HomeMy WebLinkAboutPermit Fence 1991-12-03?25 Fifth Street
Springfield, Oregon 97 477
FENCE PERMIT APPLICATION
CITY OF SPRINGFIELD
BUILt)ING SAFETY DIVISION
sPFrFtiFrELo
Offi ce :
INSPECTION LINE:
7 26-37 59
7 ?6-37 69
CITY OF SPFINGFIELD, OREGO'V
a&-Job Location:3
Assessors Map #:11 oa 3oaV
Owner:?-'aU Or"^ rL ,,*, ..-,
Address: x ,3,;t Phone *: VLl .b/o >
City: - (T".+o*State: C|YL Ziv
Value of Fence, /oUZ-
Contractor/Installer: Cttt f-v',l,if
Fence Perm'it is $5.00
Address, 5 Q,+-F
City:State:
Constructjon Contractors Registration #:
By sign'ing this permit/appf ication, I agree
fence has been constructed (726-3769). I alth'is application/permit 'is correct and that
Development Code requirements for fence stan
B rrt
to call for an inspection once my
so state that all information onI was prov'ided with the Springfield
dards.
Phone #:
Zi p:
Ex pires:
*ZU- 3,ta>
gna ure Date
FOR OFFICE USE
Date of App'l i cat i on :Jo
Receipt #Issued By:
5.ooTotal Amount Collected:
Tax Lot #: C7c) O I
o: n l"P/
checked for Del'inquenci "r, r-./ checked for Historica'l status, t-/