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HomeMy WebLinkAboutPermit Signage 1999-12-16 . DEVELOPMENT SERVICES DEPARTMENT BANNER PERMIT COMMUNITY SERVICES DIVISION 225 FIFTH STRE SPRINGFIELD, OR 97. (541) 726,3i FAX (541) 726,3< 225 Fifth Streel Springfield, Oregon 97477 Office: 726-3753 INSPECTION LINE: 726-3769 '-.. ! i " .;,1 .','4 Banner Location: It 17 S- 11Q./ k. Sf,.,eT Assessors Map #: h D L :, '2- ~?-b ~..... () V Owner of Property: J4 c-k ,'. fl~ 1<0)( I,.r Address: YSD~~v./ k:-tf"y_rf'. tV? ih.70 [q,te.. OSwe._ Or< City: State: . Tax Lot ~ ":.1 ~ Phone #:~03) .(.56 - l;-,)f"S- Zip: 770/ ,C;- ,"_".i ";;"; Contractor/Installer: L (.11...,- 1- .>011 C;~.tf,.", 1,'0 k Address: &'8lfgq SfeIlL"" .C)l)r Lfu IJ tJ 'J r<.J Phone #: I Description: fle.r-e. Vve.. State: 0 f\ ]22.'1-) (;,,,., e. - .:::J:.cj(, it-, +le Zip: q 7'j-78 City: Construction Contractors Registration Number: Expircs: tCJX Date ofInstallation: /l,,-<- ) 7 f 99 <i Date ofRemoval:~ _ -?, I 1<10"'1 Banner Permil Fee S40.00 Deposit Required SIOO.OO . , By signature, I state and agree lhat I have carefully compleled this application and hereby certify that all information herein is true and correct. I further agree and understand thallhe above described banner (s) is not larger than 60 square feel, and will be removed within 14 days from lhe date listed above. If the banner(s) is nol removed within lhe timeline specified, I will forfeit the $ I 00.00 deposit. 1 also understand lhallhis special permil can be issued only twice per calendar year per development area. I also agree to call1he inspection line at 726-3769 by the end of the 141h day to request an inspection 10 verify the removal ofthe banner(s). This inspection will begin lhe process 10 return the SIOO.OO deposit iflhe banner(s) has been removed. ~gnarure (ZAt .( /'2 -16 - 79 'Date :;'1 ----------.-------------------------------------------------------------------------------------------------------------------------------- Dale of Applicalion: 1;). _ I <n - ~ C1Q OFFICE USE Job #:,.gs I ;('1>' U_ Reeeipl #: Amount Collected: Jt.[ U-O ,- Issued By: