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Attachment C <br />REPRESENTATIVE (If different from Surveyor): <br />Name (print):jNv'c' OD4 N�A <br />Company/Organization: r0 owry- <br />Address: C) <br />City/State/Zip:^l �� C1� Phone:S�� �7�� yid-;�• �O <br />v 1 <br />E-mail: <br />Signature: 1lV� Date: <br />U " <br />"Attached additional sheets if necessary. <br />Planning & Development Updated: March 2014 <br />Planning Division <br />99 W. 10" Avenue, Eugene, OR 97401 <br />Phone: 541.682.5377 or E-mail:eugeneplanning@ci.eugene.or.us Page 4 of 4 <br />