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HomeMy WebLinkAboutPermit Signage 1999-05-28CITY OF OREGO'U SPFlINGFIELEl D EVELOP M ENT S ERWCES DE PARTME NT 225 Fifth Street Springfi eld, Oregon 97 47 7 225 FIFTH STREET SPRINGFIELD, OR 97477 (541 ) 726-3753 FAX(541) 726-368eBANNER PERMIT COMMUNITY SERVICES DIVISION Office: 726-3753 INSPECTION L[NE: 726-37 69 Banner Location: ll I A S+,- Assessors Map #: 11 o G 3l o Tax Lot 0 "l Phone #:7 q6-sr1 1 Owner of Property: Address:11 8L t4 \+- City:SAx State:M zip, q 7VT 7 City: Construction Contractors Registration Number: Description:i-rz- bo.nvrerr l, " I ,?o7 Contractorflnstaller: Address:tq{ N a{t *Phone#: 7qt-A r0t zip aT{tY Expires Date State: Date of Installation:Date of Z v Banner Permit Fee $40.00 Deposit Required 00.00 By signature, I state and agree that I have carefully completed this application and hereby certiff 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 veriff the removal of the banner(s). This inspection will begin the process to return the $100.00 deposit if the banne(s) has been removed. (--n,ilua /&q/- Signature 2o 2 OFFICE USE Job #:4)4"Date of Application: Issued By Receipt # Amount Collected: Trtra /cre/??/7 15 ft).( ^ 4wz,y'kra), a2