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~ Planning & Development <br /> Planning <br /> <br /> City of Eugene <br /> 99 West 10th Avenue <br /> Eugene, Oregon 97401 <br /> (541) 682-5377 <br /> ZONE CHA GE APPLICATIO (541) 682-5572 FAX <br /> <br /> Please complete the following application checklist. Note that additional information may be required upon <br /> further review in order to adequately address the applicable criteria for approval. If you have any questions <br /> about filling out this application, please contact Planning staff at the Permit and Information Center, phone <br /> (541) 682-5377, 99 West 10th Avenue, Eugene. <br /> <br /> List all Assessor's Map and Tax Lot numbers of the property included in the request. Please indicate <br /> if only a portion of a lot is included in the request and include any additional map and tax lot numbers <br /> for subject property. Also, include existing and proposed overlay zoning. <br /> <br /> ·Ass. essor's MaP Tax Lot Existing Zoning Proposed Zonin~o <br /> 1 7-03-3 1-.24 9200 R-2/R-3 HHistoric <br /> <br /> Street Address (if available): 996 Jefferson <br /> <br /> Existing Use(s) of the Property: Senior Services <br /> <br /> Proposed Use(s)oftheProperty: Senior Services/Other uses per proposed Special Area Zone <br /> Acres: .73 <br /> <br /> Is this zone chan~e being reviewed concurrently with another land use application? <br /> [~] Yes, application file number: CA 04- r']No <br /> <br /> Filing Fee <br /> <br />· [] A filing fee must accompany all applications.. The fee varies depending upon the type of application <br /> and is adjusted periodically by the City Manager. Check with Planning staff at the Permit and <br /> Information Center to determine the required fee or check website <br /> www. ci. eugene, or. us/PDD/Plan n i n g/PERMITS, btm <br /> <br /> Written Statement <br /> Provide 3 copies upon initial submittal. Following completeness review, submit 7 copies. <br /> <br /> A written statement demonstrating how the requested change satisfies the criteria in the Eugene <br /> Code, Section 9.8865. A list of the criteria is available at the Eugene permit and Information Center, <br /> 99 West l0th Avenue. Please note: it is the applicant's responsibility to provide adequate <br /> information demonstrating how the proposal satisfies the applicable criteria. Failure to provide such <br /> information may result in a denial of your application. <br />IZone Change Application Form Last Revised: December 31,2003 Page I of 2 <br /> <br /> 16 <br /> <br /> <br />