HomeMy WebLinkAboutPermit Signage 2001-11-14
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SP'-FIELD
BLIMP, SPINNER, PENNANT, BALLOON, SEARCHLIGHT PERMIT
COMMUNITY SERVICES DIVISION
225 FIFTH STREET
SPRINGFIELD. OR 97477
(541) 726-3753
FAX (541) 726-3689
225 Fifth Street
Springfield, Oregon 97477
Office: 726-3753
INSPECTION LINE: 726-3769
Location: t ~ D l P; fW\.tQ)( -? 'LvJ lj
Assessors Map #: \(lfY3~\o-!l3
Owner of Property: ~5 r /() (' ?
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City: ,,~( \ flr:J C1 P '\,~ State:
Contractor/Installer: ~ !tlAoJl ilJ n.J\O.~
Address: <f: 21:/:") ~\J 'f f pp c. c:, (d.t j'2( ,
City: 8en. Altf ),f /'flYl. I
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TaxLot~
Address:
.c '" Phone#: 7~l- 't~1 ~
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Phone#: (StJ3)b0:3 - 42 9l
Zip: 0; 700'R'
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State:
Construction Contractors Registratiou Number:
Description: J0OvU()() I./\-
Date ofInstallation: \ \ I 9/ D \
Expires:
Date of Removal: \ \ / \ \ 1111
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Permit Fee $80.00
Deposit Required $100.00
By signature, I state and agree that I have carefully completed this application and hereby cenify that all
information herein is true and correct I funher agree and understand that the above described display will be
removed within ten (10) days from the date listed as the date of installation above, If the display 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 once per calendar year per development area, I also agree to call the inspection line at 726-3769 by the
end of the lOth day to request an inspection to verify the removal of the display, This inspection will begin the
process to return the $100,00 deposit if the display has been removed.
Signature
Date
Date of Application:
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OFFICE USE
Job #: n r - D I 21h 1. -0 ~ Receipt #:
Amount Collected: ~ .
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Issued By:
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5417476592
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Kay Wilson
City of Springfield
We the managers at Shari's Restaurant of 1807 Pioneer
Parkway in Springfield have the intent to purchase a
balloon perinit for the weekend of November 9, 10, and 11.
We will be in your offices on November 13 to pay any
dues necessary. We have decided to remove our portable,
banner at this time as it is not in our best interest to keep it
up. Thank 'you for your time and information.
Sincerely,
Kara Thelin and BJ. Kirk
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