HomeMy WebLinkAboutPermit Fence 1991-09-12225 Fifth StreetSpringfield, 0regon 91 417
FENCE PERMIT APPLICATION
CITY OF SPRINGFIELD
BUILDING SAFETY DIVISION
SPRIT\TiFIELE,
Off .ice:
INSPECTION LINE:
726-3759
7 26-37 69
CITY OF OREGO'V
Job Location:38 t/-
Assessors Map #:11 535ts
Owner:
Tax Lot #:
Address, 8,rE Phone #: 4%-SYSa
City:
d
Value of Fence:6 3o. oo
Contractor/ I ns ta I I er :
Fence Permit is $5.00
u
State:Zi p:gJw/
Address 7.O (1-6.:4 36 Phone #:1t/A -83),,1
Zi p: ?*zr
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Construction Contractors Registratton #: ?7/6G gx pires t /1--=t-7 /
C'ity:
gna ure
itut. , A^-
By s'igning. th'is permit/application, I agree to call for an instence has been constructed (726-3769). I also state that all
!his applicat'ion/permit is iorrect ano that I was provided witDevelopment Code requirements for fence standards.
pection once my'informati on on
h the Spr i ngfi e'ld
?- /z-rt
Da-te
FOR OFFICE USE
Date of Appf ication:4-t>-c4 I Job #, 4l t O'(
Recei pt #: Zl L1 3 Issued By:
4
-hl"r.--
Total Amount Collected, 5
0
Checked for Delinquencies:L-.r'''Checked for Historical Status:N-_