HomeMy WebLinkAboutPermit Fence 1995-9-20
"
I
-,
FENCE PERHIT APPLICATION
CITY OF SPRINGFIELD
- ,
BUILDING SAFETY DIVISION
225 North Fifth Street
Spr1ngfield, Oregon 97477
Office: 726-3759
INSPECTION LINE: 726-3769
Assessors Hap II
Owner. -r;:,rI~
Job Location: -? t:''":r 2 L#,-:~~;F=CG ;?"q.
/~-r:>2..a6-2 /
(). /!. (leU I f' r
Address: ?f-\"3 d-.- ('juJ(') W Dr, ~
State: nt?
Tax Lot I:
~~
Phone I:
7L{ (n - Lj d;)"'l
Zip: Cf7 4) r:
City.
SnQu
Value of Fence~ I fYV'\ ~
Fence Perm1t 1S $5.00
Contractor/Installer:
~t fYuL !1 c., rt. \~)(fl.f.Q.. .
Address:
Phone I:
City:
State:
Zlp:
Construction Contractors Registration #:
Exp1res:
By sign1ng this permit/application, I agree to call for an inspection once my
fence has been constructed (726-3769). I also stated that all 1nformation on
this application/permit is correct and that I was provided w1th the Springfield
7l~::zq"m:;z;:;",. ,,",dud,. 9>70 90
~~ature ~~~ Date
FOR OFFICE USE
-"
Date of Application: ~-~_~~
Receipt I
/~:::>?
Issued
JOB II: f95'/9/S
B~: ~~.
/''''/
Total Amount Collected:
'"'5'. dIllS-
,
~
Checked for Delinqul'nd es:
Checked for H1storical Status: