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Attachment C <br />Planning & <br />Development <br />Planning <br />City of Eugene <br />J 99 West Avenue <br />ANNEXATION APPLICATION Eugene, Oregon 97401 <br />(541) 682-5377 <br />(S41) 682-5572 Fax <br />www.euDeneocDov <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. |f you have any questions <br />about filling out this application, please contact Planning staff at the Permit and Information Center, phone <br />(541)582-5377,99West l/ <br />Assessor's Map <br />Tax Lot <br />Zoning <br />Acreage <br />Property Address: G—LA co EN4�' <br />Plans for Future Development Permit Number (if applicable): 0�_/Vat <br />Filing Fee <br />X A fee mua1ecnompmnyaU �U amo�ony. Thefeeumr�sdependinguponthe typeofapn|�at�nandis <br />adjustedperiodica|k/bvtheCityK8mna8er. Check with Planning staff at the Permit and Information Center to <br />determine the required fee or check webyiteat <br />Annexation Last Revised May, 2009 Pagel of4 <br />Application Form <br />