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HomeMy WebLinkAboutPermit Fence 1995-5-15 ( , -.--'.,'.' - " .~' ". . . ,. . .. . ~ ", FENCE PERMIT APPLICATION CITY OF SPRINGFIELD BUILDING SAFETY DIVISION 225 North Fifth Street Springfield, Oregon 97477 Office: 726-3759 INSPECTION LINE: 726-3769 Job Location: ?cJO '2- ~'~tJfr11!:.. t- L,/~ /4L.-/C) Assessors Map tt: /762- .2 S 33 Owner: g /1/ /~ ~f:/'-r/5 ~.5 / /'Y2-eJ tJJ ~;~ OI3;~e: eft-- c::S . 7()t~ Tax Lot tt: 0 S (j I I ,. Address~cJ City~~ Phone tt: .,. .> Zip: Value of Fe(Jf X6&- /23 Fence Permit is $5.00 I Contractor/Installer: 0kft',A/;~ ~//}/~'/~vv--- Y#~f~,;V /p -, '. Address: g 7:5/;;' City: 5'//-"P- State: c::Jn E , , ' ~ Phone #: /~7rg7'9<;' Zip:' 7?/Y'? r-- Construction Contractors Registration #: ~~~~~ Expires: / ;;! -;;c~-9c By signing this permit/application, I agree to call for an inspection once my tence has been constructed (726-3769). I also stated that all information on 'thIs application/permit is correct and that I was provided with the Springfield De~.;!~. c.~~~,q.:lrements for fence standards, . ~,/ r~~__ ~-/'(~--- ?5~ Signature ..-.... Date FOR OFFICE USE Date of APPlication:6 - IS'- 9 S ' ,- JOBi: 4 ~ /7lf () Receipt. O/730,~ Issued B~ Total Amount collected:~ 6~ OD , Checked for Delinquencies: V, Checked for Historical Statl1s:~- fill? . .. ....~ Willamalane 't..g' Pa,k & Recmation Oistdct Job No. C1 '7 fc1p SYSTEMS DEVELOPMENT CHARGE WORKSHEET NAME: ~ &t'\~~~ ADDRESS: 2.1)0 ~~Q~~~\ STATE:~ '~D ' LOCATION OF jtIR_OPOSED BUILDING SI~ ^".U!> , "A.At\ -,NU:, M--- , Street Address if Known: ~ '\tOt. ~,~ {el..* ~ E:J:::J \,U ' " "'~ , PHONE: 2D5 ~~ laDlg ZIP q~D\ platt Name: ~~N- ~~ Tax Lot Number: \ f)r9;~Sa?>> ot:oll 1. DEVELOPMENT TYPE (Check appropriate dwelling(s>. SDC Calculations and dwelling type definitions are on the back.> A. Sinl:!le Family - Detached Single Family home Manufactured home not in a park NO OF UNITS X $400 PER UNIT _= $ B. Sine:le Family - Attached NO OF UNITS !2/ X $370 PER UNIT = , $ 140.rfJ C. Multi-Family Aoartment NO OF UNITS X $277 PER UNIT = $ D. Manufactured Home Park NO OF UNITS X $280 PER UNIT = $ WPRD SDC 'LAT'\ 00 $ rr...;, $~ f\Ar\CXJ $~. " 2. SDC CREDIT (If applicable) SDC-payer must furnish proof of WPRD Credit approyal. See SDC Credit Worksheet. 3. TOTAL WPRD NET SDC ASSESSED (If SDC reduced for Credit> ~q "rJ ~ I \\0 /~~ Community Serv~~Sion Date r;h, ~(. C ~r;.,,,f; 01 r1