HomeMy WebLinkAboutPermit Building 1988-1-25
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~ING & C~MMUNITY DEVELOPMENT ~
ACTIVl'fY INFORMATION st; EET
bne county
.
COMPLETE THIS SECTION. INCOMPLETE FORMS WILL BE REJECTED!
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1
Arthur Ray Warner
PERSON MAKING REQUEST
1430 Mohawk Blvd.
MAILING ADDRESS
Leon R. and Corrine O. Keefe
PROPERTY OWNER
2255 Laura Street
MAILING ADDRESS
Springfield
CITY
746-1674
BUSINESS TELEPHONE #
Oregon 97477
STATE ZIP CODE
746-2609
HOME TELEPHONE #
Springfield
CITY
746-1110
BUSINESS TELEPHONE #
'Oregon 97477
STATE ZIP CODE
746-5509
HOME TELEPHONE #
2" PROPERTY ADDRESS Same
(IF DIFFERENT FROM MAILING ADDRESS)
3 MAP & PARCEL NUMBER (from tax maps in Department of Assessment and Taxation
(REQUIRED INFORMATION) or from tax statement)
17 03 27-1 1300 RAIlA...
TOWNSH I P RANGE SECTI ON TAX LOT{S) OR PARCEL # ZONING
TOWNSHIP RANGE SECTION TAX LOT{S) OR PARCEL # ZONING
TOWNSHIP RANGE SECTION TAX LOTIS) OR PARCEL # ZDNING
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP: 2.26 ACRES
4 SUBDIVISION (if applicable) N/A LOT BLOCK
5 REQUEST (state exactly what you plan to do) Conform to existing 'office use.
** FOR STAFF USE ONLY **
'*
NUMBER -<
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DATE -<
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6 DIRECTIONS TO SITE:
Harlow road to Laura street.
ZONE/LAND USE:
BY: DATE:
TIME IN:
OUT:
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