HomeMy WebLinkAboutApplication Applicant 12/12/2024City of Springfield
Development Services Department
225 Fifth Street
Springfield, OR 97477
Tree Felling Permit
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Applicant Name: ' ft'
- pplicant: complete this sectio-i
Phone:
Company: kA JzuftoA Lfnmy
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Address: %(J
licant's R .:
Phone:
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[Fax:
Address:
Propertv Owner:
Phone:
Company:
Fax:
Address: W52.1, 1101V% r ,
ASSESSOR`S MAP NO: \-J
TAX LOT NOS : MI-61-
Property Address:
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Size of Pro
Acres sayare Feet
Description of If you are filling in this form by hand, please attach your proposal description to this application.
Pro sal:
Signatures: Please si n and
QrinLyour name and date In the aggroorlate box on the next i2aW.
Required Property Informationcomplete
Associated Cases:
I
Signs:
Case No.:
Date:
Reviewed :
Application Fee:
Technical Fee:
1postage Fee:
TOTAL FEES: 9
PR03ECT NUMBER:
Signatures
The uNerslgned acknowledges that the information In this application Is correct and accurate.
Date:
Signature
If the applicant Is not the owner, the owner hereby grants permission for the apolcant to act In his/her behalf.
Owner: .
Date: /� - a O • '�
Signature
490t/c 171e, 174ich
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