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