❑X A filing fee must accompany all Hearing's Official and Historic Review Board appeals. The fee <br />varies depending upon the type of application and is adjusted periodically by the City Manager. <br />Check with Planning staff at the Permit and Information Center 0Ae- termine the required fee or <br />check on the web at: www.eugeneplanning.org <br />Acknowledgment <br />I (we), the undersigned, hereby acknowledge that I (we) have read the above appeal form, understand <br />the requirements for filing an appeal of a Hearings Official or Historic Review Board decision, and <br />state that the information supplied is as complete and detailed as is currently possible, to the best of my <br />(our) knowledge. <br />APPELLANT <br />Name (print): 3", L?I LLL S Phone: <br />Address: L/tx L"I t f r' (mac <br />City/State/Zip: <br />Signature: `K- <br />APPELLANT <br />Name (print): .v., s.~ Zo1,4, b~ 11 Ih~-Zv Phone: <br />Address: <br />City/State/Zip: Z~uC <br />Signature: <br />wZ <br />IF this appeal is being filed by the affected recognized neighborhood association, complete the <br />following: <br />Name of Association: River Road Community Organization <br />Appeal of Initial Hearing Official Page 2 of 2 <br />or Historic Review Board Decision <br />319 <br />