HomeMy WebLinkAboutPermit Signage 1998-11-30
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BLIMP, SPINNER, PENNANT, BALLOON, SEARCHLIGHT PERMIT
COMMUNITY SERVICES DIVISION
225 FIFTH STREET
SPRINGFIELD, OR 97477
(541) 726-3753
FAX (541) 726-3689
DEVELOPMENT SERVICES DEPARTMENT
225 Fifth Street
Springfield. Oregon 97477
Office: 726-3753
INSPECTION LINE: 726-3769
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Assessors Ma;#: I f)02>{j,{~/i) - (j
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Address:6d. '60 r-=m:oOOIf P 1/ ~) Phone#:
Cit*vlrL ., ~ ~ State: (W/./
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City: . 1') J9{ /If) ~ I
Construction Contractors Registration Number:
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Date of Installation: JJ, .q...V)~~
Tax Lot
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Pbone #:
Slale:
Zip:
Expires:
Date of Removal:
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Permit Fee $40.00
Deposit Required $100.00
By signature, I stale and agree that I 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 display will be
removed within ten (10) days from the date Iisled as the date of installation above. If the display is not removed
within the timeline specified, I will forfeit the $100.00 deposit. I also understand Ihat this special permit can be
issued only once per calendar year per development area. I also agree to call the inspeclion line at 726-3769 by the
end of the 10th day to requesl an inspection to verify the removal of the display. This inspection will begin Ihe
process to relurn the $100.00 deposit if the display has been removed.
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Issued By: ( /) f/J..f)_1 AmountColleCled:-1{). a)