REPRESENTATIVE (If different from Surveyor): <br />Name <br />Address: <br />Phone: Fax: <br />E-mail: <br />Signature: <br />Date: <br />"Attached additional sheets if necessary. <br />Planning & Development <br />Planning Division <br />99 W. 10" Avenue. Eugene, OR 97401 <br />Phone. 541.682.5377 or E-mail:eugeneplanning@cn.eugene.or.us <br />Updated: March 2014 <br />Page 4 of 4 <br />