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of Urban Service Provision <br />This form is intended as a guide to assist applicants in demonstrating that a minimum level of <br />key urban services can be provided to the area proposed for annexation. Space is provided on <br />this form for you to provide detailed information on service provision. Please add additional <br />pages if necessary to provide details of servicing issues related to the area you are annexing. To <br />assist you in providing this information, some contacts are listed below. For large or difficult to <br />serve properties, you may wish to contact a private land use planning consultant to prepare <br />your application. <br />Property Owner(s) Name: <br />M AQk Ur-1INN '5F,62I K[( <br />Assessors Map and Tax Lot Numbers for Properties Proposed for Annexation <br />(For example: Map 17-03-19-31, Tax Lot 100) <br />11-03--i7i-LZ TI..*.-ZoO <br />Wastewater—All new development must connect to the wastewater (sanitary sewer) system. <br />Is wastewater service available to serve the area proposed for annexation? (For more <br />information, contact the Engineering staff at the City of Eugene Permit and Information Center <br />or call 541-682-8400.) <br />The property(les) in this annexation request: <br />✓ will be served from an existing gravity wastewater line. <br />Location and size of existing wastewater line: <br />5rt— IkxC.oM ♦Pn.4`�rf1!'k 4W�Ti€µ �J ZM@.n[T <br />will be served by an extension of an existing gravity wastewater line. <br />Where will a wastewater line be extended from? When will it be extended? By whom? <br />Stormwater — Site plans for all new development must provide for drainage to an approved <br />system consistent with the Comprehensive Stormwater Management Plan. City approval for <br />storm drainage will be required as part of the development process. (For more information, <br />contact the Engineering staff at the City of Eugene Permit and Information Center or call 541- <br />682-8400.) <br />Is the site currently served by an approved stormwater system? <br />1 NO 1 R..ELT LY <br />1 of 4 <br />