HomeMy WebLinkAboutPermit Fence 1993-1-25
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SPRINGFIELD
FENCE PERMIT APPLICATION
CITY OF SPRINGFIELD
BUILDING SAFETY DIVISION
225 North Fifth Street
Springfield, Oregon 97477
Office:
INSPECTION LINE:
726-3759
726-3769
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Assessors Map #: 17 - 0'3 - Z. 7 - 00
Tax Lot #: /~
Owner: &J6f5NE lAJA-TeR. C; P-lfCTKJc.' ~Q"
Address: ~ e: 411-1
Phone
#: =ri-1-/8$7 (4~4~J411)
Zip: 1740 t
City:. F=fJ-::RAJ6
S ta te: C::f>___
Value of Fence: 1J; 7rxXJ .t:.
Fence Permit is $5.00
Contractor/Installer: EWs~
Address: Phone #:
City:
State:
Zip:
Construction Contractors Registration #:
Expires:
By signing this permit/application, I agree to call for an inspection once my
fence 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
Development code requirements for fence standards.
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0ignature i<'\;lu.. ?iCll_rr ~1f(J.sr
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Date
FOR OFFICE USE
Receipt #
7(1)"
Issued By:
JOB II: q-:s cx::ero
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Date of Application:
/-2.5-'lJ
Total Amount Collected: ~~
Checked for Delinquendes: Checked for Historical Status: