New Search
~ <br /> City of Eugene <br /> ,i ~ Public Works <br /> ,I4ppiication for Public Improvement Permit Engineering <br /> 858 Pearl Street <br /> Job Number. - 1 Eugene, OR 97401 <br /> (541)682-5291 <br /> FAX: (541)682-5032 <br /> Contract No: I ~ <br /> I, T„A~ <br /> ~ I tJ WOLF hereby make application for a PUBLIC IMPROVEMENT PERMIT to <br /> t <br /> construct public improvements !n the public way, as described below: <br /> Type of Improvement: ~f~~'I~1$I~a`f'~R <br /> (paving, wastewater, stonnwater, street Iigtits) <br /> Location: ~~F ~ ~~~N U ~ <br /> (street or eae~neM work la within or subdivision name) <br /> North (or a~) limit:~oc ~-JGenil C bQ . t(or west) limit: i ~ g~(~l De _ <br /> in strict conformance with City of Eugene standard specifications for public improvements (including current addenda), <br /> construction plans approved by the city engineeror 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 a" copy of this )permit to the contractor performing the work. <br /> Contact Person trxuq `v ~l-S~ W ~ ~ ~ <br /> <br /> r `Signature Mailing Address ~ ~ <br /> Print sign u ere ~ <br /> Date Phone ~ l ~ l ~ City / State I Zip ~ <br /> ~"?Qr ~ ~ ~ <br /> 0o eos wnrte eEww stns urs= <br /> PUBLIC IMPROVEMENT PERMIT <br /> I'~Perrnission is hereby granted to applicant and applicant <br /> s contractor to perform the work stated above, in conformance with <br /> 'cconditions listed above, below, and on the reverse side of this permit form. <br /> ~he permit shall be void unless the work described herein is completed by: <br /> SPECIAL CONDITIONS <br /> I <br /> APPROVED: Date: <br /> City Engineer <br /> Enp: 604 FEBAtJARY 20U2 <br /> Woke: OwnedDeeipner Gnuy: Contractor Pink: Inspector <br /> <br />