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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:Date: <br />Attached additional sheets if necessary. <br />Planning & Development Updated: December 2016 <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 4 of 4September 9, 2019, Meeting – Item 2C