HomeMy WebLinkAboutPermit Miscellaneous 1985-2-13
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DATE:
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RE:
ADDRESS
O>.'llER
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MAP AND IA.X LOT
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NUMBER
ACCOUNT NUMBER IF AVAILABLE
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The above parcel is zoned
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The definition of this zoning is as follows:
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lAND MANAGfoMFN r DIV IPUBLlC WOHKS OEPT.
125 EAST 8TH AVENUE I. EUGENE. OREGON 97401
lane courffy
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(503) 687.4061, >.~'
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ACTIVITY INFORMATioN SHEET
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COMPLETE THIS SECTION. INCOMPLETE FORMS WILL BE REJECTED!
1 'PAM AN? L-Ov./
PERSON MAKING REQUEST
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MAILING ADDRESS
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CITY STATE ZIP CODE
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BUSINESS TELEPHONE # HOME TELEPHONE #
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PROPERTY OWNER
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CITY
STATE
ZIP,CODE
BUSINESS TELEPHONE # HOME TELEPHONE #
2, PROPERTY ADDRESS '5?_~O 6>f.><M~ n...tz..M
(IF DIFFERENT FROM MAILING ADDRESS)
(from tax maps in Department of Assessment and Taxation
or from tax statement) A / -r 1;,
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RANGE SECTION TAX LOT(S) OR PARCEL # ZONING
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3 MAP a PARC.L NUMBElR
(REOUIRED INFORMATION)
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TOWNSHIP
TOWNSHIP' RANGE SECTION
TAX LOT(S) OR PARCEL #
ZONING
TOWNSHIP RANGE SECTION
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP:
TAX LOT(S) OR PARCEL # ZONING
ACRES
4 SUBDIVISION (if applicable) LOT BLOCK
5 REQUEST (state exactly what you plan to do) _~....-::_~..~_.___......._,
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6 DIRECTIONS TO SITE:
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** FOR STAFF USE ONLY **
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NUMBER
DATE
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ZONE/LAND USE:
BY: DATE:
TIME IN:
OUT:
LANO MANAGEMENT DIVISION / 125 E. 8th AVE.. EUGENE, OR 97401 / 687-4061