New Search
,r 1. _ <br /> City of Eugene <br /> Public Works <br /> lppiication for ublic Improvement Permit Engineering <br /> 858 Pearl Street <br /> Eugene, OR 97401 <br /> Jdb Number. <br /> (541) 682-5291 <br /> FAX: (541)682-5032 <br /> ';Contract No: <br /> 1 <br /> I, o hereby make application for a PUBLIC IMPROVEMENT PERMIT to <br /> (owned <br /> cgnstruct public imp vements in the public way, as described below: <br /> { Type of Improve ent: Wastewater <br /> (paving, wastewater, stormwater, street itghts) <br /> 1 <br /> I <br /> ~ location: C escent Village 2nd Addition <br /> (street or easement work is within or subdvislon name) <br /> North {or east) li it: Tract B South (or west) limit: Lot 81 <br /> in strict conforrnan with City of Eugene standani specffications for public improvements (including current addenda), <br /> construction plans roved bythe city engineer or his representative, the current edition of "Procedures for Privately Engineered <br /> Projects," the Eugen 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 pemtit to the contractor performing the work. <br /> Contact Person tprmq Wade R. Holaday 302-9790 <br /> Signature f ~--t6.•~~E~ Mailing Address -90892 Diamond Ridge Loop <br /> Print signature here dha ~~-L--- <br /> Date Phone 4Lt ~ -'~38:1?9.1t~ City /State /Zip F,u gPn P , nR 9740A <br /> DO NOi WRITE BELOW THIS UNE <br /> i <br /> I PUBLIC IMPROVEMENT PERMIT <br /> i <br /> PerrMssion is hereb granted to applicant and applicants contractor to pertorm the work stated above, in conformance with <br /> j conditions listed e, below, and on the reverse side of this permit form. <br /> The permit shall be oid unless the work described herein is completed by: <br /> SPECIAL CONDITI NS <br /> I <br /> APPROVED: Date: <br /> City Engineer <br /> i <br /> <br /> Eltq: X04 FEBRUARY 2042 <br /> While: OwnerR)esipner Canary: Contractor Pink Inspector <br /> <br />