HomeMy WebLinkAboutApplication APPLICANT 1/14/2013 • •
City of Springfield SPRINGFIELD
Development Services Department
225 Fifth Street
Springfield, OR 97477 11111k •
Final Site Plan Review
Application Type (Applicant: check one)
Site Plan: ❑ Minor Site Plan Modification:
Ma'or Site Plan Modification: ❑
Required Project Information (Applicant: complete this section)
Applicant Name:TERIZ' NOVA-Y-- Phone:907-36-7-4(167
Company: NOVA/Z_ A'I2CF4-rrCGTUleCl1,NL Fax:
Address: 075 SW 54jJ P602.6 r, fberu-we p r2 17 2.23
Applicant's Rep.: PAN RU.E/J Phone:360-6'6--%34—
Company: DLit CONgfRGte11oN SCRVICCS Fax:
Address: 1301 60(..(4001.4- IT. , VA-NGockv It , PR 9 866 0
Property Owner: Gel' OA-nnu f , %ttJ- PAQTN&ZS Phone:
Company: Fax:
Address: 11 1¢ Al1EN4E OP ¶}$6 AmaleAS 1 F►`1,JJL/ 1ocf36
ASSESSOR'S MAP NO: 17-03-22-po TAX LOT NO(S): 2-30o
Property Address: 1.710 6a f
Size of Property: Acres ❑ Square Feet ❑
Proposed Name of Project: FroliTh..47 1plct2 WNg,f
Description of If you are filling in this form by hand, please attach your proposal description to this application.
Proposal: recSTWt ,cOJI
Existing Use: goI,L%UIoCW V(DE I Tentative Case #:-IP(P II2-Ocv36
Si• natures: Please si n and 'rint our name and date in the a' 'ro'riate box on the next ma e.
Required Project Information (City Intake Staff: complete this section)
Associated Applications: /
Case No.PI P i 12 -00030 Date: ) 1 111 /i Reviewed by:
Application Fee: $ ` -' 10 Technical Fee: $ (p • ( Postage Fee: $0
TOTAL FEES: $ I �O '2 I PROJECT NUMBER: ef-SrDDa)---)
Date Received:
JAN 1: 4 2013
Revised 1/1/08 Molly Markarian 1 of 4
Final Submittal
Signature
I represent this application to be complete for submittal to the City. I affirm that the information identified by the
City as necessary for processing the application is provided herein or the information will not be provided if not
otherwise contained within the submittal, and the City may begin processing the application with the information as
submitted. This statement serves as written notice pursuant to the requirements of ORS 227.178 pertaining to a
complet lication.
Owner:
Date: 1 - 1L-
ig ture
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Print
Date Received:
JAN 1 4 2013
Final Submittal
Revised 1/1/08 Molly Markarian 2 of 4