NOTICE STATEMENT: If the Eugene/Springfield Fire Marshall (or the Fire Marshal's designee) determine that there is <br />Inadequate water supply, apparatus access, or both, to the site for the development of one and two family dwellings <br />that will be subject to the Oregon Residential Specialty Code, the Eugene Building Official (or the Building' Official's <br />designee) may require compliance with one or more of the fire suppression or fire containment Uniform Alternate <br />Construction Standards set out at OAR 9194W-0925(4) and (5). <br />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?.Q Yes J ®No): <br />Name (print): LCHA Phone: <br />Address: 177 Day Island Road . <br />city/state/zip: Eugene, Oregon, 97401 <br />re: <br />APPLICANT® / APPLICANT'S REPAESEVATI' E ❑ (Check one): <br />Name (print): Andrew Brand! Contact: Hans Christiansen Y <br />Company/Organization: Lombard Apartments, LLC <br />Address: 601 Union Street, Suite 616 <br />Seattle, WA <br />City/State/zip: 98101 E-mail (if applicable): bans@evergreenhd.com <br />Phone: 206-535-6248 <br />APPLICANT'S REPRO ATATiVE a-/ DESIGNATED CONTACT PERSON (Check all that apply): <br />Name (print): Michael Reeder <br />Company/Organization: Arnold Gallagher Attorneys at Law <br />Address: 800 Willamette Street, Suite 800 <br />Eugene, O <br />City/State/zip: 97401 E-mail (if applicable): mreeder@iamoldgailagher.com <br />Phone: 541-484-0188 Fax: <br />Signature: <br />Planning A Development -Updated., March 2014 <br />Planning Division <br />99 W, 10TH Avenue, Eugene, OR 97401 <br />Phone: 541.682.5377 or E-mail: eugeneplanning0cl.eugene.or.us Page 7 of 7 <br />