Loading...
HomeMy WebLinkAboutApplication APPLICANT 2/3/2014 !City of Springfield SPRINGFIELD • Development Services Department 225 Fifth Street Springfield, OR 97477 Site Plan Review Application Type (Applicant: check one) Site Plan Review Pre-Submittal: ❑ Major Site Plan Modification Pre-Submittal: El Site Plan Review Submittal: ❑ Major Site Plan Modification Submittal: El Required Project Information (Applicant: complete this section) Applicant Name: Jesse Lovrien Phone: (503) 888-0985 Company: Hayden Homes Email: Address: 2464 SW Glacier Place,Suite 110 Redmond,OR 97756 Applicant's Rep.: Michael Cerbone Phone: (503)419-2500 Company: Cardno Email: michael.cerbone @cardno.com Address: 5415 SW Westgate Dr, Suite 100 Portland, OR 97221 Property Owner: same as applicant Phone: Company: Email: :.Address: ASSESSOR'S MAP NO: 18020321 ITAX LOT NO(S): 4400 through 6900 Property Address: Size of Property: 4.59 Acres ® Square Feet ❑ I Proposed Density: Proposed Name of Project: 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 Existing Use: Vacant New Impervious Surface Coverage (Including Bldg. Gross Floor Area): sf Si. natures: Please si•n and print our name and date in the a• •ro•riate box on the next pale. Required Project Information (City Intake Staff: complete this section) Associated Applications: I c ry� 1 Signs: /r1 , Pre-Sub Case No.: �Iw I'1 --MDI Date: 2/J 1 1 if Reviewed by: Ll IV1 ( ` (.1r Case No.: Date: Reviewed by: Application Fee: $ �fl Technica li[p,tej Tv [("r, Postage Fee: $ Jhb-V�IYIIi rr1� �G�. .. Coo 2�� TOTAL FEES: $ I PROJECT31ItJl�IBER:I2 J L? _CW — C Revised 5/21/13 KL 1 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. 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 hereb acknowledge that I/we are legally responsible for all statutory timelines, inft ati.n, requests and requirements conveyed to my representative. Owner: Date: / / ? c'/!(,4 Signature 'rt5' I-D✓R.ich/ Fort (-My oat/ y'ro-•-F.J 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 processin• -e application is provided herein or the information will not be provided if not otherwise contained within the su. al,and the City may begin processing the application with the information as submitted. This state - serves as written notice pursuant to the requirements of ORS 227.178 pertaining to a complete application Owner: / /244 Adr Date: Signatur= 0?rre L�✓n ✓ / /=v. fr-f•r"a-' tr&--c." Print • PRE-SUBMITTAL REC'D FEB 3 2014 Revised 5/21/13 KL 3 of 12