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ication fdr Public Improvement Permit <br />Job Number: <br />Contract No: <br />1, Blazer <br />construct public <br />', ~, Type of ImF <br />Location: E <br />City of Eugene <br />Public Works <br />Engineering <br />858 Pearl Street <br />Eugene, OR 97401 <br />(541) 682-5291 <br />FAX: (541)682-5032 <br />lion Company hereby make application for a PUBLIC IMPROVEMENT PERMIT to <br />t <br />in the public way, as described below: <br />Paving, curbs, wastewater and stormwater system <br />(paving, wastewater, stormwater, street lights) <br />idQe Vill <br />P.U.D. Phase I <br />', i (street or easement work is within or subdivision name) <br />' North (or east) imit: Moon Mountain Drive <br />South (or west) limit: Laurel Hill Drive <br />in strict conformance with City of Eugene standard specifications for public improvements (including current addenda), <br />Gonstntction plans a proved by the city engineer or his representative, the current edition of "Procedures for Privately Engineered <br />f~rojects," the Euge a City Code, and the standard and special conditions printed on this permit form. The owner/applicant is <br />responsible for provi ing a copy of this permit to the contractor performing the work. <br />Contact Person n Ah ~ W; 1 i <br />r _ ~~ <br />' Slignatur _ Mailing Address PMB 1 49, 3 Monroe Pkwy. ,Ste <br />Pkint sig lure ere Q H -~ ~~ J, ail <br />Daate Phone ~- City/StatelZip Lake Oswego, OR 97035 <br />~I <br />~ !70 NOT WRRE BEIAW THIS LINE <br />i <br />PUBLIC IMPROVEMENT PERMIT ' <br />P rmission is hereby granted to applicant and applicant's contractor to perform the work stated above, in conformance with <br />',conditions listed abov ,below, and on the reverse side of this permit form. <br />'!Tf~e permit shall be v id unless the work described herein is completed by: <br />Engineer <br />Date: <br />uPn <br />Eng: 60+4 FEBRUARY 2002 <br />White: OwnedDesigner Canary. Contrador Pink: Inspector <br />