By signing, the undersigned certifies that he/she has read and understood the submittal requirements outlined, and that he/she <br />understands that omission of any listed item may cause delay in processing the application. I (We), the undersigned, <br />acknowledge that the information supplied In this application Is complete and accurate to the best, of my (our) knowledge. <br />OWNER (Also the Applicant? ❑ Yes / No): <br />Name (print): LCHA PhnnP: <br />Address: 177 Day I s l and Road <br />City/State/Zip: Eugene, eg 9740 <br />Signature: <br />APPLICANT® / APPLICANT'S PRESENTATIVE ( (Check one): <br />Name (print): Andrew rand Contact : mans Christiansen <br />Company/Organization: Lombard Apartments LLC <br />Address: 601 Union Street, Ste 616 <br />Seattle,WA banahd.cog► <br />City/State/Zip: 98101 E-mail (if applicable): <br />Phone: 206-535-6248 Fax:, <br />Signature: <br />APPLICANT'S REPR - NTA IVE DESIGNATED CONTACT PERSON (Check all that appiy): ` <br />Name (print): Micheal Reeder <br />Company/Organization: Arnold Gallagher Attorneys at Law <br />Address: 800 Willamette Street, Ste: 800 <br />Eugene, OR <br />City/State/Zip: 9740.1 E-mail (if applicable): mreeder@arnoldgallagher . com <br />Phone: 541-484-0188 Fax: <br />Signature: OA <br />Note: This 1 t a compete list of requirements. Additional information maybe required after further review in order to <br />adequately address the applicable approval criteria. <br />'IV '1f u_1Q,tprjFi/,tncf' <br />Planning & Development Updated: Marti $014 <br />Planning Division <br />99 W. le Avenue, Eugene, OR 91401 <br />Phone: 541.692.S377 or E-mall:eugeneplanning®cl.eugene.or.us Page 3 of 3 <br />