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HomeMy WebLinkAboutPermit Signage 2001-07-27CITY OF SPF'A'GFIELD, OREGON DEV ELO P M ENT SERVI C ES D E PA RTM ENT 225 Fifth Street Springfield, Oregon 91 47 7 BAI\I\TERPERMIT COMMUNITY SERVICES DTVISION 225 FIFTH STREET SPRINGFIELD, OR 97477 (541) 726-3753 FAX (541) 726-3689 Office: 726-3753 INSPECTION LII{E:'l 26-37 69 Assessors Map #:l).o3.2€'3/Tax Lot 0 -tl o-o Owner of Property:$f\( Kc"-\J:l Address City: Phone #: eR-zip:.?;40-t-State: Contractor/Inst aller : Address: {ffi-,a- R-? C '--T-o-,-^ \q,.-Phone #:5-J City:L l/ Constmction Contractors Registration Number: State: (^r G{Zipz 9t YoS Expires: uc- C,rr..Q Description:-Ba" Nr\ \c\ € xl'- Date of Installation:8-lo-o1 Date of Removal: a- Zq -O Banner Permit tr'ee $80.00 Deposit Required $100.00 By signature, I state and agree that I have carefi:Ily completed this application and hereby certi$ that all information herein is tme and correct. I further agtee and understand that the above described banner (s) is not larger than 60 square feeq and will be removed within 14 days from the date listed above. If the banner(s) is not removed within the timeline specifieq I will forfeil the $100.00 deposit. I also understand that this special permit can be issued only trrice per calendar year pff development area. I also agree to call the inspection line at 726-3769 by the end of the 14th day to request an inspection to veri$ the removal of the barurer(s). This inspection will begin the process to return the $100.00 deposit if the banner(s) has been removed. r\\L \u<s se -qSignatire Cl Date OFFICE USE Dateof Applicanon: 7- &? -o t ,"6s' 0f- 0D 19r{-OlReceipt #: drnvGL-| 7 Iszued By:iL l^,Cu;*I :il #J(Da,=#;L] f]) =lttt--1..<:-[:1 ft-l I:':Jtr:' ' " #l: Tiach-bt- To tt-n- t(nL? 04-o-<- turfl. lrfu rf ., ._{."jI) r.J r= fJI:N TH -{r}lF{ f,f r..f 1l3 |-r,l -?- l-r +I 13:trT) m L*-1 ". z c) i.J i:r.'c) 6-l' ff r'.JL"l m {} (} *.1 f.J ." r.3 Fr f'J Amount Collected: SPMGFIELO Bannerlocation: 1il',-c'f dU f,B* \ S=.gek QR. q llf -T A'.\v1 €\I\ at UJ.t*l- o'^, 6' t-o t Q:31 d..rt{, +, un*+-K d-dg'-- Sa-L/q-" tU4 tl-*-) w 0/v fn h von o-iA-W*-ph{ ei.^JA nLl 0-+\91ca^-r S;J- tX tark'- +14,.-.r- 3b ,-l ljlt