HomeMy WebLinkAboutApplication Applicant 11/7/2024City of Springfield
Development & Public Works
225 Fifth Street
Springfield, OR 97477
121
Annexation Development Initiation Meeting (DIM)
SPRINGFIELD
116,
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Required Project Information
Prospective SvU\
A licant Name: C
(Applicant: complete this section)
Phone:
Company: p
V fi e�
Address: 5 �1 r
GId
E-mail:
Prospective
A licant's Rep.:
Phone:
Company:
Address:
E-mail:
Property Owner:
Phone:95LA I Va.14061
Company: ne Uuntin
Address: k `
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E-mail:
ASSESSOR'S MAP NO:
Pro ert Address: LAAta C'>t-
TAX LOT NOS
Size of Property:
Acres ❑ Square Feet ❑
Description of If you are filling in this form by hand, please attach your proposal description to this application.
Proposal: �f
Existing Use: Proposed Use:
City Zoning: Metro Designation: Population:
Prospective
Applicant:
Signature ;
4,,L ,)-e V�r �.
Print
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Date: / � / & �'/ Zo z4
Required Project Information
Case No.: 1 `'
(City Intake Staff., complete this section)
Date: IaL�2a�4 Reviewed by: S pn1'YZ L
Application Fee: $
Technical Fee: $0
Postage Fee: $0
TOTAL FEES: $
PROJECT NUMBER:
Revised 04/17/2023 sim 6 of 16