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Submitted by e-mail on December 31, 2019 Printed copy maild via U.S. Postal Service ZONE VERIFICATION Please complete the following form and provide the required information. If you have questions about filling out this application, please contact staff at the Permit and Information Center, 99 West 100' Avenue, Eugene, OR 97401, phone (541) 682-5377. Location of Property: 432 West 11th Avenue (tax map and lot: 17-03-31-3100100) Zoning of Property: C-2 Community Commercial Zone Plan designation Medium Density Residential Proposed Use of Property, if applicable: Drug Treatment Clinic - Non-residential Filing Fee The fee varies depending on staff time to process the request and will be charged once the request is complete. Please note that the fee must be paid prior to receiving the verification letter. Per the City's Construction & Development fee schedule, a zone verification is charged at $104.50 per hour plus a 9% Administrative Fee (minimum charge is X hour or $52.25plus 9% administrative fee). Written Statement Submit one paper copy and one CD copy (pdf or tiff format) of a written statement describing why the zone verification is being requested. If applicable, include information describing the proposed use including operating characteristics, building bulk and size, parking demand, and traffic generation per EC 9.1080. Please note that it is the applicant's responsibility to make sure that the CD and paper copies are identical. Note: to request a copy of a certificate of occupancy or building permit information, please contact Inspection Support staff at 541-682-5283 or ceinspectionsupport@ci.eugene.or.us. Contact Information Paul T. Conte 1461 W. 10`h Ave. Address: City/State/Zip: Eugene, OR 97402 E-mail (ifapplicable): paul.t.conte@gmail.com Phone: AJYI./ JYY.LJJL A A Fax: w December 31, 2019 2019 99 W. 10^' Avenue, Eugene, OR 97401 Phone: 541.682.5377 or E-mail: planning@ci.eugene.or.us Page i of i