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A ^4W._ <br />WPIanning <br />Attachment C <br />t l ANNEXATION <br />I <br />Please complete the following application checklist. Note that additional information may be required uponfurth� r <br />review in order to adequately address the applicable criteria for approval. If you have any questions about filling out this <br />' <br />application, please contact Planning staff at the Permit and Information Center, -phone (541)682,5377,e99_W..est_10tn <br />Avenue, Eugene. <br />List all Assessor's Map and Tax Lot numbers of the property included in the request. <br />Assessor's Map Tax Lot omng Acreage <br />O <br />003Dal <br />1 � •�-1 <br />Property Address•_51�)S 0 _A_2;?D9 <br />Plans for Future Development & Permit Number (if applicable): <br />Public Service Districts: <br />._ <br />Perks's •1�� ACn <br />Electric: <br />Water: <br />Sanitary. Sewer 0-�- E <br />Fire:.. 21'1 r/' 1� l� r ri re J'\af <br />Schools:, Elementary: L� Middle: High: <br />Other:. <br />Filing Fee <br />❑ A filing fee must accompany all applications. The fee varies depending upon the type of application and is adjusted <br />periodically by the City Manager. Check with Planning staff at the Permit and Information Center to determine the <br />required fee or check website at www.eugeneplanning.org <br />Written Statement (Submit 5 copies) <br />❑ Submit a detailed written statement describing how this request is consistent with all applicable criteria (Section <br />. 9.7825 of the Eugene Code.). <br />Planning & Development Updated: March 2014 <br />Planning Division <br />99 W. 10TH Avenue, Eugene, OR 97401 <br />Phone: 541.682.5377 or E-mail:eugeneplanning@ci.eugene.or.us Page 1 of 4 <br />