HomeMy WebLinkAboutApplication APPLICANT 12/3/2021(City of Springfield
Development & Public Works
225 Fifth Street
Springfield, OR 97477
PERMIT REVIEW INTAKE FORM
SPRINGFIELD
(City Staff completes form)
Permit Type
Dept of Motor Vehicles -New: ❑
Land Use Compatibility Statement: ❑
City: ❑
Dept of Motor Vehicles -Renewal: ❑ Zoning Verification Letter: ❑ UGB: ❑
Project Information
Applicant Name: Noe Garcia
Phone: 541-968-5202
Company:
Cell: Mi a anoe@ ahoo
Address: 4675 Good Pasture Loop, Eugene OR 97401
Property Owner: Two Cent Piece LLC
Phone:
Company:
Cell:
Address: PO Box 26125, Eugene, OR 97402
ASSESSOR'S MAP NO: 17031533
TAX LOT NOS : 01100
Property Address: 3636 Game Farm Road, Springfield, OR 97477
Description of Proposal:
MDS LUCI - Food Trailer moving onto site and connecting to utilities. The connection to
Utilities does not meet the requirements to be eligible for a Transient Merchant license.
Record Information
Record No: 811-21-000312-TYP1
Date Received: 12/3/21
Application Fee: $348
Technical Fee: $17.40
TOTAL FEES: $365.40 Assigned Planner: rA�Jkl
Revised 11.2.11 kl