HomeMy WebLinkAboutPermit Fence 1996-11-13
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PENCE PERMIT APPLICATION
CITY OF SPRINGFIELD
BUIW;J:NG' 'SAFETY DIVISION
225 North Fifth Street
Springfield, Oregon 97477
Office: 726-3759
INSPECTION LINE: 726-3769
Job Location: L(53 ~ :!IIY - :S?PI2:J .
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Assessors Hap D,1Kl^i'A (')5 I> Tax Lot II: Cl.s dO ()
Owner: TiM 1- D a~t.OO crrl-l:,
J..f 53b /I./~- S/..:;"7
Address: 1111/ Phone' D:
s?Flb /' ea.. 'i''/ '7 8,
City: State: Zip:
Value of Fence:
G,/522.
Fence Permit is $5,00
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Contractor/Installer: 7~e, ;=;(..,1 Itt\t 11Y
Address: I3rif l.I'~/.4l-\~ ~~
City: ~?rl 1'\,
t'!Dn:;' .
to
Phone D:
7'1l/-B98 ?
Zip: lf7Y?1
Expires: ,-, -;
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State:
02-
1l)~8'3 I
,Construction Contractors Registration D:
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By signing this permit/application, I agree to call for an inspection once my
fence has been constructed (726-3769). I also stated that all information on
this apPli0~permi t is COL-rect and that I was provided wi th the Sprin(lfield
"O;?";;JZ;Z' fo"" ""dud,. //-13-j'(.
Signature ~ , Date
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FOR OFFICE USE
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Date of Application: i ! - J 5 - 0 If
Receipt II ()---;;'J/70
Total Amount Collected: -n s _ (S()
Checked for Delinquend es: ~
JOB II: Q'5 /53 :z
Issued B;: ~ . MBf'IA;:)~ n--
Checked for lIistorical Status: L/'""
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