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Attachment C - Application Materials <br />Planning & <br />Development <br />Planning <br />ANNEXATION APPLICATION <br />City of Eugene <br />99 West 10 Avenue <br />Eugene, Oregon 97401 <br />(541) 682 -5377 <br />(541) 682 -5572 Fax <br />www.eugene - or.gov <br />Please complete the following application checklist. Note that additional information may be required upon <br />further review in order to adequately address the applicable criteria for approval. If you have any questions <br />about filling out this application, please contact Planning staff at the Permit and Information Center, phone <br />(541)682 -5377, 99 West 10 Avenue, Eugene. <br />List all Assessor's Map and Tax Lot numbers of the property included in the request. <br />Assessor's Map <br />Tax Lot <br />Zoning <br />Acreage <br />I 2p`�— <br />t-b(( A (A L <br />Sanitary Sewer: <br />( <br />� � Wk_ <br />-7 <br />Elementary: <br />Middle: <br />JAL <br />, ()- - <br />Property Address: <br />Plans for Future Development & Permit Number (if applicable): <br />Public Service Districts: <br />Name <br />Parks: <br />Electric: <br />Water: <br />Sanitary Sewer: <br />Fire: <br />Schools: <br />Elementary: <br />Middle: <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 <br />adjusted periodically by the City Manager. Check with Planning staff at the Permit and Information Center to <br />determine the required fee or check website at www.eugeneplanning.org <br />Annexation Last Revised May, 2009 Page 1 of 4 <br />Application Form <br />