HomeMy WebLinkAboutApplication APPLICANT 4/13/2021City of Springfield
Development & Public Works
225 Fifth Street
Springfield, OR 97477
PERMIT REVIEW INTAKE FORM
SPRINGFIELD
W 0#1
(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: ❑ UGB: ❑
Project Information
Applicant Name: Corey Maizel
Phone: 216-577-7301
Company:
Cell:
Address: 2685 High Street Eugene Or 97405
Property Owner: Ash Living Trust
Phone:
Company:
Cell:
Address: 67750 Rhodowood Drive Florence Or 97439
ASSESSOR'S MAP NO: 16-03-01-00
TAX LOT NOS : 3800
Property Address: 2167 South F Street Unit Q Springfield, Or 97477
Description of Proposal: OLCC LUCS for marijuana production location
Record Information
Record No: 811-21-000077-TYP1
Date Received: 04/13/2021
Application Fee: $ 343
Technical Fee: $ 17.15
TOTAL FEES: $ 360.15 Assigned Planner: Liz Miller
Revised 11.2.11 kl
OREGON LIQUOR CONTROL COMMISSION REQUEST
KHMIN
Land Use Compatibility Statement
What is a land use compatibility statement (LUGS)? The LUCS is a form used by a state agency
and local government to determine whether a land use proposal is consistent with local govern-
ment's comprehensive plan and land use regulations.
Why is a LUCS required? OLCC and other state agencies with permitting or approval activities that
affect land use are required by Oregon law to be consistent with local comprehensive plans and to
have a process for determining consistency. Section 34(4)(a) of 2015 Oregon Laws, Chapter 614,
requires OLCC to request and obtain the LUCS and have a positive LUCS prior to issuing a license.
CITY/COUNTY USE ONLY
Date delivered by license applicant
Initial:
When is a LUCS required? A LUCS is required for all proposed marijuana facilities before an OLCC limnse can be obtained
How to complete a LUCS:
• Step 1: Applicant completes Section 1 of this form and submits it to the appropriate city or county planning office. Applicant
verifies with local jurisdiction whether additional forms, applications, or permits are required.
• Step 2: Local jurisdiction completes Section 2 of this form indicating whether the proposed use is compatible with the acknowl-
edged comprehensive plan and land use regulations and returns signed and dated form to the applicant.
• Applicata completes Payment to local jurisdiction for processing application.
• Local jurisdictions are NOT required to begin processing LUCSformsumil Januarv4.2016 at 9:30 AM.
• Step 3: Applicata submits this date-stamped form and any supporting information provided by the city or county to the OLCC
with the license application. This form may be submitted while Section 2 is in process with the local governing body.
Secdon-- - - — _ .;d_}.
dted'by Applicant
*Sections marked with an asterisk should be verified with the localpforrung deportnient priorto submitting thisform.
APPlirant Name:tiles I�s,IW" Phone:
Mailing Address: Nl' + Rm/Ste: 4 L I�1�
City: State: Q1, ZIP: 1 �UC,
❑ Site plan of the subject property and proposed development attached? (required)
Proposed^
dam. 7
S 0
Rm/Ste:
Premises Address:
City:
S'frly
County:
{. QYt.I/
ZIP: 17�
Tax Lot 9*:
Range:
Section*
latitude:
,0 J -Q (^00 �IfBdl1
Township-:
Map*:
Longitude:
Psed use/permit type sought (A separate LUCS may be necessaryfar each proposed use even if it is on the same property):
Producer ❑ Wholesaler ❑ Processor ❑ Retailer ❑ laboratory ❑ Research Certificate
1knoindoornr ust endorso-
outdoor below mems below
Details of proposed use Inoue any attachmems): p
Uq(6 R i11+iy Ah 0tC� Co mPllant kq ir"w-
•Y
Section 2 —To be Completed by Local Jurisdiction 4
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.
Comments:
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