HomeMy WebLinkAboutApplication APPLICANT 6/19/2013 •
City of Springfield 3 SPRINGFIELD
Development Services Department
225 Fifth Street
Springfield, OR 97477
Annexation Application Type IV
Application Type (Applicant: Check one)
Annexation Application Pre-Submittal: ❑
Annexation A. .lication Submittal:
Required Proposal Information {� (Applicant: Complete This Section)
Property owner: brig UqN BEET/E7/ Phone: 810-7'/1-7880
Address: `/07'6 A6IZTM SrR587' Fax: 7890
�CB/1 E-mail: i\bIuejayw47
Owner Signature: k0L2v ~— ® cosico sr.Mir
Owner Signature:
Agent Name: Phone
Company: Fax:
Address: E-mail
Agent Signature:
If the applicant is other than the owner, the owner hereby grants permission for the applicant to act in his or her behalf, except
where signatures of the owner of record are required, only the owner may sign petition.'
ASSESSOR'S MAP NO: /S - C - /l TAX LOT NO(S): 700
Property Address: `/o7 MoterH Srg&&7
Area of Request: Acres: 0.34 Square Feet:
Existing Use(s) PK,uA4r Re-stcirwce I ADULT Fosrr2 rypME
of Property: p '/
Proposed Use PpatrnrE ?FSipE'NeE / PO LT �`osien /4oMc-
of Property:.
Required Property Information (City Intake Staff: Complete This Section)
: b Reviewed By: ��
Case No.: ANx Date
l3 ODO05 (I1la0i3 (initials).
Application Fee: 3 a . 5 I Postage Fee: 543 .Do Total Fee: 3155- . 5
.ate Received: PRJJ 3 000l3
JUN 192013
Page 8 of 16
Original Submittal
s w
Owner Signatures
This application form is used for both the required pre-submittal meeting and subsequent
complete application submittal. Owner signatures are required at both stages in the application
process.
An application without the Owner's original signature will not be accepted.
Pre-Submittal
The undersigned acknowledges that the information in this application is correct and
accurate for scheduling of the Pre- Submittal Meeting. If the applicant is not the
owner, the owner hereby grants permission for the applicant to act in his/her behalf.
I/we do hereby acknowledge that I/we are legally responsible for all statutory
timelines, information, requests and requirements conveyed-to my representative.
Owner:
Date:
Signature
•
Print
Submittal
I represent this application to be complete for submittal to the City. Consistent with the completeness check
performed on this application at the Pre-Submittal Meeting, I affirm the information identified by the City as
necessary for processing the application is provided herein or the information will not be provided if not otherwise
contained within the submittal, and the City may begin processing the application with the information as
submitted. This statement serves as written notice pursuant to the requirements of ORS 227.178 pertaining to a
complete/.pplication.
Owner: // q
/ / Date: (D -7 l -/3 •
Signaty e
Print
•
Date Received:
•
JUN 192013
Original Submittal
Page 9 of 16
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FORM 2
OWNERSHIP WORKSHEET
(This form is NOT the petition)
(Please include the name and address of ALL owners regardless of whether they
signed an annexation petition or not.
OWNERS
Property Designation Assessed Imp. Signed Signed
(Map/lot number) Name of Owner Acres Value Y/ N Yes No
ob- /I 7L1oo LAP P`1 \Aa DZ-7Ja-r3 o•36 Iil ,2HB "/
1B-o2-ob CiWtht VAN) LEEKL ) O 31, III 2_49 V y
•
TOTALS: 0,36 ))!,2-+B
TOTAL NUMBER OF OWNERS IN THE PROPOSAL 2
NUMBER OF OWNERS WHO SIGNED Z
PERCENTAGE OF OWNERS WHO SIGNED )0
TOTAL ACREAGE IN PROPOSAL (9 36
ACREAGE SIGNED FOR O 3L
PERCENTAGE OF ACREAGE SIGNED FOR )CAD
TOTAL VALUE IN THE PROPOSAL , ) 1 .22_)e
VALUE CONSENTED FOR J)I ZLf B
PERCENTAGE OF VALUE CONSENTED FOR I o0
Date Received:
13 of 16
JUN 192013
Original Submittal
•
•
FORM 3
SUPPLEMENTAL INFORMATION FORM
(Complete all the following questions and provide all the requested information. Attach
• any responses that require additional space, restating the question or request for
information on additional sheets.)
•
Contact Person: LARR-'t__VA J BEB 1F=7.)
•
E-mail:
Supply the following information regarding the annexation area.
• Estimated Population (at present): '4
• Number of Existing Residential Units: ) •
•
• Other Uses: N°K3C
• Land Area: G SG total acres
• Existing Plan Designation(s): RESt
• Existing Zoning(s): Low Sim Rcsi 7JTAL_
• Existing Land Use(s): Rtsi ,A�
• Applicable Comprehensive Plan(s): ME T ao PLAtJ
• Applicable Refinement Plan(s): „/1A
• Provide evidence that the annexation is consistent with the 'applicable
comprehensive plan(s) and any associated refinement plans. REus2E
ANI cJExATioNI to rAGiLitA-r cotutJELT'ion) 75 Ci-rt-1 5EW
boa to rA 7 L.Et SEPYj C. 5L/STEM - •
• Are there development plans associated with this proposed annexation?
Yes No
If yes, describe.
• • Is the proposed use or development allowed on the property under the current
plan designation and zoning?
Yes ■ No
• Please describe where the proposed annexation is contiguous to the city limits
(non-contiguous annexations cannot be approved under 5.7-140, Criteria).
Goa r Qvous on1 T 4-a--AST Sits S
Date Received:
Page 14 of 16
JUN 192013
•
Original Submittal
•
Does this application include all contiguous property under the same ownership?
Yes ✓ No
If no, state the reasons why all property is not included:
• Check the special districts and others that provide service• to the annexation
area:
❑ Glenwood Water District ❑ Rainbow Water and Fire District
❑ Eugene School District ❑ Pleasant Hill School District
/
Q Springfield School District ❑ McKenzie Fire & Rescue
❑ Pleasant Hill RFPD 12/Willakenzie RFPD
❑ EPUD VSUB
• Willamalane Parks and Rec District ❑ Other
• Names of persons to whom staff notes and notices should be sent, in addition to
applicant(s), such as an agent or legal representative.
(Name) (Name)
(Address) (Address)
(City) (Zip) (City) (Zip)
•
(Name) (Name)
(Address) (Address)
(City) (Zip) (City) (Zip)
Date Received:
JUN192013
Original Submittal
Page 15 of 16
LEGAL DESCRIPTION
Lot 4, Block 1 , of H. F. FRANKLIN ADDITION, as platted and recorded in Volume 14,
Page 31, recording date December 24, 1948, Lane County Oregon Plat Records, in
Lane County, Oregon, being further described as follows:
Beginning at the Southwest corner of Parcel 3 of Partition Plat 2008-P2193, as platted
and recorded as Instrument No. 2008-000548, Lane County Oregon Deeds and
Records, in Lane County, Oregon;
thence North 0°01'13" East 202.41 feet;
thence North 89°46'42" West 78.25 feet;
thence South 0°01'11" West 202.26 feet;
thence South 89°40'47" East 78.28 feet to the Point of Beginning.
Basis of bearings used herein is County Survey File No. 40865 as filed in the office of
the Lane County Surveyor.
Date Received:
JUN 192013
Original Submittal
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