REQUEST TO SPEAK FORM <br />City of Eugene Planning Division-Hearings Official Public Hearing <br />The purpose of this form is to make sure that people wishing to testify have an opportunity to do so, as well as to make <br />sure that the names and mailing addresses of those testifying are correct and become part of the record. Anyone wish- <br />ing to testify should fill out this form. People speaking at the hearing as well as those submitting written testimony will <br />be notified of the decision by mail (if mailing address is provided) <br />Meeting Date: 9/12/18 <br />Project Name: U of 0 North Campus <br />Please print clearly <br />Name: J4Vi/'-A 4olvvI4 <br />Mailing Address: ~(o s- W, /4Yf' <br />City, State, Zip: U4 N~ O R <br />9'3Yo3 <br />Are you (please check one) <br />❑ Speaking in favor <br />❑ Speaking Against <br />❑ Neutral <br />Do not wish to speak but would like to be notified of the decision <br />PLEASE RETURN FORM TO CITY OF EUGENE STAFF <br />