HomeMy WebLinkAboutPermit Miscellaneous 1990-01-01lnirx: COtfty
ACTIVI]'Y INFCRMATION SH EET
CCMPLETE iHiS SECiiON. iNCOMPLITE FORMS l,JILL BE REJECTEDI
ffi.il,
-
_--TROFERTY
OWNER
i4AILING AODRiSS MAILiNG ADDRESS
------T ITY STAIE ZiP CODE C ITY STATE CODE
a u fi lr iS s -rEIE-pH o-uE-*HOME TELEPHONE #
2 PROPERTY ADDRESS(IF DIFFTRENT FROM N
PH TEL H
3 vrae B ITAneEL
(RE U I RED I NFORI,IAT I
( fronr tax map s i n Department of Assessment
or from tax s ta temen t )#2;"3"3
SEET]T_N
NL.,MBEF|
'W'^f?23
RANGE
and Taxationrubo
Rh-n4
ZON J NG
6p'p 6b fr'o
TOEISE-TFoalt'
TOIN'sE'IF
tl P
TOImSHTF F-AT-6E SEmTON mxT0Trs)-T-Rr-TImEf7
TOTAL CONTIGUOUS PROPERTY iN SAME OI^/I.IERSHIP:
4 SUBDIVISI0N ( if aPPl icable)
(il"
MNGE SEETIOU ffi MNIIT-
ZON ING
ACRES
LOT B LOCK
5 REQUEST (state exact'ly what you plan to do)
5 OIRECTIONS TO SITE
ZONE/LAND USE
"" FOR STAFF USI ONLY i*NUMBER
DATE
Fl/,
-.1
DAT E TIME IN :-- OUT:-
BY
LAND I4ANAGEMENT OIVISI0N / 125 E' 8th AVE" EUGENE', 0R 97401 / 687-4061
I