HomeMy WebLinkAboutPermit Miscellaneous 1980-1-1
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ACTIVITY INFORMATION SHl!ET
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PERSON MAKING REQUEST (
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MAILING ADDRES'S
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I cciTY STATE ZIP CODE
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HOME TELEPHONE #
BUSINESS TELEPHONE #
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PROP~TY OWNER I
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MAILING ADDRESS
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BUSINESS TELEPHONE # HOME TELEPHONE #
2 PROPERTY ADDRESS
(IF DIFFERENT FROM MAILING ADDRESS)
3 MAP & PARCEL NUMBER, (from tax maps in Department of Assessment and Taxation
(REQUIRED INFORf1ATION) or from tax statement) ~fl-
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TOWNSHIP RANGE SECTION' TAX L~TlS) OR PARCEL # ZONING
tOWNSHIP RANGE SECTION TAX LOTlS) OR PARCEL # ZONING
(2; TOWNSHIP RANGE SECTION TAX LOTlS) OR PARCEL #' ZONING
TOTAL ,CONTIGUOUS PROPERTY IN SAME OWNERSHIP:
4 SUBDIVISION (if applicable)
ACRES
BLOCK
LOT
5 REQUEST (state exactly what you plan to do) ,
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6 DIRECTIONS TO SITE:
** FOR STAFF USE ONLY **
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ZONE/LAND USE:
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14-33
LAND MANAGEMENT DIVISION / 125 E. Bth AVE., EUGENE, OR 97401 / 687-4061