HomeMy WebLinkAboutPermit Signage 1998-3-5
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225 FIFTH STREET
SPRINGFIELD, OR 97477
(541) 726-3753
BLIMP, SPINNER, PENNANT, BALLOON, SEARCHLIGHT PERMIT FAX (541) 726-3689
COMMUNITY SERVICES nl\'ISION
Loc"l!on: <::;;3 q f' (A/\.Cgv'\. S.T
Asscssors l\1"p II: I 70 2. ~ '2, Lf ).
lJwncrof:'roperty: (Y\Cv'C ~7t1P f3le"
Address: p<,> 6GY-. ('/
City: VlO ~ J ri'f qi 't 82s-
Contractor/Installer: \('<"V\. e\C. k+(J
Address: ICl,,"L 111 0V q+'J
~Vlll(\
225 fifth Street
Springfield, Oregon 97477
City:
Construction Contractors RcgistratiOlI Number:
Description:
Date of Inst:Jllation: ~ I 6 f 'i If
Permit ree S40.00
Office: 726.3753
c,p r '~, h' '~C"ON UNC, n._"~*
T,n Lol 330 I
Phone II:
State: 0 (
Zip: q li/~
I'hone Ii:
State:
OJ
q 7.?)0
Zip:
Expires:
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Date of Hcmnvnl:
Deposit Reqnired SIOO.OO
By sign"tnn\ I stale and agree tllat I have carefully compleled this application and hereby certify that all
information I~crcin is true and correct. I further agree and understand that the above described display will be
removed within ten (10) days from the dale listed as the date of installation above, !fthe display is not removed
within the timeline specitied, I will forfeit the $100.00 deposit. I also understand that this special permit can be
i~sucd only onc,e .per calendar year per development area. I also agree to call the insp(~ction :i:lc at 726-3769 by lhe
cnd of thc 10lh day to request an il1!;pcction lo verify the rcmov~1I of th:.:: display. This inspection will begin the
process to retum the $100,00 deposit if the difoplay !1aS been removed,
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Sil,>kature
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Date of App:i,ion: . ~ !SI!L(
Issued By: 71- ffl.tl/\.--,
OfnCE US5
_ Jnb II: 3.501J/'LReceipt Ii: 02'100 l.-
Amount COl!ectcd:$ 1,/0.00