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Please complete the following application checklist. Note that additional information may be required upon further <br />review in order to adequately address the applicable criteria for approval. If you have any questions about filling out this <br />application, please contact Planning staff at the Permit and Information Center, phone (541)682-5377, 99 West SO'h <br />Avenue,Eugene. <br />List all Assessor's Map and Tax Lot numbers of the property included in the request. <br />Assessors Map <br />Tax Lot <br />Zoning <br />Acreage <br />0 -0'S -*3 - <br />ZOO <br />Electric: <br />0.A -L A,—. <br />Water: <br />W -W L>' <br />Sanitary Sewer <br />TV -O Thu <br />V4 /. <br />Fire:k11 <br />$U R <br />E.E_ FD <br />Schools: <br />Elementary: ,HoL-T <br />Middle: AAOA[pOt� <br />High: <br />Other: <br />Property Address: 43-. U r Lb Lc—'( LtAB_ r�uVy mg- ow— -t-i 4, 1 <br />Plans for Future Development & Permit Number (if applicable): <br />Public Service Districts: <br />Filing Fee <br />A filing fee must accompany all applications. The fee varies depending upon the type of application and is adjusted <br />periodically by the City Manager. Check with Planning staff at the Permit and Information Center to determine the <br />required fee or check website at www.eugeneolanning.org <br />Written Statement (Submit 5 conies) <br />E Submit a detailed written statement describing how this request is consistent with all applicable criteria (Section <br />9.7825 of the Eugene Code). <br />Planning & Development Updated: December 2016 <br />Planning Division <br />99 W. 10TM Avenue, Eugene, OR 97401 <br />Phone: 541.682.5377 or E-mail:eugeneplanning@ci.eugene.or.us Page 1 of 4 <br />Name <br />Parks: <br />uON� <br />Electric: <br />Water: <br />W -W L>' <br />Sanitary Sewer <br />TV -O Thu <br />V4 /. <br />Fire:k11 <br />$U R <br />E.E_ FD <br />Schools: <br />Elementary: ,HoL-T <br />Middle: AAOA[pOt� <br />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.eugeneolanning.org <br />Written Statement (Submit 5 conies) <br />E 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: December 2016 <br />Planning Division <br />99 W. 10TM Avenue, Eugene, OR 97401 <br />Phone: 541.682.5377 or E-mail:eugeneplanning@ci.eugene.or.us Page 1 of 4 <br />