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Home My WebLink AboutMiscellaneous DMV License 1986-04-28MU APPLICATION FOR BUSTNESS CERTIFICATE AS A DEALER OR REBUILOER oF VEHICLES (EXCEPT SNOWMOBILES AND ATV',S) i2* CERTIFICATE NO.: - -E+LI ORIGINALfl neruEwetNOTES: FAILURE TO ACCURATELY COMPLETE THIS FORM WILL CAUSE UNAVOIDABLE DELAY PLEASE TYPE OR PRINT LEGIBLY WITH INK DO NOT SUBMIT APPLICATION WITHOUT YOUR SURETY BOND ANO THE REOUIRED FEE' BU INESS TELEPHONE 5 0 3- 937 -2863BEST REBUILDERS +TOT'IING DEALERS BUSINESSNAMETION AND/OR COUNTY LANE zrP cooE 97 477SPRINGFIELD CITYMAIN BUSINESS LOCATION 762 S28th SPRTNGFIELD AND NUMBER) zrP cooE 97 431 STATE REGON CITY DEXTER MAILING ADDRESS 81983 LOST VALLEY LANE TELEPHONE 937 -2863 COUNTY LANE ZIP CODE 97 477 crw SPRINGFIELD ADDRESSSTR rh762 S TELEPHONECOUNTYZIP CODECITYADORESSSTR BUSINESS IS INCORPORATEDIF CORPORATION, LIST THE STA'TE UNDER WHOSE LAW TNDTvTDUAL I peRrrueRsHtP tr coRponlrtoru CH ORGANIZATION LIST NAME AND RESIDENCE ADDRESS OF ALL INDIVIDUAL OWNERS, PARTNERS OR PRINCIPAL CORPORATE OFFICERS P 0 3 )e 37 -2863 RESIDENCEDATE OF BIRTH 7 - 6-57OWNER TITLE RONALD D ANDERSO}I NAME zlP cooE 91 43tSTATE OREGON CITY DEXTERRESIDENCE AODRESS 81983 LOST VALLEY LANE RESIDENCE TELEPHONE () DATE OF BIRTHTITLENAME STATECITYRESIOENCE AOORESS RESIOENCE TELEPHONE () DATE OF BIRTHTITLENAME zrP cooESTATECITYENCE ADDRESSH n cnecx rF You sELL MoBILE HoMES REBUILD VHECK IF IF YES, NAME THE MAKE(S): ARE YOU A FRANCHISE D OEALER? E VES I CERTIFY THAT I AM THE APPLICANT OR AN AUTHORIZED REPRESENTATIVI ACCURATEANoTRUE.IoERTIFYTHATTHEBUSINESSDoESoRWILLDEALIN' E ANO THAT ALL INFORMATION ON THIS APPLICATION IS OR REBUILDS VEHICLES ANO IS OR WILL BE ESTABLISHED AT THE LOCATIO GIVEN zrP COOE 1 437OREGON DATE TITLE OWNER TITLE E DEXT 03 37 -2863 GNATED INISTRATIVECOMPLY CONTRAVENTIO EERDSION.VIMVEOTORICLESH (WE)EN'FORT THELAMIT,l ED AGESASTOWISHBEAGENT:ASACT (w E)TOAGREEMENT ORANYLOSSOFVISIONMLESSHAR,DHOL DTHEAGREANDTOERULESDANADMLAWSLEAWITHAPPLICABLLTO MITYFROANDORAUTHNAGENT'SOFINOREXCESSINTIONS DENCE TELEPHONE ADORESS, CITY, STA RONALD D ANDERSON EXPENSE RESULTTNG FROM ANY ACTS OR REPRESENTA INCIDENTAL EXPENSES DUE TO TERMINATION' SIGNATURE x LIST THE ADORESS ES OF ALL ADDITIONAL BUSINESS LOCATIONS. A SEPARATE APPLICATION (FORM 371) MUST BE COMPLETED FOB ANY ADDITIONAL LOCATIONS IN A DIFFERENT CITY OR COUNTY APPROVAL:I CERTIFY THAT EACH LOCA'TION SPECIFIEO ABOVE COMPLIES BUSINESS CERTIFICATE FEE (INCLUDES ONE PLATE) $96'00 WITH ALL LANO E crrv E cou USE OR BUSINESS REG ULATORY OROINANCES OF THE NTY OF I CERTIFY THAT I AM AUTHOR EVIOENCE OF SUCH AUTHORITY THE CITY OR COUNTY IZED TO SIGN THIS APPLICATION AND AS DO AFFIX HEREON THE SEAL OR STAMP OF AOOTIONAL LOCATIONS - @ $30'00 EACH - ADDITIONAL PLATES ...-----.- @ $11.00 EACH .- TOTAL:$TITLENAME 'ia t 1 SIGNATURE 2 STAMP DATE NOTE: lF THIS lS A RENEWAL OF AN EXISTING CERTIFICATE USE THE ATTACHED BILLING LIST TO CALCULATE PLATE FEES. ZIP CODE I I ffiU APPLtcATtoN FoR elstNess cERTTFTcATE As A wREcKEn oF uoroR vEHtcLES OR SALVAGE POOL OPERATOR bl>o CERTIFICATE NO.: --&ontetrunlfl ReruewRuNOTES: FAILURE TO ACCURATELY COMPLETE TH]S FORM WILL CAUSE UNAVOIOABLE DELAY PLEASE TYPE OR PRINT LEGIBLY WITH INK DO NOT SUBMIT APPLICATION WITHOUT YOUR SURETY BONO AND THE $54.00 FEE. NAME (CORPORA BUSINESS \ I LL] MAIN NESS LOCATION AND NUMBER)ZIP CODE& 762 S 28th SPRTNGFTELD 97 477 BUSINESS TELEPHONE 937 -2863 COUNTY LANE MAILING AOORESS 91983 LOST VALLEY LANE crw DEXTER STATE OREGON ztP cooE 97 43t LIST THE ADDRESSES OF ALL ADDITIONAL BUSINESS LOCATIONS. A SEPARATE APPLICATION FORM MUST BE COMPLETED FOR ANYADDITIONAL LOCATIONS IN A DIFFERENT CITY. STREET ADORESS 762 s 28rh CITY SPRINGFIELD ZIP CODE 97 477 COUNTY LANE TELEPHONE 937 22863STREETCITYZIP CODE COUNTY CHECK ORGANIZATION TYPE: El rNorvroual n plRnreRsnrp fI conponrloru IF CORPORATION, LIST THE STATE U NDER WHOSE LAW BUSINESS IS INCORPORATED LIST NAME AND RESIDENCE ADDBESS OF ALL INDIVIDUAL OWNERS, PABTNERS OR PRINCIPAL CORPOBATE OFFICERS NAME RONALD D ANDERSON TITLE OWNER DATE OF BIRTH 7 -6-57 RESIOENCE TELEPHONE F03 )e 37-2863 VALLEY LANE crw DEXTER STATE OREGON zrP cooE91 437 NAME ADDBESS TITLE DATE OF BIRTH RESIDENCE TELEPHONE () CITY STATE ZIP COOE TITLE OATE OF BIRTH RESIOENCE TELEPHONE L)RESIDENCE ADDBESS crw STATE zrP cooE THE DIMENSIONS OF THE PROPERTY ON WHICH THE BUSINESS IS LOCATED ARE 300 x.y'1 50 x. I CERTIFY THA T A M THE A PPLICA NT OR AN AUTHO B IZED REPRESENTA ,TIVE AN D THA,T ALL IN FORMA TION ON THIS APPLICA TION SACCURATEANDTRUE.ALSO CERTIFY THA,T THE R IGHT o F WAY OF ANY H IGHWAY AOJACENT TO THE LOCA TroN(s)LllSTED ABOVEUSEDFORACCESSTOTHEPREMISESANDPULrcPARKING. NAME RONALD TITLE RESIDENCED ANDERSON OWNER 03 7-863 , STATE, ZIP OATE D -l APPROVAL: I CERTIFY THAT THE GOVERNING BooY oF THE f] crrv E cour.rrv oF - HAS: A) APPROVED THE APPLICANT AS BEING SUITABLE TO ESTABLISH, MAINTAIN OR OPERATE A WRECKING YARD OB BUSINESS(oRtGtNAL APPLTCATTONS ONLY). B) DETERMINED THAT THE LOCATION OR PROPOSED LOCATION MEETS THE REOUIREMENTS FOR LOCATION UNDER SECTION 802,CHAPTER 338, OREGON LAWS 1983 (AS AMENOED By CHAPTER 16, OREGON LAWS 1985). C) DETERMINED THAT THE LOCATION DOES NOT VIOLATE ANY PROHIBITION UNDER SECTION 806, CHAPTER 338, OREGON LAWS1983 (AS AMENDED By CHAPTER 16, OREGON LAWS 1985). D) APPROVED THE LOCATION AND DETERMINED THAT THE LOCATION COMPLIES WITH ANY REGULATIONS ADOPTED BY THEJURISDICTION UNDER SECTION 807, CHAPTER 338, OREGON LAWS 1983 (AS AMENDED By CHAPTER 16, OREGON LAWS 1985). I ALSO CERTIFY THAT I AM AUTHORIZED TO SIGN THIS APPLICATION AND AS EVIDENCE OF SUCH SEAL OR STAMP OF THE CITY OR COUNTY AUTHORITY DO AFFIX HEREON THE AEip$tc\tr'EDljCePe.ae<..1 5 . tt-e:rl-t NAME tJl SIGNATURE CITY I IS AsEffis$ APPLICATTON FOR BUSINESS CERTIFICATE AS A WRECKER OF MOTOR VEHICLES oR SALVAGE POOL OPERATOR CERIFIoATE NO.: _ n oRtGtNALfl neruewalNOTES: FAILURE TO ACCURATELY COMPLETE THIS FORIII wlLL CAUSE UNAVOIDABLE DELAY PLEASE TYPE OR PRINT LEGIBLY WITH INK DO NOT SUBMTT APPLTCATION WITHOUT YOUR SURETY BOND AND THE 354,(x) FEE. UIrl NAME (CORPORATION AND/OR ASS,IJMED BUSINESS NAME) Tnerrr:nr.a (aIrr:rra Qanr{ aa BUSINESS TELEPHONE 746-7669 MAIN BUSINESS LOCATION (STREET AND NUMBER) 762 S. 28th CITY Sprinqfield ZIP CODE 97 477 COUNTY Lane MAILING ADDRESS P.O. Box 501 CITY Sprinqfield STATE OR ZIP CODE 97 477 LIST THE ADDRESSES OF ALL ADDITIONAL BUSINESS LOCATIONS. A SEPARATE APPLICATION FOBM MUST BE COMPLETED FOR ANY ADDITIONAL LOCATIONS IN A DIFFERENT CITY. CITY ZIP CODE COUNTY TELEPHONESTREET ADDRESS STREET ADDRESS CITY ZIP CODE COUNTY TELEPHONE CHECK OFIGANIZATIUi{ T-TPE: Ek,uo'vrou^l DpeRrruEnsnrp Econponarro* IF CORPORATION, LIST THE STATE UNDEH WHOSE LAW BUSINESS IS INCORPORATED LIST NAME AND BESIDENCE ADDRESS OF ALL INDIVIDUAL OWNERS, PARTNERS OR PRINCIPAL CORPORATE OFFICERS Ken Kinnard NAME TITLE Owner,/llqr. DATE OF BIRTH 7 -24-23 RESIDENCE TELEPHONE (503) 34s-4940 RESIDENCE ADDRESS 148 W. 37th Avenue crw Euqene STATE OR ztP cooE 97 405 NAME TITLE DATE OF BIRTH RESIDENCE TELEPHONE () RESIDENCE ADDRESS CITY STATE ZIP CODE NAME TITLE OATE OF BIRTH RESIDENCE TELEPHONE () RESIDENCE ADORESS CITY STATE ZIP CODE THE DIMENSIONS OF THE PROPERTY ON WHICH THE BUSINESS IS LOCATED ARE 2oo So-+tft.x ft. I CERTIFY THAT I AM THE APPLICANT OR AN AUTHORIZED REPRESENTATIVE AND THAT ALL INFORMATION ON THIS APPLICATION IS ACCURATE AND TRUE. r ALSO CERTTFY THAT THE R|GHT OF WAY OF ANY HTGHWAY ADJACENT TO THE LOCATTON(S) LTSTED ABOVE tS usED FOR ACCESS TO THE PREMTSES AND PUBLTC PARK|NG. / / Ken Kinnard NAME Owner TITLE RESIDENCE TELEPHONE ( s0318(5-7 9 40 ADDRESS, CITY, STATE, ZIP CODE 148 W. 37th Avenue 1-30-85ene OR 97477 APPBOVAL: I CEBTIFYTHATTHE GOVERNING BODY OFTHE drn A) APPROVED THE APPLICANT AS BEING SUITABLE TO ESTABLISH, (oRrGrNAL APPLTCATTONS ONLY). OR ,TE A WRECKING YARD OR BUSINESS B) DETERMINED THAT THE LOCATION OR PBOPOSED LOCATION MEETS THE REOUIREMENTS FOR LOCATION UNDER SECTION 802, oHAPTER 338, OREGON LAWS 1983 (AS AMENDED BY CHAPTER 16, OREGON LAWS 198s). C) DETERMINED THAT THE LOCATION DOES NOT VIOLATE ANY PROHIBITION UNDER SECTION 806, CHAPTER 338, OREGON LAWS 1983 (AS AMENDED BY CHAPTER 16, OREGON LAWS 1985). D) APPROVED THE LOCATION AND DETERMINED THAT THE LOCATION COMPLIES WITH ANY REGULATIONS AOOPTED BY THE JURISDICTION UNDER SECTION 807, CHAPTER 338, OREGON LAWS 1983 (AS AMENDED By CHAPTER 16, OREGON LAWS 1985). I ALSO CERTIFY THAT I AM AUTHORIZED TO SIGN THIS APPLICATION AND AS EVIDENCE OF SUCH AUTHORITY DO AFFIX HEREON THE (PLACE STAMP OH SEAL HEBE) OF APPffiCWED6YeA#l c?, ),bTT NAME _@w.aM, SIGNATUBE DATE (-OF SPRINGFI SEAL OR STAMP OF THE CITY OR COUNW