HomeMy WebLinkAboutPermit Plumbing 1997-4-1
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SPRINGFIELD
FENCE PERHITAPPLICATION
CITY OF SPRINGFIELD
BUILDING SAFETY DIVISION
225 North Fifth Street
Springfield, Oregon 97477
Office: 726-3759
INSPECTION LINE: 726-3769
Job Location: J711 C'0/-15"<C/(/iJ..
Assessors Map #: Lo+ 13 I a -r
Owner: M yoA! /!J /bG- vu tZ~~
Tax Lot #:
Address: 'pJ..%t2# T /~ J..h.
City: e~a-e~p_
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Value of Fence: to
Con trac tor/Ins taller, ~w~
State:
Phone #:
~pf?(r- Zip:
Address: 372"/
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State:
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Permit is $5.00
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Ph~e #: -7%~;2JOC(,
Zip: ?'7cr:77
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Fence
Construction Contractors Registration #:
Expires:
By signing this permit/applicatiori, I agr~e to call for an inspection once my
fence has been constructed (726-3769). I also stated that all information on
this application/permit is correct and that I was provided with the Springfield
Development code requirements for ~ence standards.
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Date
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Signature
FOR OFFICE USE
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.Issued By:
JOB .: q 7[)Lf to q
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Date of Application: y- /-
Receipt # }~/~?
Total Amount Collected: C; jfD
9':7
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Checked for Delinquencies: _____
Checked for Historical Status:
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CITY OF SPRINGFIELD
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APPLICATION AND AGREEMENT FOR TRUNK LINE SEWER HOOKUP
ApplicationishE:Sreby made by the undersigned property owner for permission
to connect to the following described property to 8 trunk.ll~e sewer owned and
. maintained by the Cit~ of Springfield, and I. agree to pay s~th a hookup charge
,pf $3.40 per front of'the property fo~-the first 150 feet i~ depth to be serv~d '~
. ~y such trunk line se~er in lieu of an assessment against the described property.'.
. An add.itional $0.02 per square foot will be charged for'-any additional property ...
.~eyond the first 150 ie~t. - .
. Property Description:
Address: 3791 Commercial Street
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Lot 13, . Adams . Plat
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Sewer hoo~up charge: ($3.40.per front foot) $
TOTAL AMOUNT $473.09
This agreement has been computed as being one-half (i) of the equivalent cost
.. of an eight (8) inch lateral sanitary sewer at the rate of.:$3.40 per abutting
front foot and does not include.the cost of a house connection to said trunk sewer;
sewer user charges, plumbing permits or other such costs to be assumed by the pro-
perty owner.
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CITY OF "sPRINGFIELD. OREGON '-
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PROPERTY OWNERS: .
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STATE OF OREGON )
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County of Lane ).
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BE IT REMEMBERED, That on
the undersigned, a Notary
appeared the. within names
th is day of , 19 ,befor.erne,..
Pub 1 i c in and for the sa i d County and State, persona lly ,
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known to me to be the identical individual . described in and who executed the
within instrument and acknowledged to me that executed the same freely and
voluntari ly.
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WITNESS my hand and seal this day and year last above written.
Notary Public
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