HomeMy WebLinkAboutPermit Fence 1995-10-4
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SPRINGFIELD
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FENCE PERMIT APPLICATION
CITY OF SPRINGFIELD
BUILDING SAFETY DIVISION
225 North Fifth Street
Springfield, Oregon 97477
Office:
INSPECTION LINE:
726-3759
726-3769
Job Location:
} '710 P/1 ('y] hoo) fj,V' /u ,<'"
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Assessors Map #: /7/J 'Z 27 ? J
Owner: !JnhJ,(/l-for IIVW1L'/#'-ir J
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Ci ty: 5/i~;"q 6.....?d
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Value of Fence: ~/.1J oJ
Address:
TaxLot#: 110/00
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Phone #: '/L// -/7-a '7
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State:
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Zip:
tJ''71/'77
Fence Permit is $5.00
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Contractor/Installer: )!.-7/), Id/-- ToV Ih'7b.<7h'7
Address: /O,!lt>)' &"b'f) Phone #:
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City:_:!{}:z,'(i;',:/'.f",>.(ri! State: d-e
Construction Contractors Registration #: f1t1//5"
, 7ij/l1 Id/ ;&011
7///-/'7t:J '7
Zip:
f''/(?'77
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Expires:
By signing this permit/application, I agree to call for an inspection once my
fence has been constructed (726-3769). I also stated that all information on
this application/permit is correct and that I was provided with the Springfield
Development code requirements for fence standards.
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Signature '~~ ,'-~
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Date
FOR OFFICE USE
'Dateof Application:" /C-.y'-<<?5"
Receipt'# /9/9 =3
Issued By:
JOB #~.f?//e:(<v"
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Total Amount Collected:
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Checked for Delinquencies:
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Checked for Historical Status:
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SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
NAME: }.1l0dlfL ~.P V1t:fS
ADDRf5S: ~ ~q 0D. 01fi.JJ. w./fJ
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PHONE: -.:Jtfl{v (pq&&
STATE:.d::. ZIP t{1Lf71
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LOCATION OF PROPOSED BUILDING SITE:
-Street Address if Known: . ,~2.;?, \ \.D
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Platt ~ame: I ~ D ~ 6 (p l'l---
htn1frl. 0.dj))Md' WI V-t '
Tax Lot Number: ?jp(JD
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1. DEVELOPMENT TYPE (Chedc appropriate dwelllrig(s). SDC calculations and dwelling type
definitions are on the back.>' , ' , ' , ' ", '
A. 'Slngie Familv - Detached
I, Single Family home
, NO OF UNITS
Manufactured home not in a park,.. I ( " "
X $400 PER UNIT.r. '.. $" If.(X) .OtJ
B. Sinqle Familv -'Attached
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NO OF UNITS,
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X $370 PER UNIT =
'$
C. Multi-Familv Aoartment' .
NO OF UNITS
X $777 PER UNIT =
$
D. Maiiuf.u:tured Home Park
NO OF UNITS
X $280 PER UNIT = ,$ ,
WPRD SDC
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.. $J/!J() .()(J
2. SDC CREDIT (If applicable) SDC-payer must furnish proof ofWPRD Credit
approval. See sac Credit Worksheet. " "
UPltY
$
$ l/~() .([1)
8f5, ~ ,t{1/j ,
3. OTAL WPRD NET SDC ASSf5SED (If SDC reduced (or Credit>