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• • irk <br /> 4. Existing and Proposed Contour Intervals must be shown as below and must be based on City Bench <br /> Mark. <br /> x 1. One -foot contour intervals for ground slopes up to five percent. <br /> _ALA A 2. Two -foot contour intervals for ground slopes between five and ten percent. <br /> _NIA 3. Five -foot contour intervals for ground slopes exceeding ten percent. <br /> x 4. Indicate which bench mark used. <br /> x 5. Existing vegetation to be preserved shall be shown on contour map. <br /> By signing, the undersigned certifies that he/she has read and understood the submittal requirements <br /> outlined, and that he/she understands that omission of any listed item may cause delay in processing <br /> this application. <br /> I (We) the undersigned acknowledge thai the information supplied in this application is complete and <br /> accurate to the best of my (our) knowledge. <br /> OWNER <br /> Signature: <br /> Name (print): Phone: <br /> Address: <br /> City /State /Zip: <br /> REPRESENTATIVE <br /> Signature: QLL_Lick..) P <br /> Name (print): Debra Delegato, Presid Phone: 747 -6486 <br /> Address: 1200 Gateway Loop <br /> City /State /Zip: Springfield, Oregon 97477 <br /> DESIGNATED CONTACT PERSON <br /> Name (print): Michelle Lan Phone: 344-1165 <br /> NOTE: This is not a complete list of requirements. Additional information may be required after <br /> further review. <br /> RS:applic.cup 12/12/94 <br /> Conditional Use Permit Application Page 4 of 4 <br />