HomeMy WebLinkAboutPermit Fence 1991-4-23
".
-'-. --
FENCE PERMIT APPLICATION
, CITY OF SPRINGFIELD
BUILDING SAFETY DIVISION
225 Fifth Street
Springfield, Oregon 97477
- ~ Offirp' 7?(i-3759
<::INSPECTION LINE: 726-376~
Assessors Map #:
Owner: 0A// f/7'5~
Address: /,f{.:f!!!,R /t~4/ /~~ Ji"r.../f?:> Phone #: ?7Lr*,,=>?/~C;-
City: ?;~;6L.-T") State:~.?< . Zip: e::::;/~~?
.... r ~ /"
/~$g .~A' ~ p~.h'"'
/ /-o~~2 <;to"'!) Y
;S?=r. ~~
Job Location:
Tax Lot #: ~/7~
Value of Fence: I ~~ ~e>
Fence Permit is $5,00
Contractor/Installer: ~~~~
,
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 state that all information on
this application/permit is correct and that I was provided with the Springfield
Development Code requirements for fence standards,
~,1~ .../~j". )
Signature
+- ';,3- r/
Uate
, FOR OFF ICE USE
Date of Application: '/- ;2~~,/
Receipt #: 19f!iii'.p~ Issued By:
Total Amount Collected: ,~~
Job #: Q/e:::>;S9.2...
~~-~
01'/ . /" ,
Checked for Delinquencies: Checked for Historical Status: