HomeMy WebLinkAboutPermit Signage 1998-10-2
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DEVELOPMENT SERVICES DEPARTMENT
BANNER PERMIT
COMMUNITY SERVICES DIVISION
225 FIFTH STREET
SPRINGFIELD, OR 97477
(541) 726-3753
FAX (541) 726-3689
225 Fifth Street
Springfield, Oregon 97477
Office: 726-3753
INSPECTION LINE: 726-3769
Banner Location; .3 \ 9, R h()t~\,)0.t & ctCXJ~
Assessors Map #: \~()?f2120 Tax Lot_D3'?1()[)
Owner of Property: bfu't-~C'~ ~
Address:~ bnif'HA~ tiaLp Phone#: ~A lr €A 2..4-
City: ~ ri. 1\ State: (OJ? / Zip: Cn1-17
Contractor/ln~taller: l )L.lD'fLQQ.)
Address:
Phone #:
City:
State:
Zip:
Construction T,\\tractors R,istration Number:
Description: IJlNu. ~ f\ (lQJ!C)
Date of Installation: \ \) . ~ ' 0. ~
Expires:
Date of Removal:
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Banner Permit Fee $40.00
Deposit Required $100.00
By signature, I state and agree that I have carefully completed this application and hereby certify that all
infonnation herein is true and correct. 1 further agree and understand that the above described banner (s) is not
larger than 60 square feel, and will be removed within ten (14) days from the date listed above, If the bannel{s)
is not removed within the timeline specified, I will forfeit the $100,00 deposit. 1 also understand that this special
pennit can be issued only twice per calendar year per development area, 1 also agree to call the inspection line at
726-3769 by the end of the 14th day to request an inspection to verify the removal of the bannel{s), This inspection
ill be' e process to return the $100,00 deposit if the bannel{s) has been removed,
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Date
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Date of Application: \ \) ,A-... - C\h
Issued BY~ \ [\~ -- .J -
OFFICE USE
Job #; C\ ~ \ ~ :tl1-ReceiPt #: 3\ \.0 ~q
Amount Collected: \ 4rJ ~