HomeMy WebLinkAboutApplication APPLICANT 2/22/2018City of Springfield
Development Services Department
225 Fifth Street
Springfield, OR 97477
Land Division Tentative Plan
Partition, Subdivision
SPRINGFIELD
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Partition Tentative Pre -Submittal: ❑ Subdivision Tentative Pre -Submittal: ❑
Partition Tentative Submittal: ❑ Subdivision Tentative Submittal: ❑
A 1icant Name: Eric Adams Phone: 541-736-4048
Company: Willamalane Park & Recreation District Fax:
Address: 250 South 32nd Street, Springfield OR 97478
Applicant's Rep.:
Phone:
Company:
Fax:
Address:
Property Owner: Willamalane Park & Recreation District
Phone: 541-736-4048
Company:
Fax:
Address:
ASSESSOR'S MAP NO: 18-02-05-11; 18-02-04-00
TAX LOT NOS :200; 3100
Property Address.•
Size of Property: Acres ❑ Square Feet ❑
Proposed Name of Subdivision: Woodland Ridge Subdivision
Description of If you are filling in this form by hand, please attach your proposal description to this application.
Proposal:
Existing Use: Vacant former Weyerhaeuser Road parcel
# of Lots/Parcels:
Totalacreage of parcels/
allowable densi :
Proposed #
Dwell Units
Signatures: Please si n and rint our name and date in thea propriate box on the next page.
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Associated Applications: Signs:
Pre -Sub Case No.:
Date: Reviewed by:
Case No.:
Date: Reviewed by:
Application Fee: $
Technical Fee: $
Posta a Fee: $
TOTAL FEES: $ PROJECT NUMBER:
Revised 1/7/14 kl 1 of 10
Owner Signatures
This application form is used for both the required pre -submittal meeting and subsequent
complete application submittal. Owner signatures are required at both stages in the application
process.
An application without the Owner's original signature will not be accepted.
Pre -Submittal
The undersigned acknowledges that the information in this application is correct and
accurate for scheduling of the Pre- Submittal Meeting. If the applicant is not the
owner, the owner hereby grants permission for the applicant to act in his/her behalf.
I/we do hereby acknowledge that I/we are legally responsible for all statutory
timelines, information, requests and requirements conveyed to my representative.
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Date:
Signature
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Submittal
I represent this application to be complete for submittal to the City. Consistent with the completeness check
performed on this application at the Pre -Submittal Meeting, I affirm 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
complete application.
Owner: , i ,
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Date: !
Signature
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Revised 1/7/14 kl 2 of 10