HomeMy WebLinkAboutApplication APPLICANT 2/6/2023'City of Springfield
Development & Public Works
225 Fifth Street
Springfield, OR 97477
PERMIT REVIEW INTAKE FORM
SPRINOFIKLD
1k 6
(City Staff completes form)
Permit
Dept of Motor Vehicles -New: ❑ Land Use Compatibility Statement: X
City: ❑
Dept of Motor Vehicles -Renewal: ❑ Zoning Verification Letter: ❑
Project Information
Applicant Name: Unified Oregon Inc. Phone:
UGB: ❑
503-298-5133
Company:
Cell:
Address: 5305 River Rd. N Ste B Keizer Or 97303
Property Owner: Polen Development LLC
Phone:
Company:
Cell:
Address: PO Box 71751 Springfield Or 97475
ASSESSOR'S MAP NO: 17032542
TAX LOT NOS : 1200
Property Address: 2155 Olympic St. Springfield Or 97477
Description of Proposal: LUCS for OLCC for marijuana retail
Record Information
Record No: 811-23-000023-TYP1
Date Rem ived:02 06
2023
Application Fee: 365
Technical Fee: $18.25
TOTAL FEES: $383.25 Assigned Planner: Tom Sievers
Revised t1.2.1 t kl
OREGON LIQUOR & CANNABIS COMMISSION REQUEST
Land Use Compatibility Statement
What Is a land use compatibility statement (LUCS)? The LUCS 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 LUGS 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 LUCS and have a positive LUCS prior to issuing a license.
CITY/COUNTY USE ONLY
Date delivered by license applicant:
Dote Received: z -z -Zi
Planner: TS
Received by (print):
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Iridal: -r!
When is a LUCS required? A LUCS is required for all proposed marijuana facilities before an OLCC license can be obtained.
Now 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 paymentto local jurisdiction for processing application.
• Local jurisdictions are NOT required to begin processing LUCS forms until January 4. 2036 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: Unified Oregon Inc. Phone: 503-298-5133
Mailing Address: 5305 River Rd N Sm B Rm/Ste:
City: Keizer State: OR ZIP: 97303
m Site plan of the subject property and proposed development attached? (required)
Proposed 2155 Olympic St
Rm/Ste:
Premises Address:
City: Springfield County: Lane ZIP: 97477
Tax Lot p•: 1200 Range/ 3W/25 tanmde:
Section/
Township*: 17S Map*: 17032542 Longitude:
Proposed use/permit type sought (A separate LUCS maybe necessary for each proposed use even Tit is on the same property):
❑ Producer ❑ Wholesaler ❑ Processor Retailer ❑ Laboratory ❑ Research Certificate
Note Indoor or Ustendome-
outdoor below mens below
Debate of proposed use (note any attachments):
Site Localtiion:
igi 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.
V,The proposed land use has been reviewed and is not prohibited.
If the proposed land use is allowable only as o conditional use, permits are required as noted below.
Comments:
Name of Reviewing Local Official (print):
Title:
Date:
Email:
Phone:
Signature:
Check this box if there are attachments to this form:
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REMINDER: Local jurisdictions are NOT required to begin processing �
LUCS forms until January 4. 2016 at 8:30 AM