HomeMy WebLinkAboutPermit Fence 1991-6-10 (2)
.. .~. ..
~.
.
SPRINGFIELD
FENCE PERMIT APPLICATION
CITY OF SPRINGFIELD
BUILDING SAFETY DIVISION
225 Fifth Street
Springfield, Oregon 97477
Office: 726-3759
INSPECTION LINE: 726-3769
Job Location: ;) '-/;) /
()Or"nrk \-I-rpp f-
Assessors Map #:
Owner: t~ t) r ; " (\ p
/7/J '<,
L
"27
.~ /Vi :-r1\
2-- 2--
Tax Lot #:
A7(:.t'?
Address: S/).y"v\p,. Phone #: 11/6 -/?t2X.;
City: <.;" r'- ; n ,,+=; e Ii State: IJrplf) 11 Zip: 97~:7:7
(J~
Value of Fence: )(() /) Fence Permit is $5.00
Contractor II ns ta 11 er: () lAJ fC .e.I
Address: Phone #:
City:
State:
.Zip:
Expires:
Construction Contractors Registration #:
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 requirement~ for fence standards.
/~:"~~" - -/ Jffh~rl
Signature
?-//J-fY
Uate
. FOR OFFICE USE
Date of Application:
&~(O-/(
Job #:
9/c:J0!J1
/#~hV'-L
Receipt #:
:::J() 7(':::l, I
Issued By:
~c;'p-o
V
Checked for Historical Status:
--
Total Amount Collected:
. Checked for Oelinquencies: