HomeMy WebLinkAboutApplication APPLICANT 8/20/2008
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City of Springfield
Development Services Department
225 Fifth Street .
Springfield, OR 97477
Land Division Plat
Partition, Subdivision
Applicant Name: VF.R..I\J g~NS(YV
<:'88-8&'7'7
Company:
[Address: '1 4-0 /-It>> oj ") 'i' N.
IAPPlicant's Rep.: DJ4ur=: CcJL.l...I/o,,{'.
Icompanv: 7550(. g/.'-tE wrr', .5('1-100"/, I?:D
IAddress: Co -rr/l(';.r=. r;A'() liE... . 0""- 974-24-
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'[property Owner:
t:: '-1 GE",II/6
'j '7 4-eJJ
Company:
Address:
j
Phone: 7/_ 7-~ 790 I
Fax: I
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Phone: I
Fax: I
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IASSESSOR'S MAP NO: /"7 - 02 -<r'? - 4-1 ITAX LOT NOeS):
Property Address:
Size of Property: / B z c. (, 'Acres n Sauare Feet IT!--
Iproposed Name of Subdivision:
'/DescriPtion of. If you are filling in this form. by hand, please attach your proposal description to this application.
Proposal: 3 PAl? /'E/ ,,0.14,;//-1///1/ l>LE /j1.,II/.J:) l""/9 J2.. r/ r/(:~ Ai
IExistino Use: vlt/c/-l/\/-r I Tentative Case #:5,-<",- 2'..1', -"''''bll
1# of Lots/par~els: 3 lAva. Lot/Parcel Size: 1: t"U'D sf IDensitv: 7 du/acre
Si natures: Please si nand rint our name and date in the a ro riate box on the next
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Associated Applications: 2,u6 7...r;u a.. _ ~I \ (....(..e..&)
Ipre-sub Case No.: PRE2DDIb-0l902;8 Date: 'I Reviewed by:
Case No.: ~ () ~ CO -C'5tft'\? <() Date: ~ /-z;.,./G~I Reviewed by: ~ /'f)f(
Application Fee: $~(q II lTechnical Fee: $ 13~ 85 Ipostaae Fee: $0'
TOTAL FEES: $ 2..3/ O. <35 I PROJECT NUMBER: 6'Rj ~-=+_6b\~ ~
-OOl.i;'"~Mi~.
Revised 1/1/08 Molly Markarian
1 of 6
AUG 2 0 2008
Original Submittal
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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
The undersigned acknowledges that the information in this application is correct and accurate for scheduling of the
Pre- Submittal Meeting.
Owner:
Date:
Signature
Print
Submittal
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 purs'!ant to the requirements of ORS 227.178 pertaining to a complete
application.
Owner:
c.
/~~
Signature
Date:
g~Zo -0&
\JSIl-A/ w. g,~.N.so,^,
Print
Date Received:
AUG 2 0 2008
Original submittal....
Revised,.l/l/OS Molly Markarian
20f6