HomeMy WebLinkAboutNotice PLANNER 1/17/2008
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AFFIDAVIT OF SERVICE
STATE OF OREGON }
} SS.
County of Lane }
I, Brenda Jones, being first duly sworn, do hereby depose and say as follows:
1.
I state that I am a Secretary for the Planning Division of the Development
Services Department, City of Springfield, Oregon.
2.
I state that in my capacity as Secretary, I prepared and caused to be
mailed copies of DLCD Notice of Adoption for ZON20Q7-00053
Brethren Community Services (See attachment "A") on January 17,
. .
2008 addressed to (see Attachment "B"), by causing said letters to be
placed in a U.S. mail box with postage fully prepaid thereon.
-'
!A~
Brenda Jones
Planning Secretary
STATE OF OREGON, County of Lane
(' ~~ I ~ ,2008 Personally appeared the above named Brenda Jones,
~retary, Ylho acknowledged the foregoing instrument to be their voluntary act. Before
me:
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_., .....____~11
OFFICIAL SEAL
DEVETTE KELLY I
NOTARY puBLIC - OREGON \
COMMISSION NO. 420351 :
MY COMMISSION EX~I~~~~~~.~ 1~_ j
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My Commission Expires: ~!Js-LJJ
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52
DLCD
Notice of Adoption
THIS FORM .MUST BE MAILED TO OLCD
ihJ..tt.1H 5 WORKING DAYS AFfER J..ru!. FINAL DECISION
PER ORS 197.610, OAR CHAPTER 660 - OMSION 18
Jurisdiction: SPRINGFIELD. OREGON Local file number: ZON2007 -00053
Date of Adoption: 1/15/2008 Date Mailed: 1/17/2008
Was a Notice of Proposed Amendment (Form 1) mailed to OLCD? YesOate: 11/1412007
o Comprehensive Plan Text Amendment 0 Comprehensive Plan Map Amendment
o Land Use Regulation Amendment ~ Zoning Map Amendment
o New Land Use Regulation 0 Other.
Summarize the adopted amendment. Do not use technical terms. Do not write USee Attachedn.
ZONING MAP AMENDMENT CHANGING LOS ACRES OF COMMUNITY COMMERCIALLY ZONED
LAND TO MIXED-USE RESIDENTIAL IN ORDER TO MAKE TIIE LOCAL SPRINGr lliLD ZONING
CONSISTENT WITIl'THE EUGENE-SPRINGFIELD METRO AREA GENERAL PLAN TEXT AND
DIAGRAM. TIIE ZONE CHANGE IS NOT CONfROVERCIAL AND IS WITIllN TIIE CITY OF
SPRINGFIELD'S JURISDICTION.
Does the Adoption differ from proposal? No, no explaination is necessary
Plan Map Changed from: to:
Zone Map Changed from: COMMUNITY COMMERCIAL to: MIXED-USE RESIDENTIAL
Location: 1062. 1072. 1082. AND 1096 MAIN STR. SPRINGFIELD Acres Involved: 1
Specify Density: Previous: 1 UNIT PER COMMERCIAL LOT New: 80% RESIDNT PER LOT
Applicable statewide planning goals:
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
~~DDDDDDDDDDDDDDDDD
Was an Exception Adopted? 0 YES ~ NO
Did OLCD receive a Notice of Proposed Amendment...
45-days prior to first evidentiary hearing?
If no, do the statewide planning goals apply?
If no, did Emergency Circumstances require immediate adoption?
[8J Yes
o Yes
DYes
ONo
ONo
DNo
OLeo file No.
Please list all affected State or Federal AQencies, Local Governments or Special Districts:
I
Local Contact: Planner, Kitti M. Gale
Address: 225 Fifth Street
City: Springfield, Oregon Zip: 97477-
Phone: (541) 726-3632 Extension:
Fax Number: 541-726-3689
E-mail Address:kgale@ci.springfield.or.us
ADOPTION SUBlVUl"lAL REQlJlliEMENTS
This form must be mailed to DLCD within 5 workine days after the final decision,
per ORS 197.610, OAR Chapter 660 - Division 18.
1. Send this Form and TWO Comnlete Conies (documents and maps) of the Adopted Amendment to:
A.l.l~ON: PLAN AMENDMENT SPECIALIST
DEPARTMENT OF LAND CONSERVATION AND DEVELOPMENT
635 CAPITOL STREET NE, SlH 1 ~ 150
SALEM, OREGON 97301-2540
2. Electronic Submittals: At least one hard copy must be sent by mail or in person, but you may also submit
an electronic copy, by either email or .I:' 1.1:" . You may connect to this address to .I:' 1.t" }'J.v}Josals and
adoptions: webserver.lcd.state.or.us. To obtain our Usemame and password for .I:' U', call Mara Ulloa at
503-373-0050 extension 238, or by emailingmara.ulloa@State.or.us.
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3. Please Note: Adopted materials must be sent to DLCD not later than FIVE (5) working days
following the .date of the final decision on the amendment
4. Submittal of this Notice of Adoption must include the text of the amendment plus adopted findings
and supplementary information.
5. The deadline to appeal will not be extended if you submit this notice of adoption within five working
days of the final decision. Appeals to LUBA may be filed within TWENTY-ONE (21) days of the date,
the Notice of Adoption is sent to DLCD.
6. In addition to sending the Notice of Adoption to DLCD, you must notify persons who
participated in the local hearing and requested notice of the final decision.
7. Need More Copies? You can now access these forms online at http://l~ill'I.lcd.state.or.us/. Please
print on 8-112xll ereen Dauer onlv. You may also call the DLCD Office at (503) 373-0050; or Fax
your request to: (503) 378-5518; or Emai.l your request to mara.ulloa@state.or.us - Al u:....NTION:
PLAN AMENDMENT SPECIALIST.
http://www.lcd.stat~.or.uslLCD/forms.shtm1
Updated November 27, 2006
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FINAL ORDER
BEFOREl1lli PLANNING COMMISSION
CITY OF SPRING~lliLD, OREGON
ZONING MAP AMENDMENT REQUEST
CASE NO. ZON2007-00053
FINDINGS, CONCLUSION
AND FINAL ORDER
(
NATURE OF TliE APPLICATION
Zoning Map amendment from Community Commercial (CC) to Mixed-Use Residential
(MUR) for approximately 1.05 acres located north of Main Street and identified on
Assessor Map 17-03-35-41 Tax Lots 4600, 4700, 4800, and 4900.
1. On October 10,2007, the following application for a Zone Map Amendment-
Type ill was accepted: Change the zoning of approximately, 1.05 acres of land
located. at 1062, 1072, 1082, and 1096 Main Street in Springfield from
Community Commercial to Mixed-Use Residential, Planning Case Number
ZON2007-00053; and,
2. The application was submitted and completed in accordance with Section 5.4-105
of the Springfield Develv}I.LLlent Code. Timely and sufficient notice of the public
hearing has been provided pursuant to Section 5.2-115 of the Springfield
Development code; and,
3. On January 15,2008, a public hearing for the review of the Zoning Map
Amendment-Type ill was held before the Springfield Planning Commission. The
Development Services Department staff report, which included criteria of
approval, findings and recommendations, together with oral and written testimony
submitted, has been considered and is part of the record of this ptoceeding;
therefore,
CONCLUSION
On the basis of this record, it has been concluded that Zone Map Amendment-Type ill
ZON2007-00053 is consistent with SDC Section 5.2-115 criteria This general finding is
supported by specific findings of fact and conclusions in the attached report Exhibit A.
FINAL ORDER
It is ORDERED by the Planning Commission of Springfield that Planning Case Number
2007-00053, Zone Map Amendment-Type ill application be GRANTED.
This ORDER was reviewed and approved by the p~~J~ssion January 15, 2008.
. ,40:1
Plannt'g Comniission Chairperson
Al lEST
AYES: <c
NOES: -1'f
ABSENT: I
ABSTAIN: JZf
Zoning Map Amendment - Type III
Staff Report and Findings
Hearln2' Uate:
January 15, 2008
l.:ase Number:
ZON 2007-00053
SUblect ~rooertv:
Assessor Map No. 17-03-35-41,
TL 4600, 4700, 4800 & 4900
Aoolicant JOwner
Attn: Patricia Wright
Brethren Community Srvc
Spfld Church of Brethren
I 072 Main Street
Springfield, Or 974n
Aoolicant's ReDresentative
Destin Ferdun
Lunabridge
3575 NE Shaver
Portland, OR 97212
Date Submitted:
October 17, 2007
REOUEST: The Applicant requests a Zoning Map Amendment-Type III to change the zoning of
approximately 1.05 acres of land from Community Commercial (CC) to Mixed-Use Residential
(MUR). The land is located at 1062 Main Street, 1072 Main Street, 1082 Main Street & 1096
Main Street in Springfield, and identified on Assessor Map 17-03-35-41 Tax Lots 4600, 4700,
4800 & 4900. The purpose of this proposed action is to correct an inconsistency between the
Metro Plan Diagram (Exhibit A) and the local zoning map. The existing CC zoning is not
consistent with the Metro Plan Diagram and the Director has determined that this application
qualifies to be processed as a City-sponsored Zoning Map Amendment-Type III, as established by
department policy in 2006. The Planning Commission is asked to consider the applicant's
request and the findings of fact contained herein, and then to confirm that the proposed zoning
is consistent with the Metro Plan and that the MUR zone deSignation is appropriate in this case.
VICINITY MAP (not to scale)
UBjECT PROPERTY
'062. '072. '082 & '096
Main Street (I 05 acres)
Alley ri~ht of way
(9
NORTH
Tax Lots 4900. 4800. 4700 & 4600
PROPERTY DESCRIPTION: The subject property is located on the north side of Main
Street, east of 10th Street as shown above and in Exhibit B. The subject property is
approximately 1.05 acres, which encompasses four tax lots as identified on Assessor Map 17-03-
, .
35-41 Tax Lots 4600, 4700, 4800 & 4900. The land IS currently under one owner, the
Springfield Church of the Brethren, doing non-profit business and known as Brethren
Community Services (BCS). The property is developed with several structures, which serve the
BCS's mission. The property has access from both Main Street and the abutting alley to the
north.
REVIEW PROCESS: This City sponsored Zoning Map Amendment-Type III application is a
quasi-judicial zoning map amendment that includes four abutting tax lots owned by the BCS;
involves the application of existing policy to a specific factual setting; and, does not require a
Metrq Plan Diagram amendment. SDC Section 5.22-115'(A) states that Quasi-judicial Zoning Map
Amendments may be approved by the Planning Commission and that the Planning Commission's
deciSion is the final local deCision. This application is reviewed under Type III procedures listed
in SDC Section 5.1-135 and Section 5.22-1 10. The application was accepted as complete on
Oct 17, 2007.
Approval of this request would allow development in accordance with the standards of SDC
Section 3.2-600 Springfield Mixed-Use Zoning Districts. The owner is interested in seeking new
redevelopment approval for the subject property, thus the zoning must be made consistent with
the Metro Plan DIagram deSignation prior to site plan approval. There are no maximum
residential densities established for MUR districts except those regulated by building heights.
Future development of the site will require either a Type II or Type III land-use review process
(Site Plan Review and/or approval of a land diVision), which shall include notice to surrounding
property owners.
DISCUSSION: In this report, staff will demonstrate that the proposed MUR zoning is
appropriate and consistent with the Metro Plan Diagram (see Exhibit A attached to this report)
and that the proposal meets the criteria for approval of quasi-judicial Zoning Map amendments in
accordance at Springfield Development Code Section 5.22-115(C).
RECOMMENDATION: Upon review of the applicant's request, staff finds that the proposed
Mixed-Use ReSidential zoning is consistent With both the Metro Plan Diagram and the Metro Plan
policies and therefore recommends approval of the applicant's request.
r-
ZONING OF SURROUNDING PROPERTIES: Land to the north is currently zoned and
developed with Low Density Residential (LDR) uses. Land to the east, south, and the west is
currently zoned Community Commercial (CC). Prior to new development of the neighboring
properties, those ow~ers will also have to resolve their own plan/zone conflicts. The Metro Plan
DIagram designation for the neighboring properties to the east and west is also Mixed-Use
Residential (MUR); deSignation for the neighboring properties to the south is Mixed-Use
Commercial (MUC).
SDC Section 5.22-115 Criteria of Approval - Zoning District Change
SDC Section 5.22-115 establishes the criteria to be used in approving zone changes. In
consideration of this request, the Planning Commission or Hearings Official shall approve
findings, which demonstrate that all of the following applicable criteria have been addressed:
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SDC Section 5.22-115 C (I)
Criterion I: Consistency with applicable Metro Plan policies and the Metro Plan Diagram
The Metro Plan provides the public with general guidelines for individual planning decisIons.
Reference to supplemental planning documents of a more localized scope, Including
neighborhood refinement plans, is advisable when applying the Metro Plan to specific parcels of
land or individual tax lots (Metro Plan page 1-2, #4). The Metro Plan serves as a general planning
framework to be augmented, as needed, by more detailed planning programs in order to meet
the specific needs of the various local governments {Metro Plan page 1-2, #8).
finding # I: No refinement plan has been adopted for this specific area. There are no
supplemental planning documents of a more 10cal,Ized scope that include the subject property.
finding #2: In this case, the Metro Plan DIagram provides sufficient specificity to apply the
Metro Plan to the subject property because two identifiable features are shown: 10th Street and
Main Street (See Exhibit A).
Planning Commission 01/15/2008 Amendment to Finding #2
In this case, the Metro Plan Diagram provides sufficient specificity to apply the Metro
Plan to the subject property because identifiable features are shown: 'the end of the
Downtown Refinement Plan, which is Tenth and Main ,Streets (see fxf1ibit A).
The Metro Plan Diagram clearly indicates Mixed-Use Residential (MUR) plan designation in the
area of land east of I Oth Street and north of Main Street. The Metro Plan Diagram also
establishes the northerly limit of this MUR plan deSignation area as seen In Exhibit A
finding #3: The Metro Plan designation of the subject property IS Mixed-Use Residential
(MUR). The applicant's proposed MUR zoning is therefore consistent with the Metro Plan
designation and the Plan policies. The eXisting, local, Community Commercial zoning represents
a Planlzone conflict that must be corrected prior to further development of the site.
The follOWing Metro Plan policies support the applicant's request
Metro Plan Land SUDDlv and Demand Pollcv A2: Residentially designated land
within the UGB should be zoned consistent with the Metro Plan and
applicable plans and policies.
Metro Plan Land SUDDlv and Demand Pollcv A4: Use annexation, provision of
adequate public facilities and services, rezoning, redevelopment, and infill to
meet the 20-year projected housing demand.
Metro Plan Residential DenSity Pollcv AI 0: Promote higher residential density
inside the urban growth boundary that utilizes existing infrastructure,
improves the efficiency of public services and facilities, and conserves rural
resource lands outside the urban growth boundary.
Metro Plan Residential Density Policv All: Generally locate higher density
residential development near employment or commercial services, in
proximity to major transportation systems or within transportation-efficient
nodes. '
3'
Metro Plan Residential Density Poliev A12: Coordinate higher density residential
development with the provision of adequate infrastructure and services,
open space, and other urban amer;lities.
Metro Plan Residential Density PollevAl3: Increase overall residential density in
the metropolitan area by creating more opportunities for effectively
designed in-fill, redevelopment, and mixed use while considering impacts of
increased residential density on historic, existing, and future neighborhoods.
Finding #4: Approval of the applicant's request would allow an Increase of residential density
on the subject property from a maximum of one unit per commercial development site to
unlimited residential unit density, except that which WIll be restricted by building height. (The
maximum # of residential units Will be reviewed at the time of site plan review.)
Finding #5: Approval of the applicant's request would create an opportunity for effectively
designed in-fill development in accordance With Metro Plan policies that includes both
commercIal and residential use. Metro Plan Residential Density Policy AI4 states: Review
local zoning and development regulations periodically to remove barriers to higher
density housing and to make provisions for a full range of housing options.
Finding #6: The presence of inconsistent Community Commercial-only (CC) zoning within
areas deSignated Mixed-Use ReSidential on the Metro Plan limits and restricts redevelopment
opportunities through limitation of both residential density and restraints on design. The
existing CC z~ning creates a restraint on both residential and commercial infill.
Finding #7: Approval of the proposed zone change will create an opportunity to increase the
number of residential units permitted and thus increase overall density and additional housing
options Within the metropolitan area. Metro Plan page III-A-8 ReSidential Density Policv AI6
states: Allow for the development of zoning districts which allow overlap of the
established Metro Plan density ranges to promote housing choice and result in
either maintaining or increasing housing density in those districts. Under no
circumstances, shall housing densities be allowed below existing Metro Plan density
ranges.
Finding #8: The existing Springfield zoning for the subject property presently permits a
reSidential density allocation (one per commercial site) that is lower than local Mixed-Use
Residential zoning (minimum of 20 per gross acre).
Finding #9: The existing CC zoning is inconsistent With the Metro Plan text.
Conclusion #1: Staff finds that the MUR zoning requested by the applicant is consistent with
the applicable Metro Plan poliCies. In addition, the Metro Plan Diagram provides the level of
specificity necessary to apply the MUR designation to the subject property. The proposal
therefore satisfies the approval criterion of SDC Section 5.22-115 C (I).
SDC Section 5.22-115 C (2)
4
Criterion 2: Consistency with a1>P'icab'e Refinement Plans. Plan District maps.
Conceptual Development Plans and functional plans; and
Finding #10: There are no Refinement Plans, Plan D,strict maps, or Conceptual Development
Plans for the subject property; Metro Plan designations establish the basis for functional plans
(transportation, public facilities, etc.) in the metro area, thus zoning in accordance with the
Metro Plan designation shall be consistent with the applicable functional plans.
Conclusion #2: Staff finds that the proposal satisfies the approval criterion of SDC Section
5.22-115 C (2).
SDC Section 5.22-115 C (3)
Criterion 3: The property is presently provided with adequate public facilities. services
and transportation networks to sU1>Port the use. or these facilities. services; and
transportation networks are planned to be provided concurrently with the development
of the property.
Finding # II: The subject property has approximately 255 feet of frontage on Main, a Major
Arterial public street, which is under the Jurisdiction of the State of Oregon Highway
Department (O.D.O.T.)
Finding #12: Main Street IS fully improved and the existing transportation systems provide
access to the property. Specific access requirements will be addressed through the site plan
review process when the applicant submits a redevelopment proposal.
Finding #13: The City's Conceptual Street Map shows the current right-of-way and does not,
propose any future changes.
Finding # 14: A public, IS-inch stormwater line is located in Main Street along the frontage of
the subject property. An S-inch public sanitary sewer is located In the public alley right-of-way
to the north of the subject property.
Finding # 15: The property is served by Springfield Fire and Life Safety. Specific access to the
site for fire and life safety vehicles is currently adequate. Note: Future access for
redevelopment Will be determined through the site plan review process.
Finding #16: The site is served by Springfield School District 19.
Finding # 17: The site IS within the Wlllamalane Parks and Recreation District.
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Finding #18: Traffic impacts of the proposed rezoning to MUR and future redevelopment
proposals Will be reviewed at the time of site plan review.
/
Finding #19: Lane Transit District (L TD) reviewed the appll,catlon and found that the
proposed zone change will not affect existing transit service.
Finding #20: Solid waste management service IS available at the subject property. The City
and Sanipac have an exclusive franchise arrangement for garbage service inside the city limits.
5
finding #21: The site receives police protection from the City of Springfield that IS consistent
With service provision throughout the city and With service that IS now prOVided to adjacent
properties.
finding #22: Qwest and Comcast currently provide telephone and cable communication
se~lce in this area. There are also an array of wireless companies that provide communication
services. The City has no exclusive franchise arrangements With telecommunication or wireless
companies; the field IS competitive and therefore guarantees a wide selection.
Conclusion #3: The property is presently provided with adequate public facilities, services and
transportation networks to support the current use; therefore, the proposal satisfies the
criterion at SDC Section 5.22-115 C3 as described herein. Note: All future public and private
improvement requirements and utility connection points will be determined when the applicant
submits a site plan review application for redevelopment.
SDC Section 5.22-115 C (4)
Criterion 4: Legislative Zoning Map amendments that involve a Metro Plan Diagram
amendment shall:
(a) Meet the approval criteria specified in SDC Section 5.14-100; and
(b) Comply with Oregon Administrative Rule (OAR) 660-012-0060, where applicable.
Finding #23: As described herein the applicant's request meets the approval criteria speCified
in SDC Section 5.14-100.
Finding #24: This City Sponsored Zoning Map Amendment-Type'" application is a Quasi-judicial
Zoning Map amendment which affects a single applkant's property; involves the application of
eXisting policy to a specific factual setting; and, does not require a Metro Plan Diagram
amendment.
Conclusion #4: Staff finds that the proposal satisfies the approval criterion of SDC Section
5.22-115 C (2) as deSCribed herein.
CONDITIONS OF APPROVAL: SDC Section 5.22-120: The Approval Authority may
attach conditions as may be reasonably necessary to allow the Zoning Map
amendment to be granted.
Conclusion #4:
RECOMMENDATION: Staff finds that the proposed Zoning Map Amendment-Type III is
consistent with the criteria of SDC Section 5.22-115 as described herein. Staff recommends
that the Planning Commission approve the requested Zonmg Map amendment without additional
conditions.
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E~IT A
METRO PLAN DIAGRAM MAP
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JTE\~
--....
--"
......
E9
/'./
~
RaDroads
Eugene-Springfield
Metropolitan Area
General Plan
Plan Diagram
(!he IlltetpretatlOD and purpose of the Plan DIagram, and descnptlons
of the land uses and symbols shown. are contamed III Chapter ll-G )
D low Density Residential D Ug ht M odIum Industtial II Ag r1culture
D Madlum Oenslty Residential ~ Campus Industrial II Forest Land
~ I-Igh Dansby Residential [J lJnIversby Research II Rural Rasldentlal
>f ~... ~:
II Commercial 0 Government and Education II Rural Commercial
II Major Retail Centers II Parks and Open Space ~ Rural Industrial
II Heavy industrial 0 Natwal Resource II Airport Reserve
ISS Special Heavy Industrial D Sand and Gravel
'~".'
Urban Growth Boundary
#,;<t...."',#
Metro Plan Boundary
RIvers and Ponds
Overlay.::
~ Mixed U"" Areas
8 Nod aI Development Area
o VVIIIamette Gr!lenway
,~
.~
~
NORTII
1\1
Vicinity map is not to scale
. . t f 10th Street and includes four tax lots addressed as
~~~~e~~:~~:t:s1~~2 ~ain Street, 1082 Main Street and 1096 Main Street
E:x.trnsIT C
. . .. 8233418
Legal Description
PARCH I. .
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8631
0757
9641
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ate Jan. 17. 2008
Sender's FadEx
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1054-6085-6
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lame Kittl Gale
Phone (541 I 726-3610
ompanvC 11 Y OF SP R I NGFLD / DEV
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DaptJAoorlSurteJRoom
IlvSPRINGFIELD
State 0 R
ZIP 97477-4671
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97)01-2540
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ZIP
0368751909
4a Express Package Service
[)j FedEx Pnonty Overnight 0 FedEx Standard Overnight
Next busmess mornmg." Fnday Next bUSiness aftemoOfl"'
shipments will be delIVered on Monday Saturday Delivery NOT available
unless SATURDAY Delivery IS selected
O FedEx 20ay 0 FedEx Express Saver
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unless SATURDAY Delivery IS selected
L-...:: FadEx Envelope rate not available Minimum charoe One pound rate ----.J
Packages up 10 150 Ibs.
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de!lverytoselectlocabOns.*
Saturday Delivery NOT available.
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shlpmemswlll be deJlVeredon Monday
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* CaJUor Confirmation
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shlpmentsWlUbedelrveredonMonday
unless SAWROAY DelNery IS selected
Packages over 150 Ibs.
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-To most IccatJons.
5 Packagmg
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-Declared value fimrt$500.
6 Special Handling 1 Include fedEx address In Sec'''n 3 1
D SATURDAYDehvel'( D HOLDWeekday 0 HOLDSaturday
NOT Available for at FedEx LoCan011 at FedEx Locanon
FedE><S~nd,'" 1N''""h, NOT Available for Available ONLY for
FedEx First Overnight, FedEx Express Fed&: Am Overnight FedEx Pnonty Overnight and
Saver or FedEx30ayFrelghl FedEx20aytnseJectlacat!ons.
Does tillS shipment contam dangerous goods?
DOB box must be checked
10 No 0 Ves 0 Ves I 0 ~~,c,lc.eUNl845
As per attached Shlppe(s Oeelarabon 1,.1.. ~ ~g
oangeroUSgOOdS(mclud~::~:~:~;~:~:stllPPed~;~:I:kaglng 0 Cargo Aircraft Only
7 Payment ~'111o Enter fedEx Accl No or Credrt Canl No below
rV Sender 0 ReCipient D Third Party D Credrt Card I 0 Cash/Check
LAAcctNo mSectlon
1 WlU be billed
FedExAcctNo
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Total Packages
Total Weight
Total Oeclared Valuet
$
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tOur Ileblllly IS limited to$l00 unless you declare a hIgher value See back fO( deta~s. By usmg ttns A1rbill you agree to the
S9Mce conditions on the back of thiS AI/mil and 10 the currentFedEx SaMee GUIde rncludmg tenns thatllmrtour liability
8 ReSidential Delivery Signature Options II yo"""""" ,,,,n,tu,,, checkO""''''',d""ct
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