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HomeMy WebLinkAboutApplication APPLICANT 3/26/2021;City of Springfield Development & Public Works 225 Fifth Street Springfield, OR 97477 PERMIT REVIEW INTAKE FORM $PRINOFIC� (City Staff completes form) Permit Type Dept of Motor Vehicles -New: ❑ Land Use Compatibility Statement: ❑ City: Dept of Motor Vehicles -Renewal: Zoning Verification Letter: ❑ UGB: ❑ Project Information Applicant: Kelly Schrader Phone: 541-999-0796 Company: Team Oregon Auto Group LLC Cell: Address: 2634 Wayside Ln, Springfield, OR 97477 Property Owner: David Hyland Phone: Company: Cell: Address: 90570 Nadeau Rd, Springfield, OR 97478 ASSESSOR'S MAP NO: TAX LOT NO(S): Property Address: 1517 S A Street, Springfield, OR 97477 Description of Proposal: DMV Co -locate on existing lot Record Information Record No: 811-21-000062-TYP1 Date Received: 03/26/2021 Application Fee: $343.00 Technical Fee: $17.15 TOTAL FEES: $360.15 Assigned Planner: Revised 11.2.11 kl 10 APPLICATION TO CORRECT DEALER / REBUILDER VEHICLE DEALER CERTIFICATE m..rc.....wwmwm.. NUMBER t)L) '�,©EFFEGTNE DATE EXPIRATION DATE [DEALER DR `LATIN®SNAME� tpsl , I_/� Check the reason for correction: Oa(4 la4t1 /Y12, vµ0P�1 ❑ Name Change Address Change ❑ Add I Remove Owners ❑ Ong. !Structure Change l Instructions: VALIDATION USE ONLY • The fee for a corrected dadficate:$30. • Name change and/or address change:$30.(Be sura to attach Bond Rider and lnsuance Ceni(oste). • Organizational structure change :$30.di Individual partnership or LLU to Corp) (Be sure to such bond Poor and insurance cerlificalej. • Adding/Removing LLC member or corporate officer No Fee • Each new owner must complete and sign lines 12-16 or 17-21. More directions on back. • Each owner being removed must sign line 22 or 23. • One owner must sign line 24. • Provide copy of valid photo ID if changing residence address. • Dealer number and expiration date will stay the same. Submit the completed application to: DMV Business Licensing Unit, 1905 Lana Ave NE, Salem Oregon 97314. NOTE: If the dealership has been sold, the new owners) must obtain their own vehicle dealer certificate Using the Form 735-370 Packet since a dealer cenfficate Is not transferable. NAME CHANGE NEW 9191NE99 NAME (11l assume business name, nll'.n Regn4y Numbn¢) OR IVE99 REGI' N hIBER I FFOERHL EMPLOYER IOE TIFICATION NUMBER Any alteration of Line 3 voids location approval. ADDRESS CHANGE NEWS A VRE55 I'aV61N 9 L nUCTEO �Rc910ENr.F �PflEVI0U9 SulFLEME NTAL \5\� g, A 3y�r2�(�`\� BVSINEss TELEPHONE HONE (541 )gRq-o��t� 91 \ t lc r \Ci1V IPCOO 1ir� 4 AooREss1 REnsilo1 c EMAI/L`�•f�l -c e y(r`y� {�(y /�� 2Lv3y W sIVC lAr IC (� /� /t .rk^. ry /IlP\`coo \ 1' ll \ tS\V �r—I1 .IOV69TR 666'SI q ION -1 too31 Y OE LOCATION APPROVAL - Required only if dealer is changing business location sn of Local Zoning and Business Regulatory Compliance. ORS 822.005 requires a vehicle dealer certificate, unless exempt under ORS 822.015, for any persoonn who. pe (a) Buys, sells, brokers, trades or exchanges vehicles either outright or by means of any conditional sale, bailment, lease, security interest, consignment or otherwise; OR (b) Displays a new or used vehicle, trailer or semitrailer; OR (c) Acts as any type of agent for the owner of a vehicle to sell the vehicle or acts as any type of agent for a person interested in buying a vehicle to buy a vehicle. THE CERTIFICATION BELOW IS TO BE COMPLETED BY THE LOCAL ZONING OFFICIAL. The approval below should be based upon whether the applicant can do ANY of the activities listed in (a) through (c) above under applicable ordinances, at the location of the business given on Line 3. Pursuant to ORS 822.01 applicant meets requirements below, s[ ers In whit t lvedty t att elocationo t is uslness ae state on this application with any landordinances complies with any land use ordinances or business regulatory ordinances of the jurisdiction pursuant to ORS 822.025(6). regulnasso finance pursuant CITY OR C COUNTY OF: TELEPHONE NUMBER I PRINT NAME TITLE SIGNATURE DATE X LI, Restrictions on the location Place stamp or seal here V approval are in an attached letter from the zoning authority,