HomeMy WebLinkAboutPermit Signage 2011-3-21
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"'~'~~"Z' , '>t;'U?I;TM..mrSERINGFIELD, OREGON~: :'~:," .
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225 FIFTH STREET. SPRINGFIElD, OR 97477 . PH:(541)726.3753 . FAX: (541)726-3689
City Job Number
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. Description
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Date of Removal
Date of Installation
Permit Fee: $225.00 including $100.00 Deposit and applicable fees.
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 tirneline
specified, I will forfeit the $100.00 deposit. I also understand that this special pennit 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). Tbis inspection will begin the process to return the $100.00 deposit if the banner(s) and/or
portable sign(s) has b e' oved.
Date of Application
Issued By
D~
Amount Collected
Shared Drive (T:)'Building Fonns/Banne:r]ortable Sign Permit CSD 7-08.doc
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www.ci.springfield.or.us
TRANSACTION RECEIPT
811-SPR2011-00455
28 W Q ST C
CITY OF SPRINGFIELD
225 Fifth St
Springfleld,OR 97477
541-726-3753
permilcenter@ci.springfieJd.or.us
~'e~.'fOOE;N:rjX~I;:~~' , ,"'" -. '15 ~iQB~6',C"ASHi-ER:'D'B'OW'LS"BygJ~~'~'~~
Check robert timmons
29148
RECEIPT NO: 2011000516 RECORD NO: 811-SPR2011-00455 DATE: 03/21/2011
[OESCRIe:TION' , -. '., -~,.,. "J ;;~ct; .~:-. ;;';::;:;;;;:;;';,3';;'" . --.'AC:CQUNf..cODE-~;;~-';'";:~AMQUNT;OUE .>.;;;.:"~
Admin fee (10% of applicable fees) 224-00000-426605 20.00
_Ban~!'c~ortable 224-00000-425602 100.00
.~n..n~c!:orta~e Deposit 821-00000-215500 100.00
_ TeEhnolo~y fee (5% of perm~. total) 100-00000-425605 5.00
TOTAL DUE: 225.00
.. COMMgNTs::;.:t:;'-.; '~/.."f.>'_ "'\.3;AMOUNT.PAID.
return deposit to: robert timmons 225.00
28 w q street unit c, springfield or
TOTAL PAID:
225.00