HomeMy WebLinkAboutApplication APPLICANT 8/31/2021City of Springfield
Development & Public Works
225 Fifth Street
Springfield, OR 97477
Annexation Application Type IV
3 SPNINpFIlLD
Application Type (Applicant: Check one)
Annexation Application Pre -Submittal:
El
Annexation Allolication Submittal: Pri
Required Proposal Information (Applicant: Complete This Section)
308.672.2909
Property Owner: Daryl and Patty Basco Phone' 541.5147601
Address: 4012 Jasper Road, Springfield, OR, 97478 Fax:
ary. ns gmai.00m
E-mail: plbriscoUgmail.mm
Owner Signature:
Owner Signature:
Agent Name:
Phone
Company:
Fax:
Address:
E-mail
Agent Signature:
If the applicant is other than the owner, the owner hereby grants permission for the applicant to act in his or her behalf, except
where slgnaMres of the owner of record are required, only the owner may sign the petition.
ASSESSOR'S MAP NO:
1 18-02-06-14-07700
TAX LOT NO S :
1 18-02-06-14-07700
Property Address'
4012 Jasper Road, Springfield, OR, 97478
Area of Request:
Acres: 022
uare Feet:
Existing Use(S) Residential 1001
of Property:
Proposed Use Residential 1001
of Property:
Required Property Information (City Intake Staff., Complete This Section) No.: Date: Reviewed By:
initials
ApplicationFee:
Postage Fee: Total Fee:
Revised 4/8/14 B] Page 8 of 17
Owner Signatures
This application form is used for both the required pre -submittal meeting and subsequent
complete application submittal. Owner signatures are required at both stages in the application
process.
An application without the Owner's original signature will not be accepted.
The undersigned acknowledges that the information in this application is correct and
accurate for scheduling of the Pre- Submittal Meeting. If the applicant is not the
owner, the owner hereby grants permission for the applicant to act in his/her behalf.
I/we do hereby acknowledge that I/we are legally responsible for all statutory
timelines, information, requests and requirements conveyed to my representative.
Date:
1 represent this application to be complete for submittal to the City. Consistent with the completeness check
performed on this application at the Pre -Submittal Meeting, I affirm the information identified by the City as
necessary for processing the application is provided herein or the information will not be provided if not otherwise
contained within the submittal, and the City may begin processing the application with the information as
submitted. This statement serves as written notice pursuant to the requirements of ORS 227.178 pertaining to a
complete applicah
.<'% `V Date: 1<10%1 aaai
'f�naytur_e �r,SGJ
Revised 4/8/14 BI Page 9 of 17
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FORM 2
OWNERSHIP WORKSHEET
(This form is NOT the petition)
(Please include the name and address of ALL owners regardless of whether they
signed an annexation petition or not.
OWNERS
Property Designation
(Nap/b[ number)
Name of Owner
Acres
Assessed
Value
Imp.
Y / N
Signed
Yes
Signed
No
1602-061407700
Daryl Brisco
0.22
$189,929
Y
X
$189,929
18-02-06-14-07700
Patty Brisco
0.22
$189,929
Y
x
TOTALS:
0.22
$189,929
TOTAL NUMBER OF OWNERS IN THE PROPOSAL
2
NUMBER OF OWNERS WHO SIGNED
2
PERCENTAGE OF OWNERS WHO SIGNED
100%
TOTAL ACREAGE IN PROPOSAL
0.22
ACREAGE SIGNED FOR
0.22
PERCENTAGE OF ACREAGE SIGNED FOR
100%
TOTAL VALUE IN THE PROPOSAL
$189,929
VALUE CONSENTED FOR
$189,929
PERCENTAGE OF VALUE CONSENTED FOR
100%
Revised 4/8/14 BJ 14 of 17
FORM 3
SUPPLEMENTAL INFORMATION FORM
(Complete a// the following questions and provide all the requested information. Attach
any responses that require additional space, restating the question or request for
information on additional sheets.)
Contact Person: Daryl or Patty Brisco
E-mail: daryl.brisco@gmail.com plbriwo@gmail.com
Supplythe following information regarding the annexation area.
• Estimated Population (at present): 2
• Number of Existing Residential Units:
• Other Uses:
• Land Area: 022 total acres
• Existing Plan Designation(s):
• Existing Zoning(s): Residential
• Existing Land Use(s): Residential
• Applicable Comprehensive Plan(s): Metro Pian
• Applicable Refinement Plan(s):
• Provide evidence that the annexation is consistent with the applicable
comprehensive plan(s) and any associated refinement plans.
Annexation required to connect to city sanitary sewer
• Are there development plans associated with this proposed annexation?
Yes x No
If yes, describe.
Connecting to the city Sewer
• Is the proposed use or development allowed on the property under the current
plan designation and zoning?
Yes x No
• Please describe where the proposed annexation is contiguous to the city limits
(non-contiguous annexations cannot be approved under 5.7-140, Criteria).
Contiguous along Eastern and Southern boundaries
Revised 4/8/14 BJ Page 15 of 17
Does this application include all contiguous property under the same ownership?
Yes x No
If no, state the reasons why all property is not included:
• Check the special districts and others that provide service to the annexation
area:
❑ Glenwood Water District
❑ Eugene School District
CJ Springfield School District
❑ Pleasant Hill RFPD
❑ EPUD
IN Willamalane Parks and Rec District
❑ Rainbow Water and Fire District
❑ Pleasant Hill School District
❑ McKenzie Fire & Rescue
IN Willakenzie RFPD
M SUB
❑ Other
• Names of persons to whom staff notes and notices should be sent, in addition to
applicant(s), such as an agent or legal representative.
(Name)
(Address)
(City) (Zip)
(Name)
(Address)
(City) (Zip)
(Name)
(Address)
(City) (Zip)
(Name)
(Address)
(City) (Zip)
Revised 4/8/14 BJ Page 16 of 17
FORM 4
WAIVER OF ONE YEAR TIME LIMIT
FOR ANNEXATION PURSUANT TO ORS 222.173
This waiver of the time limit is for the following described property:
18-02-06-14-07700
Map and Tax Lot Number
assigned)
4012 Jasper Road Springfield, OR, 97478
Street Address of Property (if address has been
ONE WAIVER OF TIME LIMIT FOR EACH PARCEL, PLEASE
We, the owner(s) of the property described above understand the
annexation process can take more than one year but desire to annex to have
City services. Therefore, we agree to waive the one-year time limitation on
this petition to annex established by Oregon Revised Statutes 222.173, and
further agree that this contract shall be effective [ ] indefinitely or [ ] until
Date
Sionatures of Legal Owners
Please print or type name
Si nature
Date Signed
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Revised 4/8/14 8] Page 17 of 17
ANNEXATION LEGAL DESCRIPTION
Lot 3, Block 1, HAZELWOOD, as platted and recorded in Book 33, Page 7, Lane
County Oregon Plat Records. situated in Lane County, State of Oregon, in the
Northeast quarter of Section 6, Township 18 South, Range 2 West, Willamette Meridian,
being further described as follows:
Beginning at the northeast corner of Lot 3, Block 1, HAZELWOOD, as platted and
recorded in Book 33, Page 7, Lane County Oregon Plat Records.
Thence on boundaries of Lot 3, Block 1, of said FIRST ADDITION TO MENLO PARK
the following courses:
1. West 118.76 feet.
2. South 06008'40" East 83.59 feet to the northerly right of way of Jasper Road
and the current City Limits line.
3. Thence on said City Limits line East 110.65 feet to the westerly right of way of
Filbert Lane.
4. Thence continuing on said City Limits line North 0°34'21" West 83.11 feet, to
the Point of Beginning.
Containing 9,533 square feet.
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