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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