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HomeMy WebLinkAboutPermit Signage 2009-6-5 ~ ..~ ~ "~ ~ .. ..__J~ ~ ~ ~ ..~ ~ ~ ~ ~ ~ I. '. "~ i i' .~ I. I. >. eo 'Il'_J~ e: ~ I~ ~ ~,. ~j ~j ~ -. . r-~ ~ .~ ~ i ~ ~,. ~~ 1 m , ..'-e t. SPRINGFIELD....,.. 225 FIlTH STREET. SPRINGFIEW, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 City Job Number ~q-\C\P) Job Location 00 y;c/ mo.__In ~ Assessors M~r \ flO2n1.W 5PJ[d} ()t2 97c;78 Tax Lot-dL?x:O ~",j"""'" "-1)' '"'' ~$'l.~"'-",,'h"'V' "'''''.4''--'1-tr.~~'; >" 'o~E'"'l'i"-':'''l'_~'-~!~",l~'"'::\i '7'. -,. ~~~"""~r~~~.~'t,r~..,..:-"T;>/-:'~-?;:;:~ i=;:~~::~~~~lli\~~~~~:~:~~i~;~~~~[;;~~~i~:~~J,~~{'~~ Address&.;/r/II fha1.[l c,j- City Sfb ~._ f'w ,.- ~-_~l:.ri-" ._."W,..'#@_ .'{{;ifij('J.actffMitsilIl -. t;;'i(':'!!.:~'::ia4-';\1:;;..'t&',~K~...;,j'" Contractor (Y\ P- --:\f) '{l Addres. q(")i ~ \ 0(('", A ^ }., 2 City L'0~ .D~.A_ phonp 7L/tf050r ZiJ: Of 7Lf78 StateD e Di; r-oS . "G:rt,-r.=,1iTIf-ii.j,t;,' "i.."'--, :~',lli':'~*-~:::'~--~'liciit"'?"~"~~'~;,t,';':-i~i?,j;':;J:f.:~"""':>'-';'~-= ;;~..",~:,""j;:~ .;"";~ '.."~..'...''''''''l' .--", ".'-' '~-.' ""'.' ~'>~.:"J1\jj~"'~' .r.~"'>":'# r,.;"'>;..... '~,.,."..... '--". 'P;:""'-'cJi~.--.;..,.~-t'$ "' {~.;<y ',' ,,, : ""<N"','""~~' S'1\J-~:'-a,~$;::,~{' ;;. - tn. ~ "",,;t?",?;<ff\.w,Ii,P'li'1Fj"'.;.,'..T --::<,:-.,.-:.; vt:' ""i":;;-'; ,iC"'" ,i::..:,10t....~ ,..{!\}&2,~III~~' ;At.::,ifI5'/',t;,fJArt.~. i-"'..'~1'}' imf.4ft~7.E,~::i.;/'fl:f'd?0~j~~.4.'::?i}.,,:ITi".-i';' ~:::"X<?:I>~\?t{~ 7/)-l~""7ld~&0~,-ttii/Tl-7Z:~-~~~,,"...~~v.,"3 ~~ '>tate Pho~" ( "~-O(I(')CJ rfL Zip CCjL\O)L Construction Contractors License # . Expire. DescriptioI' ~\"'0.Jt.... \),(T) ~.c 0 01 '-? (\ \ \(\\I~'--=, '-\ 'f.-)( Date of Installation2iD" , 9:~ I r)~ Date ofRemov~l :-\" ")\\ G ~, (')~ Permit Fee: $225.00 including $100.00 Deposit and applicable fees. By signature, I state and agree that I have carefully completed this application and hereby certify that all information herein is true and correct. I further agree and understand that the above described banner(s) and/or portable sign(s) is not larger than 60 square feet, and will be removed within 30 days from the date listed above. If the banner(s) and/or portable sign 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 30th day to request an inspection to verify the removal of the banner(s) and/or portable sign(s). This inspection will begin the process to return the $100.00 deposit if the banner(s) and/or portable sign(s) has been removed. .. Signatl'rp'fV2 D?tp ~~ yJb 9 '''~ii~,rn;;~i0=Z"T,1!t;;' Il1l!Klf!~!'i's lob # (lq ~ i'1'({ Amount Collected Shared Drive {T:)lBuilding FonnslBanncr_Portable Sign Permit CSD 7-08.doc