The URL can be used to link to this page

Home My WebLink AboutPermit Signage 2013-6-3 SPRINGFIELD CITY OF SPRINGFIELD, OREGON �� ..{yy�225 FIFTH STREET • SPRINGFIELD.OR 97477 • PH:(541172R-3753 •FAX:(541)726-3//689 City Job Number , _ S(3 ' O (( 3 b r s.r=a' Job Location �5 1 �kQ i4 ii Sek- '�t Assessors Map 1 -7 o3 10 Tax Lot D 7/ O o S •� Business Name C_u 5(21.4 P,AD -Roc e Q ra Business Contact Name m jOR _ Phone -67)- cl� ) 1 r � .•.0.-44 Owner of Property fl\A BIZ "f(�oe 35[ Sktl,( Si- Phone 4/ 62Cf-CI70o • �T�ica^ Address �/� v+.J11 City State d� Zip 9 6 7 7/ •,r,..y Contractor/Installer Sa-Ann-a OLY. CIA kr-,(re_ Zt I gAddress Phone —t t City State Zip EjO Construction Contractors License# Expires rj '' Description 11Y F' (,vdcx p✓w lP o -4- ....yr--44 Date of Installation 6/° /S Date of Removal % "° /3 pi t Permit Fee: $225.00 including$100.00 Deposit and applicable fees. GI By signature,I state and agree that I have carefully completed this application and hereby certify that r Z_ 4_ all information herein is true and correct. I further agree and understand that individual banners and o p portable signs subject to this permit may not be larger than 60 square feet. I also agree and understand ,•ter that temporary signs shall be removed within 30 days from the date listed above. If the temporary sign(s) are not removed within the timeline specified, I will forfeit the $100.00 deposit. I also understand that this special permit can only be issued four(4)times per calendar year per development . , area. I also agree to call the inspection line at(541)-726-3769 by the end of the 30th day to request an inspection to verify the removal of t- - p• sign(s). T spection will begin the process to ftreturn the $100.00 deposit if th• ern.,, : (have be , ov 1. Q. Property Owner Signature —�/1/��j>I�a-- /i Date 3 _111 t For /;lice Use .:0113C. ft= Date of Application 003 Job# Receipt# 70(7 - lO tY `��( Issued By Amount Collected 22 Sr Shand Drive(r)/Uuilding Fomss/remporay Sign Permit CSD 3-12.dot SPRINGFIELD--- CITY OF SPRINGFIELD 225 Fifth St '�Co EGON TRANSACTION RECEIPT Spdngfeld,OR 97477 541-726-3753 811-SPR2013-01136 www.springfieldor.gov 351 SHELLEY ST permitcenter©sphngfield-or.gov RECEIPT NO: 2013001085 RECORD NO:811SPR2013-01136 DATE:06/03/2013 �lo1 [oY'krr__ _ ?ice t" }4 � = -'ACCOUNT CODE/TRANS CODE .-s,r. AMOUNTDUE-'s Admin fee(10%of applicable fees) 224-00000-426605 1098 20.00 Banner, Portable 224-00000-425602 1065 100.00 Banner, Portable Deposit 821-00000-215500 1049 100.00 Technology fee(5%of permit total) 100-00000-425605 2099 5.00 TOTAL DUE: 225.00 PAYMENTITYPE . _. ,,r,. �q 1 .`A O N. PA D•t Y ._1.. r.:.PAYOR .:`=casNiEri::beowlser�_„_,::_;��COMMENTS y:�� . el._.�a.r... ..... _ 2 _ ....—a�'2'cui Check oregon horse center refund to: oregon horse center 225.00 10340 90751 prairie rd,eugene OR 97402 TOTAL PAID: 225.00 • 4