Submitted by e-mail on December 31, 2019 <br />A Printed copy maild via U.S. Postal Service <br />,.aft <br />ZONE VERIFICATION <br />* Planning <br />Please complete the following form and provide the required information. if you have questions about filling out this <br />application, please contact staff at the Permit and Information Center, 99 West 10'h Avenue, Eugene, OR 97401, phone <br />(541) 682-5377. <br />Location of Property: 432 West 11th Avenue (tax map and lot: 17-03-31-3100100) <br />Zoning of Property, C-2 Community Commercial Zone Plan designation Medium Density Residential <br />Proposed Use of Property, if applicable; Drug Treatment Clinic - Non-residential <br />Filing fee <br />The fee varies depending on staff time to process the request and will be charged once the request is complete. Please <br />note that the fee must be paid prior to receiving the verification letter. Per the CiWs Construction & Development fee <br />schedule, a zone verification is charged at $10450 per hour plus a 9% Administrative Fee (minimum charge is % hour or <br />$52.25plus 9% administrative fee). <br />Written Statement <br />Submit one paper copy and one CD copy (pdf or tiff format) of a written statement describing why the zone verification <br />is being requested. If applicable, include information describing the proposed use including operating characteristics, <br />building bulk and size, parking demand, and traffic generation per EC 9.1080. Please note that it is the applicant's <br />responsibility to make sure that the CD and paper copies are identical. <br />Note: to request a copy of a certificate of occupancy or building permit information, please contact inspection Support <br />staff at 541-682-5283 or ceinspectionsupport@ci.eugene.or.us. <br />Contact Information <br />Paul T. Conte <br />Name (print): <br />Company/Organization: <br />Address: <br />City/State/Zip: <br />Phone: <br />Signature: J <br />1461 W. 10fh Ave. <br />Eugene, OR 97402 E-mail (if applicable): pau'l.t.conte@gmail.com <br />541.344.2552 Fax: <br />raf/7--/) / December 31, 2019 <br />www. eu4ene-or.9av/pla <br />Planning & Development Updated: July 2014 <br />Planning Division <br />99 W. 10T" Avenue, Eugene, OR 97401 <br />Phone: 541.652.5377 or E-mail: planning@cLeugene.or.us Page 4 of 1 <br />