HomeMy WebLinkAboutPermit Signage 2010-12-10
225 FlFTII STREIT. SPRINGFlEW, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
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CITY OF .sPRINGFIELD, OREGON -
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Tax Lot 02- 10C
Address 333'3>
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Construction Contractors License #
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Description tiMNtll.. ,/ t{n)",Io/e s:-.;..
Date of Installation 10 - Z S" - ) D Date of Removal -' -
Permit Fee:5:0lfin"cluding $100.00 Deposit and applicable fees. 'J -
By signature, I state and agree that I have carefully completed this application and hereby certify that
all information herein is true and correct. I further agree and understand that the above described
banner(s) and/or Portable sign(s) is not larger than 60 square feet, and will be removed within 30 days
,from the date listed above. If the banner(s) and/or portable sign 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 twice per calendar year per development area. I also agree to call the inspection line at 726-3769
by the end of the 30th day to request an inspection to verify the removal of the banner(s) and/or portable
sign(s). This inspection will begin the process to return the $100.00 deposit if the banner(s) and/or
portable sign(s) has,been removed.
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Shared Drive (T:)IBuilding FormslBanner]ortable Sign Permit CSD 7-08.doc
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www.cLspringfield.or.us
TRANSACTION RECEIPT
811-SPR2010-00871
1891 PIONEER PARKWAY
EAST
CITY OF SPRINGFIELD
225 Fifth 51
Springfield,OR 97477
541-726-3753
pennilcenter@ci,springfield.or.us
RECEIPT NO: 2010001044 RECORD NO: 81 I-SPR2010-00871 DATE: 12/15/2010
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Banner, Portable 224-00000-425602 $100.00
Techno.l<?gy fee (5% of permit total) 100-00000-425605 $5.00
Admin fee (10% of applicable fees) 224-00000-426605 $10.00
TOTAL DUE: $115.00
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Check
113
safeway inc
$115.00
$115.00