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HomeMy WebLinkAboutPermit Building 1983-01-030ir LliiE c0rlBI i I ON LICATI IHFoRllATI0t{ Lii{t 726-3753 Dq Go ) QN i.\-- c)5t;S. Ztr'th SrJob Address EIIERGY SOURCES Hea t l.Jater Heater Ranqe So. Ftq. llain- t-eqal Descriptlon /g-o3-a/ <to-oD 1 6 o Va lue of llork:*!-,,eon c()0wner Address Bty'i I cii nrFanily I I-F-erniiT-Tnfo : Dejcri be l'lork( lesidence tlith Attached Garage '€.r Build Singie 0..,[nel- 0lnrr o,f--i Construction Lender 5 Addres s Phone name addre s s lcs. no.exrr'res ohone no. Primary Structura l El ectri ca l llechanical n ame addres s l ics. no.p Yn'rps )ohone no. I Pl umbi no Electrical ilechanical PLUIlB I IIG ELECTRI CAL MECHANICAL FFF CHARGE N0_FFF rHA ACF NO FFF THARGF Each single fixture Residence of SQ. FT furnace/burner to BTU' s Relocated building (new fix. additional ) New circuits alts. or extensions Floor furnace and vent S. F. Residence(1 bath)SERV I C ES Recessed wal I Soace heater and vent Duplex (1 bath) each Additional bath Temporary Constructi on Apol iance vent <pna ratp l.later servi ce Change in existing rcs'i dence Stationar-v evap cooi er Sewer multifamily, comn. or Indrrstria l Vent fan with sinole duct Storm Sewer 0f amps. Vent system apart from heatino or A.C. c0r4r.1./lND. FEEDERS Mechanical exhaust hood and duct Insta l I /al ter/rel ocate di<trib. feeders l.lood stove/heater 0f ISSUANCE OF PFRI1IT TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES I.'HERE STATE LII.I REQU shalI not be vali'l until IRES that the Electrica'l work be done by an E the label has been signed by an Electrical 5 'Iectrica'l Contractor, the e'lectrical portion of this permit upervisor and returned to the Building Division Y EXAIl IIIE D the comp app lica alI gon Buil t i 0n fo r t a nd do here b.y cert 1 ,fv th a t a n ti 0n reon I s true and correct,and I fur ther cer ri f v that any and State of ore sion of the t^/o rk pe rformed sh a I I be do ne 1 n cco rdance w'l th t he 0rd i na nce s of th c c I ty f Soringfi e I d a nd th La vJS of the oerta 'I n 1 ng to the wor k de sc r 1 bed here 'I n an )U tha t NC 0c CUPAHC wl 1 I be made of any s Board i s t ru ct ure t{l th ou L the p erm 'I s d ing Divi 701 .055 s I on I further c ert I fy tha t my reg i s t ra t I on !r'l th the Bu I .I der s l fu 1 l fo rc e a nd t frec t s req u 1 r'ed by 0Rs tha t f exempt t he ba s 1 s for e xempt 'I on 'I 5 noted he reon a nd th at n I v su bcon trac to rs a nd ernp I oyee s who a re 'I n c0mD i 'I a nce w1 t h OPS 7 0 1 055 wl I I be us ed on thi s proj ec t 3 Ll +l 6 3 o , lifil.lE ( p1 ease pri nt )R^ht rT Lowr S I GiIATURE Zone /tl^V T yoe/const. SZIY units Sq.Ftg. l'lain x value- Fire Zone Bedrooms 0c cy Load Sg. Ftg. Acces Val ue Flood Plain stories / 0ccv eroup B-Z sq. Ftg. 0t I ue__!6&!=_ oN y6a-5_TOTAL VALUATI BUILDIIIG PERI'IIT Charges anC Su rcha rges ___7_?_::_ /.?8 PI an Ck. Cornm/ Ind 55,1/8.ldo Per Fee ha-eo Pa b\a?Svstems Deve chutot (1'5r opment 6?,q Plan Ck. Res 30:i/Bldq Per Fee P.P?d 622fr PLUI4E ING PERI'II T Charges and Su rcha rges Fence Dgmo ELECTRICAL PERI:IT Charges and Surcha rges Sidewalk A/C Pavi ng Tota'l Cornb. Permi t 73.eE Curb CutI{ECHATIICAL PEP.HIT Charges and c,,,-f,--^^-iiirTOTALld e, ?8 Ft9!q Sq Access. 0ther d gh?lu-gt"c.l -8,.*^-!r I LAII :TORS COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnishA. Job Address8. Legal Descriptionl. example- Tax Lot 100, Lane County Map ReferenceD-T'3-T:2. example- Lot l. Block 3, Znd Addition toSFTin!-lieta EstatesC. Name, etc. of owner and construction lenderD. Energy Sources el cal cei forced air gas 2.e or solarE. Squa valuati Orl' ? examp_le- 1?50 sq. foot house, 500 sq. foot g exampie- if new project, check-new - if addicheck add, etc. a rage tion, II. F. Euilding permit information:l. example - construct single family house with anm;aEA garase ?. example - remodel existing garage into family roomJ. exampte - convert single family residence intorestaurant (change of use)G. Value of work ai defined in Section 303 (a) of theStructural Specialty CodeH. DESIGN TEAI.I AND CONTRACTORS To avoid design or construction delays, Building0ivision Staff must be able to contact approprijtepersons regarding design information or job sitecorrections, etc. Abbreviated Plun:bing, Mechanical, & Electrical Schedu.lesA. Lxcept where blank spaces occur in the descriptionportion of the Mechanical and Electrical Schedu.les,the applicant need fill-in only the No. Boxes adjaient - to the appropriate item(s) to be installedB. Full Plumbing, Mechanical, and Electrical Schedulesare available at the Building Divisionl. To conserve space on the permit form the scheduleshave been abbreviated2. If the item(s) to be installed are not covered onthe abbreviated schedules you shouid consult theful I schedulesC. EUiLDING DIVISION STAFF I.IILL FILL OUT ALL FEES AND CHARGES OI{ THE SCHEDULESD. As noted on the CAp, the label must be delivered to theelectrical contractor for signature by his electrrrcai - supervisor. The general contractor ii.not authorizedto sign the electrical labelApplicant to sign and date l,lhenever possible, the initial application wi.l .l be used asa.worksheet on1y. Where possiblb, Building Division Staffwill.prepare a type written copy and returi it to theapplicant at the time the actual permit is issued for his s i gna ture. Fees and Charges Plan check fees are due and payable at the time of theapplication, and no plans wiil-be processed until thesetees are paid. Al l other fees and charqes are due andpayable when the permit is issued. FOR OFFICE USE ONLY III. IV v PERMIT VALIDATION Permit Cler ) {UD)'q PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY: Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: PLANS REVIEWED BY s'r I j date (o .o f ) /-/t3: ^, r-'-..-.-.e.J--r.-t:1:.6,--_ -. f .i-:a-,.; a l ffiU APPLICATION FOR BUSINESS CFNTFICATE / ?ECKER OF MOTOR VEHICLES OR SALVAG )T OPERATOR ORIGINAL RENEWALENOTES: FAILURE TO ACCURATELY COIvIPLETE THIS FORM wLL CAUSE UNAVOIDABLE DEI-AY. PLEASE TYPE OR PRINT LEGIBLY WITH INK DO NOT SUBMIT THIS APPLICATION WITHOUT YOUR SURETY EOND AND THE REOUIRED FEE.CERTIFICATE NO: NAME (CORPORATION AND/OR ASSUMED BUSINESS NAME) STRINCFIBLD AUIO nECYCLERS, IilC BUSINESS TELEPHONE 7w-95p.L MAIN BUSINESS LOCATION (STREET AND NUMBER) ?ro s, 28th slBEEr clw STRINGtrIEI;D ZIP CODE 9714.77 COUNTY IAtrE MAILING ADDRESSP.0. Box I27 CITY SIRITGFIBLD STATE CR ZIP CODEylt+77 1 2 3 LIST THE ADDRESSES OF ALL ADDITIONAL BUSINESS LOCATIONS. A SEPARATE APPLICATION FORM MUST BE COMPLETED FOR ANY ADDITIONAL LOCATIONS IN A DIFFERENT CITY. 4 5 6 7 B 9 10 11 12 13 14 15 16 17 18 APPROVAL: I CERTIFY THAT THE GOVERNING BODY OF THE HAS: A) APPROVED THE APPLICANT AS BEING SUITABLE TO ESTABLISH, MAINTAIN OR OPERATE A WRECKING YARD OR BUSINESS (oRtGtNAL APPLTCATTONS ONLY). B) DETERMINED THAT THE LOCATION OR PBOPOSED LOCATION MEETS THE REOUIREMENTS FOR LOCATION UNDER OREGON REVISEO STATUTE 822.1 10. C) DETERMINED THAT THE LOCATION DOES NOT VIOLATE ANY PROHIBITION UNDER OREGON REVISED STATUTE 822.135. D) APPROVED THE LOCATION ANO DETERMINED THAT THE LOCATION COMPLIES WITH ANY REGULATIONS ADOPTED BY THE JURISDICTION UNDER OREGON REVISED STATUTE 822.140. IALSO CERTIFY THAT IAM AUTHORIZED TO SIGN THIS APPLICATION AND AS EVIDENCE OF SUCH AUTHORITY DO AFFIX HEREON THE SEAL OR STAMP OF THE CITY OR COUNTY FEE: $54.00 fl crrv I couxry or STREET ADORESS CITY ZIP CODE COUNTY TELEPHONE STREET ADDRESS CITY zrP cooE COUNTY TELEPHONE CHECK ORGANIZATION TYPE: fl rNotvrouau E peRrruEnsHtp d"orroro,o* IF CORPORATION. LIST THE STATE UNDER WHOSE I.i{W BUSINESS IS INCORPORATED: OREGOil LIST NAME AND RESIDENCE ADDRESS OF ALL INDIVIDUAL OWNERS, PARTNERS OR PRINCIPAL CORPORATE OFFICERS NAME CEARIES W. EARBAL TITLE TRESIDEI{T OATE OF BIRTH 8-zr-l+5 RESIDENCE TELEPHONE t !3 t 7\L-226\ RESIDENCE ADORESS 3$72L JASTER RoAD CITY STRINGTIELD STATE CR ZIP CODE yt14;77 NAME WII,LIAM E. EARRAT TITLE SECNE'ARY DATE OF BIRTHt2-5-23 RESIDENCE TELEPHONE t 5o3t 7\7-8707 RESIDENCE ADDRESS85lr7j JAsIER PIRK RoAD CITY PI;EASflIT EII,L STATEffi ZIP CODE 97\5' NAME TITLE DATE OF BIRTH RESIDENCE TELEPHONE () BESIDENCE ADDRESS CITY STATE ZIP CODE THE DIMENSIONS OF THE PROPERTY ON WHICH THE BUSINESS IS LOCATED ARE 500 ft. x 900 ft. I CERTIFY THAT I AM THE APPLICANT OR AN AUTHORIZED BEPRESENTATIVE AND THAT ALL ]NFORMATION ON THIS APPLICATION IS ACCURATE ANO TRUE. I ALSO CERTTFY THAT THE R|GHT OF WAY OF ANY HTGHWAY ADJACENT TO THE LOCATTON(S) LTSTED ABOVE lS USED FOB ACCESS TO THE PREMISES ANO PUBLIC PARKING. *oUfitnrus tl. EARRAL rrrLE ?RESIDEIIE RESIDENCE TELEPHONE ( 5O3 )Jl+r-225\ ^"StHg'fJAili''f83h, sprlasftera, or %t+78 D{f-7-89 APPROUED 810 NAME r', CV*tn+) n { r/APmoM TITLE PTANN rtlf-, fmil"sdNerune,n'' / Lt+^*{"ra . D( *{n rx-b**. DArE //- B:g? SUBMIT APPLICATION AND SUBETY BOND, WITH ALL REOUIRED FEES AND SIGNATURES TO: BUSINESS L]CENSING UNIT 1905 LANA AVE. NE SALEM, OR 97314.2350 o-88) (^ , gr^r" , P.odd by STATE PRNfiNG E*tts ffiU APPLICATION FOR TYPE I BUSINESS CET{TIFICATE AS A oEALER on neauttDeR oF vEHtclEs NOTE: FAILURE TO ACCURATELY COMPLETE THIS FORM wlLL CAUSE UNAVOIDABLE DELAY. PLEASE TYPE OR PRINT LEGIBLY WITH INK. ORIGINAL RENEWAL* (See bottom right cornor ot page) CERTIFICATE NO: BUSINESS TELEPHONE 7t1.7 -960l- NAME (CORPORATION AND/OR ASSUMEO BUSINESS NAME) -liPI?II{GFIIILD /rUT0 niiCYCLl-lRS, INC. CITY ('nri no-Pi o'l zl ZIP CODE oryl.J.n,7 COUNTY T.n n rr MAIN BUSINESS LOCATION (STREET AND NUMBER) 21l, il - 2,qth Stroot ZIP CODE onlt,cn crtY 'lnri yr crfi o"l d stAre Or MAILING ADDRESS P-O- ROI( 12? 1 A SEPARATE SUPPLEMENTAL APPLICATION 372) MUST BE COMPLETED ADDITIONAL LOCATION FROM WHICH YOU OPERATE YOUR BUSINESS. 2 3 4 5 6 7 8I 10 11 12 13 14 15 16 17 18 WITH ALL REOUIRED SIGNATURES AND FEES TO: CHECK ORGANIZATION TYPE: E rruorvroull- f] plnrNensutp El conponerroru IF CORPORATION, LISTTHE STATE UNDEB WHOSE LAW BUSINESS IS INGORPORATED: otiilG0t{ DO YOU SELL THESE VEHICLE TYPES? SNOWMOBILESTRAVELTRAILERS MOTORCYCLES/MOPEDS CLASS I ATVS MOBILE HOMES MOTOR HOMES CAMPERS fl ves E *ofl ves El No E ves E r.ro Eves Eruo E ves E r.ro Eves E ruo DO YOU REBUILD VEHICLES? nves E ruo E yes E r'ro AREYOUAFRANCHISEDDEALER? E VES E TTO IF "YES," NAMETHE MAKE(S): LIST NAME AND RESIDENCE ADDRESS OF ALL INDIVIDUAL OWNERS, PARTNERS OR PRINCIPAL CORPORATE OFFICERS: NArEu,\nLns I,,r. HARnAL ''"tPRESrD;INT DATEOF BIRTHi)-at-Ll,o TlR55"?Eif'i2Y"6tt o --: - --rr: ^ -l , CITY STATE ZIP CODE n/rrr |., o RESIDENCE ADDHESS aAz'7c!. -Tnc.on F)n^rl NAMEr,rlTT,T,T AI\.n l-r RESIDENCE ADDRESS Q(lt.O ( To 6h^r I)nnlr I) a^A H AQI.' AT. TITLE STATE :/ OATE OF BIRTH'la (..)nesror(Ce r(<nd ry ELEPHoNE tta Q.,.'ani 6r 1-1- ^-lt / / NAME TITLE OATE OF BIRTH E RESIDENCE ADDRESS CITY STATE ZIP CODE 1 CERTIFY THAT I AM THE APPLICANT OR AN AUTHORIZED REPRESENTATIVE AND THAT ALL INFORMATION ON THIS APPLICATION IS ACCURATE AND TRUE. I CERTIFY THAT THE BUSINESS DOES OR WILL DEAL IN VEHICLES, OR REBUILDS VEHICLES AND IS OR WILL BE ESTABLISHED AT THE LOCATION GIVEN. NAME CI{ APT,11S 'r/H ARR AT,pl.r?qT nnl\Trn TITLE () RESIOENCE TELEPHONE (n"olt.1 ccAlr. ADDRESS, CITY, STATE, ZIP CODE 1 6?2?1: .T qsnr.r r,l nrr.l X LAWS ANO ADMINISTRATIVE RULES AND AGREE TO HOLD THE DIVISION HARMLESS OF ANY LOSS OR EXPENSE RESULTING FROM ANY ACTS OR REPRESENTATIONS IN EXCESS OR IN CONTRAVENTION OF AGENT'S AUTHORITY as an and must lhis WITH ALL APPLTCABLEr(wE) wrsH BE AND FROM INCIDENTAL EXPENSES DUE TO TERMINATION. AGREEMENT TO ACT AS AGENT: THEA LIMITED TOr(wE) SIGNATURE x TITLE DATE APPROVAL: I CERTIFY THAT THE LOCATION SPECIFIED ABOVE COMPLIES WITH ALL LAND USE OR BUSINESS BEGULATORY ORDINANCES OF THE E ctry n couuryor SPRINGFIELD I CEBTIFY THAT I AM AUTHOBIZED TO SIGN THIS APPLICATION AND AS EVIOENCE OF SUCH AUTHORITY OO AFFIX HEREON THE SEAL OR STAMP OF THECITYOR COUNTY. Cynthia L. Harmon Planning Technician NAME TITLE BUSINESS CERTIFICATE FEE (INCLUDES ONE PLATE) (SEE ATTACHED SUPPLEMENTAL APPLICATIONS) $e6.50 $TOTAL: ADOITIONAL PLATES $11.50 EACH ADDITIONAL LOCATIONS $30.00 EAcH DATE HEHE) x * IF THIS IS A RENEWAL OF AN EXIST]NG CERTIFICATE, USE THE ATTACHED BILLING LIST TO CALCULATE PLATE FEES. THE BILLING LIST MUST BE SUEMITTED WITH YOUR RENEWAL APPLICATION 735-370 (5-88) BUSINESS LICENStNG UNIT, 1905 LANAAVE. NE, SALEM, OR 97314-2350 Producod by STATE PRINTIN6 CITY T)1 ^^-^.^l 1r:'r 1 Bmu APPI ICATION FOR BUSINESS CERTIFICATE AS' tt-*=lQF MOTORVEHICLESOR SALVAGE POc :ERATOR E onrctNAL M *=*twAL NOTES:FATLURE TO ACCURATELY COMPLETE THIS FOBM WILL CAUSE UNAVOIDABLE DELAY' PLEASETYPE OR PRINT LEGIBLY WITH tNK. DO NOT SUBMTT THIS APPLICATION W]THOUT YOURSURETYBONDANDTHEREOUIREDFEE. CERTIFICATENO: E 5o )Lt?-96oLELD AUTO RECYCLERS INC, AND/OR(coRPoRA SPRINGFI IANE97477 CODEcrw SPRINGFIEID750 S. 28TH LOCA'MAIN (STREET 9?4?? cooESTATE ORSPRINGFIETD CITY PO BOX I27 1 2 3 LIST THE ADDRESSES OF ALL ADDITIONAL BUSINESS LOCATIONS. A SEPARATE APPLICATION FORM MUST BE COMPLETED FOR ANY 4 5 6 ADDITIONAL LOCATION S IN A DIFFERENT CITY I CERTIFY THAT I AM THE APPLICANT OR AN AUTHORIZED REPRESENTATIVE AND THAT ALL ACCURATE AND TRUE. I ALSO CERTIFY THAT THE RIGHT OF WAY OF ANY IIIGHWAY ADJACENT TO 7 I 9 10 11 12 13 14 15 16 INFORMAT]ON ON TH]S APPLICATION IS THE LOCATION(S) LISTED ABOVE lS USED FOR ACCESS TO THE PREMISES AND PUBLIC PARKING. 5o l+2800 DATE APPROVAL: ICERTIFYTHATTHEGOVERNINGBODYOFTHE E CITY E COUruNTOT HAS: ..'n! eeenoveD THE AppLtcANT AS BErNG SUTTABLE TO ESTABLTSH, MAINTAIN OR OPERATE A WRECKING YARD OR BUSINESS . (oRrclNAL APPLTCATTONS ONLn. B) DETERMTNED THAT THE LOCATTON OR PROPOSED LOCATTON MEETS THE REQUIHEMENTS FOR LOCATION UNDER OREGON REVISED STATUTE 822.1 1 O, c) DETERMTNED THAT THE LOCATTON DOES NOT VTOLATE ANy PROH|BTT|ON UNDER OREGON REVISED STATUTE 822.135. D) APPROVED THE LOCATTON AND DETERMTNEO THAT THE LOCATTON GOMPLTES WTH ANY FEGUTITIONS ADOPTED BY THE JURISDICTION UNDER OREGON REVISED STATUTE 822.140, TELEPHONECOUNTYzlP COOECITY A TELEPHONECOUNTYZIP CODECITYADDRESS IF OREGONE penrreRsntp El conponartouE tnotvtoueu TYPE:CHECK LIST NAME AND RESIDENCE ADDRESS OF ALL INDIVIDUAL OWNERS, PARTNERS OR PRINCIPAL CORPORATE OFFICERS DATE OF BIBTH 08-2L-t+6 RESIDENCE TELEPHONE Fo3 I 484-2800PRESIDENT TITLE CHARLES W. HARRAT ZIP CODE 9?40L STATE OREUGENE CITYADDRESS DATE OF BIRTH L2-5-23 RESIDENCE TELEPHONE t5o)t ?47-B?o?SECRETARY TITLE WILI,IATI E. HARRAI zrP cooE 9?t+55 STATE OR CITY PJ RESIDENCE B BESIOENCE TELEPHONE () DATE OF BIRTHNAME. ZIP CODESTATECITYRESIDENCE ADDRESS THE DIMENSIONS OF THE PROPERW ON WHICH THE BUSINESS IS LOCATED ARE 900500ft.x tt. PRESIDENT TITLE LARKSPIIB^:AVE., EUGENE, 0R 97t+oL zrP cooE L579 17 1B , ALSO CERTIFY THAT I AM AUTHOBIZEO TO S'GN THIS APPL'CATION AND OF SUCH AUTHORITY DO AFFIX HEREON THE FEE: $54.00ffPR(,UEIl NAME TITLE ,A) .oo'12/zl !!?!!T llPLtcAftou ANDSUPETYBoND, wrrH ALL REourREo reei AI{DS'GA'ATURES rO 8US'NESS L,CEl,rS,t G UN'T,905 LAIIA A yE r{E OR SEAL OB STAMP OF THE CITY OR COUNTY. Prod'rod b, SIATE pRtilIflG --:=:-- STREET ADDRESS 157A URKSPUB AVE - NAME PLEASANT HILL TITLE S,GNATUFE yddw cITy 0F spRINGFIELD planning and Development Department DATE OF LETTER March 14, 1988 DATE OF MEETING March 10, 1988 APPLICANT Char'les Harral 750 South 28th Street Springfjeld, 0R 97477 SUBJECT CITY JOURNALan exi sti ng NUMBER 88-03-36. Pre-APPI ic off i ce sto rage he s sor Charl es Harra'l Gary Karp, Cindie Harmon, and Lorne Pleger. ation Conference to discuss an addition to building. Add'itional work wi'l'l be done in actua'l appl'ication. The I ocation of the zoning 'is Heavy Industrial; the Metro Plan s Map# 18-03-01-00; Tax Lot# 00100. phases as property i Des'ignatio d n ATTENDANCE APPLICANT: CITY STAFF: ACTION No formal action was taken, th'is meeting was held to provide the appl icant w'ith information plior to submitting a formal applicat'ion for a Type III Discretionary Use approva'l and Type I Site Plan Review approval. DISCUSSION The 'items d'iscussed may not include all issues which may be revjewed as part of the actual appl icat'ion. MINIMUM DEVELOPMENT STANDARDS (MDS) ARE INTENDED TO MAKE IT EASIER FOR BUSINESSES TO MOVE IN OR TO EXPAND EXISTING STRUCTURES. MDS ARE APPLIED IN LIEU OF FULL SITE PLAN REVIEt,l TO ENSURE MINIMAL COMPLIANCE t^lITH APPEARANCE AND SAFETY STANDARDS SPECIFIED IN THE SPRINGFIELD DEVELOPMENT CODE AND TO REDUCE PROCESSING TIME FOR DEVELOPMENT APPROVAL. THE FOLLOI^IING ARE CONSIDERED MINIMAL DEVELOPMENT STANDARDS: ed and shown 750 South 28th Street. Page 2 Harral Pre-Appl ication tl THE DEVELOPMENT MUST CONNECT TO PUBLIC UTILITIES. Thene is no storm o1 s3n'itary sewer in the jmmediate area. The sjte does have anoperating septic tank. A-copy of the Lane cornty sanitarian,s septic approvalwil I be required as part oi- tne aituil -aipr icit.ion. tr-aoaitionar bathroomfacilities are included as part of the ipplication, verification from thesanitarian wil'l be required to show that the ex'isting system will be able to tohandle the additional f aci l.ities. THE DEVELOPMENT MUST COMPLY I.IITH THE SPRINGFIELD BUILDING SAFETY CODES. Tne expansion will nequire building permits. PARKING AND CIRCULATION AREAS MUST BE PAVED AND STRIPED, AND WHEEL STOPS MUST BEI NSIAL LE D. An office expansion-of 1,500 square feet will require 5 paved and striped parkingspaces (1 space rqi. every 300 tqru." teli of gross floor area). The pavedparking'is for the office aoijt'ion only. If you wjsi to pave-aaditional parking,please remember that back'ing into the puol i. i.ttr't-of -way is prohibited. CURB CUTS WHICH EXCEED THE STANDARDS OF THIS CODE MUST BE CLOSED AND REPLACEDWITH STANDARD CURB AND GUTTER, AND SIDEWALK WHERE NECESSARY. There are no curb cuts and sidewalk - an Improvement Agreement w.ill be requ.ired.In relation to the parking issue d'iscussed above, pleas6 remember that continuouscurb cuts will not be permitted. The minimum curb cut permitted js 24 feet, tne maximum is 35 feet. tl tl tl tl tl tl SIDEWALKS MUST BE INSTALLED WHEN THE SITE ABUTS A CURB AND GUTTER. A PUBLIC IMPROVEMENT AGREEMENT MUST BE REQUIRED WHEN THE SITE DOES NOT ABUT CURB AND GUTTER. There is no curb and gutter. At this point South 28th Street is gravel. An Improvement Agreement w'ill be required. A 5 FOOT tdIDE LANDSCAPED PLANTER STRIP WITH PERMANENT IRRIGATION MUST BE INSTALLED BETWEEN THE STREET-SIDE PROPERTY LINES AND PARKING AREAS OR STRUCTURES. IF STREET TREES DO NOT TXIST, THEY MUST BE INSTALLED IN THIS PLANTER STRIP. Planter strjps will be required to be installed. Please show them on your plans. STREET LIGHTS MUST BE INSTALLED. Two 135 watt Low Pressure Sodium street lights wi'll be required to be installed on existing power poles as part of S'ite Plan/Djscretionary Use approval. tl Page 3 Harral Pre-Appl icat'ion OTHER TRASH RECEPTACLES AND OUTDOOR STORAGE AREAS MUST BE SCREENED. The appl'icant has stated that the box car be'ing used for storage which js located outside of the screened area w'ill be moved w'ithin the screened area. tl DEDICATION OF RIGHT.OF.WAY. The fee for a Djscretionary Use application js $250.00; there is a $100.00 fee for a Type I Sjte Plan applilation. There is a 20 percent discount for attending a pre-ippl'!cat'ion Conference; t,he DU application wjll be $200.00, the Site Plan app'l.ication wjl I be g80.00. The dead'l'!ne for the May 4th Planning Conrmission meetjng is April 1, 1988. Declicat'ion of right-of-waY wi I I be requi red a1 ong the feet ) . APPLICATION PROCEDURE Associ ate Pl anner" Copy To: DRC Members to 30 feet from the centerline of South 28th Street frontage of the entire property (an additional i0 PREPARED BY K I MU AF .ICATION FOR BUSINESS CE "IFICATE AS A WRECKER OF MOTOR VEHICLEi OR SAEVAGE POOL OPERATOR t&wo*5 ORIGINAL E neruewAL*NOTES: FAILURE TO ACCURATELY COMPLETE THIS FORM WILL CAUSE UNAVOIDABLE DELAYplelsEtvpe oR pRtNT LEGIBLv wtrH tNK DO NOT SUBMIT APPLICATION WITHOUT YOUR SURETY BOND AND THE REOUIRED FEE. 1 3 LIST THE ADDRESSES OF ADDITIONAL LOCATIONS I ALL ADDITIONAL BUSINESS LOCATIONS. A SEPARATE APPLICATION FORM MUST BE COMPLETED FOR ANYN A DIFFERENT CITY. field Auto Rec NAME s \1,l-ers BUSINESS NAME)BUSINESS TELEPHONE 747 -960L 750 South 28th Street NUMBER) Springfield crw ZIP CODE 97477 / t t,, COUNTY , ' 'Lane O. Box 127 AODRESS Springfield CITY Oregon STATE zrP cooE 97 477 4 5 6 7 8 I 10 11 12 13 14 15 16 APPROVAL: I CERTIFY THAT THE GOVERNING BODY OF THE E C Y f] COUruTY OT HAS: A) APPROVED THE APPLICANT AS BEING SUITABLE TO ESTABLISH, MAINTAIN OR OPERATE A WRECKING YARO OR BUSINESS (oRrGtNAL APPLTCATTONS ONLY). B) DETERMINED THAT THE LOCATION OR PROPOSED LOCATION MEETS THE REOUIREMENTS FOR LOCATION UNDER SECTION 802, CHAPTER 338, OREGON LAWS 1983 (AS AMENDED BY CHAPTER 16, OREGON LAWS 1985). C) DETERMINED THAT THE LOCATION DOES NOT VIOLATE ANY PROHIBITION UNOER $ECTION 806, CHAPTER 338, OREGON LAWS 1983 (AS AMENDED By CHAPTEB 16, OREGON LAWS 1985). D) APPROVED THE LOCATTON AND DETERMTNED THAT THE LOCATTON COMPLTES W|TH ANy REGULATTONS ADOPTED BY THE JURtsDtcTtoN UNDER SECTToN 807, CHAPTER 338, OREGON LAWS 1983 (AS AMENDED BY CHAPTER 16, OREGON LAWS 198s). I ALSO CERTIFY THAT I AM AUTHOBIZEO TO SIGN THIS APPLICATION AND AS EVIDENCE OF SUCH AUTHORIry DO AFFIX HEREON THE SEAL OR STAMP OF THE CITY OR COUNTY 17 18 STREET CITY ZIP CODE COUNTY TELEPHONE STREET CITY ZIP CODE COUNTY CHECK TYPE: E rruovrounl D pmrruEnsnrp tr CORPORATION IF CORPORATION, LIST THE STATE UN DER WHOSE LAW BUSINESS IS INCORPORATED LIST NAME AND RESIDENCE ADORESS OF ALL INDIVIDUAL OWNERS, PARTNERS OR PRINCIPAL CORPORATE OFFICERS NAME Charles W Harral TITLE Owner DATE OF BIRTH 8/2L/46 RESIOENCE TELEPHONE ( s03 ) 484 2800 RESIDENCE ADDRESS 1579 Larkspur CITY Eusene STATE Oreqon ZIP CODE 9740L NAME TITLE DATE OF BIRTH RESIDENCE TELEPHONE () BESIDENCE ADDRESS CITY STATE ZIP CODE NAME TITLE DATE OF BIRTH RESIDENCE TELEPHONE L) R ADDRESS CITY STATE ztP cooE THE OIMENSIONS OF THE PHOPERTY ON WHICH THE BUSINESS IS LOCATED ARE 1000 ft.x 500 tt. I CERTIFY THAT I AM THE APPLICANT OR AN AUTHORIZED REPRESENTATIVE ANO THAT ALL INFORMATION ON THIS APPLICATION 15 ACCURATE AND TRUE. I ALSO CERTIFY THAT THE RIGHT OF WAY OF ANy HtcHWAy AOJACENT TO THE LOCATTON(S) LTSTED ABOVE tS USED FOR ACCESS TO THE PREMISES AND PUBLIC PARKING. NAME Charles W. Ilarral TITLE Owner RESIOENCE TELEPHONE( s01 484 28oo AOORESS, CITY, STATE, ZIP CODE L579 L arkspur Eugene, Oregon 97401 SIGNATURE DATE LL/L7187 PLACE STAMP OR SEAL HEBE TITLE o NAME t DATE CMJ OF SIGNATUBE FEE: $54.00 CERTIFICATE NO: - I Gd* EBES MU APPLICATION FOt _ ISINESS CERTIFICATE AS AWRECKET- ORSALVAGEPOOLOPERATOR tr MOTOR VEHTCLES , CERTIFICATE NO.: - ','lE ontc'*o.,(\ tr\ ..' ,RENEWAL t NOTES: FAILURE TO ACCURATELY COMPLETE THIS 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. (F, tl"i(( (, -) LIST THE ADDRESSES OF ALL AODITIONAL BUSINESS LOCATIONS. A SEPARATE APPLICATION FORM MUST BE COMPLETED FOR ANY ADDITIONAL LOCATIONS IN A DIFFERENT CITY 3-7 47 -9601,\,i)iED BUSINESS NAME)NAM TION AND/OB AUTO zlP 97 477 /tl llfibld CITY 1 AND NUMBER)BUSINESS LOCA' rh 97 477 STATE Orfield CITY S STREET ADDRESS NA ..'r'' CITY ZIP CODE COUNTY TELEPHONE AODRESS CITY ZIP CODE COUNTY TELEPHONE INOIVIOUAL E plnrruensntp D conponnrtoH IF CORPORATION THE STATE UNDER rs a. :' LIST NAME AND RESIOENCE ADDRESS OF ALL INDIVIDUAL OWNERS, PARTNERS OR PRINCIPAL CORPOBATE OFFICERS NAME Charles W. Ilarral TITLE Owner DATE OF BIRTH 8l2Ll46 RESIDENCE TELEPHONE (s03 ) 484-2800 RESIOENCE ADDRESS 17AL Aa1 Yorrno ll ?Og crw Eusene STATE Oreqon ZIP CODE 97 401 NAME TITLE OATE OF BIBTH RESIDENCE TELEPHONE () RESIDENCE ADDRESS ctw STATE ZIP CODE NAME TITLE DATE OF BIRTH RESIOENCE ADDRESS crw STATE zrP coDE THE DIMENSIONS OF THE PROPERTY ON WHICH THE BUSINESS IS LOCATED ARE 900 ft. x 500 ft. I CERTIFY THAT I AM THE APPLICANT OB 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 AOJACENT TO THE LOCATTON(S) LTSTED ABOVE tS USED FOR ACCESS TO THE PREMISES AND PUBLIC PARKING. NAME Charles W. Ilarral TITLE Owner RESIDENCE TELEPHONE ( s04rk89b48oo CITY, STATE. ZIP CODE 1784 Cel Y ll 208 L0lze 186 APPROVAL: ICERTIFYTHATTHEGOVERNINGBODYOFTHE E CITy- D COuruwoF-HAS: A) APPROVED THE APPLICANT AS BEING SUITABLE TO ESTABLISH, MAINTAIN OR OPERATE A WRECKING YARD OR BUSINESS (oRtctNAL APPLTCATTONS ONLY) B) DETERMINED THATTHE LOCATION OR PROPOSED LOCATION MEETS THE REOUIREMENTS FOR LOCATION UNDER SECTION 802, oHAPTER 338, OREGON LAWS 1983 (AS AMENDED 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 GHAPTER 16, OREGON LAWS 1985). D) APPROVED THE LOCATION ANO DETERMINED THAT THE LOCATION COMPLIES WITH ANY REGULATIONS AOOPTED BY THE JURISDICTION UNOER SECTION 807, CHAPTER 338, OREGON LAWS 1983 (AS AMENDEO By CHAPTER 16, OREGON LAWS 1985). I ALSO CERTIFY THAT I AM AUTHORIZED TO SIGN THIS APPLICATION ANO AS EVIDENCE OF SUCH AUTHORITY DO AFFIX HEREON THE SEALOR STAMPOFTHE ClrY OR COUNTY PLACESTAMPOR SEALHERE) I OA (9-8s)CITY OF SPEI,IT{GFIELD ( a t RESIOENCE TELEPHONE () j- .-{f ?":' ' : '4 +i SURETY BOND -I ..? 801_3L7 FAILUREToAccuRATELYCoMPLETETHISFoRMWILLGAUSEUNAVoIDABLEDELAY KNOW ALL MEN BY THESE PRESENTS: 'Charles W IIarraI BOND NO THAT DOING BUSINESS AS gpringf ield Auto Recyclers BUSINESS NAME,ANY) 750 S 28th St Srcringfield, Or 97477 HAVING PRINCIPAL PLACE OF BUSINESS AT WITH ADDITIONAL PLACES OF BUSINESS AT (ADDRESS, C|TY,STATE, ZrP COOE) CITY, STATE, ZIP (ADDRESS, CITY, STATE, ZIP CCT{IRASTOR^S BCNDING AND INSTJRANCE CCI,IPAIIUT J srATE OF OBEGON, AS PRINCIPAL(S), AND ,l 901- SE Oak, Suite 208 Portland, Or 972L4 CITY, STATE, ZIP. ,,i.1 . l 503 8719_ TITLE BE EXECUTED BE HEREUNTO A CORPORATION ORGANIZED AND EXISTING UNDER AND BY VIRTUE OF THE LAWS OF THE STATE OF AND AUTHORIZED TO TRANSACT A SURETY BUSINESS ]N THE STATE OF OREGON, AS SURETY, ARE HELD AND FIRMLY BOUND UNTO THE STATE OF OREGON lN THE PENAL SUM OF $2OOO.OO FOR THE PAYMENT OF WHICH WE HEREBY BIND OURSELVES, OUR RESPECTIVE SUCCESSORS AND ASSIGNS, JOINTLY AND SEVERALLY, FIRMLY BY THESE PRESENTS. THE CONDITION OF THIS OBLIGATION IS SUCH THAT WHEN THE ABOVE NAMED PRINCIPAL HAS BEEN ISSUED A - CERTIFICATE TO CONDUCT, IN THIS STATE, A BUSINESS WRECKING, DISMANTLING AND SUBSTANTIALLY ALTERING, THE i FORM OFVEHICLES SAID PRINCIPAL SHALL CONDUCT SUCH BUSINESS WITHOUT FRAUD OR FRAUDULENT REPRESENTA.*: TION, AND WTTHOUT VIOLATION OF ANY OF THE PROVISIONS OF CHAPTER 481, OREGON REV]SED STATUTES THEN AND IN ; THAT EVENT THIS OBLIGATION TO BE VOID, OTHERWISE TO REMAIN IN FULL FORCE AND EFFECT UNLESS CANCELLED;I PURSUANT TO ORS 743.755. iiri January 1 8719-AND EXPIRES Decsnber 31 THIS BOND IS EFFECTIVE tN wrNEss WHEREOF, THE SAID PRINCI BY ITS AUTHORIZED REPRESENTATIVE AFFIXED OF ANY ALTERATTON VOIDS THIS BOND PAL AND SAID SUREW HAVE EACH CAUSED THESE PRESENTS TO OR REPRESENTATIVES AND THE SURETY CORPORATE SEAL TO DAY OF rg 86. :, Orner Attorney-in-Fact, :, SURETY'S AGEIIT OR REPRESENTATIVE MUST COMPLETE THIS SECTION: IN THE EVENT A PROBLEM ARISES CONCERNING THIS BOND, CONTACT: NAMEr rContractors BondJlg and tnsurance Co. ADDRESS PO Bo>( L2053 TELEPHONE 232-4000 CITY, STATE, ZIP CODE : PorEland, Or 97212 PLACE SURETY SEAL BELOW ) ,';.,.)r (, ,,. \tll (:f ,'r I i' ' .\\\\\\ t t ..$ji1,1 tl. . I \', ,rr1, .\\ .., .t, i /r,(: I l- (r-,(r.{t i t r, I.t'ri (t.-\, i)\ tt a, 't ' ( t'( (t tr.l1l (' I ) r) ') l.t l'r ( I ( lr' /. * APPROVEO BY ATTORNEY GENERAL'S OFFICE '85 232-4000 / t'' Washinqton -l rri I I \ : AddA!/v) SP]lINGFIELD CITY OF SPRINGFIELD Office of Community & Economic Development Planning and Development Department 21-Mar-1986 13:11 Mr. Chuck Harnal C o Rec yc1 ers n re go 77 SUBJECT: PARTS RACK A field inspection of your property at 750 South 28th Street was conducted on March 10, 1986 for the purpose of approving an extension of an exlsting DMV auto wreckers'license for Springfie'ld Auto Recyclens. l.lhi1e performing this inspection it was noted that a parts rack, several feet higher than the surrounding fence, had been erected contrary to Zoning Code provisions regulating auto wrecking yards. Sections 5.04(10), i4.06 A(4)(b) and 17.05 A(3)(j) of the Springfield Zoning Codestate: "Auto wreck'ing, storage and towing yards shall be completely enclosed with a seven foot solid fence and operable gates." The purpose and intent of these repeated admonitions for enclosure of wreckingyands is so that al1 operations and storage is screened fr"om pub'lic view. Dismantled autos or auto parts, whether they are stacked haphazardly or neatlywithin racks, are not supposed to be seen from the street. This is literally the only requirement the City Zoning Code makes of auto wrecking businesses and you are in clear violation. Because your business is operating under a Condit'ional Use Permit issued by the Planning Commission (Journal No. S-75-29, granted on 9/3/75), the P'lanning Comm'iss'ion may review your use as specified in Sect'ion 17.08 (1) and (4) of the Springfieid Zoning Code: "That the permit granted is being or recently has been exercised contrary to the terms or condit'ions of such approval , or is in vio1at'ionof any statute, ordinance, law, or regulat'ion; That the cond'itions specif ica11y ment'ioned in the permit have not been met." The P'lanning Commission agenda for April 2,1986 will include a recommendation from staff to set a public hearing date for review of your Cond'itional Use Permit. Thisletter, along with the minutes and staff report from the 9/3175 Plann'ing Commission meeting wi 1 1 be incl uded for Planning Commission review. South 28th Street 225 North Sth Sheet o Springfield, Oregon97477 . 503/726-3753 t You are welcome to attend the meeting of the 2nd, however, the reason this item'ison the agenda is solely to set a date fon a subsequent public hearing, not todiscuss the specifics of your rack or Conditional Use Permit. If you dismantleyour rack before the meet'ing of the 2nd, please inform this office so that we can remove this item from the agenda. Cordial ly, Gregory S. Mott Development Code Administratorcc: Cynthia Harmon, Permit Coordinator APPLICATION FOR SINESS CERTIFICATE AS AWRECKER - OR SALVAGE POOL OPERATOR CdC/tvro qL, do3tffisBMU IMOTORVEHICLES CERTIFICATE NO.: I ontotluu )tr.nntut'txt NorES: FAILURE To ACCURATELY CoMPLETE THIS FORM WILL CAUSE UNAVO\DABLE DELAYI PLEASE TYPE OR PRINT LEGIBLY WITH INK DO NOT SUBMIT APPLICATION WITHOUT YOUR SURETY BOND AND THE $54.00 FEE. ,TroN AND/OR MED BUSINAME fZt ,.9 NAME) %o/BUSINESS E L D ZIP CODE 77q77 NTY /-ANE- FI ELD OA ,TE ZIP CODE?z 7 LIST THE ADDRESSES OF ADDITIONAL LOCATIONS II ALL ADDITIONAL BUS N A DIFFERENT CITY. INESS LOCATIONS. A SEPARATE APPLICATION FORM MUST BE COMPLETED FOR ANY STREET ADDBESS CITY ZIP CODE COUNTY STREET ADD CITY ZIP CODE COUNTY fl rruorvrouar- !PAFTTNERSHTp E conponnrroru ORGANIZATION IE.COHPORATION. LISI THE STATE UNDER wHosE lRw susrNess id INCORPOHATED. STLI NA M ANDE R ESIDE ENC oADDRESS AF LL INDIVIDUAL OWNEB PJ,ERS,ARTN PBOR rNcr PAL TECORPORA SOFFICER t( ,4aa?+u NAME TITLE OF BIRTH 2/- {LDATE RESIDENCE TELEPHONE 0aRESIDENCE L r CITY STATE dre ztP oTITLEBIRTHDATERESIDENCETELEPHONE CITY STATE ztP TITLE RESI CITY STATE fr. x ft. qtz C) THE DIMENSIONS OF THE PROP,ERTY ON WHICH THE BU NESS ts LOCA ,TED ARE REPBESENTA CERTI FY THA T AM THE APPLICANT OR ANTEACCURA AUTHORIZEDANDTRUE.ALSO c TIVEERTI ANDFY TrHATHATTHE ALLHRIG INFOREDUSOFT MAFOR TIONWAFo ONACCESSTOANY TH ISTHEHIGPREHWA APPLICAMISES TIONAND ISADJACENTPUBLICroRPAETHKILOCANG,TtoN(S)LISTED ABOVE IS4nnpaL NAM E 4L RESI DENCE o DATE oere /2_ ',ff'fr#h ^b*tlfuR"cr-\ ,rc CF spRr Nc FIEID CITY SURETY BOND FAILURE TO ACCURATELY COMPLETE THIS FORM WILL CAUSE UNAVOIDABLE DELA\ KNOW ALL MEN BY THESE PRESENTS THAT DOING BUSINESS AS eld Auto Re lers HAVING PRINCIPAL PLACE OF BUSINESS AT WITH ADDITIONAL PLACES OF BUSINESS AT 750 South 28th Street BOND NO.:BO13Il ield oR 97u77 ATE, fLAcE SURETY SEAL BELOW Jane Thorsen atttorney-in_Facts SECTION: ,1 2 32-4 A r{,.,*,*'ri*$J q lf(rltt?uii{} llLar': .r*., irlrlj l''.r.:ir1,, . '-r i BEPfi ESENTATIVE MUST COMPLETE BOND,CONTACI .. i. I -.'i SPRINGFIELE, CITY OF SPRINGFIELD Department of Public Works CERTIF IED LETTER SincerelY, January J.0, 1984 ctor/Plans Examiner Springfield Auto RecYclers 750 South 28th Street Springfield, Oregon 97477 Dear Business Owner: The springfield Building 991: Od*inistrative -code requires that' in order for a permit to renain valid, constructror, ,Jrt'-*rttorir"a iy-ri-riust uegin within 180 days fron the date of purcr,ur" of the permit. if worr i, ,rlf"i;";";; "ii"i"""a during the course of construction for a period "*.""air,! 180-days, ;t;";;;'it *ir1 automatically expire' Ifapermithasexpiredtlg:Y'p"nsiontil{::^'bandonmentofworkonaprojecthasnot exceeded one year, a permit-to rtart or resume-*.rt may be purchased foi one half the fee required for a comparaUi" ,"r-!uT'it, p'o'iili"ti''t "o Lhung"t have been nade in the origi.uf pfu"t andTor specifications ' rf a permit has not yet elrir,ed and apermit holder anticipates the need for more time to begin "or,riir.iioi,-*ort, .i" i"p"'iitenaeni'oi-suiraing rnay choose to grant a one tine extension of the permit ,il.'15"";;;;; iso auy, upon rece-ipi'rro* the permit holder of a written request explaini'i-*i'y the extension is necessary' The attached formindicates the nost recent infornati-on in our record's with-regard to construction activity associated with your p"il't;."^;;";;" advise tiris office of your intention, *iii';;;;t;" .h"';:;ii"u'v-i"ri ci'oi'i.v'-;;;* the date or this letter' please direct all inquiries to the springfield Building safety Division at 726-3753' Y.d J. Puent ding InsPeBuil th 225 North 5th Street a Springfield, Oregon 97 477 a 503/726'3753 JOB ADDRESS: 7 0 28th Street Ivlay 13, l98g JOB #: ' 8J0 404LAST ACTIVITY DATE: OTHER: NO INSPE CTION RECORDED: CURRENT STATUS oF PERITIIT: VALID:However, your permit will expire on If^Io" rvish to requesoffice in writing pri t an -extension t ,:y" permit, please notify thisor to the above mentionfJ-;;;;.tXX EXPIRED:Your permit expired on Novenber IS ff y9u plan to start orapplied for.resume work on the project, a new permit must be January c1 eal our , Lg83 * ]Jl i}8o"expired" box' above, is--checked and ru o:_r::.hear from you bytu'i#"1;:1,ff{*;rJ}:iil"}jirr;,i:.1::j, we wil I UNITED STATES oFftctAL RETURN SERV PENALTY FOR PBIVATE USE TO AVOIO PAYIEITT OF POSTAGE, t3OO ?TO othsrlso rtlL to blct Endona eii*"fulum adlrcgil to nrriber. SEI{DER 0n Pdnt I thr below. Recdpt Soquegted" 1,0 |ronl CITY OFgFHIfiIGFIELD DEPARTMENT OF PUELIC WORKE oREGON 97477 (City, State, and ZIP Code) !lll c,z,lllotr! bmoo-tmItn .9 O SEIIDEB: Colrptete items 1, 2" 3, arl 1-- :' a Add vour adeess in the "RETURN TO" space on reYefse. (coilsrrlT PoSTIASTER FOR FEES) t. The following service is requested (checl one). Eklho* to whom and date detivered D Sho*, to whom, date, and address of delivery.. z. E nesrRrcrED DELIVERy (The restdcted delivery fee is charged in additbn to ,he return receipt fee.) ^TOTAL 3,L -a -0-i Springfield Auto Recyclers 750 South 28th Street Qnri n ofi al rl f)rcoon q7 477 & Af,NCtl ADORESSEO T(.h r. rvtt or SERYTcE: ' - | Enrosreno I rrsunro IEETTED Dcoo ILlmEss rlr I ARTICLE NUMBEFi 329963798 (Ahy! oeln slgnature of addressee or agent) SIGi{ATURE D eAdr"sr.. above.article E Arttroriz"d tg*t a)d- G.ADoBESts (Oz&, 7. UIABI..E TO D€UVEF AECAUSE 5. I!\ ----:-