HomeMy WebLinkAboutApplication APPLICANT 12/15/2022City of Springfield
Development & Public Works
225 Fifth Street
Springfield, OR 97477
Floodplain Overlay District Development
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1
Required Project Information
Applicant Name:
(Applicant: complete this section)
Phone:
Com an
k \ Email. C['
Address \\
Applicant's Rep.:
Phone:
Company:
Email:
Address:
Property Owner:
Phone: \-'-L
Compan
♦
Email.
Address:
5.v.a.,.
ASSESSOR'S MAP NO:
TAX LOT NO(S):
Property Address:
Size of Property:
%\
Acres ❑ S uare Feet
Zonin
Existing Use:
Description of if you are filling
Proposal:
in this form by hand, please attach your proposal description to this application.
Signatures: Please si nand
Associated Cases:
rint
our name and date in thea ro nate box on the next a e.
Case No.: ` 1 I -ZZ- OD62.
3—T P i
I Date: 12 I s '2p2Z
Reviewed by;
Application Fee: $T10
r Dt
Technical Fee: $ ) v 8 • LK
Posta a Fee: $0
TOTAL FEES: rVL I-7 •
4S
PROJECT NUMBER:
Revised 3/9/22 Sandy Belson 1 of 4
Signatures
nt:
The undersigned acknowledges that the information in this application is correct and accurate.
Date: IZ-`l-Zz
Sigifaiture
lGy2 M c-. Gn
Print
—5:*r Date: 12 -
Signature
Revised 3/9/22 Sandy Belson 2 of 4
Description of proposal
We our applying to get a floodplain development permit so we can
have Priority One Heating & Air Conditioning connect a 500 -gallon
Propane tank that we purchased from Suburban Propane to get heat to
the shop area. We had to put this on hold because The City of
Springfield Development & Public Works wanted us to get a
Topographic and location Survey done. This was completed by SSW
Engineers on 12/1/2022.
12113/22, 10:59 AM
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12/13/22, 10:58 AM
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