HomeMy WebLinkAbout1984-027 Permit -Construct Road~¢%% APPLICATION AND PERMIT TO
o~ % PERMIT NUMBER
%~¢~ HIGHWAY DIVISION ~8789
~iGRWAY NAME
MILEPOtNT
EI~INEERS STATION
Rogue Valley 22.05 90+51
HIGHWAY NUMBER J COUNTY SIDE OF HIGHWAY APPROACH TO SERVE
63 J Jackson :,eX NORTH ID EAST
[] SOUTH [] WEST Mistletoe Road
AND
BETWEEN OR NEAR LANDMARKS
_ Tolman Cr_e_e_k. Road
APPLICANT NAME AND ADDRESS
F-
City of Ashland
City Hall
Ashland, OR 97520
Crowson. Road
HIGHWAY REFERENCE MAP AND A]q-ACHED DRAWING NUMBERS
.5B-23-24
BOND REQUIRED ; AMOUNT OF BOND
REFERENCE ~
[] YES [~ NO OAR734-50-025(6) $ N/A
INSURANCE
REQUIRED
! [] ADMINISTRATIVE FEE
WAIVED
C~4'/ ~ REFERENCE
[] ~YES ~NO OAR 734-50-025(3) ! [] TEMPORARY DEPOSIT
AMOUNT CHECK NUMBER
$ ~/A N/A
ASS- DtSTRICT MAINTENANCE SUPERVISOR -- . DATE COMPLETE
A~ICA~T ~ APPLICATION DATE /~' ......
~ .!-- % ~ . I -- ~ ,~APF'ROACH ROAD COMPLETION DATE:
X ~~ ~ ' ~ ~7~ REFERENCE'O*R7~5~05~4) 11 1 84
if]-~h~app~icantd~aresthath~[sh~isth~w~r~ssee~ft-~he~ealpr~pe~adj~i~ingth~a~vedes~rib~highwaya~dhas~~;a~auth~ri~t~app~yf~rthisp~~i~.when~i~a~
[ / p[ication is approv~ by ~e Oepa~ent of Transpo~ation. ~o applicant is sub oct to the terms and provisions contain~ herein and a~ach~ hereto; and the terms of Oregon ~-
~ ministrative Rule, Chapter 7~. Division 50, wh ch is by this reference reader pa~ of this permit. Copies of the Rule may be obtain¢ from the District Maintenance Sup~isor's oHice.
jectto~eapprovalofc~t. .'..':,c,'.:,'.~"..."".~ .';-.,".,~..~' .'"., '. ...,... ...'".....,. ....,., ..., ...... ... ... ~ :., ...,,.,,.., ; , ..;, ,:~...:;:,
building regulations, lts~ '. · e..;:. '" · "'.. '" .¢' " "'. ....... :'.'.,.,.'~..~'t ".~ . ',4..~
planning goals. (OAR 734-50-0bb)
SPECIAL PROVISIONS
l--If the proposed applicMion requires traffic control devices and/or special road construction, the applicant shall provide a copy of this application
to the affected local government. The original application must be signed by the local government official.
LOCAL GOVERNMENT OFFICIAL SIGNATURE / TITLE DATE
X Seed!on/
2--The applicant or his contractor shall notify the ~t~j~i~ Maintenance Supervisor's office at least 48 hours in advance of commencing work and
after completing the work covered by this permit. (OAR 734-50~040) Telephone Number:
482-4344 Curt Yocham
See reverse side for additional Special Provisions.
TYPE 2 APPROACH ROAD ~ PAVED
R/W
Line__~ , _.
Dd Iv. Pip
t
'--Edge of Pvmt.
DR/W
P _AN
t
NOTE: AIl material and workmanship shalt be in accordance with ti3e cur.
rent State of Oregon Standard Specification for Highway Construction.
W= 24' R,= 17'
Dp= 18' D~= - 6i
CULVERT PIPE REQUIRED? ~4
[] YES ' ~ NO See
[R~,= 20' iA= 900
Da/w= 32 '
attached plans.
TYPE
DIAMETER (INCHES)
SIZE AND TYPE
STONE BASE
STONELEVELING SIZEAND ~PE COMPACTEDTHICKNESS(INCHES)
COURSE
ASPHALTIC
CONCRETE
PAVEMENT
CLASS
~(FEET) _
COMPACTED THICKNESS (INCHES)
COMPACTED THICKNESS JlNCHES)
STA. 0+81~7 B.O.B ~
'-'MATCH EX1ST.FPVMT .... -~
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