HomeMy WebLinkAboutApplication APPLICANT 10/25/2022'City of Springfield
Development & Public Works
225 Fifth Street
Springfield, OR 97477
PERMIT REVIEW INTAKE FORM
i
PNINOPIl
(City Staff completes form)
Permit Type
Dept of Motor Vehicles -New: ❑Land Use Compatibility Statement: X City: X
Dept of Motor Vehicles -Renewal: ElZoning Verification Letter: ElUGs: ❑
Project Information
Applicant Name: Christopher Vaughn Phone: 541-735-1121
Com an
Cell:
Address: 2187 S. F Street Springfield,
OR 97477
Property Owner: Ash Living Trust
Phone:
Company:
cell:
Address: 89198 Sutton Lake Drive
Florence OR 97439
ASSESSOR'S MAP NO: 18030100
TAX LOT NOS : 03800
Property Address: 2187 S. F Street
Description of Proposal:
OLCC LUCS for Marijuana Producer
Record Information
Record No: 811-22-000236-TYPI
Date Received: 10/25/22
Application Fee $365.00
Technical Fee: $18.25
TOTAL FEES: $383.25
Assigned Planner:L. Miller
Revised 11.2.11 M
OREGON LIQUOR ft CANNABIS COMMISSION REQUEST
Land Use Compatibility Statement
What is a land use compatibility statement (LUCS)? The LUGS is a form used by a state agency
and local government to determine whether a land use proposal is consistent with local govern-
ment's comprehensive plan and land use regulations.
Why is a LUCS required? OLCC and other state agencies with permitting or approval activities that
affect land use are required by Oregon law to be consistent with local comprehensive plans and to
have a process for determining consistency. Section 34(4)(a) of 2015 Oregon Laws, Chapter 614,
requires OLCC to request and obtain the LUGS and have a positive WCS prior to issuing a license.
CITY/COUNTY USE ONLY
Date delivered by license applicant.
Received by (Print):
Iridal:
When is a LUCS required? A LUGS is required for all proposed marijuana facilities before an OLCC license can be obtained.
How to complete a LUCS:
• Step 1: Applicant completes Section 1 of this form and submits it to the appropriate city or county planning office. Applicant
verifies with local jurisdiction whether additional forms, applications, or permits are required.
• Step 2: Local jurisdiction completes Section 2 of this form Indicating whether the proposed use Is compatible with the acknowl-
edged comprehensive plan and land use regulations and returns signed and dated form to the applicant.
• Applicant completes payment to local jurisdiction for processing application.
• Local jurisdictions are NOT required to begin processing LUGS forms until January 4. 2016 at 8:30 AM.
• Step 3: Applicant submits this date-stamped form and any supporting information provided by the city or county to the OLCC
with the license application. This form may be submitted while Section 2 is in process with the local governing body.
Applicant Name: smpher Vaughn Phone: r
17351121
Mailing Address: 1875 Fst Rm/Ste:
City: f
pringrreld State: F1 ZIP: 477
❑ Site plan of the subject property and proposed development attached? (required)
Proposed
rFS F st
Rm/Ste:
Premises Address:
City:
pnngrteld
r
County:
ane
ZIP: 477
Tax Lot it*:
Range
Iadtuae:
800
Section*:
17S R03W
80301000
Township*:
Map*:
Longitude:
Proposed use/permit type sought (A separate LUCS may he necessaryfor each proposed use even if it is on the same property):
✓ Producer ❑ Wholesaler ❑ Processor
❑ Retailer ❑ Laboratory
❑ Research Certificate
Note indoor or Dstendmse-
outdoor below mems below
Details of proposed use (note arty attachments(:
Indoor, moving existing ficense 9020-1001983F8OF from Suite K to Suite Q for temporary non -operation stooge.
S6 Foo_"JOWN1512 Ji2Lti"L 5700A'— uN&,, tto,,SC co /1"o tl- ,A" k l 106
PCZw,f.. (�2u�xTto1� ,
Site Location:
❑ Inside city limits ❑ Inside UGB ❑ Outside UGB
Name of Jurisdiction:
Property Zoning of
Proposed Premises:
❑ The proposed land use has been reviewed and is prohibited.
❑ The proposed land use has been reviewed and is not prohibited.
If the proposed land use is allowable only as a conditional use, permits are required as noted below.
Cammenh:
Name of Reviewing Local Official (prim):
Title:
Date:
Email:
Phone:
Signature:
Check this box if there are attachments to this form:
REMINDER: Local jurisdictions are NOT required to begin processing
LUCS forms until January 4. 2016 at 8:30 AM