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HomeMy WebLinkAboutPermit Fence 1991-5-1 , .- FENCE PERMIT APPLICATION CITY OF SPRINGFIELO BUILDING SAFETY DIVISION 225 Fifth Street Springfield, Oregon 97477 Office: INSPECTION LINE: 726-37~ 726-37~~~ Job Location: &09 3 /Y7~ ~ ......":\ Assessors Map #: . \\ DQ ~34 Tax Lot #: n()(JoO Owner: W~ A.cft&~~-1&~ L-. ;ii. Phone #: 0;Jb~ 2'/& <( State: ()Jt:.. Zip: C/7 tl7g' Address: (n {')q '5 Y)1 ,(1,'-': City: ,~fI(() Value of Fence: ~J. 17~t? , I Fence Permit is $5.00 Contractor/Installer: IJ--f~ Address: Phone #: City: State: Zip: Construction Contractors Registration #: Expires: By signing this permit/application, I agree to call for an inspection once my fence has been constructed (726-3769). I also state that all information on this application/permit is correct and that I was provided with the Springfield Development Code requirements for fence standards. ~//PI AI' j/;.J/#r, Signature - .tr - /- <}/ uate FOR OFFICE USE Date of Application: ~- \. q \ Receipt #: \~ 0\~?1 Issued By: ~u\(\.C\. 5.cO Job #: q /0 (f3 0 0... . (w I Total Amount Collected: Checked for Delinquencies: Checked for Historical Status: