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REPRESENTATIVE (If different from Surveyor): <br />Name (print): <br />Company/Organization: <br />Address: <br />City/State/Zip: Phone: Fax: <br />E-mail: <br />Signature: Elate: <br />Attached additional sheets if necessary. <br />Planning & De . CoPment - updated: December 2016 <br />Planning Division <br />99 W. JOTH Avenue, Eugene, OR 97401 <br />Phone: 541.5$2.5377 or E-mail:eugenep5lanning@6.eugene.or.us Page 4 of 4April 8, 2019, Meeting – Item 2C