HomeMy WebLinkAboutPermit Signage 1994-02-01CITY OF SPR OREGO'V
225 fifth Street
Springfield, Oregon 97477
BANNER, BLITIP. Ai'iD SEARCHLIGHT
SPECIAL PER},IIT
COMI"II.JNITY SERV]CES DIVISIOI\]
SPFIIl.GFTELO
0ffice:
INSPECTION LINE:
7 26-37 53
7 26-37 69
Job Location:t53'- ilot+&rlts Brvr:.
Location of Proposed Object: 153'T ltcaitgJt':- R ir. n
Assessors Map *:[r o" L1al rax Lot +, 6( 3OC
ovne* S g bU.S Gov.a N\es
Address: I t ? L"att rS*Phone *: 1?7'60Z ql
Ci ty:s 4r Z S tate ztp: 911_\77
Con t rac t or / Ins tal1er :h t,;€Q.
Acldress:
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Phone #'---
Ci ty:State:Zip:
Construction Contractors Registration lrlumller Expi res: --
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Description:tlJ*u-
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3'F5'0ptil{
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gnature ate
OFFICE USE
Job *:q oDate of ApPlication:
-W _ Issued By:Receipt *:T7frM
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Amount Collected:+0.50
Date of rnstallation:
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41
special Permit Fee $40.00 Deposit Required $100.00
By signature, I state and agree that f have carefully c<;mpleted this application
"i,a-[Er"Uy certify that a1].-information herein is true and correct. I further
;;;"; and"understlnd that the above deseribed is not larger than 60 square feet,
"td rilt be removed ruithin ten (10) days from tlte date listed above. If the
"Uor" described is not removed vithin the timeline specified, I vi11 forfelt the
sroo.oo deposit. I also understand that this special permit can be issued only
once per calendar year per developmellt area'