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Application APPLICANT 5/11/2009
r City of Springfield Development Services Department 225 Fifth Street Springfield, OR 97477 Official Zoning Map Amendment, Type III . .. vY\. Phone: 517-3050, ]Fax: ,731..-1~C1L- 57 'n; :<;-h--u-t- 5r;')f-Wh"jJ n;<.. q747 ~ ::1-::::=, J ' ._1\ ~ . - - ..- --- Applicant Name: Company: Address: Don -\\",~tJ, ~q() s" Applicant Signature: ::::B>"", Property Owner: I J)on vY\, \.tolZ-iZliJ. Iphone: I 5/7-.305"1 Company: I lFax: I i~I,,-1 {Po 2- Address: I ''''10 50 57rH4.h-U-t>"~lf"'.-v;~,,IJ;OR ,9''-17'''5 Owner Signature: I ~^",......,. \ \, .=\--,~- ~ If the applicant is other than the owner, the owner hereby grants permission for the applicant to act in his or her ~half ASSESSOR'S MAP NO: C -'2;t'Z.. - 3't -:, L- TAX LOT NO(S):..:J -, -cp ", Property Address: 5<14-0 M A II-! <;,....~~-p--.., Area of Request Square Feet: Acres: . 5" i Existing Use(s) of Property: ~e.; :cAe Y\. t;J Description of The Proposal: ~>-\~T"I""c ZO.....,"} 'r \ 11M. CA-- -lL ~ c....... LDR.. M.:n R ~ c:.f,;;-~ , M ~-hr, ~ Required Property Information (City Intake Staff: complete this section) Application Fee: f) c: III I!?J Received by: j -11., I Date: ~ (initials) -n. ~L Postage Fee: -$ ?--..~,c... DO Total Fee: $ ~ {~ .0 0 , I Case No.: Date Received: MAY t 1 2009 Original Submittal Lu f. OF~. ~"l~u.l'.l~.l.JD VICll\'t 1 i MAP ZON2009-00014 5940 Main Street ~ITTI~I' _[ MAIN ST MAIN ST !ii :t I'- 0> 10 In - ~ . Date Received: MAY 1 1 2009 Original Submittal 'f ~ o co. '" ~ll J!. Map 17-02-34-32 Tax Lot 800 North + _""'. I"'T "",on '~~I~l;t~:~:.,:~ ".. -. ,,?~:~ ~:~:~\" '......m ..... ,..,~m 'K,:,:~~~ ~~::::o"" .... "'0 :"" I.l:'\\~&. r.D" ~ ..,.., ~~ 501): . . 504. ~... 00"" " . ~PARCEL 1 V) $: 500,,~ ~ 2JL 502 tl ~ ~ -5~_i "-r' 505. ~.: ~900; 901 : 902? ~:~>.~o. . ~ ~ ) -'''1~0Y~'~ 3 ~ 4 G'~ 6 Il. = ~; 7 8 ~ . I>~ /" ,,:...;.~,..... </ AA..C t:l- ~i\~. 4 ~'L. ~ 19- '''''.0 ,...""""'\. ,....1...~. ,~.o"\' "'\~."'o ,.....,-:t '-.....0 c;...o" <..0. 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( "--J ~ \ G '-" I~ I~ Ii ( I, ,~ I~ ,..- APPR!JlClNATL l/16 TH CORNER 17 02 34 32 ) d.-/D7 '-' """'---- -'-I 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 3200900000000000351 Date: 05/1112009 II :52:24AM Job/Journal Number ZON2009,OOO 14 Description Postage Fee Type 1I1 ,$385 Payments: Type of Payment Check Paid By DON HORTON Item Total: Check.Number Authorization Received By Batch Number Number How Received Amount Due 385,00 $385.00 Amount Paid emm 1273 In Person Payment Total: $385.00 $385.00 Date Received: MAY!'1 2009 Original Submittal ( cRcccintl Page 1 of 1 5111/2009 541-726"3753 Phone 541-726-3676 Fax Description Postage Fee Type 111 ' $385 CTY Zoning Map Amendment s:\Tidemark\forms\casefees I.rpt Trans Code 2226 1242 Fees Associa 1 With Case #: ZON20u9-00014 5940 MAIN ST HORTON DON M & LAUREN E Revenue Account Number 100-00000-425505 100-00000-425002 " Page 1 ofl Date Calculated Calculated By EM EM 5/11/2009 5/11/2009 Total Due: I Date Received: MAY t 1 2009 Original Submittal Original Amount 385.00 0.00 5/11/2009 1:11:40PM Amount Due 0.00 0.00 $0.00