New Search
+ j <br /> City of Eugene <br /> Public Works <br /> 14pplication for Public Improvement Permit Engineering <br /> ' /L~ / ~ 858 Pearl Street <br /> Job Number. ~j Eugene, OR 97401 <br /> (541)682-5291 <br /> FAX: (541)682-5032 <br /> Contract No: <br /> I, Paul Lemmon hereby make application for a PUBLIC IMPROVEMENT PERMIT toy <br /> (owner) <br /> construct public improvements in the public way, as described below: <br /> Type of Improvement: Paving, wastewater, stormwater, street lights <br /> (paving, wastewater, stom>!water, street tights) <br /> i <br /> Location: Tel Estates <br /> I~ ' (street or easement work a within or subdivision name) <br /> ger Drive Excaliber Lane <br /> North (or east~f~t: South (or west) Gmfi <br /> in sbict conformance with City of Eugene standard specifications for public improvements (including current addenda), <br /> construction plans approved by the ~Y engineer or his representative, the current edition of °Procedures for Privately Engineered <br /> i Projects,' the Eugene City Code, and the standard and speaal conditions printed on this permit form. The owner/applicant is <br /> j responsible for providing a copy of this permit to the contractor performing the work. <br /> Pe Paul Lemmon <br /> Signature Mailing Address 5520 Barger drive <br /> Print signature here ~ d " I <br /> 'Date_,~~ lG ~d ~ Phone~'y/~ ~g9-0/3~City/State/Ztp Eugene, OR 97402 <br /> I' <br /> m rtor wry scow rws r~ <br /> j PUBLIC IMPROVEMENT PERMIT <br /> ~ Permission is hereby granted to applicant and applicants contractor to perform the work stated above, in conformance with <br /> j conditions listed above, below, and on the reverse side of this permit form. <br /> I <br /> fihe permit shall be void unless the work described herein is completed by. <br /> i <br /> SPECIAL CONDITIONS <br /> I~ <br /> APPROVED: Date: <br /> ~ City Engineer <br /> i <br /> <br /> Eng; 604 <br /> White: OwnedDesigner Canary: Coirtractor Pink Inspector FEBRUARY 20U2 <br /> <br />