HomeMy WebLinkAboutPermit Signage 2011-3-28
ZZ5 flITH STREET. SFRlNGflELD, OR 97477 . FH:(541)726-3753 . FAX: (541)726-3689
~. FIREWORKS SALES LOT/CHRISTMAS TREE LOT Banner/Fortable Sign Fennit
~; City Job Number c;yCL'Z..OC(- Dc:::. 553
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J~~: 1705. ZbZ 3 Tax Lot . 6230Z.
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. SPRINGFIELD
Owner
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Owner of Property It\2..<:..- -r~()/\vur ~kl-'"
Address:333:::) New 1+y6e- fNLIc:.- I<-n
City . 11M ~iv be- (J/tfL\s::... State _. N V
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Contractor lY'f y,.- L't'* {C-1Ib'lc:- Se.o'ro....Sf;-\-~
Address '6 751'-{~~7.;vv ~~ PhoneJ2::ll-,\ 4Co-I5"'Z.'j
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Construction Contractors License #
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Date of Installation ~).M..L Z?,,,r~ 7J')\ \
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Date of Removal .:J.J\{ ("-\:I,,. loll
Permit Fee: $115.00
Permit is valid for 30 days from date ofInstallation
. 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
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Date 3..U~\ I
Date of Application
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Amount Collected
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For Office Use
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Job #
Issued By
Shared Drive (T:)lBuilding FonnsIFireworkslChristmas Tree Banner-Portable Sign Permit }.2010.doc
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TRANSACTION RECEIPT
CITY OF SPRINGFIELD
225 Fifth 5t
Springfield, OR 97477
541.726-3753
www.ci.springfield.or.us
811-SPR2011-00553
1891 PIONEER PARKWAY EAST
permilce nter@cLsprlngfield.or.us
RECEIPT NO: 2011000665 RECORD NO: 811-SPR2011-00553
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Admin fee (10% of applicable fees) 224-00000-426605
Banner, Portable 224-00000-425602
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Technology fee (5% of permit total) 100-00000-425605
TOTAL DUE:
DATE: 04/06/2011
':~-AMOUNtDUE_;"; h
10,00
100.00
5.00
115,00
,_,AMqU~T PAID
115,00
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i:!.RAY-IV1~NJ;~~, ,,:? ,PAYOR:" -CASHIER/i)BOWLSBY""",
Check AMERICAN PROMO EVENTS
7316
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TOTAL PAID:
115,00