HomeMy WebLinkAboutApplication APPLICANT 6/15/202111City of Springfield
Development & Public Works
225 Fifth Street
Springfield, OR 97477
PERMIT REVIEW INTAKE FORM
SPRINGFIELDIL
(City Staff completes form)
Permit
Dept of Motor Vehicles -New: ❑
Land Use Compatibility Statement: ® City: ❑
Dept of Motor Vehicles -Renewal: ❑
Project Information
Zoning Verification Letter: ❑ UGB: ❑
Applicant: Jordan Dunn
Phone, 541-591-2620
Company: Seventh Hill Releaf LLC
Email:
Address: 215 S 19th Street
Property Owner:
Phone:
Company: Wave Holdings LLC
Cell:
Address: 780 E 38th Ave., Eugene, OR 97405
ASSESSOR'S MAP NO: 17-03-36-42
TAX LOT NO(S): 7800
Property Address: 215S 191h Street, Springfield, OR 97477
Description of Proposal:
CBD Product Manufacturer
Record Information
Record No: 811-21-000151-TYPi
Date Received: June 15, 2021
Application Fee: $343.00
Technical Fee: $17.15
TOTAL FEES: $360.15
Assigned Planner: Drew Larson
Revised 11.2.11 kl
OREGON LAND USE COMPATIBILITY STATEMENT (LUCS)
�--' _ DEPARTMENT Of
AGRICULTURE
THIS FORM MUST ACCOMPANY THE HEMP HANDLERS REGISTRATIONAPPLICATION
SECTION 1: TO BE FILLED OUT BY APPLICANT
1
1. Business Name Sc'`ItAVlk\ uContact Person I�IOJ��p—Gr^ ,tiwnl
Phone S"(1t' S¢I - C7baQ Cell Phone N/U
Mailing Address jiS S. lq"- Si' "A --
City S
City
State OK ZIP 87'177
State OR- ZIP
Tax Acct. R D33 007 Tax Lot A 7900 Township 1 / 11 Range Section
Latitude Longitude Property zoning ['ICAU-7 �Otiti�e,�
2. Describe the type of hemp business ori acili'ty and the services or products provided:
SECTION 2: TO BE FILLED OUT BY CITY OR PLANN��IN++G OFFICIAL
3. The facility proposal is located: Inside city limits y�L Outside UGB ❑p Inside UGB F]4. Name of city or county that has land use jurisdiction:`
(Jurisdiction means the legal entity that is responsible for land use decision r the subject proppeerrtty)
5. The business or facility complies with all applicable local land use requirements: Yes IJy, No ❑
Oregon Department of Agriculture, Hemp Program • Phone 503966-4652 • Website: httpsy/oda.direct/HEMP
Hemp Handler Registration Application Rev.11/20
5A. List all local reviews or approvals that were required oft he applicant before the LUCS consistency was
determined. (This does not include past requirements that do not relate to the pending ODA registration
request).
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arir);�0�ti QIU.�,w� VZ��JN vJ
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 governmen urrently processing remaining requirements to attain LUCS consistency?
Yes ❑ No
6. P n i 9offcia viewer's telephone number:
zt((
glad rr1le-1 V. VafirM L �k> ZJZ1
-paigrualure of Planning Official Print name Title Date
(Depending upon city/county agreement onjunsdiction outside city limits but within UGB)
ATTENTION;A LUGS approval cannot be accepted by ODA until the following:
• All local requirements have been met.
• Written findings of fact for all local decisions addressed under 6 through 6B must be attached to the
LUGS.
• Question 6: The business or facility complies with all applicable local land use requirements is marked
Yes.
Oregon Department of Agriculture, Hemp Program • Phone 503-986-4652 • Website:https://oda.direct/HEMP
Hemp Handler Registration Application Rev.11/20