HomeMy WebLinkAboutPermit Fence 1995-11-1
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SPHINGFI~LD,." ...,.....
lIENCE PlmHI'l' APPLICATION
CITY OI' Sl'lnNGl/II~LD
llUILDJNG" 'SAi/E'l'Y "DIVISION
225 North Fifth Street
Springfi~ld, Oregon 97477
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Job Location: 9/0 ~ ~+.
Assessor's Hap III ' \'0 ~9.lr \3
Owner: C h~cle ~ A 1 k: "-
Address: ~ J '1- ~ L (' ,,""'I
Ci ty: 8p~i d f) f State:
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Value of Fence: ~ v
Contractor/Installer:
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Address:: ~~~
City: s~k~
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Construction Contractors
State:
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Registration II:
Office: 726-3759
INSPECTION LINE: 726-3769
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Tax Lot tt: Mffi'J
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Phone' 11: '") L-) '7 - 0 s~cj. Co
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Expires:
Dy signin~ this permit/application, I agrec to ~all for an inspection once my
fcnce Ilas been constructed (726-3769). I also statcd that all information on
. t h i~l~f,~ a t ion/po l'llli t is 00 l'roc t and tha t I was prov idod wi th tho Sprl nef io Id
Dev.p" code l'0~ r,en)l;o l' fence "tandardo. II~ 1_ 7 :;-
Signa ture ,_' ,_-, Dn te
FOR OFFICE USE
/ Date of APplication:' \ \ . \ . ~
Recclpt U \~AS~..
Total Amount Collected: ~ ~
Checked fOL' Delinquencies:
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Issued By:
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Checked for Historical Status: