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HomeMy WebLinkAboutPermit Building 1972-4-1 6Q~ bne co.,mty ACTIVITY INFORMATION SHEET ~ COMPLETE THIS SECTION, INCOMPLETE FORMS WILL HE RLJLCTEU! 1 /LJ~o D I'€. p_~ PERSON MAKIN REQUEST f1, 31 -:fa .c;f('~ ROQ rI MA LI NG DDRtSS BUSINESS TELEPHONE # 2 PROPERTY AODRESS /J CI ~ (IF DIFFERENT FROM1lAIUFlG ADDRESST I{_L IAJC10 (efL1 'PRO ERTY OWNE \ MA I LI NG ADDRESS j)~,- C!TY S rATE ZIP CODE BUSINESS TELEPHONE # HOME TELEPHONE # 3 MAP & PARCEL NUMBER (REQUIRED INFORMATION) rJ Lf 'i~l g (.0".../ 5 Sf:-. lfA~ T1ii-[r[sif!J> RANGE SECTION ? '&-Y-C q 1 <;S TOWNSHIP RANGE SECTION TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP: I? TOWNSHIP' (from tax maps in Departme~f Assessment and Taxation or from tax statement)..-, r">~ c::------ d- II), ~ jt;;., .:." C--Z~ RANGE ~CTION TAX LOT(S) OR PARCEL # ZONING TAX LOT(S) OR PARCEL # ZONING TAX LOT(S) OR PARCEL # ZONING '=3 S? C,r /(J -e..__ ACRES 4 SUBDIVISION (if applicable) 5 :~tQUEST (state exactly what you plan to do) -fJ~AA 0 A--1L. p), ~.QA 7J. LOT BLOCK A.J 1- Ja ~f\._ ';LJA A. .J, ; C, - -.-.- ----, ---- --'..- - -----,- 6 DIRECTIONS TO SITE: ~4~.'nd.sx ~~-,-4-#~ t~j~ lY1L ~A;d.,-(p~ '_' 13:1. .. .. ~ J '-. - n CJi ~~~~~ NUMBER I ;ci - , Vl DATE~ ~ ~i\L- ) , / I . ** FOR STAFF USE ONLY *. ZONE/LAND USE: BY: DATE: TIME IN: OUT: il (..~ \~)/)Lu --------------o~.vtr-'H..-- - --- - - ----,----~---- , LAND MANAGEMENT DIVISION / 125 E, Rth AVE.. EUGENE. OR 97401 / 687-4061 - - . ... ; o I...!- ' ...L-,./ " // / <1 7 IJ - -a; G.J-.&-'u,1 (J-},-, t/}..C/'(, "'it;; - 7)?--~,dc /V"'''])!L-< p \oe.~ """ en ~ C\ ~ ~ Qo C) A' , n / L? // ,/ \ ~ - ~ ~....".e ~ Cl,e;C rl , ~o ~t.....('L-m.., \'sc:.u...~ _ '; ... ,/ I~I Ii] fftfU-rnlA:'~~t~,,-<c.j!. r~l-'Y/-d'~It-~ 7t C#7v,I.e..(~o/,1:d fA ,} 1)) ~-s,dJ J~ ( L Co -~ 3t:?-7 ? ) +/97 1 /2..?-nC{(rttf t'/ )..0: - c:; 30-76 Tn) -If (U'C -P 73 -77 ) , (.Ld1i(.., t-tfV7/<.-- ~c.Z;;0 f~"z-. ;fad/c-;( r-r<./ , i jd,-:$- (Cd VI ) *!i< ~ !fYI- .A-?7'~L 7" F' oS':2hY" rU:' -;2SY'J'-J'j * / tj 7 <1 - d '-1"'" to It../-) /)J fI ...;,.:/ u,c4 L. C - /2. of r:. - 7 V I , ~ 1 - ;4.~ ."~?0 Ltf(~r'f /'J?(;1'v1 1<1 7 tj - c?...../I J/) )lCt1~ '7f.~"J1l...L ~ ~Z/ ~).(JH-&l)/::J d-u/J~ )'- ~(~ ~ "..C ~ ~~ (!~..,-L.. ~L- 'f]..-XJZ.'U!i)C/,>')t.--' 0L"rr-~, ~/1/ fI./~,'" dt-p.~<:iJ 4~,,-,"...&-,~ -4 L~:wf:,~ /1-.e('..~..~~' y:.. ;t-~~?t! /klf-ur ~Jt...f:- J>-/..t<<~)'P" I 7'- -::,f, /9'8' C) !Z-a"na-(rz:l...t!.1 .::... c.. - / z 6 c:; -7 ;7({ Le.. - / / i,.j- J" 0) ~*' ~,l ~ LC - //66'-t:fo ..(~A..i.'/JL[.{.(.LC!l, V ...j I ' ~ V' / ./' ./' - . () ar~ /t..~~d~U~(~ ~;:-t;u,; '-~0 _..c.tf'c1;:"1~'{' --'- ~7': /J./ . {/ _"'/15' ~-::; (..(''/-..f~z..-... //6--t<-t:[,(..( l....../ I t/ --.J