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Application APPLICANT 8/29/2008
City of Springfield Development Services L~>,~~ent 225 Fifth Street Springfield, OR 97477 Phone: (541) 726-3759 Fax: (541) 726-3689 SPRINGFIELD Historical Review Application, Type I Minor Alterations: Sites and Structures Assessor's Map No: II -D~--?'c) ~2.4 Tax Lot No: Locationofproperty fl":l2 (..: fu-Qo,\-, ,.'Srr'-, njfi {1\r\ ; ()rz~ Existing use of property t), V'I, \-~J ~ e.:\1,,~J. ,\-\- (' t;;:1 Mch t ~I aD Descriptionofproposal'j\--.\,; ~ a \1Q.1't) 0\1\ QKlV,.e~1-'l'lttL '\^I\~"("\ hli\A~(\9 ~ f'e.<i~Yi~ <;:,o1l\l\~tr.-;T'l3 \;\q 1'1 06lSt-H.. l',-\- \r\,,~ ~ lnn,em.C'()+; RVlA rhH'J! Ik-...-orf'uv-, ~\~oO. fun i~d dO'-NV1:\{-",K ~'11T('H.)~ . . . . . \ o l"\ fu Coi'h ,'7)~-\- <;i'<Lt D(C~, blAlldi I'I~ 11",,/- n.QQJ<. ,~~~(Q..~ ~ d\e..., --n--.;s'2 ilk tAl ~1\ 'vi~ <trl-<1'" " I ; n~ \01 'NeIL 1?dt5 "(l,v1/1 a \0 I - -hold . 0'clk. 1.J-.>;\tlA", eV-A"-\"lnax-1'\n +t....o..r.""~((Q..1 ' Owner Name: Address: '~~:(QA..0 &ioe.-~n , . C)/Llct 'TlA1r-:0Illry 1\2..08d ~rir~hQ\d J OIL ' Phone (<;'LI\)1L.{,,-'L91L3 EbbErt Memorial United Methodist Church . 532 C Street, Springfield, OR 97477 Phone 746-3513 Applicant Name Address: The undeJ:'5igned acknowledges-that the iofonnatloD In.thls application Is cornet aDd accurate. Applicant Signature: a~ f;/~ ' ' If the applicant is other. than the owner, the owner hereby grants permissioDJor the applk:ant to act in their behalf. Owner's Signature: Q,o.-:_lma........ ~_ AR~......T~ <' , Plea.e attach the names, addresses, phone numbers and slgnatnres of any additional C "C _,~. owners., For Office Use Olily: , Journal No. jiacc 7M- ~ 1./ Received By " ~ ' Assessor's Map No. \1-()3-~~/4 Tax Lot No, II J 00 '. 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