HomeMy WebLinkAboutApplication PLANNER 3/18/2009
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City of Springfield
Development Services Department
225 Fifth Street
Springfield, OR 97477
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Annexation Application Type IV - R-~ U)~ wr:tJU/-JL~
Property Owner: " c.Dt1AUt L ().,.r1~ Phone:
I Address: d-77S"' /1~ ~ Fax: "I
I " x:h:1A-,~~ 1 0 It- 97Lf 77 .E-mail: I
lowner Signature: I 'I (JIJ . /'
\owner Signature: I' I
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!AgentName: ('-'4 dJ ,vlfl.A.nlA."jl~ Phone I
Icompany: U j" ;" () J . Fax: .1
IAddress: E-mail I
!Agent Signature: , I
I".,~~"~~e ~a.PI?'I.i~':1t;,jS'?th~~:'t.~an:\th~:tow,n~'r;;~~e,"q:^,~er'h~rt;~y ~~n~'''~~~rTl_!SSi?~ flJr'th,e,. appliCa~~tio"ac(irl"hi~ or'h~r: be~~,lf, -exc~Pt '"I
\!h~e~'.signa_t~~s~of"~h,,~;"Qw!1~r;,~rrecorc:H~~e !~,gl}ired, orllyt~e.9wn~r~_may's,lgn th~ petitio!): ' , ::','" "". :.i ;" '-" :",'"_,,.
IASSESSOR'S MAP NO: I / 7-03-2Lj -'31 I TAX LOT NO(S): I oZ.L>00 I
I Property Address: ,;L 77 g / q -M ~ I
!~r,~iJ'>.f Request: ~c.~~s:,._ 9: D l,s,uare Feet: I
Existing Use(s) I
of Property: I
Proposed Use I'R~ (Uc:ctzA... W~ I€e;F.' L.teP,;LOD7-ooco"l
of Property: 1J25h-~~, EC ;- 2:i-cZ"
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Reviewed By: ~ ...,LJ
3-; J -iJi (initials) 1\ ~
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I Total Fee: I .?-(5
Case No.: J/lP2f)()9-o{){):Jd..... Date:
IAPPlication Fee: UfliaAJitt..C I Postage Fee:
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Date Recelvea
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fvlARl 32009
Planner: BJ