HomeMy WebLinkAboutApplication APPLICANT 5/26/2022;City of Springfield
Development & Public Works
225 Fifth Street
Springfield, OR 97477
PERMIT REVIEW INTAKE FORM
SPRINGFIELD
(City Staff completes form)
Permit
Dept of Motor Vehicles -New: ❑
Land Use Compatibility Statement: ❑ City: ❑
Dept of Motor Vehicles -Renewal: X
Project Information
Zoning Verification Letter: ❑ Will: ❑
Applicant Name: Cascade Auto of Springfield Phone: 808-220-6623
Company:
Cell:
Address: 200 40th Street Springfield
Ore on 97478
Property Owner: James Dobson
Phone:
Com an
Cell:
Address: 200 401h Street Springfield
Or
ASSESSOR'S MAP NO: 17-02-31-41
TAX LOT NO(S): : 1000
Property Address: 200 40`h Street
Description of Proposal: DMV Renewal
Record Information
Record No: 811-22-000138-TYP1
Date Received: 05/26/22
Application Fee: 348
Technical Fee: 17.40 ,
TOTAL FEES: $365.40
Assigned Planner: Liz Miller
Revised 11.2.11 kl
10
APPLICATION TO CORRECT DEALER / REBUILDER
VEHICLE DEALER CERTIFICATE
_
DEALER NUMBER
EFFECTIVE DATE EXPIRK OATS CURB TBU515E55NVAME 5
O
Check the reason fir c rrecti-oonni:
❑ Name Change I'�Address Change ❑ Add / Remove Owners E] Ong. / Structure Change
P
Instructions: VALIDATION USE ONLY
• The fee for a cerrected certificate: $30.
• Name change and/or address change: $30. Attach Bond Rider and Insurance Generate.
• Organizational structure change: $30. (e.g., Individual soldiership a LLC to Carp.) Attach a band rider
and insurance cedifirale.
• Adding/Removing LLC member or corporate officer: No Fee
_
• Each new owner must complete and sign lines 12-16 or 17-21.
• Each owner being removed must sign line 22 or 23.
• One owner must sign line 24.
• Provide copy of valid photo ID if charging residence address.
• Dealer number and expiration date will stay the same.
Submit the Completed application to. DMV Business Licensing, 1905 Lana Ave NE, Salem Oregon 97314..,.
NOTE: If the dealership has been sold, the new owners) must obtain their own vehicle dealer Certificate using the Form 735-370kIDENTIFICATIONNUMBER
certificate Is not transferable.
NAME CHANGE
NEW BU INE NAME IttasSumeE Eminw name, fill in eelarry Number.) REGON BUSINESSR MBE
qL MPL YER
ean P"
Any alteration of Line 3 voids Iota ion approval.
ADDRESS CHANGEEW
STR'c0 NI NE ILLBE CONOl1LTED RESIDENCE PREVIOVSSUP E PL FPXnN
rVSINE9
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ZIP CODE
"T ((J tau 60
`2lIX
EA RE 9
J4' Cliff 7 • ZIPCODE
JEMRL III W
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I ET DORE FBuslrvess LDCATIo
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LOCATION APPROVAL - Required only If dealer is changing business location
Certification of Local Zoning and Business Regulatory Compliance. ORS 822.005 requires a vehicle dealer certificate, unless exempt
under ORS 822.015, for any person who:
(a) Buys, sells, brokers, trades or exchanges vehicles either outright or by means of any conditional sale, bailment, lease, security
interest, consignment or otherwise; OR
(b) Displays a new or used vehicle, trailer or semitrailer; OR
(c) Acts as any type of agent for the owner of a vehicle to sell the vehicle or acts as any type of agent for a person interested in
buying a vehicle to buy a vehicle.
THE CERTIFICATION BELOW IS TO BE COMPLETED BY-THE LOCAL ZONING OFFICIAL. The approval below should be based
upon whether the jurisdiction allows the applicant ANY of the activities in (a) through (c) above under its ordinances, at the location of
the business given on Line 3.
As the zoning official for the jurisdiction where this business is located, i Very, by my signature hot= that the location othis husmess as shown on this application
complies with any land use ordinances or business regulatory ordinances of the jurisdiction pursuant to ORS 822.025(6),
❑ CITY OF: COUNTY OF:
TELEPHONE NUMBER
PRINT NAME
TITLE
SIGNATURE
DATE
X
Place stamp or seal here T
El Restrictions on the location
approval are in an attached
letter from the zoning authority.
id 2
l) a 164112