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HomeMy WebLinkAboutPermit Signage 1998-11-13 ~ Nov-12-98 04:45P -:. P.Ol .. '" 'SpnlNcr'CLU , -, ......l _ "!II 225 Flr.m SmEET SPRINGFIELD, OR 97477 (541) 726.3753 FAX (54 11726-3689 -.; BANNER PERMIT CUMMUNITY SERVICES DlVISIUN 22) filth Street Springfield, Oregon 97477 Office: 726-3753 INSi'l:CnON LINl:: 726-3769 BannerLocalion:_.....&it &;/ri~ A~(5 -I!4yLcl./} ) / . (.;?~1l..3 Y1 17-fl.....:)7-t..'- Y?fl <for) Tax LoI Vt1 /rlP7 l-a(j).... A//aKi fl/.ff/~ I",-q F /s-(1... I'honell: rf)y Assessors Map #: Own.. ofl'ro~l1y: Addres" ~ - C=- U ft'Pf Stale: Zip: Cily:... Contractor/Installer: ~~1 -roooe P: Addre..: City: Slate: ZiD:_ ----- COlllllruction Contractor> Regislralion Number: _____ ------- Expires:.u .--.........- ."- Dc:xripliuu: Dalt orInstallation: / ~/ 1 'i 4,y Banner Permit Fee: S40.00 Dale of Removal: ...11/?jl1.J:......._ Deposil Rtquired SlOO.OO By Jlgn.atun, Iltat~ and agree that 1 have careful1y compl~red thi~ applicarion and h~h'y ct:r1ify thaI all infonnation herein is true and correct. I further ag,ee and understand thallhe above described banner (s) i, nol larger than 60 square feel. and will be removed within ten (14) days from the date listed above. tfthe banner(s) is nol removed within the time line specified, I will forfeit tht SI 00.00 de"",it. r also understand that this .pe<:ial pennit can be issued only twice per c:alendar year per development area. I Dlso agree to call the inspection line ot 726-3769 by the end of the 14th dDy to request an inspection to verify Ihe removal of the banner(s). This inspection will begin the process to retUrn the Sioo.OO deposit if the banner(s) has been removed. C4i.r;1~~ ___:~/!~~_____ OFFrCE USE n..t.....r A 1"11"1 I i....ti"n. -_.~ ... . .,-,.....-..-... l)"'- \ ~-<1 '1 Jo~#' q] /51 0 ,,".";",#. .. " "n.... ....... . ......... . . -. 6D ^mounl (;Ollected~t). Lg~ Issued 8y:QJY\QJ!.b~ \'\:",J 4!'Lt~Q IrA ,'t:)\ . aU. ,