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Owner Name:: <br /> <br />Permit Address:: <br /> <br />APPLICATI¢ AND PERMIT TO CONSTRUCT {IVEWAY ACCESS <br />PURSUANT TO ORS, 374.305 AND MARION COUNTY OR. #651 <br /> <br />Applicant Name: <br /> <br />Mailing Address: <br /> <br />Permit No,, ,g~ ¢'~-~7~--~ <br /> <br />Curbed Street: <br />Yes No ~ <br />Fee: ¢¢¢ / 7~ 8) <br />Planning Action:: <br />Yes No ~ <br />Case No. <br /> <br />Phone: (Home) ."~4~-~2 4/~'- (Work) <br />Applicant hereby applies to Marion County for permission to construct <br />along the -~'/~ side. <br />Proposed location of driveway from corner or landmark (n~-curbed street only):~/~, <br /> <br /> ~1 / / / <br />SPECIAL PROVISIONS: <br />1, For curbed streets, applicant or contractor shall ~ti~ the Depa~ment of Public Works at 588-5036 24 hours prior <br /> to pouring concrete. <br /> <br />2,, The driveway access shall be constructed in accordance with requirements as shown, <br />3 Construction of said access shall be completed on or before , ~ ~ ,19 ~ O, If construction is <br /> not completed by this date, this permit shall be void. <br /> <br />CONSTRUCTION REQUIREMENTS:* <br /> <br />1, Location of driveway from property corner or other landmark: <br /> <br />2. Curbed Street: W = <br /> ! <br />3 Non-Curbed Street: W -- ~,¢.,.~ R -~ /~, z <br /> Culvert Pipe:: Type: ~'¢~c'~¢-¢.~- Dia,,: __.-~' <br /> <br /> Driveway Surface:: Asphalt Class:: __ <br /> Base Rock Size:: / // <br /> Driveways with heavy traffic volume or truck traffic shall be paved,, <br /> <br />*NOTE: REFER TO CONSTRUCTION STANDARDS SHEET <br /> <br />Length: <br /> <br /> Thickness <br /> <br /> Thickness <br /> <br />The Applicant shall indemnify and save harmless Marion County, its Board of Commissioners, its officers and employees from all suits and actions; or claims of <br />any character brought because of any injuries or damages received er sustained by any person, or properly on account of the operations of the said Applicant, <br />his Subcontractors or the employeee of either; er on account of or in consequence of any neglect in safeguarding the work; or because of any act or cruise*on, <br />neglect or misconducl of the said Applicant, <br />Applicant declares he is the owner or owner's agent of the real property abutting the above described County road, This permit is issued subject to the terms <br />and provisions cof3taij:~dThe~ein and attached hereto, and is accepted by the applicant subject to said terms, <br /> <br />Marion County <br /> <br />Department of Publi~ Works <br /> <br /> DPW -Al <br />Rev,, 9~8-87 <br /> <br /> <br />