HomeMy WebLinkAboutApplication Applicant 11/6/2023!City of Springfield
Development & Public Works
225 Fifth Street
Springfield, OR 97477L'
SPRINGFIELD
LAND USE COMPATIBILIITY STATEMENT (LUCS), DEPARTMENT OF
MOTOR VEHICLES (DMV) and ZONING VERIFICATION LETTER
Application form
Permit .-
Dept of Motor Vehicles -New: Land Use Compatibility Statement: ❑ city:
Dept of Motor Vehicles -Renewal: ❑ Zoning Verification Letter: ❑ UGB: ❑
Project • •
Applicant Name: Phone: 5</(-G53 -? GLI'Z
company: `rin cav� '�-dl
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Address: SV -4,0 UAcJLr --' S r, �n 0Z 0(_?W7 g �✓�
Pro er Owner: Vc,_k le vQ�6hone:
Company: E-mail:
Address: c2-S.2%k�� �c��.9 �-� -ran t �� ®�
ASSESSOR'S MAP NO:
TAX LOT NOS : 0
Property Address: SS:�( Q NJ Gi n 5-�- 5' r- c O� ok g
Description of proposal/ request:
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Record rmation (Staff to complete)
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Record No: O�l-o 25 c) --N Date Received: I �I LOLL
Application Fee: $ 105
Technical Fee: $
TOTAL FEES: $ • 9-5 Assigned Planner:
Revised 2023 04 04 slm
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11
"0PJUAPPLICATION FOR
1 THREE YEAR VEHICLE DEALER CERTIFICATE
DENTMENf OF
7A
ISIS I AVE NE SALEM O EGON 973SERVICE4 AS A DEALER OR REBUILDER OF VEHICLES
-ANA
CUSTOMER NUMBER EFFECTIVE DATE EXPIRATION DATE DEALER NUMBER F-1 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
with your renewal application. LATE FEE
Original Certificate (Includes one plate) ................................. "$1,187.00 SUPALEMENTALS
Additional Locations @$350.00 ..................... $ 0.00 RENEWAL PLATES
(Supplemental Application Form 735-372 required for each
ADDITIONAL PLATES
location) $ 0.00
Additional plates 12" x 6" or 7" x 4" $54.50... TOTAL
(Two sizes, standard and small, available) TOTAL = $ 1,187.00 > TEMPORARYPLATES
BUSINESS NAME AND ADDRESS Any alteration of tine 3 voids location approval.
LEGAL NAME OF APPLICANT (OWNER, PARTNERSHIP, LLC OR CORPORATION NAME) FEDERAL ID NUMBER (FEIN) OREGON REGISTRY # (IF LLC OR CORPORATION)
Darrick Senseney 193-4276308 1219227998
BUSINESS NAME (IF ASSUMED BUSINESS NAME, FILL IN REGISTRY NO.) OREGON REGISTRY NO. BUSINESS TELEPHONE
Thrive Motors 219227998 541-653-7642
MAIN BUSINESS LOCATION (STREET AND NUMBER) CITY
ZIP CODE
COUNTY
3890 Main St Springfield
97478
Lane
MAILING ADDRESS CITY
STATE
ZIP CODE
EMAIL
Same as above I
thrivemotorsllc@gmail.com
TYPE OF OPERATION If corporation, list the state under
which business is incorporated:
CHECK ORGANIZATION TYPE: ❑ Individual E] Partnership ® LLC ❑ Corporation: _
/ 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
I
IF "YES," SERVICE FACILITY LOCATION (STREET AND NUMBER) CITY ZIP CODE
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 official for the jurisdiction where this business is located, I verify by my signature that the location of this business as stated on this application
complies with any land use ordinances of the jurisdictionPursuant to ORS 822.025.
TELEPHONE NUMBER
❑ ❑
CITY OF: COUNTY OF:
PRINT NAME
TITLE
SIGNATURE
DATE
X
V Race stamp or seal here O
❑ Check box if restrictions on the location
approval are in an attached letter from
the zoning authority.
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