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EXIS Tll.l'r SUILDING P=3ilT NO,( r neettcA3L=- )
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FEE9, SIDELUALKS CURB-CUT uJ.4L< x'tlo.oo + *O.15/LF.( X )
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TOTAL PEffIIT FEE:
I ;IIVE,CAR=RJLLY EXAYIN=D COI-1PI ETED APPLICATION rcR PEB,,IIT, A\D DO HER=BY CERTIFY :UAT ALLNrc31ATIOh{ I-]ER=ON 19 TRJE AND CORR=CT, AI{D I FURTH=R CERTIFY TI.],ET ANY AND AI L u^rR< P=Fo=f1EDgTALL BE DONE N ACCORDANCE IUITH TI-J= ORDINA\CE9 G TI.{E CII-( G SPRINCtrIELD AND TH= LAI.,IJS CF TI.{ESTATE OF OreGON PERTAINING TO THE u.JOR< DEgCRIS=D H=REIN, AND TI]AT NO OCCUPANCY IIJ|LL 3= I'1AD=OF ANY 9TFIICTUR= U'ITI.{CJT PES,IISSION G THE BUILDING DI\4sICTT I FUR;I.,IER CERTFT T!.]AT ONLY C'O:iTRACTORSAND EI1PLOYEE9 UJi-.{O ARE IN COHPLIANCE TUITH c'Rs 1OIO5> TUILL BE US=D ON TI-{I5 PROJECT
SIGNED DATE
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