HomeMy WebLinkAboutPermit Signage 1998-03-12}-\
CITY OF OREGON
SPRTNCfTELO
DEVE LOP M ENT S ERVICES DE PARTM E NT
225 Fifth Street
Springfield, Oregon 97 477
BANNER PERMIT
COMMUNITY SERYICES DryISION
225 FIFTH STREET
SPRINGFIELO, OR 97477
(541 ) 726-3753
FAX (541) 726-368e
Office: 726-3753
INSPECTION LftlB: 726-37 69
Bannerr,ocation: t 7t Sc, /L{ ry >d€}l cyL ?zfft
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Assessors Map 1D
Owner of Property:
Address:
Tax Lot
Phone *: 3{/ Wf ^ fr7 z-,-{r a'5.?T+
ZipzCity:A r.^J.,Jl State: DA
Contractor/Installer:e wt\D>-
Address:Phone #:
City:
Construction Contractorc Registration Number:
State:zip:
Expires:
Description:
Date of Installation: 3- tZ--"y Date of
Banner Permit Fee $40.00 Deposit Required $100.00
By signature, I state and agree that I have carefully completed this application and hereby certi$ that all
information herein is true and correct. I further agree and understand that the above described banner (s) is not
larger than 60 square feet, and will be removed within ten (14) days from the date listed above. If the banner(s)
is not removed within the timeline specified, I will forfeit the $100.00 deposit. I also understand that this special
permit can be issued only twice per calendar year per development area. I also agree to call the inspection line at
726'3769 by the end of the l4th day to request an inspection to verifu the removal of the banne(s). This inspection
will begin the process to the $l deposit if the banner(s) has been removed.
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Date
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OFFICE USE
Date of Application: 3 - l) -'l <Job#' Q(o 3o 3 Receipt *, &4rt1J
Issued By:q^)
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Amount Collected: -S f r..lO
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