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Home My WebLink AboutApplication APPLICANT 5/25/2022'City of Springfield Development & Public Works 225 Fifth Street Springfield, OR 97477 PERMIT REVIEW INTAKE FORM ISPNINOFl� (City Staff completes form) Permit Type Dept of Motor Vehicles -New: ❑ Land Use Compatibility Statement: ® City: ❑ 71 Dept of Motor Vehicles -Renewal: ❑ Zoning Verification Letter: ❑ UGB: ED Project Information Applicant: Laura Farthing Phone: 541-685-7464 Company: Eugene Water & Electric Board Email: laura.farthing@eweb.org Address: PO Box 10148, Eugene, OR 97440 Property Owner: City of Eugene & City of Springfield Phone: Company. s Cell: Address: ASSESSOR'S MAP NO: 18-03-02-40; 18-03-03-40 TAX LOT NO(S): 3800; 700, 300, 1000, 1100 Property Address: n/a Description of Proposal: LUCS form for the diversion and storing of water from the Willamette River for Eugene drinking water ------------- :Record Information Record No: 811-22-000134-TYP1 Date Received:tA" 25, 2022 Application Fee: $376.00 Technical Fee: $18.80 TOTAL FEES: $394.80 Assigned Planner: Revised 11.2.11 Id Land Use Information Form Attachment 2 — Land Use Information Form OREGON erre,ees DEP , EP.IRTHE.Y ]' NOTE TO APPLICANTS Oregon Water Resources Department 725 Summer Street NE, Suite A Salem, Oregon 97301-1266 (503)986-0900 www.oregon.gov/OWRD In order for your application to be processed by the Water Resources Department (WRD), this Land Use Information Form must be completed by a local government planning official in the jurisdictions) where your water right will be used and developed. The planning official may choose to complete the form while you wait, or return the receipt stub to you. Applications received by WRD without the Land Use Form or the receipt stub will be returned to you. Please be aware that your application will not be approved without land use approval. This form is NOT required if: 1) Water is to be diverted, conveyed, and/or used only on federal lands; OR 2) The application is for a water right transfer, allocation of conserved water,exchange, permit amendment, or ground water registration modification, and all of the following apply: a) The existing and proposed water use is located entirely within lands zoned for exclusive farm -use or within an Irrigation district; b) The application involves a change in place of use only; c) The change does not involve the placement or modification of structures, including but not limited to water diversion, impoundment, distribution facilities, water wells and well houses; and d) The application involves irrigation water uses only. NOTE TO LOCAL GOVERNMENTS The person presenting the attached Land Use Information Form is applying for or modifying a water right. The Water Resources Department (WRD) requires its applicants to obtain land -use information to be sure the water rights do not result in land uses that are incompatible with your comprehensive plan. Please complete the form or detach the receipt stub and return it to the applicant for inclusion in their water right application. You will receive notice once the applicant formally submits his or her request to the WRD. The notice will give more information about WRD's water rights process and provide additional comment opportunities. You will have 30 days from the date of the notice to complete the land -use form and return it to the WRD. If no land -use information is received from you within that 30 -day period, the WRD may presume the land use associated with the proposed water right is compatible with your comprehensive plan. Your attention to this request for information is greatly appreciated by the Water Resources Department. If you have any questions concerning this form, please contact the WRD's Customer Service Group at 503-986-0801. Revised 3/8/3010 Land Use Information Form - Page 1 offs WR/FS Land Use Information Form Applicant(s): Eugene Water & Electric Board Mailing Address: 4200 Roosevelt Blvd. Attachment 2 — Land Use Information Form OREGON Oregon water Resources Department Section 725 Summer Street NE, Suite A Tax Lot# Salem, Oregon 97301-1266 Water to be: (503) 986-0900 sear[--CsooPC" wwwAragan.gov/OWRD ne 1.-111 Lsi SW SW City: Eugene State: OR Zip Code: 97402 Daytime Phone: 541-685-7435 A. Land and Location Please include the following information for all tax lots where water will be diverted (taken from its source), conveyed (transported), and/or used or developed. Applicants for municipal use, or irrigation uses within irrigation districts may substitute existing and proposed service -area boundaries for the tax -lot information requested below. Township Range Section xx Tax Lot# Plan Designation (e.g., Rural Residemial/1111-5) Water to be: Proposed land Use: 18 3W 2 SW SW 380D EMU -Glenwood ®Dlwned 0canerea [I Used Municipal 18 3W 3 SW SW- 0700 EMU -Glenwood ❑Drveded 0cnn.ered ❑ased. Municipal L 3W 3 SW SW 0300 EMU -Glenwood Cl p-. 0cen.e,ed 11 used Municioal 18 3W 3 SW Sw 1000 EMU -Glenwood El lawmen ODteveyad ❑used Municipal IS 3W 3 SWSW 1100 Light Medium Industrial C] Diverted ®Cowered ❑u:<d Municipal Ust all counties and cities where water is proposed to be diverted, conveyed, and/or used or developed: City of Springfield B. Description of Proposed Use Type of application to be filed with the Water Resources Department: ® Permit to Use or Store Water ❑ Water Right Transfer ❑ Permit Amendment or Ground Water Registration Modification Limited Water Use License ❑ Allocation of conserved Water ❑ Exchange of Water Source of water: ® Reservoir/Pond ❑ Ground Water ❑ Surface Water (name) Stored water from Dorena and Cottage Grove Res. Estimated quantity of water needed: 437 ❑ cubic feet per second ❑ gallons per minute ® acre-feet Intended use of water: ❑Irrigation E] commercial ❑ Industrial ❑ Domestic for household(s) ® Municipal ❑ Quasi -Municipal ❑ Instream ❑ Other Sriefly describe: EWEB is requesting a water use permit for the use of stored water from Dorena and Cottage Grove Reservoi will use as a redundant source of water supply to serve its customers within its municipal service area. Note to applicant: If the Land Use Information Form cannot be completed while you wait, please have a local government representative sign the receipt at the bottom of the next page and Include it with the application filed with the Water Resources Department. Revised 2/8/2010 Land Use Information Farm - Page 2 of 5 WR / FS Attachment 2 — Land Use Information Form See bottom of Page 3. -) Revised 2/8/2010 Land Uze Information Form - Page 3 of 5 WR / F5 Attachment 2 — Land Use Information Form For Local Government Use Only The following section must be completed by a planning official from each county and city listed unless the project will be located entirely within the city limits. In that case, only the city planning agency must complete this form. This deals only with the local land -use plan. Do not include approval for activities such as building or grading permits. Please check the appropriate box below and Provide the requested information ❑ Land uses to be served by the proposed water uses (including proposed construction) are allowed outright or are not regulated by your comprehensive plan. Cite applicable ordinance section(s): ❑ Land uses to be served by the proposed water uses (including proposed construction) involve discretionary land -use approvals as listed in the table below. (Please attach documentation of applicable land -use approvals which have already been obtained. Record of Action/land-use decision and accompanying findings are sufficient.) If approvals have been obtained but all appeal periods have not ended, check "Being pursued." Type of Land -Use Apprmal Needed cite Most Signignnq Applicable Plan P.Ides& Land -Use Approval: (e.g., plan amendments, remnes, conditional -use Ordinance Section References Permits, etc.) ❑Obtain. ❑ Being Pursued ❑tenied ❑NM Being Pursued! ❑Obtained E] Being Pursued Dented [I N. Being Nn,aO ❑Obtained! ❑Being Pursued ❑Denied ❑ Not Being Pursued ❑Obtained ❑Beteg Pursued ❑Denied ❑NM Being Pursued ❑Obtoined [I Being Pursued ❑Denld ❑ Not Being Pursued Local governments are invited to express special land -use concerns or make recommendations to the Water Resources Department regarding this proposed use of water below, or on a separate sheet. Title: Phone: Date: Government Entity: Note to local government representative: Please complete this form or sign the receipt below and return it to the applicant. if you sign the receipt, you will have 30 days from the Water Resources Department's notice date to return the completed Land Use Information Form or WIRD may presume the land use associated with the proposed use of water is compatible with local comprehensive plans. _ City Receipt for Request for Land Use Information Staff Revised 2/E/2010 Land Use Information Form - Page 4 of 5 WR / FS Signature: Attachment 2 — Land Use Information Form Phone: Date: Revised 2/6/2010 Land Use Information Form - Page 5 of 5 WR/FS