HomeMy WebLinkAboutApplication Applicant 2/13/2024 (7)Appendix 3A-2 Rev 01/26/16 Page 1 of 1 EDSP Adopted December 03, 2012
Operations and Maintenance Agreement
Private Stormwater Management and Treatment System
Land Development Application Number:___________________________________________________
Owner's Name:________________________________________________________________________
Phone No.:___________________________________
Mailing Address:_______________________________________________________________________
City_____________________________ State_____________ Zip________________
Site Address:__________________________________________________________________________
City_____________________________ State_____________ Zip________________
Site Map and Tax lot No.:________________________________________________________________
(Or attach document with additional lot information if the facility crosses more than one lot)
Type of Facility(ies)____________________________________________________________________
Requirements
1) Stormwater Management Site Plan, (min. 8 1/2" x 11" attached to this form) showing the location of
the facility(ies) in relation to building structures or other permanent monuments on the site, sources of
runoff entering the facility(ies), and where stormwater will be discharged to after leaving the
facility(ies). Landscape and vegetation should be clear on the Plan submitted or submit a separate
Landscape Plan document showing vegetation type, location, and quantity (landscape plan). These
can be the same Plans submitted for development review.
The stormwater management facility(ies) shown on the Site Plan are a required condition of
development approval for the identified property. The owner of the identified property is required to
operate and maintain the facility(ies) in accordance with the Facility Specific Operation and
Maintenance Plan(s) (O&M Plan(s)) attached to this form and on file with the City. The O&M Plan
for the facility(ies) will be available at the Development and Public Works Department, 225 5th Street,
Springfield, Oregon between the hours of 8 a.m. and 5 p.m., Monday through Friday.
2) Financially responsible party (circle one):
Property Owner Homeowner Association Other (describe) __________________________
3) Party(ies) responsible for maintenance (only if other than owner).
Daytime phone no. (______) _______ -_______
Emergency/after-hours contact phone no. (______) _______ - _______
Maintenance Contact Party(ies) Name & Business Address: _____________________________
______________________________________________________________________________
4) Maintenance practices and schedule for the stormwater facility(ies) are included in the Facility
Specific O&M Plan(s) attached to this form and filed with the Development and Public Works
Department, City of Springfield. The operation and maintenance practices are based on the version of
the City of Eugene's Stormwater Management Manual in effect at the date of development
application, as modified by any plans attached to this document at the time of signing.
Application Date:
By signing below, Filer accepts and agrees to the terms and conditions contained in the Operations and
Maintenance Plan(s) and in any document executed by Filer and recorded with it.
Filer Signature:
Print Name: