HomeMy WebLinkAboutPermit Signage 1999-7-20
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BLIMP, SPINNER, PENNANT, BALLOON, SEARCHLIGHT PERMIT
COMMUNITY SERVICES DIVISION
225 Fifth Street
Springfield, Oregon 97477
Office: 726-3753
INSPECTION LINE: 726-3769
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ciAssessors Map #: 1'1 b 3 Ol. c., ~ I
ffiowner of Property: sfO..C':h!)'{~ '1.-lJ.
~Address: 1-0~O OUxr\A 0iL. St. 1.4:
~ity: c:'on VJq tE:\J
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:i,Contractor/lnstaller: ~lJ ~ <:,.
, Tax Lot
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State:
Phone#[0lf/) 7 ?In- '1/;,'{0
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Zip: Q1417
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Address:
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City:
State:
Zip:
Construction Contractors Registration Number:
OAo blR
Expires:
Description:
Date of Installation:
71$
Date of Removal:
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Permit Fee $40.00
Deposit Required $100.00
By signature, I state and agree that I have carefully complcted this application and hereby certify Ihat all
infornlation herein is true and correct. I further agrce and understand that the above dcscribed display will be
rcmoved within ten (10) days from the date listed as thc date of installation above. Iflhe display is nol rell10vcd
within the timeline specified, I will forfcit the $100.00 deposit. I also undcrstand that this special pcrmit can be
- €":'.iJ' c issued only oncc per calendar year per development arca. I also agree to call the inspection line at 726-3769 by thc
;:! ~ .E ~ III ~,g end of the 10th day to requesl an inspection to verify the removal of the display. This inspection will bcgin thc
5 :5 iii ~ :;,g ~ process to return the $100.00 deposit if the display has been removed.
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Job #: ....Q.9 () q ~ /p
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