Fillable Appeal Application Community Development Department PO Box 2460 (City of La Pine)

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Appeal Application Community Development Department PO Box 2460 (City of La Pine)

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Community Development Department
PO Box 2460 16345 Sixth Street
La Pine, Oregon 97739
Phone: (541) 536-1432 Fax: (541) 536-1462
Email: info@ci.la-pine.or.us
Page 1 of 2
Appeal Application
PLEASE NOTE: INCOMPLETE APPLICATIONS WILL NOT BE ACCEPTED
Original File Number # _____________
Fee $ 50% of Application Fee File Number # _______________
PERSON FILING APPEAL: _______
ADDRESS: _______
CITY: STATE:______________________ZIP:_______________
PHONE: EMAIL: ______
IN ORDER TO APPLY FOR AN APPEAL:
1. THE FILER MUST HAVE SUBMITTED TESTIMONY AT THE HEARING, OR MUST HAVE
SUBMITTED WRITTEN TESTIMONY PRIOR TO THE HEARING, OR MUST BE A PERSON TO
WHOM NOTICE WAS TO BE MAILED AND TO WHOM NO NOTICE WAS MAILED.
2. IF A HEARING WAS HELD, A TRANSCRIPTION OF THE MAGNETIC/CD TAPE RECORD MUST BE
SUBMITTED BY THE APPLICANT. FAILURE TO SUBMIT THE TRANSCRIPTION WITHIN TEN
DAYS AFTER THE NOTICE IS FILED SHALL RENDER A NOTICE OF APPEAL INSUFFICIENT.
3. A BURDEN OF PROOF STATEMENT MUST BE ATTACHED. THE BURDEN OF PROOF SPECIFIES
THE GROUNDS FOR THE APPEAL AND ADDRESSES ERRORS WITHIN THE ADOPTED
FINDINGS OF FACT DOCUMENT.
Community Development Department
PO Box 2460 16345 Sixth Street
La Pine, Oregon 97739
Phone: (541) 536-1432 Fax: (541) 536-1462
Email: info@ci.la-pine.or.us
Page 2 of 2
4. THE FILING FEE MUST ACCOMPANY THE APPLICATION FOR APPEAL.
I AM APPEALING THE STAFF REPORT / FINDINGS OF FACT OF THE PROPERTY KNOWN AS:
T-15 R-13 SECTION , TAX LOT ,
REFERENCED IN (FILE NUMBER)
SIGNATURE DATE
FOR OFFICE USE ONLY
Date Received:
Rec'd By:
Fee Paid:
Receipt #:
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Appeal Application Community Development Department PO Box 2460 (City of La Pine)

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Completed 4 August 2020

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