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HomeMy WebLinkAboutApplication APPLICANT 11/10/2020 (2)City of Springfield Development & Public Works 225 Fifth Street Springfield, OR 97477 PERMIT REVIEW INTAKE FORM SPRINGFIELD (City Staff completes form) Dept of Motor Vehicles -New: ❑ Land Use Compatibility Statement: X City: X Dept of Motor Vehicles -Renewal: ❑ Zoning Verification Letter: ❑ UGB: ❑ Project Information Applicant Name: Jeremy Kwit Phone:? Company: Cell: Address: 70 SW Century Drive, Ste. 110-113, Bend, OR 97702 Property Owner: Olympic Street Pro erties Phone: Company: Celh Address: PO Box 26125 Eugene, OR 97402 ASSESSOR'S MAP NO: 17032541 TAX LOT NOS : 1101 Property Address: 2329 Olympic Street Description of Proposal: OLCC LUCS for Marijuana Retail Facility Record Information Record NoAl—A-6 6 1 "If Date Received: 11/ 10/20 Application Fee: $343 Technical Fee: $17.15 TOTAL FEES: $360.15 Assigned Planner:L. Miller Revised 11.2.11 kl Site Location: ❑ Inside city limits ❑ Inside UGB ❑ Outside UGB Name of Jurisdiction: Property Zoning of Proposed Premises: ❑ The proposed land use has been reviewed and is prohibited. ❑ The proposed land use has been reviewed and is not prohibited. If the proposed land use is allowable only as a conditional use, permits are required as noted below. co.MenM Name of Reviewing Local Official (print): Title: Date: Email: Phone: Signature: Check this box if there are attachments to this form REMINDER: Local jurisdictions are NOT required to begin processing LUCS forms until January 4. 2016 at 8:30 AM Submitted Mdbaotsubmas mariluanalbeme rpplication M andne dcensing rystern and � pobappdmdm fce. � Received OLCC LKense MvesGgomrrecelies applba[be and begMsreview. Local Government LOM Use CorrpIXblay Statement aM local � op[-ou[reuiewedforprMibiteduse. � Completeness Review License MvesngotorondAppFmn[colla[all addidenal neeessary bforma[bn. Application Review license Mvesdgomr resiewsa(plba[bn to \determine ifsuhmiaed infmma[ion meets requiremen s. Premises Inspection O¢Chspectcr visits sae to determine corrpFmce\ uiah phySiod requirements: scanty, opem[IOIIs, HC / Approved 6 ocet Rrequirements ofappdwUM mdprem4esinspecdoo. / �1. Ti V76� ..�s�.' Denied House Bi1134OOprohibds the OLCC from issuing a recreational marijuana license if the propos use is prohibited by the local governmgbody. Possible Denial bThe OL ¢ m ust reviewfor colrp lion ce Ow.admneco ivemks and Oregon w. In sonecases, o {aRn[bl deniol nt may be o wrearne if the applicant can "Mut, ns ueor othermse showgad o ....._._:'�' mute to overcome the denbl bosh. f Possible Denial nt Aail di peRbn mea dIXapremises does notmeet securag aperu[bml, o! otherreyulrenents. An opportari ryis poeW W to nec[any compliance m usues, butfoilure to do so ora second 1 failed inspecdon may,su tin appbmdon denid. License Issued r License Fee Due ! :. _.. . All Fees Paid 1\\ The bcense is issued and can be Applicant printed ptheapplicant.It must be pays [helbersirgfeein the entire ryslem. displayed prominm[ly at the location.