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. <br /> <br /> ' City of Eugene <br /> Public Works <br /> Application or Public Improvement Permit Engineering <br /> 858 Pearl Street <br /> Job Number. Eugene, OR 97401 <br /> (541) 682-5291 <br /> PAX: (541) 682-5032 <br /> Contract No: <br /> I <br /> I, Walt Drew hereby make application for a PUBLIC fMPROVEMENT PERMIT to= <br /> (mod <br /> construct public i provements in the public way, as described below: <br /> Type of impr vement: Raving, wastewater, street swales <br /> ail (paving, wastewater, stormwater, street lights) <br /> i <br /> II Location: hael's Choice <br /> (street or easement work is within or subdivision name) <br /> North (or east limit: South (or west) limit: <br /> in strict conform ce with City of Eugene standard spec'rfications for public improvements (including current addenda), <br /> construction plans proved bythe city engineeror his representative, the current edition of "Procedures for Privately Engineered <br /> ~'rojects,° the Eug ne City Code, and the standard and special conditions printed on this permit form. The owner/applicant is <br /> tesponsible for pro iding a copy of this permit to the contractor performing the work. <br /> ~ontact Person Apr; Wald Drew <br /> $i nature ~ / Mailing Address 1 1 35 Cal Young Rd <br /> 9 <br /> Tint signature here <br /> ate Phone~$3' ~d4~ City/State/Zip Eugene, OR 97401 <br /> ~I <br /> oo wos wanE eFaow Trtts ttr+E <br /> PUBLIC IMPROVEMENT PERMIT <br /> Permission is hereb granted to applicant and applicant's contractor to perform the work stated above, in conforrnance with <br /> conditions listed abo e, below, and on the reverse side of this permit form. <br /> T ' e permit shall be id unless the work described herein is completed by: <br /> S ECIAL CONDITI S <br /> I <br /> i <br /> i <br /> AP~ROVED: Date: <br /> City Engineer <br /> Eng: 604 FEBRUARY 2002 <br /> White: OwnegDesigner Canary. Corrtractor Pink: Inspector <br /> <br />