HomeMy WebLinkAboutApplication Applicant 10/18/2021�ity of Springfield
Development & Public Works
225 Fifth Street
Springfield, OR 97477
Land Division Plat
Partition-, Subdivision
Partition Plat Pre -Submittal:
Partition Plat Submittal: _
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Subdivision Plat Pre -Submittal:
Subdivision Plat Submittal:
Applicant Name: Kathy Thomas Phone: 541-896-0408
Company: Monkey Hero, LLC Fax:
Address:
Applicant's Re .:Anthony J. Favreau Phone:541-683-7048
Company: The Favreau Group, LLC Fax:
Address: 3750 Norwich Ave., Eugene, OR 97408
Pra a Owner: Same as applicant Phone:
Company: Fax:
Address:
ASSESSOR'S MAP NO:17-03-26-31 ITAX LOT NOI; S] . 900
Proverty Address:1620 5th St.
Size of Property". 0.49 Acres ® Square Feet ❑
Proposed Name of Subdivision: Kinglet Court
Description of if you are filling in this form by hand, please attach your proposal description to this application.
Proposal: 6-Lot Residential Subdivision
Existing Use: Single Family Residence Tentative Case #:
# of Lots Parce�--_ Av. . Lot Parcel Size: 3,550 sf I Densi : 12 du acre
Signatures: Please skin and print your name and date in the appropriate box on the next_�ag
Associated Applications:
Pre -Sub Case No.: Date: Reviewed by:
Case No.: a5ai Nn I Date: f D (�O Reviewed b : CAW1
Application Fee: $ 43LV I Technical Fee: $ Posta a Fee: $C
TOTAL FEES: $ 35 PROJECT NUMBER: Ta
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Owner Signatures
This application form is used for both the required pre -submittal meeting and subsequent
complete application submittal. Owner signatures are required at both stages in the application
process.
An application without the Owner's original signature will not be accepted.
Pre -Submittal
Owner:
The undersigned acknowledges that the information in this application is correct and
accurate for scheduling of the Pre- Submittal Meeting. If the applicant is not the
owner, the owner hereby grants permission for the applicant to act in his/her behalf.
I/we do hereby acknowledge that I/we are legally responsible for all statutory
timelines, information, requests and requirements conveyed to my representative.
'4z&yy-a-d_ Date: 08/01 /2024
Sig ture
Print
Submittal
Owner:
I represent this application to be complete for submittal to the City. Consistent with the completeness check
performed on this application at the Pre -Submittal Meeting, I affirm the information identified by the City as
necessary for processing the application is provided herein or the information will not be provided if not otherwise
contained within the submittal, and the City may begin processing the application with the information as
submitted. This statement serves as written notice pursuant to the requirements of ORS 227.178 pertaining to a
complete application.
&- Date: 10/14/2024
Sii natu
Monkey Hero LLC by Kathy Thomas
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