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A ~ication for ublic Improvement Permit City ofEugene <br /> Public Works Engineering <br /> 858 Pearl Street <br /> Eugene, OR 97401 <br /> Job Number ~ Contract Number 541.682.5241Phone <br /> ~ 541.682.5032 Fax <br /> i <br /> I, Jeff Parker hereby make application for a PUBLIC IMPROVEMENT PERMIT to construct public improvements <br /> (owner) <br /> in the public way, as de~cribed below: <br /> Type of improvement Paving, wastewater, stormwater, street lights <br /> (paving, wastewater, stormwater, street lights) <br /> !Location: Timberline Hills Phase 3 <br /> (Street or easement. work is within or subdivision name) <br /> North (or east) limit: Summerset Hills VIII (North) South (or west) limit: The Summit PUD (West) <br /> in strict conformance wi h City of Eugene standard specifications for public improvements (including current addenda), construction <br /> plans approved by the ci y engineer or his representative, the current edition of "Procedures for Privately Engineered Projects," the <br /> Eulgene City Code, and t e standard and special conditions printed on this permit form. The owner/applicant is responsible for providing <br /> a do{~y of this permit to t e contractor performing the work. <br /> Cpntact Person (print) mpass Engineering, Stacy Stubblefield, PE Phone Number 503-653-9093 <br /> SIG NTUR <br /> Stacy Stubblefield Billing information: <br /> PRINT SIGN TORE <br /> Same O Different, see below <br /> ~i 1 /9/2 08 <br /> DATE Jeff Parker, Parker Development <br /> 4105 E International Way, Suite 501 "A`~"E <br /> MAILINGA RE55 1750 SW Blankenship Road <br /> Milw ukie, Oregon 97222 BILLING ADDIIE55 <br /> CITY,STATE,ZIP West Linn, Oregon 97068 <br /> 503-6 3-9093 crtr,sTATErz~P <br /> PHONE NUM R(buslness huusil <br /> PUBLIC IMPROVEMENT PERMIT <br /> Perr'ni~sion is hereby gran ed to applicant and applicant's contractor to perform the work stated above, in conformance with conditions <br /> list~d above, below, and o the reverse side of this permit form. <br /> <br /> The permit shalt be void u less the work described herein is completed by: <br /> SPECIAL CONDITIONS <br /> APP ROVED: DATE: Original io the City of Eugene <br /> City Engineer ' Copies to Owner, Co-owner, and Inspector <br /> I <br /> <br />