HomeMy WebLinkAboutPermit Signage 2009-6-5
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225 FIITH STREIT. SPRJNGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
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Construction Contractors License #
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Date of Installatin~ 3L:>"-.P - ~ ~
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\1e~lrow 4'/.7
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Date of Removal 3",')\,-\ (}'" t ('J~.
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 bannerCs) 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' tion' begin the proce return the $100.00 deposit if the banner(s) and/or
portable sign s) h ~ re ",,;,J.
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Shared Drive (T:)lBuilding FonnsIBanncr]ortable Sign Permit eso 7-08.doc:
22;'5 Fifttt Street
Springfield, Oregon 97477
541-726-3759 Phone
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City of Springfield Official Receipt
Development Services Department
Public Works Department
Job/Journal Number
COM2009-00798
COM2009-00798
COM2009-00798
COM2009-00798
COM2009-00799
COM2009-00799
COM2009-00799
COM2009-00799
<;9M2009=0081J0_ -:s
GOM2009'00800
CCOM2009-00800.J
::-:COMZ009'0080P
Payments:
Type of Payment
Check
cReceint I
RECEIPT #:
2200900000000000617
Date: 06/0512009
Description
Banner Special Permit
Deposit
+ 5% Technology Fee
***+ 10% Administrative Fee***
Banner Special Permit
Deposit
+ 5% Technology Fee
***+ 10%" Administrative Fee"**
Banner Special Permit
Depos it
+ 5% Technology Fee
***+ 10% Administrative Fee***
Paid By
OREGON HORSE CENTER
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
4096
In Person
Payment Total:
nJffi
Page I of I
2:03:28PM
Amount Due
100.00
100.00
5.00
20.00
100.00
100.00
5.00
20.00
100.00
100.00
5.00
20.00
$675.00
Amount Paid
$675.00
$675.00
'6/5/2009