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<br /> ` City of Eugene <br /> Public Works <br /> Application for Public Improvement Permit Engineering <br /> /J 858 Pearl Street <br /> Job Number. y~~L_~ Eugene, OR 97401 <br /> (541)682-5291 <br /> FAX: (541)682-5032 <br /> Contract No: <br /> I, Hayden HomeG 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 liQhtins; <br /> (paving, vrastewater, stormwater, street Tights) <br /> Location: Meadow View Park-Phase 1 <br /> (street or easement work is within or subd"rvision name) <br /> North (or easy) limit: South (or west) limit <br /> in strict conformance with City of Eugene standard specifications for public improvements (including current addenda), <br /> construction plans approved bythe city engineerorhis represerrtative, 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 a copy of this permit to the contractor performing the work. <br /> Contact p rs tp ~ llavid Cady ~f/ pF <br /> Signatu Mailing Address 2464 SW Glacier Pl. , Ste 110 <br /> 'Print signature herd ~ G1`tdy <br /> date Phone 541-923-6607 ~y /State /2p Redmond. OR 97756 <br /> no trot ward BFaow nits urre <br /> PUBLIC IMPROVEMENT PERMIT <br /> Permission is hereby granted to applicant and applicants 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 /> 4 <br /> Enga 604 ~eauar?r 2arz <br /> White: Owner/Designer Canary. Contractor fink Inspector <br /> <br />