HomeMy WebLinkAboutNotes Applicant 11/14/2024 (8)FORM 4
WAIVER OF ONE YEAR TIME LIMIT
FOR ANNEXATION PURSUANT TO ORS 222.173
This waiver of the time limit is for the following described property:
See Tax Lot Inventory
Map and Tax Lot Number
assigned)
See Tax Lot Inventory
Street Address of Property (if address has been
ONE WAIVER OF TIME LIMIT FOR EACH PARCEL, PLEASE
We, the owner(s) of the property described above understand the annexation
process can take more than one year but desire to annex to have City services.
Therefore, we agree to waive the one-year time limitation on this petition to
annex established by Oregon Revised Statutes 222.173, and further agree
that this contract shall be effective [ ✓ ] indefinitely or [ ] until
Date
Sinnatures �f Lenal Owners
Please rint or type name
Si nature
Date Si ned
City of Springfield/SEDA
L Z
Lane County
Roth & Roth LLC
7 --24
LCOG: L: \BC\2005
BOUNCHANGE
TRANSITION\APPLICATION
FORMS\SPRINGFIELO\30-03-OB
UPDATED
FORMS\PRE-SUBMITTAL
ANNEXATION
APPLICATION
10-07-09.DOC
Lasf Saved: May 3,
2023
Revised 04/17/2023 slm Page 16 of 16