HomeMy WebLinkAboutApplication APPLICANT 1/31/2023;City of Springfield
Development & Public Works
225 Fifth Street
Springfield, OR 97477
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PERMIT REVIEW INTAKE FORM (City Staff completes form)
Permit Type
De t of Motor Vehicles -New: ❑ Land Use Com atibilit Stat t• x X
P p Y State
. city.
Dept of Motor Vehicles -Renewal: ❑ Zoning Verification Letter: ❑ UGB: ❑
Project Information
Applicant Name: Phone: 541-726-7778
Company: Perlenfein Inc.
Address: PO Box 640 Corvallis
OR 97339
Property Owner: 3000 Main Street LLC
Phone:
Company:
Cell:
Address: 635 NW Rondo Street
Albany,OR 97321
ASSESSOR'S MAP NO: 17023100
TAX LOT NOS : 00701
Property Address: 3000 Main Street S
rinfield OR 97478
Description of Proposal:
DMV Location Approval for Dismantler
License Renewal
Record Information
Record No: 811-23-000018-TYPI
Date Received:01/31/23
Application Fee: 365.00
Technical Fee: $18.25
TOTAL FEES: $383.25
Assigned Planner:L. Miller
Revised 11.2.11 Id
Coroorate mailing address:•
PO B. E40 !
Larvallis, QR 97339
January 25, 2023
City of Springfield
225 5'h St.
Springfield, OR 97477
Attn: Liz
541-726-2301
Hello Liz!
Ph: 541-757-0456
AUTO WRECKING Fax: 541-738-4402
W W W.AUTOWRECK.INO.COM
Please see attached check for $383.25 to cover the fees regarding the Local Government Approval for our
Wrecker License Renewal #WR2386.
Please complete and sign off on the included application.
A returned stamped envelop has been included for return of the signed application.
Please email a copy of the signed application to kimberly.nugent@autwreckine.com.
Regards,
/--y ti-c�-f-
Kimberly Nugent I Accounting Manager
B & R Auto Wrecking
PO Box 640
Corvallis OR 97339
541-207-9018 (Office)
Kim berlv.N uaent Cala utowreckine.co m
APPLICATION FOR ANNUAL ICERTIFICATE NUMBER
WR2386
SUPPLEMENTAL BUSINESS CERTIFICATE EXPIRATION DATE
AS A DISMANTLER OF MOTOR VEHICLES OR
•"`.... . SALVAGE POOL OPERATOR
FEE: $500
• PLEASE TYPE OR PRINT LEGIBLY WITH INK.
• ANY ALTERATION OF LINE 2 VOIDS LOCATION APPROVAL. ❑ ORIGINAL Q RENEWAL
BUSINESS NAME
BUSINESS TELEPHONE
Perlenfein,Inc.
(541 )726-7778
SUPPISMENTAL LOCATION (STREET AND HUMBER)
CfrY
COUNTY
LPCOOE
3000 Main Street
Springfield
20
97478
SAM BUSINESS LOCATION ADDRESS
CITY
COUNTY
21P CODE
MAILING ADDRESS
CITY
COUNTY
STATE
9
PO Box 640
Corvallis
Benton
OR
73
97339'
a) THE DIMENSIONS OF THE PROPERTY ON WHICH THE BUSINESS IS LOCATED ARE 2.5 Acres ft. X ft.
b) ORS 822.115(4) requires applicants to file a description of the location of the dismantling yard. Accordingly,
please submit a plat map or similar description of the location of the premises.
LOCAL GOVERNMENT APPROVAL (CITY /COUNTY)
By signing this application the City or County authorizes a dismantler business to be conducted at the
location listed on Line 2 of this application. If a dismantler business cannot be conducted at that
location, or if any of the conditions below are not met, do not sign this approval.
1 represent an incorporated city with a population of 100,000 or more.
By signing on Line 8, 1 comfy that pursuant to ORS 822.110(1)(a) the address listed as the place Of business to be approved for use in the motor
vehicle dismantling business is coned for industrial use or subject M another mning classification that permits the type of business conducted by
the dismantler.
1 represent a County, or an incorporated city with a population of less than 100,000.
By signing on Line 8, I certify the following:CITY
A/I
OF
THAT THE GOVERN ING BODY OF THE NC UNTY <T�'I \Il l✓\ HAS:
A) APPROVED THE APPLICANT AS BEING SUITABLE TO ESTABLISH, ♦ PLACE STAMP OR SEAL HERE
MAINTAIN OR OPERATE A MOTOR VEHICLE DISMANTLING BUSINESS
(ORIGINAL APPLICATIONS ONLY).
B) DETERMINED THAT THE LOCATION OR PROPOSED LOCATION MEETS
THE REQUIREMENTS FOR THAT LOCATION UNDER ORS 822.110.
C) DETERMINED THAT THE LOCATION DOES NOT VIOLATE MY ANMfr`JF[1
APPLICABLE PROVISION OF ORS 822.135. cii { yY ,;� n{T+GfIEID
D) APPROVED THE LOCATION AND DETERMINED THAT THE LOCATION
COMPLIES WITH ANY REGULATIONS ADOPTED BY THE JURISDICTION
UNDER ORS 822.140. APPRDYED
❑ Restrictions on the location approval are in an attached leder from the CRY OF SPRINGREID
zoning authority.
I ALSO CERTIFY THAT I AM AUTHORIZED TO SIGN THIS APPLICATION AND AS EVIDENCE OF SUCH AUTHORITY DO
AFFIX HEREON THE SEAL OR STAMP OF THE CITY OR COUNTY.
—2 OF O-ERNMENT IIFIC�
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SIGNATURE ' OFFJCML
DATE
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