New Search
1 <br /> s <br /> City of Eugene <br /> Public Works <br /> Appiication fo 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, ~~N ~'t'1-l ~ . Z"tG~c.._ hereby make application for a PUBLIC IMPROVEMENT PERMIT to <br /> (wed <br /> construct public im rovements in the public way, as described below: <br /> Type of Improv ent: ~~-V t!`~~. ~ ~tA~TE-t~.a ~.-~£,rL . STZx2~N ~,cr A.-T'E-2- ~ 'STIZ€E~ c..,tCa+k~iS <br /> (paving, wastewater, stonnvrater, street lights) <br /> Location: ~i t--+4A~~ 9'T' T <br /> (street or easement work is within or subdMsion name) <br /> North (or east) mit: 50UT~ n F ~ South or west) limit: Sa7y1Z-F OF +~,~14rL1 ~T <br /> im strict conforman with City of Eugene standard specifications for public improvements (including current addenda), <br /> construction plans roved by the city engineer or his representative, the current edition of "Procedures for Privately Engineered <br /> F~rojects,' the Euge 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 (prmq JOh-t A~-tic ©~t~ <br /> €S <br /> Signature ~J Mailing Address - ~ 0 • Z52"I <br /> Print signature here J O?.?A- - f~ <br /> Date l0 •O(O.0 Phone S' City /State /Zip 4y2.. 91 ~ Z <br /> no troy wnrrE st:cow TM~ iJNE <br /> PUBLIC IMPROVEMENT PERMIT <br /> Permission is hereb granted to applicant and applicants contractor to perform the work stated above, in conformance with <br /> conditions listed abo ,below, and on the reverse side of this permit fomt. <br /> The permit shall be v id unless the work described herein is completed by: <br /> SPECIAL CONDITIO S <br /> ;APPROVED: Date: <br /> City Engineer <br /> <br /> Eng: 604 FEBRUARY 2002 <br /> white: OMmerlDesigner Canary: Contnutor Pink inspector <br /> <br />