<br /> 1 <br /> t ~ <br /> City of Eugene <br /> Public Works <br /> Application for Public Improvement Permit Engineering <br /> 858 Pearl Street <br /> Job Number: Eugene, OR 97401 <br /> (541) 682-5291 <br /> FAX: (541) 682-5032 <br /> Contract No: <br /> I, Visionary Investments II. Inc. hereby make application for a PUBLIC IMPROVEMENT PERMIT to <br /> (owner) <br /> construct public improvements in the public way, as described below; <br /> Type of Improvement: Paving, wastewater, stromwater, sigage <br /> (paving, wastewater, stormwater, street lights) <br /> Location: East Ridge Village PTJD Phase 5 (1st. Addition ) <br /> (street or easement work is within or subdivision name) <br /> North (or east) limit: Glenwood Drive South (or west) limit: East Ridge Village Pi:lD <br /> in strict conformance with City of Eugene standard specifications for public improvements (including current addenda), <br /> construction plans approved bythe city engineer or his representative, the current edition of "Procedures for Privately Engineered <br /> Projects," the Eugene City Code, and the standard and special conditions printed on this permit form. The owner/applicant is <br /> responsible for providing opy of this permit to the contractor performing the work. <br /> Contact Per on ~ Nan Williams <br /> { <br /> Signa re Mailing Address P.O. ]3ox 10107 <br /> Print i at a 1Va Williams <br /> Date Z1Y U Phone pity /State !Zip Eugene, OR 97440 <br /> DO NOT WRITE BELOW THIS UNE <br /> PUBLIC IMPROVEMENT PERMIT <br /> Permission is hereby granted to applicant and applicant's contractor to perform the work stated above, in conformance with <br /> conditions listed above, below, and on the reverse side of this permit form. <br /> The permit shall be void unless the work described herein is completed by: <br /> SPECIAL CONDITIONS <br /> APPROVED: Date: <br /> City Engineer <br /> Eng; 604 FEBRUARY 2002 <br /> White: Owner/Designer Canary: Contractor Pink' Inspector <br /> <br />