HomeMy WebLinkAboutPermit Signage 2011-4-29
225 F1ITH STREET. SPRINGFIELD, OR 97477 . PH;(541)726-3753 . FAX; (541)726-3689
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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 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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Date of Application
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For Office Use
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Receipt # ZO(f-
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Job#
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Amount Collected
Shared Drive (T:)/Building Fonns/Banner]ortable Sign Permit CSD 7-08.doc
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www.ci.springfield.orus
TRANSACTION RECEIPT
811-SPR2011-00733
2600 MAIN ST
CITY OF SPRINGFIELD
225 Fifth St
Springfield,OR 97477
541.726-3753
permitcenter@ci,springfield,or.us
RECEIPT NO: 2011000863
tDESCRle.!IOr.f~j~"""' "iii~"'-E,,:i'~;:?i'~~~}V;''1~':'
Admin fee (10% of applicable fees)
Banner, Portable
Banner, Portable Deposit
Technology fee (5% of permit total)
RECORD NO: 811.SPR2011.00733 DATE: 05/03/2011
; "j,,1:~i,; .F'i.' ;.:,~ ,';'ACCbUNfj::ODE,i:;: ;;;'ift:. .... AMOUNT.DUE", . .
224-00000-426605 20.00
224-00000-425602 100.00
821-00000-215500 100.00
100-00000.425605 5.00
TOTAL DUE: 225.00
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retrun deposit to: midtown mma 225.00
2600 main st suite E, springfield
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t~~~ YMENT~TY~E '; .... ::':';1':;" Y.O~: :;'c~i81~"DBOWLSBY:
Check midtown mma
1929
TOTAL PAID:
225.00