HomeMy WebLinkAboutApplication APPLICANT 2/3/2014 !City of Springfield SPRINGFIELD
Development Services Department
225 Fifth Street
• Springfield, OR 97477
Major Replat Tentative Plan
Application Type (Applicant: check one)
Re•lat Ma'or Tentative Pre-Submittal: !•1 R s lat Ma'or Tenta lye Submit. • l: •
Required Project Information (Applicant: complete this section)
Applicant Name: Jesse Lovrien Phone: (503)888-0985
Company: Hayden Homes E-mail:jlovrien @Hayden-Homes.com
Address: 2464 SW Glacier Place, Suite 110 Redmond,OR 97756
Applicant's Rep.: Michael Cerbone Phone: (503)419-2500
Company: Cardno E-mail:michael.cerbone @cardno.com
Address: 5415 SW Westgate Dr, Suite 100 Portland,OR 97221
PROPERTY 1 (See Page 2 to add additional properties)
Assessor's Map#: 18020321 Tax Lot: 4400 through 6900
Property Address:
Property Owner: same as applicant Phone:
•Address: E-Mail:
Name of Subdivision: Mountain Gate
Description of If you are filling in this form by hand,please attach your proposal description to this application.
Proposal: Modification of an already approved,phased subdivision
It of Lots/Parcels: 16 'Avg. Lot/Parcel Size: sf (Density: du/acre
Si'natures: Please si•n and •rint our name and date in the a• •ro•riate box on •a•e 3.
Required Project Information (City Intake Staff: complete this section)
Associated Applications: Signs: /
Pre-Sub Case No.: P 1 Q J L- WOO Date: 2 /g/i q Reviewed by: 1—, m(l` r
Case No.: // Date: Reviewed by:
Application Fee: $31-110 Technical Fee: $ Postage Fee: $
TOTAL FEES: $ 3 q - PROJECT NUMBER°P-J —00020
PRE-SUBMIImmi PEC'D
FEB 3 2014
1
Revised 10.14.13 kl
Additional Properties :
PROPERTY 2
Assessor's Map #: Tax Lot #:
Property Address:
Property Owner: Phone:
Company: E-mail:
Address:
PROPERTY 3
Assessor's Map #: Tax Lot #:
Property Address:
Property Owner: Phone:
Company: E-mail:
Address:
i
• ARE-SUBM'm RECD
FEB 3 2014
Revised 10.14.13 KL 2 of 12
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.
Property 1:
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 • ,'ner hereby grants permission for the applicant to act in his/her behalf.
I/we do he ely a owledge that I/we are legally responsible for all statutory
timelines, ' or - 'on, requests and requirements conveyed to my representative.
Owner:
�. J ✓ Date: //2— 679
Sign ire /
La✓/UEA/ For_ HA'rOCAJ Ka-el
Print
Property 2:
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
Property 3:
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 -RE huh+� "' •' CD
FFB 3 2014
Revised 10.14.13 KL 3 of 12
6.
Property 1:
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 withi e submittal, and the City may begin processing the application with the information as
submitted. Thi- snteme serves as written notice pursuant to the requirements of ORS 227.178 pertaining to a
complete appli ati.n.
Owner: /
;� _ Date: I W/�
�
Signal
e La✓g.�w , poz ,5s-yacsv
Print
Property 2:
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 application.
Owner:
Date:
Signature
•
Print
Property 3:
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 application,
Owner:
Date:
Signature
Print
S PRE-SUBMInAI PEC'D
FEB 3 2014
Revised 10.14.13 KL 4 of 12
1 .