HomeMy WebLinkAboutPermit Signage 1998-11-10OREGONCITY OF
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DEV ELOP M ENT S EBW CES DE PA RTM E NT
225 Fifth Street
Springfield, Oregon 97 477
BANNERPERMIT
COMMUNITY SERVICES DIVISION
225 FIFTH STREET
SPR/NGF'ELD, OR 974N
(541 ) 726-3753
FM(541) 726-368e
Office: 726-3753
INSPECTION LIl.lE: 7 26-37 69
!*7 L N fI S+. (^;-- BBanner Location
Assessors Map #:11 o3 aQ 3/Taxlot O O 7&)
Owner of Property:
Address: Qo.u--r-
City:
Cont racto r/Insta Iler :nLd r\r2,r
State:?fZ- zip,
Phone #: 7q 7 -s313
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Address:Phone #:
State:zip:
Construction Contractors Registration Number:Expires:
Description:)"--
Date of Installation 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 certify that all
information herein is ffue 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 yi"" p..."!"ra* V"* q.. a91_e-!9pg9n!.T9u. I also agree to call the inspection line at
iZO-Zlag by the end of th;i4ffi-aay 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 banner(s) has been removed.
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Signature Date
OFFICE USE
Job #:Date of Receipt
Issued By:Amount Collected:c
City:
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