New Search
City of Eugene <br /> Public Works <br /> 4p lication fold Public Improvement Permit Engineering <br /> 858 Pearl Street <br /> ob Number: __~~~L// Eugene, OR 97401 <br /> (541) 682-5291 <br /> FAX: (541) 682-5032 <br /> ontra~c~t No: <br /> T~-~ <br /> ~ d"`'" hereby make application for a PUBLIC IMPROVEMENT PERMIT to <br /> (owner) <br /> onstruct public implrovements in the public way, as described below: <br /> Type of Improvement: ~ ? QC`s - t-~`~ <br /> ~ \ ~ ~ S i C Wit, !~~£~~i"~'k~`c4.j tLi(~ <br /> (paving, wastewater, stomtwater, street lights) <br /> n ~ <br /> Location. r 1 ~ . ~ 1 <br /> (street or easement work Ys within or sutxNvlsion name) <br /> North (or east) I~mit: South (or west) limit: <br /> i <br /> i strict confomtande with City of Eugene standard specifications for public improvements (including current addenda), <br /> nstruction plans approved by the city engineeror his representative, the current edition of "Procedures for Privately Engineered <br /> rojects," the Eugenie City Code, and the standard and special conditions printed on this permit form. The owner/applicant is <br /> r sponsible for providing a copy of this permit to the contractor performing the work. <br /> ontact Person IP~nn <br /> ignature~ C~ ~~1~'-" Mailing Address y ~y~ ~GG~(L~"f-~ <br /> rint si nature here ~ ~ ~"r <br /> ate t ~ - b Phone ~ - Z City /State /Zip ~Y Lam- ~ ~ <br /> DO NOT WRITE BELOWT111SLINE <br /> PUBLIC IMPROVEMENT PERMIT <br /> P rrnission is hereby granted to applicant and applicant's contractor to perform the work stated above, in conformance with <br /> c nditions listed above, below, and on the reverse side of this permit form. <br /> T e permit shall be vooid unless the work described herein is completed by: <br /> S ECIAL CONDITIONS <br /> A PROVED: ~ Date: <br /> City Engineer <br /> <br /> Eng: 604 FEBRUARY 2002 <br /> Whke: OwneNDesigner Canary: Contractor Plnk: Inspector <br /> <br />