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Home My WebLink AboutApplication Applicant 6/1/2023City of Springfield Development & Public Works 225 Fifth Street Springfield, OR 97477 SPRINGFIE� IL 9#1 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 Applicant Nam,..lPhone:5q)-M-A551 Company: Lo 0.% hifn LI -G E-mail: Address: qp/J6A'A_,44 Ed Spr;ldj Iq 7 (S(ukk k) Property Owner: �j Phone: -ZZQj' Company: an E-mail: Address: 931 T ! I 7Y777 ASSESSOR'S MAP NO: I7 -0a -3I- til TAX LOT NO 5 : (POW Property Address: 4DI5 Win 9-, SPritt f( 6p. J1 7t (S-LukA) Description of proposal/request: O Gi iO � ' Record Information (Staff to complete) CC Record No: O�I-aJ2' ODC)I,21- P 7Date Received: 1 o3 Application Fee: $ 3(o5' DD Technical Fee: $ TOTAL FEES: $ 383' c)-5' Assigned Planner: Revised 2023 04 04 slm 10 11 APPLICATION FOR THREE YEAR VEHICLE DEALER CERTIFICATE is mAS A DEALER OR REBUILDER OF VEHICLES " CUSTOMER NUMBER EFFECTIVE DATE EXPIRATION-DATE DEALER NUMBER p�p,, IO,I ORIGINAL ❑ RENEWAL If this is a renewal, do not complete the fee information. Use the > CERTIFICATE FEE attached billing list to calculate your fees. The billing list MUST be submitted a with your renewal application. LATE FEE Original Certificate (Includes one plate)................................. $ 7,187.08 aUPPLEMENTALS Additional Locations 0$350.00..................... $ 0.00 RENEVw-PLATES (Supplemental Application Form 735-372 required for each location) $ 0.00 ADDITIONAL PLATES Additional plates 12" x 6'.—Z— or 7" x 4"_ $54.50.. WAL $ (Two sizes, standard and small, available)TAL = $ Pi.ATEs > TEMPORARY 1 BUSINESS NAME AND ADDRESS Any alteration of Line 3 voids location approval. LEGAL NAME FAPP PANT'(OWNER,ARTNERSHIP, LLC OR CORPORATION NAME) FEDERALID NUMBER (FEIN) OREGON REGISTRY# (IFLLCORCORPORATION) it r BUSINESS NgME(IF ASSUMED BUSINESS NAME, FILL IN REGISTRY NO.) GON REGISTRY NO. BU INESS TELEPHONE Liu AOO Uc, MAIN LOCATION STRPF1 ANTI NUMBER( CITY ZIP CODE COUNTY ISIN ti015 vt a LG;wi MAILINGADDRESS v - 572`1 `3f CITY STATE ZIP CODE WAIL liK LowfyGAt TYPE OF OPERATION CdIp"InSAII,Iietthessueunder wnicn euelR.ffi.c rncPm.,et.a: CHECK ORGANIZATION TYPE: ❑ Individual ❑ Partnership ®LLC ❑ Corporation: I/ we primarily sell: ❑ New Vehicles ® Used Vehicles I /we are a franchise dealer: ❑ Yes No If "Yes," name the makes > I /we sell NEW RECREATIONAL VEHICLES: ❑ Yes ® No IF"YES," SERVICE FACILITY LOCATION (STREET AND NUMBER) CITY ZIPCODE LOCATION APPROVAL (If renewal, required only if 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 offidal for the jurisdiction where this business is tooted, I verify by my signature that the Iacaflon of this business as slated on this application complies Mh any land use ordinances of the jurisdiction pursuant to ORS 822.025. ❑ CITY OF: ❑ TELEPHONE NUMBER COUNTY OF: PRINT NAME TITLE SIGNATURE DATE V Race stamp or soaN here V ❑ Check box if restrictions on the location approval are in an attached letter from the zoning authority. P.O. t 14 3 12 13 14 15 W. 17 18 19 20 21 BUSINESS LOCATION INFORMATION: Property is (check one): F1OWNED W LEASED/RENTED: LEASE OR RENTAL PERIOD: 2G If property is "Leased / Rented" complete the following: PROPER OWNER'S 5 L ME(..,—wcp,nyvrop"M R«o,�s) TELEPHONENUM7,9 CJ IF ^-' n A ,✓,Ml Vv✓c+' `/ IPR OWN 'S AIL ADDRESS _(� CITU STfQER U ZIP/\�1'l% 77 (Be sure to attach a Separate sheet to show additional owners.) • Listthe primary owner, partners, LLC members or corporate officers. • If member of a limited liability company (LLC) is a corporation, the president must provide information below. • If a partner of a partnership is a corporation, the president must provide information below. • If corporation or LLC, the Oregon registered agent name and addresses are required below. 0460N4 EgED AGE ME TELEPHONE NUMBER OREGON REGISTERED AGSM MAILING ADDRESS CRY {{�� STATE ZIP CODE OREGON REGIS REDSTREETADDRESS AGENT C STATE ZIP CODE ' 4 7A L ok 47 PRINCIPAL'S DEALER HISTORY Information on the principals of this business is requested under Oregon Revised Statutes (ORS) 822.035 and Oregon Administrative Rule (OAR) 735-150-0024. OAR 735-150-0010(28) defines the principal of a dealership as "an owner, partner, corporate officer or other person who controls or manages the business organization or employees or agents of the business organization." "Principat" includes all owners, partners, members, corporate officers, or directors. Please provide the following information about all owners listed on this application and other principal(s) of the business: Has any principal of this dealership been financially or operationally involved in any jurisdiction, including Oregon, with a vehicle dealership whose certificate or right to apply for a certificate was revoked or is currently suspended? RNID ❑ VES, revoked or is currently suspended. If "YES," complete Section 19. NAME OF DEALERSHIP PRINCIPAL'S NAME(S) DEALER CERTIFICATE NUMBER STATEWHERE SUSPENDED I REVOKED DATE OF SUSPENSION/ REVOCATION EXPIRATIONOFSUSPENSION Has any applicant ever been an owner or principal on a vehicle dealer certificate in Oregon (excluding Current application)? IeN NO ❑ YES: If "YES," complete Section 21. NAME OF DEALERSHIP PRINCIPAL'S NAMES) a Z;; K fi LLC D ER CERUFICATE NUMBER OWNER INFORMATION AND CERTIFICATION False certification is a Class B misdemeanor under ORS 162.085 and is punishable by six months in jail, a fine of up to $2,500 or both. In addition, civil penalties and DMV sanctions against you or your dealer certificate may be imposed. With this in mind.. , I CERTIFY... • I am an owner, a partner, limited liability company member or corporate officer of this dealership and my name is listed on this application. • ALL information on this application is accurate and complete. • I deal in vehicles and conduct business at the location given on Line 3 of this application. • The dealership will comply with all applicable laws and administrative rules. • Uwe hereby certify that the persons named in this application are not acting as the alter ego, in the place of, or on behalf of, any other person or persons in seeking this certificate. P,g ] 22 23 24 26 2s 27 26 29 30 31 32 33 34 35 36 37 38 39 40 41 DMV AGENT AGREEMENT The dealer is granted the following options as a DMV agent and must comply with all applicable laws and administrative rules. The dealer is not obligated to perform any of these options except as required by law. *Snowmobile dealers must act as DMV agents for Oregon residents. • *Accept applications and fees for titles and registrations of vehicles they sell, and only charge fee amounts set by Oregon Revised Statutes (ORS) and Oregon Administrative Rules (OAR). • Perform vehicle identification number inspections on vehicles they sell, except a dealer may not perform an inspection under those situations described in OAR 735 -022 -0070(6)(A -G). • Issue temporary registration permits for unregistered vehicles they sell. • Agent status ran be placed on probation, suspension or revoked as allowed in OAR 735-150-0120 for non-compliance of any ORS of the Oregon Vehicle Code. • By signing this application on Page 3, the dealer becomes an agent of DMV and agrees to comply with all administrative rules and all dealer related statutes in the Oregon Vehicle Code. OWNERSHIP INFORMATION PRINTNAME FOFER, PARTN 'V Carc , LLC MEMBER OR CORPORATE OFFICER TITLE Ow MJBER ['7 TELEPHONE NU221-0.57 221'0 S 1 DATEIF9IRTH DRIVERLICENSENUMBER RESIDENCCEADSDRE 4 3 5 3A PL MAILING ADOgESS IF DIFFEREN I - 157 n 5 AV,, 52y STATE OF R IL Ik CITY S r; E CODE 4 CITY S ZIP CODE 1-414 CE FYI G81 TU OFOWNE OW NUNS 22 ACOVE TE X M 26, 2023 PRINT NAME OF OWNER, PARTNER, LLC MEMBER OR CORPORATE OFFICER TITLE TELEPHONENUMBER DATE OF BIRTH DRIVER LICENSE NUMBER STATE OF ISSUANCE EMAIL RESIDENCEADDRESS CITY STATE ZIPOODE MAILING ADDRESS (IF DIFFERENT) CITY STATE ZIPCODE CERTIFYING SIGNATURE OF OWNER SHOWN ON LINE 27 ABOVE X DATE PRINT NAME OF OWNER,PARTNER, LLC MEMBER OR CORPORATE OFFICER TITLE TELEPHONE NUMBER DATE OF BIRTH DRIVER LICENSE NUMBER STATE OF ISSUANCE EMAIL RESIDENCE ADDRESS CITY STATE ZIPCODE MAILING ADDRESS(IF DIFFERENT) CITY STATE I ZIP CODE CERTIFYING SIGNATURE OF OWNER SHOWN ON LINE 32 ABOVE X DATE PRINT NAME OF OWNER, PARTNER, LLL MEMBER OR CORPORATE OFFICER TITLE TELEPHONE NUMBER DATE OF BIRTH DRIVER UGENBE NUMBER STATE OF ISSUANCE EMAIL RESIDENCE ADDRESS CITY $TATE ZIP CODE MAILING ADDRESS (IF DIFFERENT) CITY STATE ZIP CODE CERTIFYING SIGNATURE OF OWNER SHOWN ON LINE 37 ABOVE X DATE ee• 3 (Ower far Photo ID...)