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r~1 <br />ANNEXATION <br />Plannirg <br />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)6$2-5377, 95 West 10th <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 Zoning Acreage <br />Property Address: <br />Plans for Future Development & Permit Number (if applicable) <br />Public Service Districts: <br />Dame <br />Parks: Iw 'e'rrs <br />Electric: 15 VV 11~- B <br />Water: <br />Sanitary Se <br />T ~ <br />wer -it, Of e4vt et <br />Fire: S 07*q Clam P-FP <br />Schools. Elementary: ~ Middle: dg's r 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 />W'ritten Statement (Submit S conies) <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: December 2016 <br />Planning Division <br />99 w. 10TH Avenue, Eugene, OR 97401 <br />Phone: 541.68.2.5377 or E-mail:eugeneplanning['ia cl.eugene.or.us Page 1 of 4April 8, 2019, Meeting – Item 2C