9-13A&E MATERIAL IS
IN PLACE
D
CURe I APPROACt-l APRON,
AFTER FORMS A~ E~CTED
ElUT PRIOR TO pOURING
CONCRETE.
FEES.
/0 LT
51DEWALK5
.Ie>,e>e> + .e>J5fLF. ( X )
0;: WALK
CURB-CUT
.Ie>.e>e> + ~J5fLF. ( X )
WALK X'
II, 5 C>
COMMERICAL DRIVEWAY& S>-lALL
>-lAY!: &' TO 8' FLAIR&
3'- 0' STA'lDARD
/
l
"
""
I.
1
$
TOTAL r-Cl"<I liT FEE. "
x'
I >-lAVE CAREFULL,. EXA...,INED THE COMPLETED APPLICATION FOR PERMIT, A'lD DO HERE9Y CERTIFY Tf.lAT ALL
IN:"-GRMATION t-lEREON 1& TRUE A"D CORRECT, A'lD I FURTHER CERTIFY THAT A'll' AND ALL UOR< PEl'rORMED
S>-lALL BE DONE IN ACCORDA'lCE WlTf.I THE ORDINA'lCES OF Tf.lE CITY OF SPRINCOF]ELD, AND T>-lE LAW& OF Tt-lE
STATE OF ORECOON PERTA]NINCO TO Tf.lE WOl'il< DE&cRI9ED HE~IN, A'lD T>-lAT NO OCCUPA'lC" UHLL BE MADE
OF A",. STRJCTURE WITf.lOUT PERMISSION OF Tf.lE ElU]LDING DIVISION. I FURTHER CERT]FY T>-lAT o.-lL,. CONTRACTORS
"'''D EMPLOYEES w;.;0 ARE ]100' Co...,PLlA'lCE WITt-l OR& 101.0&& WILL 9E USED ON Tf.lI& PROJECT,
.~4/-r,~~.-??Z7~~'
-;7-.-/" ~q1!,
DATE