HomeMy WebLinkAboutPermit Signage 1997-1-16
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SPRINGFIELD.......,.
BANNER, BLIMP, AND SEARCHLIGHT
SPECIAL PERMIT
COMMUNITY SERVICES DIVISION
225 Fifth Street Office:
Springfield',%e!~n 97477'__//1/1_ j,. /'_ INSPECTION LINE:
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Job Location: I b P~-U1 ~k' ,i11hfJ. l.t (J {Jc;K jqJ
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Assessors Map #: 1(01)1);0 'lJ?/ laY. ~ot #: ()(aktfb
Owner: I f;(ter kt(jJl1. [/1/ frlhU
Phone #:
State: ~ZiP: (/f1t{11
726-3753
726-3769
Location of Proposed Object:
Address:
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City:
Contractor/Installer: ,
Address: ~~
City:
I'hone #:
State:
Zip:
Construction Contractors Registration Number~
Description: ~ 1.1' ~1 ~
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Date of Installation: ~~
Expires:
Special Permit Fee $40.00
Deposit Required $100.00
By signature, I state and agree that! have ,carefully completed this application
and 'hereby certify that all information herein is true and correct, I further
agree and understand that the above described ,is not larger than 60 square feet,
and will be removed within ten (10) days from the date listed above. If the
above described is not removed within the timeline specified, I viII forfeit the
$100.00 deposit. I also understand that this special permit can be issued only
once per calendar year per development area,
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Date
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OFFICE USE
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