HomeMy WebLinkAboutApplication APPLICANT 6/8/2022City of Springfield
Development & Public Works
225 Fifth Street
Springfield, OR 97477IL
Annexation Application Type IV
3 SPNINOFI
Application Type (Applicant:
Check one)
Aion A lication Pre -Submittal:
U❑v
ion ion Submittal:
Required Proposal Information (Applicant:
Property ownr/�(P�Q
Complete
Phone:
This Section)
5111 -T63 -q3 -
1-T63'93Address•
Address:
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Fax:
E-mail:
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Owner Signature:
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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
where signatures of the owner of record are required, only the owner may sign the petition.
to act in his or her behalf, except
ASSESSOR'S MAP NO:I$
- M- - O b - I L4 TAX LOT NOS :
$400
Propertyy Address:
93,;t, S - L4 ul ' pl. c¢.
Area of Request:
Acres: 19-2o
S uare
Feet:
Existing Use(s) &-LL-f n1G
of Property:
Proposed Use VJESlaie: T AL_ 1T„IZLL_ItJ G --No CHANGE
of Property:
Required Property Information (City Intake Staff: Complete This Section)
Case No.: $11-2Z-Opph/cf-ppm Date: b�frlTvzz initials Reviewed
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Application Fee:
Postage Fee: Total Fee:
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Revised 4/8/14 133 Page 8 of 17
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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.
bmittal
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.
Owner:
Date:
Si/gnature
I 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 application.
Date:
Signature
Revised 4/8/14 BI Page 9 of 17
APPLICANTS SHOULD COMPLETE THE FOLLOWING STEPS PRIOR TO SUBMITTING AN
APPLICATION. APPLICATIONS NOT HAVING ALL BOXES CHECKED WILL BE RETURNED
TO THE APPLICANT AND WILL THEREFORE DELAY THE APPLICATION REVIEW
PROCESS.
❑ Application Fee IspC s.7a2s(8)hs7]
Refer to the Development Code Fee Schedule for the appropriate fee calculation formula. Fees
are based upon the area of land being annexed. Copies of the fee schedule are available at the
Development & Public Works Department. Fees are payable to the City of Springfield.
❑ Petition/ Petition Signature Sheet sDC 5.7-125(a)(2)i
To initiate an annexation by consents from property owners as explained below, complete the
attached Petition Signature Sheet (refer to Form 1). (Photocopies may be submitted @ Pre -
Submittal, with original copies @ time of application submittal).
Consent by Property Owners FORS 222.170(1)1
If the proposal is to be initiated by the owners of at least one-half of the land area, land
value, and land ownership, complete Form 2. To give consent for a particular piece of
property, persons who own an interest in the property, or who are purchasers of property
on a contract sale that is recorded with the county, must sign the annexation petition.
Generally, this means that both husband and wife should sign. In the case of a corporation
or business, the person who is authorized to sign legal documents for the firm may sign the
annexation petition. Please provide evidence of such authorization. To ensure that the
necessary signatures are obtained, please complete the attached worksheet (Form 2).
(Photocopies may be submitted @ Pre -Submittal, with original copies @ time of
application submittal).
❑ Certification of Ownership Isoc 5.7-125(8)(5)7
After completing the attached Petition Signature Sheet (Form 1), have the Lane County
Department of Assessment and Taxation certify the ownerships within the proposed annexation
area. (Photocopies may be submitted @ Pre -Submittal, with original copies @ time of
application submittal).
❑ Owners Worksheet
Information on the Petition Signature Sheet can also be found on Form 2, Owners and Electors
Worksheet. (Photocopies may be submitted @ Pre -Submittal, with original copies @
time of application submittal).
❑ Supplemental Information Form Isoc 5.7-125(8)(1) aid (11)7
Form 3 (attached) provides additional information for the proposed annexation that is not
requested on the Annexation Application Type IV form, such as special districts that currently
provide services to the proposed annexation area. (Photocopies may be submitted @ Pre -
Submittal, with original copies @ time of application submittal).
❑ Copy of the Deed (required at application submittal)
❑ Copy of Preliminary Title Report (required at application submittal)
Title Report has to be issued within the past 30 days documenting ownership and listing all
encumbrances.
Revised 4/8/14 53 Page 10 of 17
F1 Annexation Description [SDC 5.7-125(B)(9)]
A metes and bounds legal description of the territory to be annexed or withdrawn must be
submitted electronically in Microsoft Word or a compatible software program. A legal description
shall consist of a series of courses in which the first course shall start at a point of beginning.
Each course shall be identified by bearings and distances and, when available, refer to deed
lines, deed corners and other monuments. A lot, block and subdivision description may be
substituted for the metes and bounds description if the area is platted. The Oregon Department
of Revenue has the authority to approve or disapprove a legal description. A professionally
stamped legal description does not ensure Department of Revenue approval.
❑ Cadastral Map [SDC 5.7-125(B)(10)]
Three (3) full-size paper copies and one (1) digital copy (in .pdf format) of the Lane County
Assessor's tax map that shows the proposed annexation area in relationship to the existing city
limits. If Digital Copy (in.pdf format) is not available, Nine (9) full-size paper copies and one (1)
reduced size redline map at 8 1/2 x 11 are required. Paper copy maps must be printed to scale.
On all submitted maps the annexation area shall be outlined in redline with survey courses and
bearings labeled for cross-reference with the metes and bounds legal description. If the
annexation area extends across more than one tax map, sufficient copies of each affected tax
map must be provided. Please be aware that annexation redline closures must avoid creating
gaps or overlaps, and may not necessarily correspond with the property legal description.
Cadastral maps can be obtained from the Lane County Assessment and Taxation Office.
❑ ORS 222.173 Waiver Form [SDC 5.7-125(B)(8)]
Complete the attached waiver (Form 4). The waiver should be signed by each owner within the
proposed annexation area.
F1 Public/Private Utility Plan [SDC 5.7-125(B)(12)]
A plan describing how the proposed annexation area can be served by key facilities and services
must be provided with the Annexation Agreement. Planning and public works staff will work with
the applicant to complete the Annexation Agreement.
O Written Narrative addressing approval criteria as specified below. All annexation requests
must be accompanied with a narrative providing an explanation and justification of response with
the criteria stated in the application (also stated below). [SDC 5.7-125(B)(13) and (14)]
A. The affected territory proposed to be annexed is within the City's portions of the urban
growth boundary and is contiguous to the city limits or separated from the City limits
only by a public right-of-way or a stream lake or other body of water;
B. The proposed annexation is consistent with applicable policies in the Metro Plan and in
any applicable refinement plan or Plan Districts;
C. The proposed annexation will result in a boundary in which the minimum level of key
urban facilities and services as defined in the Metro Plan can be provided in an orderly
efficient and timely manner; and
D. Where applicable fiscal impacts to the City have been mitigated through a signed
Annexation Agreement or other mechanism approved by the City Council.
❑Three (3) copies of the previously required information.
ALL PLANS AND ATTACHMENTS MUST BE FOLDED TO 81/2- BY 11" AND BOUND BY
RUBBER BANDS.
Revised 4/8/14 BI Page 11 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
TOTAL NUMBER OF OWNERS IN THE PROPOSAL
NUMBER OF OWNERS WHO SIGNED
PERCENTAGE OF OWNERS WHO SIGNED
TOTAL ACREAGE IN PROPOSAL
ACREAGE SIGNED FOR
PERCENTAGE OF ACREAGE SIGNED FOR
TOTAL VALUE IN THE PROPOSAL
VALUE CONSENTED FOR
PERCENTAGE OF VALUE CONSENTED FOR
/Q
Revised 4/8/14 E] 14 of 17
FORM 3
SUPPLEMENTAL INFORMATION FORM
(Complete all the following questions and provide all the requested information. Attach
any responses that require additional space, restating the question or request for
%�� information "own `a,,ddditional sheets.)
Contact Person: (_. 1e,17'1e/5 i//�6 �4e1^
E-mail: (fa 7 k"/ 03(6W ama/ , tn0/n
Supply the following information regarding the annexation area.
• Estimated Population (at present):
• Number of Existing Residential Units:
• Other Uses: n CTYI�'
• Land Area: total acres
/ 1 /
• Existing Plan Designation(s): l
• Existing Zoning(s): leu) 7 /�e.� �i' Q.�
• Existing Land Use(s):
• Applicable Comprehensive Plan(s):.Sp.-I ela 2030 'P/a..
• Applicable Refinement Plan(s):
Provide evidence that the
annexation is consistent with the applicable
comprehensive plan(s) and any associated refinement plans.
• Are there development plans associated with this proposed annexation?
Yes I No
If yes, describe.
Connec4h6n 4-o G'fi4 soave J"e i o I 'raic s -i�
• Is the proposed use or development allowed on the property under the current
plan designation and zoning?
Yes ✓ No
• Please describe where the proposed annexation is contiguous to the city limits
(non-contiguous annexations cannot be approved under 5.7-140, Criteria).
oT CD c S3'fr- e' 0.v.¢( yn u"�'h 4cYlh t? .
Revised 4/8/14 ] Page 15 of 17
Does this application include all contiguous property under the same ownership?
Yes 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 ❑ Rainbow Water and Fire District
❑ Eugene School District ❑ Pleasant Hill School District
EX'Springfield School District ❑ McKenzie Fire & Rescue
❑ Pleasant Hill RFPD GR�Willakenzie RFPD
❑ EEPUD mr'SUB
W Willamalane Parks and Rec District ❑ 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 BI Page 16 of 17
Annexation Description
For
City of Springfield
Map 18-02-06-14, Tax Lot 08400 / Osage Street / S. 40`^ Place
Lot 1, Block 3 of the plat of Hazelwood, as platted and recorded in Book 33, Page 7, Lane County Oregon
Plat Records, Lane County, Oregon.
AND: those portions of South 401h Place and Osage Street as dedicated for public use on said plat of
Hazelwood, being more particularly described as follows:
Beginning at the southeast corner of Lot 2, Block 2 of Hazelwood, as platted and recorded in Book 33,
Page 7, Lane County Oregon Plat Records, Lane County Oregon, said point being on the westerly margin
of South 40th Place and northerly margin of Jasper Road; thence North 00'30'20" West, along said
westerly margin of South 4& Place, 423.44 feet to a point of curvature; thence along the arc of a 25.44
foot radius curve to the left, the chord bearing of which bears North 45'15'10" West 35.82 feet to a
point on the southerly margin of Osage Street; thence West, along said southerly margin of Osage Street
314.78 feet to the northwest corner of Lot 8, Block 3 of said Hazelwood; thence leaving said southerly
margin of Osage Street, North 00'30'20" West 50.00 feet, to the southwest corner of the plat of H.F.
Franklin Addition, as platted and recorded Book 14, Page 31, Lane County Oregon Plat Records, said
southwest corner of H.F. Franklin Addition also being on the northerly margin of Osage Street; thence
East, along said northerly margin of Osage Street, 390,00 feet to the northwest corner of Lot 9, Block 1
of said Hazelwood, also being on the easterly margin of South 40th Place; thence South 00°30'20" East,
along said easterly margin of South 40th Place, 498.66 feet to the southwest corner of Lot 4, Block 1 of
said Hazelwood, said point also being on the northerly margin of Jasper Road; thence leaving said
easterly margin along the northerly margin of Jasper Road, West 50.00 feet, to the Point of Beginning, all
in Lane County, Oregon.
Bearings and distances are based on the plat of Hazelwood, as platted and recorded in Book 33, Page 7,
Lane County Oregon Plat Records, Lane County, Oregon.
EXPIRES DEC 31, 2023
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