HomeMy WebLinkAboutApplication APPLICANT 12/1/2020(City of Springfield
Development & Public Works
225 Fifth Street
Springfield, OR 97477
PERMIT REVIEW INTAKE FORM
SPRINGFIELD
(City Staff completes form)
Permit Type
Dept of Motor Vehicles -New: ❑ Land Use Compatibility Statement: ❑
City: X
Dept of Motor Vehicles -Renewal: X Zoning Verification Letter: ❑ UGe: ❑
Project Information
Applicant Name: Charles Harral
Phone: 541-747-9601
Company: Springfield Auto Rec. clers
Cell:
Address: 750 South 281" Street, Springfield OR 97477
Property Owner: Charles Harral
Phone:
Company:
Cell:
Address: PO Box 127
ASSESSOR'S MAP NO: 18030100
TAX LOT NOS : 00100
Property Address: 750 S 28" Street, Springfield
Description of Proposal:
DMV Location Approval Renewal for wrecking/dismantler's yard
Record Information
Record No: 811-20-000231-TYPS
Date Received: 12-1-20
Application Fee: $343
Technical Fee: $17.15
TOTAL FEES: $360.15 Assigned Planner:L. Miller
Revised 11.2.11 kl
10
APPLICATION FOR CERTIFICATE NUMBER
' ANNUAL BUSINESS CERTIFICATE EFZ030DATE
AS A DISMANTLER OF MOTOR VEHICLES OR vl—O I -2o2
SALVAGE POOL OPERATOR FEE: $500 EXPIRATION DATE
2-
• PLEASE TYPE OR PRINT LEGIBLY WITH INK.
• ANY ALTERATION OF LINE 3 VOIDS LOCATION APPROVALI ]ORIGINAL �,HENEWAL
LEGAL NAME OF APPIICANT(OWNER. PAPTNEfl9HIP. LLC .......
a CORPORATONNAMEI FEDERAL EMPLOYEE IG NUMBER (FErN)0REGONaEGI51AYHUMBEa11FLLCORCORPORATONI
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5 - e! �� cle
0977
BUSINESS NAME OF PPLICAMNFp9sUMEO BU9IHE94 NAME RIRADE HAMS)
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9A 91NGNh55UMEUB1191NNE99aNPME OR iIUnE NAME)
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CHECK ORGANMATION TYPE: If Corporation, list the state where
❑ Individual ❑ Partnership ❑ LLC Corporation: the business Is Incorporated:
National Motor Vehicle Title Information System (NMVTIS) number REQUIRED: ® p a
a) THE DIMENSIONS OF THE PROPERTY ON WHICH THE BUSINESS IS LOCATED ARE Fid ft. X .50c) ft.
b) ORS 822.115(4) requires applicants to file a description of the location of the dismantling yard. Accordingly,
please submit a plat map or other description of the location of the premises.
LOCAL GOVERNMENT APPROVAL (CITY / COUNTY)
By signing this application you are authorizing a dismantler business to be conducted at the location listed
on Line 3 of this application. If a dismantler business cannot be conducted at this location, do not sign
this approval.
❑ I represent an incorporated city with a population of 100,000 or more.
By signing on Line 10, 1 certify that pursuant to ORS 822.110(1)(a) the address listed as the place of business for use in the motor vehicle
dismantling business is zoned for industrial use or subject to another zoning classification that pennfts the type of business Conducted by
the dismantler.
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bl I represent a county, or an incomomted city with a population of less than100,000.
By signing on Line 10,1 certify the following:
raf CITY
THATTHE GOVERNING BODYOFTHE ]COUNTY OF Vrl n"I�IS (V\ .HAS:
A) APPROVED THE APPLICANT AS BEING SUITABLE TO ESTABLISH, ♦ PLACE STAMP OR SEAL HERE
MAINTAIN OR OPERATE A MOTOR VEHICLE DISMANTLING BUSINESS
(ORIGINAL APPLICATIONS ONLY).
B) DETERMINED THAT THE LOCATION OR PROPOSED LOCATION MEETS
THE REQUIREMENTS FOR THAT LOCATION UNDER ORS 822.110.
C) DETERMINED THAT THE LOCATION DOES NOT VIOLATE ANY
APPLICABLE PROVISION OF ORS 822.135. APPDLi�fED
D) APPROVED THE LOCATION AND DETERMINED THAT THE LOCATION CITM 1a�RINGRI
COMPLIES WITH ANY REGULATIONS ADOPTED BY THE JURISDICTION
UNDER ORS 822.140.
❑ Restrictions on the location approval are in an attached letter from the
zoning authority.
I ALSO CERTIFY THAT I AM AUTHORIZED TO SIGN THIS APPLICATION AND AS EVIDENCE OF SUCH AUTHORITY DO
AFFIX HEREON SEAL OR STAMP OF THE CITY OPER COUNTY.
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