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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 � LL E - \ JT - \k\ � } { \ /\) { . { � \ \ \ e \\ q{E! ) G f °;&r Dila { �) _ §::) ! �a / ( & z ) . � 4 L4 \ 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 r ( ?• 51,v cel klu Z[ Sc� l Z�C 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. Page 1 of 1