HomeMy WebLinkAboutApplication APPLICANT 6/4/2020ICity of Springfield
Development & Public Works
225 Fifth Street
Springfield, OR 97477
PERMIT REVIEW INTAKE FORM
SPRINGFIELD
I& #A,
(City Staff completes form)
Permit Type
Dept of Motor Vehicles -New: ❑ Land Use Compatibility Statement: X
City: X
Dept of Motor Vehicles -Renewal: ❑ Zoning Verification Letter: ❑
Project Information
UGB: ❑
Applicant Name: Preston Scheidt
Phone:
503 927.5472
Company: Green Goat Labs LLC
Cell:
Address: 136 42nd Street Springfield Ore on 97477
Property Owner: Furlong Family LLC
Phone:
Company:
Cell:
Address: 3714 Virginia Ave Springfield Ore on 97478
ASSESSOR'S MAP NO: 17-02-32-32
TAX LOT NOS : 1300
Property Address: 136 42nd Street
Description of Proposal: LUCS for hemp processing
Record Information
Record No: 811-20-000103-TYP1
Date Received: 06/04/2020
Application Fee: 343
Technical Fee: $17.15
TOTAL FEES: $360.15 Assigned Planner:
Revised 11.2.11 kl
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LAND USE COMPATIBILITY STATEMENT (LUCS(
THI5 FORM MUST ACCOMPANY THE HEM P HANDLERS CHANGE OF STATUS REPORT FORM.
SECTON 1—TO BE FILLED OUT BY APPLICANT
1. Business name Lalft9til l L0.A a W- Contact person ?,es si kelli
Telephone Cell phone $0 $' nL3 - S 40.2.
Mdl
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Location address:
Taxaat #Ol z?'tlhax lot#
cut 't'Itowashlp': cA Reage Section
Latitude 44OttbL2C' Longitude tZ2FLga0Pmpemyzoning:UnAFM,f;y
2. )asaibethe aofhemusi
p baroness or facility and the services or ancel sprovided:
�ro
SECTION 2—TO BE FILLED OUT BY CITY OR COUNTY PLANNING OFFICIAL
3. The facility proposal is looted: Inside city limits_ Outside UGB_ Inside UGB_
5. Name of city or county that has land use Jurisdiction:
jurisdiction means the legal entry [hat is responsible or land ues decisions for the subject of
property or land use.)
5. The business or facility complies with all applicable local land use requirements: Yes❑No❑
Sa. Gat all tool reviews or approvals that were required of the applicant before the LUCS consistency was
determined. (This does not include past requirements that do not relate to the pending QUA registration
request).
Oregon Oepartmen[ of AOtkugur4 Pemp Program, Ph.. Sof 996465] Fri Hemisfate.ocr¢
• Wehs le: hoz://oda dirftrJHEMP
nm. 11/13/1019
-OVER
5b. If no, identify reasons for noncompliance or list requirements that the applicant must comply with
before LUCS consistency can be determined.
Sc. Is local government currently processing remaining requirements to attain W CS consistency?
Yes NO
6. Planning official mviewer's telephone number:
SIGNATURES
Date
Planning Official Print name
Date
Planning Official Print name
(depending upon city/munty agreement on jurisdiction outside city limits but within UGB)
ATTENTION: A W CS approval cannot be accepted by ODA until all local requirements have been met.
Written findings of fact for all local decisions addressed under 5 through Sb must be attached to the LUGS.
Oregon DepartmentPf Ngiculture, Hemp Program, MuneSM-98"02 Email: Hemp@etla.state.orus
• Website: https:,AidT directfHEMP
Rev, 31/13/2019