HomeMy WebLinkAboutApplication APPLICANT 8/18/2022jCity of Springfield
Development & Public Works
225 Fifth Street
Springfield, OR 97477
PERMIT REVIEW INTAKE FORM
SPNINOFIE
Permit Type
Dept of Motor Vehicles -New: ❑
Land Use Compatibility Statement: ❑ City:
—77--'77
Dept of Motor Vehicles -Renewal: ❑ Zoning Verification Letter: UGB: ❑
Project Information
Applicant: ' � h ,f ��
Phone: 5y 1 -7 yc( 14a Ll
CompanyTre L iC i�rw ��
Email: t (,k le�wrry I Sck.DlCol W.I
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Address: -7(9 p eK (Z 1`7477
Property Owner: fin
Phone: 5y1 795 to'40
Company: e UW} rt -m 1N Sc_hc"A
Cell: 5-41 -751 Ll, q O
Address: -7(Q. 5- 'yec`�- r,A e D2 '7yT7
ASSESSOR'S MAP NO:
1.7033
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TAX LOT NO(S): t0900
Property Address: _7(00 a�$'F g-�.�eL. C� �'e�G� UV- 97q?
Description of Proposal: .ZOJ� l A) vim. `(: • 1
Record Information
Record No: ��-�� �0101'� 'C'�;��
Date Received:
Application Fee: $ 7�
Technical Fee:
TOTAL FEES: $ 3�3.� Assigned Planner: D.
Revised 11.2.11 Id
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