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 O North Campus <br />Please print clearly <br />Name: , ,,J' ✓ 1l L~ti~ <br />Mailing Address: <br />214 kz-:~s (S <br />City, State, Zip: V'1 <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 />