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<br />EXHIBIT 5 <br /> <br />c <br /> <br />MANUFACTURED DWELLING PARK CLOSURE <br />PERMIT APPLICATION <br /> <br />PROPERTY INFORMATION <br /> <br />1. Attach an accurate legal description of the property included in this permit <br />application. <br /> <br />2. Assessor's map(s) and tax lot(s) numbers of the property: <br /> <br />3. Project name and address: <br /> <br />4. Number of permanent spaces: <br /> <br />5. Number of recreational/other spaces: <br /> <br />6. In what year( s) was the park opened? <br /> <br />INFORMATION CONCERNING THIS REQUEST <br /> <br />The application shall be accompanied by all of the following: <br /> <br />1. An affidavit of the applicant conforming to the requirements of R-1086-C-4 ; <br /> <br />2. A Tenant Survey Report affidavit, R-1086-D; and <br /> <br />3. Any filed or executed park closure instruments. <br /> <br />FILING FEE <br /> <br />A permit application must be accompanied by a filing fee as established by Order <br />of the City Manager pursuant to Section 2.020 of the Eugene Code. <br /> <br />ACKNOWLEDGEMENT <br /> <br />I/We, the undersigned, hereby acknowledge that IlWe have read the above <br />application and its attachments understand the requirements for an application <br />for a manufactured dwelling park closure, and state that the information supplied <br /> <br />Exhibit 5: Manufactured Dwelling Park <br />Closure Permit Application <br /> <br />Page 10f2 <br />