HomeMy WebLinkAboutPermit Signage 1998-12-13
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DEVELOPMENT SERVICES DEPARTMENT
225 FIFTH STREET
SPRINGFIELD. OR 97477
(541) 726.3753
FAX(541) 726.3689
BLIMP, SPINNER, PENNANT, BALLOON, SEARCHLIGHT PERMIT
COMMUNITY SERVICES DIVISION
225 Fifth Street
Springfield, Oregon 97477
Office: 726-3753
INSPECTION LINE: 726-3769
Location:
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Tax Lot
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Assessors Map #:
Owner of Property: ~r_Ct~
Address: <i:; (" '2..., ~'--
City: SOil-I' ,1 e1 1" J ~
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ContractorlInstaller: 0 liJ-.1lftV
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Phone #: 747 - 33 7 Lf
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State:
Address:
Phone #:
City:
State:
Zip:
Construction Contractors Registration Number:
Expires:
Description:_ bA-nr"\"".e.'S_. ~Il~) -l::.V\+. c."--nnn<;,,c_J~
Date ofInstallation: 11'\a.\('(' Jt\. q \ C:;Cj ~ Date of Removal: i'Y\a V <U\.::J.O \Cl 'i 'i
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
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 listed as the date of installation above. If the display is not removed
within the time line specified, I will forfeit the $100.00 deposit. I also understand that this special permit can be
issued only once per calendar year per development area. I also agree to call the inspection line at 726-3769 by the
end of the lOth day to request an inspection to verify the removal of the display. This inspection will begin the
process to return the $100,00 deposit ifthe display has been removed,
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OFFICE USE
Date of Application: d - i;;L - "i ~
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Job #:
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Amount Collected: ~ H-o, -
Issued By: