New Search
City of Eugene <br /> Public Works <br /> <br /> Ap lication for'Public Improvement Permit Engineering <br /> 858 Pearl Street <br /> ~ Eugene, OR 97401 <br /> J b Number: (541) 682-5291 <br /> FAX: (541)682-5032 <br /> ontract No: <br /> JENNINGS EVELOPMENT LCC hereby make application for a PUBLIC IMPROVEMENT PERMIT to <br /> 1~' (owner) <br /> • c nstruct public imp vements in the public way, as described below: <br /> ,,Type of Improv ment: WASTEWATER ANn SmnRMwATFR <br /> (paving, wastewater, stormwater, street Iighffi) <br /> location: T .1 i S R <br /> (street or easement work is within or subdvision name) <br /> ~lorth (or east) I mit: TAX T nT 1 7 p.p South (or west) limit: YANG-~ <br /> i strict conforman with City of Eugene standard specifications for public improvements (including current addenda), <br /> nstruction plans roved by the city engineeror his representative, the current edition of "Procedures for Privately Engineered <br /> rojects," the Euge City Code, and the standard and special conditions printed on this permit form. The owner/applicant is <br /> sponsible for providing a copy of this permit to the contractor performing the work. <br /> I <br /> ontact Person [pr+nq~~l DOUG WE~.,R.~-PH ~~S~11~ X61 -9779 <br /> i nature ~ ~AAailing Address JENNINGS DEVELOPMENT LCC <br /> 9 <br /> riM sig ature here KE N t~.8 $ 3b8' EAST 1 1 TH AVE . <br /> ate Phone ~ 41 - 4 3 4 - 21 1 4 pity /State /Zip ,Erir_F>`?>~ C1R_.-Q <br /> 7_4~D <br /> 1 <br /> DO NOT WRRE BELOW THIS IJNE <br /> PUBLIC IMPROVEMENT PERMIT <br /> ermission is hereby granted to applicant and applicant's contractor to perform the work stated above, in conformance with <br /> onditions listed above, below, and on the reverse side of this permit form. <br /> he perrnft shall be void unless the work described herein is completed by: <br /> PECIAL CONDITI NS <br /> PPROVED: Date: <br /> City Engineer <br /> I <br /> Enp: 6 FEBRUARY 2DLt2 <br /> WMte: OwnedDesipner Canary: Contractor Pink: Inspector <br /> <br />