HomeMy WebLinkAboutApplication Applicant 5/30/2023City of Springfield
Development & Public Works
225 Fifth Street
Springfield, OR 97477
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PNINGFIE�
LAND USE COMPATIBILIITY STATEMENT (LUCS), DEPARTMENT OF
MOTOR VEHICLES (DMV) and ZONING VERIFICATION LETTER
Application form
Permit Type
Dept of Motor Vehicles -New: Land Use Compatibility Statement: ❑ City:
❑
Dept of Motor Vehicles -Renewal: ❑ Zoning Verification Letter: ❑ UGB:
Project Information
A licant Name: Qa a _ Arm dfj� Phone: d0 6.
❑
100,000k
Company: _T1, ,0A MoS2,rs
E-mail: Qalei
Address: 3y'I'l MAin( Sf SPr,
Frc so IZ CJ4y}e
Property Owner: ? �4'r
Phone: Sq -aSS--7'-786
Company: S
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Address: "Zl 0\ i3a i 1
RD S[< 3 1 E' n� 02- 9
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ASSESSOR'S MAP NO:
ITAX LOT NOS : -7010-7X-7
Property Address:
Description of proposal/ request:
Record Information(Staff o complete)
9
Record No: b J'QI%�N I' �I
Date Received: 6-1 a,3
Application Fee: fps
Technical Fee:
TOTAL FEES: $ 3F3.
Assigned Planner:
Revised 2023 04 04 slur
W
11
APPLICATION FOR
THREE YEAR VEHICLE DEALER CERTIFICATE
, AS A DEALER OR REBUILDER OF VEHICLES
CUSTOMER NU 113;1
EFFECTIVEDATE
EXPIRATIONOATE
DEALEfrNUMBER
❑ORIGINAL
❑ RENEWAL
ewaldo
If this is a ren, not complete the fee information. Use theim
ICATE FEE
attached billing list to calculate your fees. The billing list MUST be submit
with your renewal application.
EEOriginal
Certificate (Includes one plate) .................._....._.. $1,187.MENTALSAdditional
Locations @$350.00..........._........ $ 0AL
PLATES(Supplemental
Application Form 735-372 required foreach
location) $0NAL
PLATESAdditional
L $(Two
plates 12" x 6" or7"x4" $54.50..
sizes, standard and small, available) TOTAL = $ 1,18RARY
PLATES
BUSINESS NAME AND ADDRESS Any alrerafion of Line 3 voids location approval.
LEGAL NAME OFAPPLICANT(OWNER,PA3TNEHSHIE LLC OR CORPORATION NAME) FEDERAL ID NUMBER (VEIN) OREGONREGISTBy k(IF LLCOR CORPORATION)
cn� m�t
BUSINESS NAME (IF ASSUMED BUSINESS NAME FILL IN REGISTRY NO.)
OREGON REGISTRY NO.
BUSINESS TELEPHONE
n S
MAI STINESSLOCATIONIST ET ANO NUMBER)
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CITY
ZII�PCODE
a{
COUNTY
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rin
-1'
r �I,rr. c
MAILING ADDRESS
3y?� mart s�
CITY
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STgTIE LIP CODE
4iv?�
EMAIL
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A or
a
TYPE OF OPERATION If 11�HrOdsllsuf list the state under
which business is Incomnread:
CHECK ORGANIZATION TYPE: Individual ❑Partnership .LLC ❑Corporation:_
I /we primarily sell: ❑ New Vehicles Used Vehicles
I /we are a franchise dealer: ❑ Yes 13�,No If "Yes," name the makes >
I /we sell NEW RECREATIONAL VEHICLES: ❑ Yes 514 -No
IF "YES,' SERVICE FACILITY I OCA I ION (STREET AND NUMBER) CITY
ZIP CODE
LOCATION APPROVAL (If renewal, required only u dealer is changing business location)
Certification of local zoning. ORS 822.005 requires a vehicle dealer certificate, unless exempt under ORS 822.015, for any person
who;
(a) Buys, sells, brokers, trades or exchanges vehicles either outright or by means of any Conditional sale, bailment, lease,
security interest, consignment or otherwise; OR
(b) Displays a new or used vehicle, trailer, or semitrailer for sale; OR
(c) Acts as any type of agent for the owner of a vehicle to sell the vehicle or acts as any type of agent for a person interested
in buying a vehicle to buy a vehicle.
THE CERTIFICATION BELOW IS TO BE COMPLETED BY THE LOCAL ZONING OFFICIAL. The approval below should be based
upon whether the applicant can do ANY of the activities listed in (a) through (c) above under applicable ordinances, at the location
of the business given on Line 3. Pursuant to ORS 822.025, applicant shall meet requirements below.
As the zoning official for thejurisdlction where this business is located, I verify by my signature that the location of this business as staled on this application
complies with any land use ordinances of the jurisdiction pursuant to ORS 822.025.
❑ CITY OF: -1COUNTYOF
TELEPHONE NUMBER
PRINT NAME
TRLE
SIGNATURE
GATE
X
Mass st;arnp or seal [vers 7
❑ Check box if restrictions on the location
approval are in an attached letter from
the zoning authority.
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