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HomeMy WebLinkAboutPermit Signage 2011-6-13 225 FIITH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 gj City Job Number ~\\ - \)\br~1 "~~ 3 <:l^O J 0, A ~ ..~ Job Location 5/ ~'~ SA- ..~ Assessors Map /7 D 3, d 7 I D Tax Lot 691 cD (Q) Hia~iI~~~ql:~,,~~~~i;~f~:E~rr~;:irj~~'t~f~jfi(JJlc;;~;~1,~;~~t~t~';*trr;;: ;~2~~\~~;~4~;~~~~r1:?r~;:"~:'~~~I~ ~;;:~~;;;:;:~~vY\A=~';,- -c:rx-~----<~. ;~-_._~ -- ....", ,~ Add,,~ '1 D 7f>l_P .-{ Cu Ll.o..& ~ Ph"P f, '1i '1 76) ~ City?'A-J S.J) ~ State LR- Zip 97 (I 1) ~ ~ ~ ..~ ~ a e: ~ II I, >.. OO@ ~ ~ , ~ ~j ~) .... ''l''''~j{ r:t//JJ ..~ 1 ~ ~-j~ ~ ~ ~' Date of Application i Issued By ~ Amount Collected '.J\ L ~ ,~o~--;f Qin\~ct9 ~ ~ ()~,~ ~~ 0 \\,\XD /(ruiJ l1~ ~Orf~~~-~~~o;\ .--; '1 ~ ..' ~ \! ,~~::: ';:'~\~IrtyJ10j~SIhtThiGFffitli; 0REG0Srf~l!f~~~~,;t it't~~ ~:' -t~~' t:" "-<f'g -""":'0 "'1iSLc~: 7fr'i"r~~~~;;;",""'~)" , _;$",::"'>< >- _..,,~~ .1",h'~' "_ Contractor Address ~~ CuO c:v'&-o 7;-P Phonp City State Zip Construction Contractors License # Expire. ,Description Lf'r R 122 ~(") Date of Installation L48Af Date of Removal 6., IS - 1/ ..9 ~ - 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). Ibis inspection will begin the proce s return the $100.00 deposit if the banner(s) and/or portable ~,h 're ov d. Signa 9 -0 J3 - - - .:r ~- "me $I/~I/ / .~ ~""'~',",,'"''''''v''''Y''-'~!Y.''''~-'i'''';~ ""'''~'~ d'~~~="'_':;y,"~'",,,, Q.- i":0i!jt:7t~~r~"~~;:;:.~~~2',~h;itj~8J)' Job # Receipt #