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HomeMy WebLinkAboutPermit Fence 1995-10-4 . . SPRINGFIELD ..- , 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 ,<'" .\. Assessors Map #: /7/J 'Z 27 ? J Owner: !JnhJ,(/l-for IIVW1L'/#'-ir J I..v,;fo(' //t2Pi Ci ty: 5/i~;"q 6.....?d , /' Value of Fence: ~/.1J oJ Address: TaxLot#: 110/00 \ . <://Y'11>f!:'v?(cf / E//.O..--,,..,... ~ , (" v Phone #: '/L// -/7-a '7 " State: /))1 Zip: tJ''71/'77 Fence Permit is $5.00 , Contractor/Installer: )!.-7/), Id/-- ToV Ih'7b.<7h'7 Address: /O,!lt>)' &"b'f) Phone #: , City:_:!{}:z,'(i;',:/'.f",>.(ri! State: d-e Construction Contractors Registration #: f1t1//5" , 7ij/l1 Id/ ;&011 7///-/'7t:J '7 Zip: f''/(?'77 'J- -I ? -qr.. 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. , , (?O,k,n.L..YYT) J ,~4'-47 n / Signature '~~ ,'-~ 11}- 4- 9S Date FOR OFFICE USE 'Dateof Application:" /C-.y'-<<?5" Receipt'# /9/9 =3 Issued By: JOB #~.f?//e:(<v" 4~- ~~ \ -- Total Amount Collected: ?-:~ Checked for Delinquencies: ~ Checked for Historical Status: / . . '!'.,. '1 . . @ !!)!J1ti!om.l!!i,\~ .' '. lob No. QDOJ\5 SYSTEMS DEVELOPMENT CHARGE WORKSHEET NAME: }.1l0dlfL ~.P V1t:fS ADDRf5S: ~ ~q 0D. 01fi.JJ. w./fJ . . . ~ . PHONE: -.:Jtfl{v (pq&& STATE:.d::. ZIP t{1Lf71 ..1 ! . . ' - '"-.--.- LOCATION OF PROPOSED BUILDING SITE: -Street Address if Known: . ,~2.;?, \ \.D . . Platt ~ame: I ~ D ~ 6 (p l'l--- htn1frl. 0.dj))Md' WI V-t ' Tax Lot Number: ?jp(JD I 1 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 , i NO OF UNITS, .' , . 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 .." . .. $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>