HomeMy WebLinkAboutPermit Fence 1995-5-15
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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
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Tax Lot tt: 0 S (j I I
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Address~cJ
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Phone tt:
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Zip:
Value of Fe(Jf X6&- /23
Fence Permit is $5.00
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Contractor/Installer:
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Address: g 7:5/;;'
City: 5'//-"P-
State: c::Jn E
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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, .
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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:~
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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...;,
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$~.
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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