HomeMy WebLinkAboutApplication Applicant 11/17/2023City of Springfield
Development & Public Works
225 Fifth Street
Springfield, OR 97477
0
Annexation Development Issues Meeting (DIM)
SPRINGFIELD
1k
-Required Project•
Prospective
Applicant Name:
•(Applicant:completesection)
Phone: Sy 1 - 6lSq
Company: ,�
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Fax:
Address:
E-mail-
Prospective
Applicant's Rep.: -
Phone: (Sg 210 - uz2 ?
Company: ",
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Fax:
Address: 81
E-mail:<�Afi.;nrase ;sof- w
Property Owner: <.,,�;
1, Phone:
Company:
Fax:
Address: X33 ,,,.
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E-mail:
ASSESSOR'S MAP NO:/ -v3 -3 y-3' "noo TAX LOT NOS : 60 60Z>
Property Address: Z "l, ILTl4d
Size of Property: ,.3
4 Acres Square Feet El
Description of If you are filling in this form by hand, please attach your proposal description to this application.
Proposal:
Existing Use: ,
Proposed Use: S
City Zonin C)+M
Metro Designation: Population:
Prospective
Applicant:
Signature
Print
Date:
,Required Project
Case No.: Date: Reviewed by
Application Fee: Technical Fee: $0 Postage Fee: $0
TOTAL FEES: $ PROJECT NUMBER:
Revised 4/8/14 133 6 of 17
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