HomeMy WebLinkAboutHome Occupation Form 1989-07-10l
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APPLICATIvT{ FOR TYPE I BUSINESS CeRTIFICATE
ORIGINALAS A DEALER OR REBUILOER OF VEHICLES
NoTE: FAILURE TO ACCURATELY COMPLETE THIS FORM WILL CAUSE UNAVOIDABLE DELAY
PLEASE TYPE OR PRINT LEGIBLY WITH INK
K RENEWAL *
CERTIFICATE NO:nsq
1
2
3
4
A SEPARATE SUPPLEMENTALAPPLICATTON (FORM 372) MUST BE COMPLETED FOR EACH
ADDITIONAL LOCATION FROM WHICH YOU OPERATE YOUR BUSINESS.
NAME (gqFPORATTON AND/OR ASqUMED BUSTNESS NAME)'tSnrvt(e
b-{ - rnooKe BUSINESS TELEPHONE12b- r238',
MArN BUSTNESS LOCATTON (STREET AND NUMBER)
3 *\+ (,n ) o6 d (aar c D("Sprru"r$ "tJ
ZIP CODE9r(r't COUNTYLn,v<-
MAILING ADDRESS""(:
'1a. \CITY v STATE ZIP CODE
5
6
7
8
o
10
11
12
13
14
15
16
17
18
SUBMIT ALL REQUIRED SIGNATURES AND FEES TO:
CHECK ORGANIZATION TYPE:
Ei-rruoruoull E panrneRsnrp E conponnrroru
IF CORPORATION, LIST THE STATE UNDER WHOSE LAW BUSINESS IS INCORPORATEO
MOBILE HOMES
MOTOR HOMES
CAMPERS
E ves E-ruo
E ves 6ruo
E ves El-r.ro
YES Elno
YES E-ruo
YES El-r.ro
YES
YES
E-r.ro
E].ruo
DO YOU SELL THESE VEHICLE TYPES?
TRAVELTRAILERS
MOTORCYCLE/MOPEDS
CLASS I ATVS
SNOWMOBILES
DO YOU REBUILD
VEHICLES?
AREyouAFRANcHTsEDDEALER? n ves W uo IF "YES", NAME THE MAKE(S):
LIST NAME AND RESIDENCE ADDRESS OF ALL INDIVIOUAL OWNERS, PARTNERS OR PRINCIPAL CORPORATE OFFICERS
*o"?(u,.. e F{ rvl o o(t <Ow u€r(TITLE ?tT'd'I'vo
'E1138$"=1*"'fffQo*tlJooJla, a DR "''Spn:ua-h* ld STAT5(''""ff5 u'r ',
NAME TITLE OATE OF BIRTH TELEPHONERrsrDE\cE
RESIDENCE ADDRESS CITY STATE ZIP CODE
NAME TITLE OATE OF BIRTH TELEPHONERfsrDElcE
BESIDENCE ADDRESS CITY STATE ZIP CODE
I CERTIFY THAT I AM THE APPLICANT OR AN AUTHORTZED REPRESENTATIVE AND THAT ALL TNFORMATION ON THIS APPLICATION IS
ACCURATE AND TRUE. I CERTIFY THAT THE BUSTNESS DOES OR WILL DEAL IN VEHICLES, OR REBUILDS VEHICLES AND tS OR WILL BE
ESTABLISHED ATTHE LOCATION GIVEN.
c< H. l'Yl so(e TITLE RESIDENCE TELEPHONE(so)\ 126^tL3 y
ZIP CODEorlla^t. Dr
OR CLASS I A
a 1)
THIS AGREEMENT IF YOU SELL SNOWMOBIAGREEMENT TO ACT AS AGENT:
CITY3v I
RESULTING
INCIDENTAL
TOwtsH BE DESIGNATED AAS AGENTLIMITED THEFOR(wE)VEHICLESMOTOR DtvrstoN.AGREE TO COMPL WITH,Y APPLICABLEALL(wE)
ANLAWS ADMID ISTRAN RULES,TIVE AGREEAND HOLDTO otvtTHE SION HARMLESS ANYOF ORLOSS EXPENSE ACTS ORFROMANY
REPRESENTA ,TIONS EXCESSIN INOR OF AUTHORITYAGENT'S FROMANO DUEEXPENSES TERMINATION.TO
SIGNA TITLE
A,,DU/1--1-to-g?DATE
$96.00
Cl,rtnrh'
OATE
1-0-Eci
(PLACE ST,THE BILLING LIST MUST BE SUBMITTED WITH YOUR RENEWAL APPLICATION
TOTAL:*
BUSTNESS CERTTFTCATE FEE (tNCLUDES ONE PLATE)
NAME
* IF THIS IS A RENEWAL OF AN EXISTING CERTIFICATE USE THE
ATTACHED BILLING LIST TO CALCULATE PLATE FEES.
ADDTTTONAL LOCATTONS _@ $3O.OO EACH
(sEE ATTACHED SUppLEM ENTAL AppLtCATtONS)
AODTTTONAL PLATES _@ $1 1.00 EACH
APPROVAL: I CERTIFY THAT THE LOCATTON SPEC|FIED ABOVE COMPL|ES
WITH ALL LAND USE OR BUSINESS REGULATORY ORDINANCES OF THE
E crrv E courury or
I CEHTIFY THAT I AM AUTHORIZED TO SIGN THIS APPLICATION AND AS
EVIOENCE OF SUCH AUTHOBITY DO AFFIX HEREON THE SEAL OB STAMP OF
THE CITY OR COUNTY.
tt orr ,Pi,ur*\AVE. NE, SALEM, OR 97314-2350pL'r
CONTRAVENTION
TITLE
r ).....fV. P6ffY\ r i- /rvlr'-nrN4Tnf s
735-370
APPLICATIONFORTYPEIB\TSINESSCERTIFICATE
As A DEALER oR REBUILDER oF vEHtcLES mt OR\G\NAL
RENEWAL*
(S6e bottom right colnor ol Page)NoTE: FAILURE TO ACCURATELY COMPLETE THIS FORM WILL CAUSE UNAVOIDABLE DELAY
PLEASETYPE OR PRINT LEGIBLY WITH INK.GERTIFICATE NO:
1
A SEPARATE SUPPLEMENTAL APPLICAT|ON (FORM I
ADDITIONAL LOCATION FROM WHICH YOU
372) MUST BE COMPLETED FOR EACH
I OPERATE YOUR BUSINESS.
BUSINESS NAME)L BUSINESS TELEPHONE
77G- tB8
^J<
ANO
Sanqyo G " /J q1v11zrP cooE COUNTY
)-,r1t'l <-
CITY STATE ZIP CODE
4
5
6
7
8I
10
11
12
13
14
15
16
17
18
ETY BOND WITH ALL REOUIRED SIGNATURES AND FEES TO:
CHECK ORGANIZATION TYPE:
f] truououel E penrxeRsxrp n coRponarroru
LIST THE STATE UNOER WHOSE LAW BUSINESS IS INCOBPORATED:IF COBPORATION,
MOBILE HOMES
MOTOR HOMES
CAMPERS
NO
NO
NO
E Yes
n yrs
E vEs
E r.ro
Eruo
E r.ro
YES
Eves ENo
DO YOU SELL THESE VEHICLE TYPES?
TRAVELTRAILERS
MOTOBCYCLES/MOPEDS
CLASSIATVS
sNowMoBrLEs Eves Er.ro
DO YOU REBUILD
VEHICLES?
YES N
YES tr
AREYoUAFRANcHtsEDDEALER? n ves NO IF "YES,'' NAMETHE MAKE{S):
LIST NAME AND RESIDENCE ADDRESS OF ALL INDIVIDUAL OWNERS, PARTNERS OR PRINCIPAL CORPORATE OFFICERS:
NAME TITLE DATE OF BIBTH RESIDENCE TELEPHONE()
RESIDENCE ADDRESS crw STATE ZIP CODE
NAME TITLE DATE OF BIRTH TELEPHONE
TSrDE\CERESIDENCE ADDRESS crw STATE ZIP CODE
NAME TITLE DATE OF BIRTH TELEPHONET':')"=RESIDENCE ADDRESS CITY STATE ZIP CODE
I CERTIFY ,TTHA AM APPLICANTTI,IE ANOR AUTHORIZED REPRESENTA AND,TIVE THA'AI-LT INFORMA ON,TION THIS APPLICA'tsTION,TEACCURA AND TRUE.CERTIFY THA,T BUSINESSTFIE ORDOES LLwt INDEAL OR LDSREBUIVEHlCLES,ANDVEHICLES s wtOR BELL,ABLISHEEST A'D rHET TIONLOCA'GlVEN.
NAME TITLE TELEPHONE
ADDRESS, CIry, STATE, ZIP CODE SIGNATUBE
x
as law,this
ESENTATIONS TERMlNATION.
I TO B A LIMITED FORAGENT vEHtcLEs Y ALLWITHADMIANDISTRAN,TIVE RULES AGREAND TOE HOLD DtvtstoNTHE OFHARMLESS ANY RESUL'NGT!FROM ACTSANY ORREPRINEXCESSINORCONTRA.VENTION A.GENT'SOF FROMAND EXPENSESNTAL DUE TO
agrgemont.AGREEMENT TO ACT AS AGENT:to b€
must
SIGNATURE
X
TITLE DATE
APPROVAL: I CERTIFY THAT THE LOCATTON SpECtFtED ABOVE COMPL|ES
WITH ALL LAND USE OR BUSINESS REGULATORY ORDINANCES OF THE
D crry E courury or
I CERTIFY THAT I AM AUTHOBIZED TO SIGN THIS APPLICATION AI..i3 AS
EVIDENCE OF SUCH AUTHORITY DO AFFIX HEREON THE SEAI. OB STAMP OFTHECITYOR COUI{TY.
OR SEALfrFPffitrET
t
NAME TITLE
SIGNATUR
X
DATE
&,
BUSTNESS CERTIFTCATE FEE (tNCLUDES ONE PLATE)
ADDTTTONAL LOCATTONS
-----,G, $30.00 EACH
(sEE ATTACFiED SUppLEMENTAL AppLtCAItOltS)
AODTTTONAL PLATES
-.---@
$1 1.50 EACH
$e6.s0
$TOTAL:
* IF THIS IS A RENEWAL OF AN EXISTING CERTIFICATE, USE THE
ATTACHED BILLING LISTTO CALCULATE PLATE FEES.
THE BILLING LIST MUST BE SUBMITTEO WITH YOUR RENEWAL APPLICATION
73s-370 (5-88)
uNtT, 1905 LANA AVE. NE, SALEM, OR 97314-2350
Ptoduced by
STATE PRINTING
CITY OF SPRINGFIELD
PLANNING AND DEVELOPMENT DEPARTHENT
225 FIFTH STREET
SPRTNGFIELD, oREGoN 97477
PHONE: (503) 726-3759
EOITE OCCUPATTON APPLICATION
SPRINGFIELE,
LOCATION OF PROPERTY
EXISTING USE OF PROPERTY
DESCRIPTION OF PRO POSAI,
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ADDRESS S Pr,r.<-
PHONE:
}.-Jt)e6.
EOHB OCCUPATION AGRBBHBITT
THE APPLICANT'S SIGNATURE OF THIS AGREEMENT CERTIFIES ACKNOI.ILEDGMENT OF THE FOLLOVING
CONDITIONS OF OPERATION:
1. EXCEPT FOR THE ONE NON-ILLUMINATED L L/2 SQUARE FOOT VALL SIGN PERMITTED IN
SECTION 16.OgO(t) OF THE SPRINGFIELD DEVELoPMENT CoDE, THERE SHALL BE N0 DISPLAY
}IHICH IIOULD INDICATE FROM THE EXTERIOR THAT THE BUILDING IS USED FOR ANY PURPOSE
OTHER THAN A RESIDENTIAL D1IELLING.
2. THERE SHALL BE NO OUTSIDE STORAGE OF MATERIALS.
3. NO HECHANICAL EQUIPMENT SHALL BE PERMITTED EXCEPT THAT }IHICH IS COMPATIBLE 1IITH
RESIDENTIAL PURPOSES.
4. THERE SHALL BE NO OFFENSM N0ISE, VIBRATION, SMOKE' DUST, 0D0RS, HEAT 0R GLARE
NOTICEABLE AT OR BEYOND THE PROPERTY LINE RESULTING FROM THE OPERATION'
5. A MAxIMUM OF 2 VORKERS MAY BE EMPLOYED AT ANY GIVEN TIME BETIIEBN THE HOURS OF 7
A.H. AND B P.M. IN ADDITION TO FAMILY MEMBERS VHO RESIDE AT THE DVELLING'
6 TTIE OPERATION SHALL NOT
ON-STREET PARKING AREAS.
CREATE HAZARDOUS TRAFFIC CONDITIONS OR I.INDULY BURDEN
7
B
IFTHEPR0PoSEDUSEREQUIRESAMoDIFICATIoNToTHEDVELLING0RACCESSoRY
STRUCTURE oF A NATURE THAT IS NoT TYPICALLY FOUND IN RESIDENTIAL DISTRICTS' THE
PROPoSED USE SHALL BE CONSIDERED INAPPROPRIATE AND THEREFORE INELIGIBLE AS A
HO},IE OCCUPATION.
9. NO HERCHANDISE OTHER THAN WHAT IS PRODUCED ON-SITE SHALL BE SOLD TO THE PUBLIC
FROM THE PREMISES.
IT IS T'NDERSTOOD THAT IF NEIGHBORHOOD COMPLAINTS ARE RECEIVED, THE NATURE OF THIS
HOHE OCCUPATION IIILL BE RE-INVESTIGATED. IF THIS HOME OCCUPATION IS FO1JND IN
vIoLATIoNoFTHESPRINGFIELDDEVEL0PMENTCoDE'THEUSE!!ILLBETERMINATEDUPoN
NOTIFICATION IN I.IRITING BY TIIE PLANNING AND DEVELOPMENT DIRECTOR'
IT IS FURTHER IJNDBRSTOOD THAT APPROVAL OF THIS APPLICATION DOES NOT EXEMPT TIIE
APPLICANT FROU THE REQUIREHENTS OF ANY OTHER CITY CODES OR ORDINANCES'
COHMERCIAL AUTO
BODY-FENDER VoRK'
PERMITTED.
REPAIR, INCLUDING BUT NOT
PAINTING AND DETAILING'
LIMITED TO TI.JNE-UPS, ALIGNMENTS'
AND UPHOLSTERING SHALL NOT BE
eppt rcant ,S SI
P AND DEP TE
DATE