New Search
4 <br /> City of Eugene <br /> Public Works <br /> Application fQr Public Improvement Permit Engineering <br /> 2 C 858 Pearl Street <br /> Job Number. ~ Eugene, OR 97401 <br /> } (541) 682-5291 <br /> FAX: (541) 682-5032 <br /> Contract No: <br /> r <br /> I, SCOTT 1'1 ? D 1 E H L FOR ARI.I ~ ~ hereby make application for a PUBLIC IMPROVEMENT PERMIT to; <br /> (owner) <br /> construct public ir!nprovements in the public way, as described below: <br /> Type of Improvement: Paving, wastewater, storm water, street lights <br /> (paving, wastewater, stortnwater, street lights) <br /> Location: ' Crescent Villa e Phase 2 <br /> (street or easement work is within or subdivision name) <br /> North (orea~t) limit: Shadow View Drive South (or west) limit: Crescent Avenue <br /> in strict conform~Ince with City of Eugene standard spec'rfications for public improvements (including current addenda), <br /> construction pla approved bythe city engineer or his represerrtaUve, the current edition of "Procedures for Privately Engineered <br /> Projects," the Eu ene City Code, and the standard and special conditions printed on this permit form. The owner/applicant is <br /> responsible for pr viding a copy of this permit to the contractor performing the work. <br /> Contact Person ca?; LARRY -E I M(.~NN l N Cr ~ DE VE~?°MENT <br /> Signature Mailing Address 8J/ C'OCJNTRY CL~1$ I?Oi40 <br /> Print signature he a SCOTT M . t)tEHt el-IIEI= OPERATINrr OFPtCtcR <br /> Date S E Y'T Phone 3 yY- SSOO City /State /Zip E V(y~ H f? , O ~ 9 ~ y0/ <br /> III DO NOT WRITE BELOW THIS UNE <br /> 'L PUBLIC IMPROVEMENT PERMIT <br /> Permission is he I by granted to applicant and applicants contractor to perform the work stated above, in conformance with <br /> conditions listed ~ove, below, and on the reverse side of this permit form. <br /> The permit shall Ibe void unless the work described herein is completed by: <br /> I <br /> SPECIAL CONDI~'IONS <br /> II <br /> APPROVED: ' Date: <br /> ~ City Engineer <br /> <br /> Eng: 604 FEBRUARY 2002 <br /> 1Nhite: Owner/Designer Canary Cornractor Rnk: Inspector <br /> <br />