HomeMy WebLinkAboutPermit Signage 2011-5-3
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22511FTI1 STREET . SPRINGFIELD, OR 97477 . 1'1-1:(541)726,3753 . FAX: (541)726,3689
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Construction Contractors License #
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Description
Date of Installation
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Date of Removal
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Permit Fee: $225.00 including SlOO.OO Deposit and applicable fl'cs.
By signature,. 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 I fo eit the $100,00 deposit I also understand that this special permit can be issued
only twice pe ale year per development area I also agree to call the inspection line at 726-3769
by the end of 3 y to request an inspection to verifY the removal of the banner(s) and/or portable
sign(s). This' -1\bWn the process to return the $100,00 deposit if the banner(s) and/or
portable sign(s e . ot ,
Signatur
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Date of Applic
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Issued By
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Receipt# 20({ - 0 .",)
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Shared Drive (I:}'Building FormsIBanncr _Portable Sign Permit CSD 7-08.doc