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HomeMy WebLinkAboutAddressing Change 2006-9-14 KeP. ~ . _1 .',-' \...-''oA Sep-14-06 05:25P , 54_788 P.02 CITY OF SPRINGFIELD, OREGON ' 225 FIFI'H STREET. SPRINGFIELD,OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 Property Owner: ADpRE~S CHANG~ ~UEST . .J 'f::Jc.(C /((?f) h~ ~ ^- ,0:: B()\{ 7~LI ~J{J , Mailing Address: Cit~: C; flIt... ( &-1 <-1 - l' V Person or Agency requesting change if other than owner: Zip: q 7t{7 7 State: OK Phone number where you can be contacted between 1 :OOpm and 5:00pm: ~t-/ (- 7l/ (- 7 s-s-i Address of property you are requesting to be changed: Assessor Map #: V1D1~ '2.\ ooED Tax Lot #: I '7- 0 Z. -"'S 1- (J oRO I Please explain specifically why you feel the address needs to be changed: . Proposed Address: CoW\W\ ph cwl f'J..v-L- S71( Signature: /J /7 /7 _______ Date: q - 14 --tJ 6 - / /~ r vt...-- ,,:' ,,', "":',.;:,::}.," ,,' <:~,:e":~~}:~!~'!:/:;;1;:{i:%W~;;;8~:::.'c':':"":t;;-;:'::~M.L: ,'.;/,m;,:':j::1!d:~ ::;} > L":i';, .',/;'::j;\;:. ~;/: ;';e~:: ':"W ..,;. .:~~:i:~::"fl<<t!.. .f: Y~E"}"3't:\"Cl:'1~"':": ., ~nei"!' c',' Reference-Number: W23l'L\ m<z[). \lX\ \ 'Approved n\~ Denied' If approved, new ad~ress . : ~' (L. A ~ Reviewed By: l1h~ \ Date: · n.olo - Shared Drive(T):/Building FonnslAddress Change Request ll.o2,doc (B)